Muscle Strength

Question 1

Rectus Abdominis Origin

Answer 1

Pubic crest and symphysis

Question 2

Rectus Abdominis Insertion

Answer 2

Costal cartilage of 5th - 7th ribs and xiphoid of sternum

Question 3

Rectus Abdominis Action

Answer 3

Flexes vertebrae column, posterior pelvic tilts

Question 4

Rectus Abdominis Nerve

Answer 4

T5-T12 rami

Question 5

Rectus Abdominis Fucntional Deficit

Answer 5

Difficulty raising head if thorax is not fixed
Difficulty sitting from supine
Poor trunk balance
Weakness will cause anterior pelvic tilt and lordosis
Shortness can cause thoracic kyphosis

Question 6

External Oblique - Anterior Fibers Origin

Answer 6

External surfaces of ribs 5-8 interdigitating with serratus anterior

Question 7

External Oblique - Anterior Fibers Insertion

Answer 7

into aponeurosis ending with linea alba, fibers extend obliquely down and medially

Question 8

External Oblique - Anterior Fibers Action

Answer 8

Bilaterally = flex trunk, support and compress abdominal viscera, assist in respiration 
Unilaterally = with ant fibers of IO on opp side, rotate and flex vertebral column, thorax ant

Question 9

External Oblique - Anterior Fibers Nerve

Answer 9

T5-T12

Question 10

External Oblique - Anterior Fibers Functional Deficit

Answer 10

Severe weakness will effect cough and respiration

Question 11

External Oblique - Lateral Fibers Origin

Answer 11

External surface of 9th rib, interdigitate with serratus ant and ext surface of ribs 10-12 interdigitating with lat

Question 12

External Oblique - Lateral Fibers Insertion

Answer 12

Inguinal ligament, ASIS and pubic tubercle and into external lip of ant 1/2 iliac crest

Question 13

External Oblique - Lateral Fibers Action

Answer 13

Bilaterally = flex spine, posterior pelvic tilt
Unilaterally = with IO on same side laterally flex vertebral column, vertebral rotation

Question 14

External Oblique - Lateral Fibers - Comment

Answer 14

Does not contract with curl-up exercise, best way to challenge is with extremity motion with abdominal stabilization, sidelying hip abduction will also facilitate the muscle, any exercise using serratus ant or lat will facilitate

Question 15

Internal Oblique Origin

Answer 15

Inguinal ligament, iliac crest, thoraco lumbar fascia

Question 16

Internal Oblique Insertion

Answer 16

Pubic crest, pectineal line and linea alba, inferior borders of 10-12 ribs

Question 17

Internal Oblique Action - Lower fibers

Answer 17

Lower fibers support abdominal viscera

Question 18

Internal Oblique Action Upper fibers

Answer 18

Upper fibers bilaterally flex vertebral column, support viscera, depress thorax and assist in respiration
Unilaterally with EO on opp side rotate vertebral column

Question 19

Internal Oblique Action Lateral Fibers

Answer 19

Lateral fibers = flex vertebral column, depress thorax, unilaterally with lateral fibers of external on same side laterally flex spine

Question 20

Internal Oblique Nerve

Answer 20

T7-T12
Iliohyppogastric
Ilioinguinal
Ventral rami

Question 21

Internal Oblique Function

Answer 21

with weakness can get scoliosis, poor trunk balance

If IO is shortened will get a kyphosis and depressed chest

Question 22

Internal Oblique comments

Answer 22

Used primarily with curl-ups

If doing curl up excessibely may see shortness and rounded shoulder posture

Question 23

Transverse Abdominis Origin

Answer 23

inner surfaces of cartilages of lower six ribs, interdigitates with diaphragm, thoracolumbar fascia, anterior 3/4s of internal lip of iliac crest and lateral one third of inguinal ligament

Question 24

Transverse Abdominis Insertion

Answer 24

linea alba by broad aponeurosis, pubic crest and pecten pubis

Question 25

Transverse Abdominis Action

Answer 25

acts like a girdle to flatten abdominal wall, upper portion helps to decrease infrasternal angle of the ribs in expiration

Question 26

Transverse Abdominis Nerve

Answer 26

T7-12, iliohypogastric, ilioinguinal, ventral divisions

Question 27

Transverse Abdominis Function

Answer 27

bulging of anterior abdominal wall, indirectly leading to lumbar lordosis, attachment on thoracolumbar fascia assists with lumbar stability

Question 28

Back extensor group includes

Answer 28

``` erector spinae multifidi rotators interspinales intertransversarii ```

Question 29

Erector Spinae Superficial Group Origin

Answer 29

iliac crest and erector spinae aponeurosis

Question 30

Erector Spinae Superficial Group Insertion

Answer 30

ribs

Question 31

Erector Spinae Superficial Group Function

Answer 31

Extend spine even though they dont attach to spine

Question 32

Erector Spinae Superficial Group Comments

Answer 32

muscle bulk is lateral to the spinous processes and is found in the mid to upper lumber spine. Runs superiorly and posteriorly from pelvis to ribs owing to convexity of the thoracic cage. Lengthens with 1 sided anterior rotation of pelvis (gait). Contracts with sidebending and rotation to same side. Contracts with lumbar extension. Eccentric contraction during forward bending. Helps with SI stabilization secondary to its attachment on aponeurosis causing sacral flexion and increasing tension on sacrotuberous and interosseous ligaments.

Question 33

Erector Spinae Deep Group Origin

Answer 33

ilium and deep surface of thoracolumbar fascia

Question 34

Erector Spinae Deep Group Insertion

Answer 34

transverse processes of lower lumbar vertebrae

Question 35

Erector Spinae Deep Group Comments

Answer 35

muscle fiber course is superior, medial and anterior therefore force of contraction is posterior shear and extension. Tension in muscles balance anterior shear forces generated by iliopsoas muscle and translation motion during forward bending.

Question 36

Multifidus Origin

Answer 36

dorsal surface of sacrum, sacrotuberous ligament, erector spinae aponeurosis, PSIS and posterior sacroiliac ligaments

Question 37

Multifidus Insertion

Answer 37

covers surface of sacrum and runs superiorly and medially to attach to spinous processes of sacral and lumbar vertebra.

Question 38

Multifidus Function

Answer 38

controls flexion and anterior shear of spine during flexion via eccentric contraction, exerts compressive force on lumbar spine.

Question 39

Multifidus Cmment

Answer 39

if patients have pain with compression of lumbar spine (i.e. prolonged standing) contraction of back extensors accentuates the problem.

Question 40

Interspinalis and intertransversarii O and I

Answer 40

from spinous process to spinous process for the interspinalis and from transverse process to transverse process for intertransversarii.

Question 41

Interspinalis and intertransversarii FUnction

Answer 41

interspinales thought to extends spine and intertransversarii extend and laterally flex. Probably false assumption

Question 42

Interspinalis and intertransversarii Comments

Answer 42

small muscles contribution to movement is small. More important contribution is proprioceptive. They have 4-7 times the number of muscle spindles as multifidus. May be the mm most affected by manual therapy interventions

Question 43

Latissimus Dorsi Origin

Answer 43

spinous processes of last 6 thoracic vertebra, last 3-4 ribs Through the thoracolumbar fascia from all lumbar spinous process and sacrum and posterior 1/3 of external lip of iliac crest, slip from the inferior angle of the scapula

Question 44

Lat Insertion

Answer 44

intertubercular grove of humerus

Question 45

Lat Action

Answer 45

with origin fixed medially rotates, adducts and extends the shoulder joint. Depresses shoulder girdle and assists in lateral flexion of trunk With the insertion fixed – tilts pelvis anteriorly and laterally, acting bilaterally assists in hyperextending the spine and anteriorly tilting the pelvis

Question 46

Lat Nerve

Answer 46

thoracodorsal C6-8

Question 47

Lat function

Answer 47

weakness in arm, with C curve of spine lateral fibers of concavity are usually shortened. Anterior fibers are shortened with marked thoracic kyphosis

Question 48

Lat comments

Answer 48

most superficial of back muscles, affects back primarily through thoracolumbar fascia. If muscle is short, back extends as a compensatory movement with shoulder flexion. If the latt is stiffer than the abdominals (which limit lumbar extension) the back will extend even when the muscle is not short. If patients have low back in extension the shortness or stiffness of this muscle may contribute to pain when they reach overhead

Question 49

Iliopsoas Origin

Answer 49

anterior surfaces of Transverse processes of all lumbar vertebrae, sides of vertebral bodies and intervertebral disks of last thoracic and all lumbar vertebrae

Question 50

Iliopsoas Insertion

Answer 50

lessor trochanter of femur

Question 51

Iliopsoas Nerve

Answer 51

Lumbar plexus, L1-4

Question 52

Iliopsoas Action

Answer 52

with origin fixed – flexes the hip joint. With insertion fixed and acting bilaterally, provides anterior shear and compression, increases lumbar lordosis, L iliopsoas will move the lumbar spine into sidebending L and rotation R