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OPP II Exam 1 > QL, Psoas, Piriformis > Flashcards

QL, Psoas, Piriformis Flashcards

1
Q

What are the origins and insertions of the quadratus lumborum?

A

origin: iliac crest and iliolumbar ligament
insertion: 12th rib, iliac crest, and transverse process L1-L4

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2
Q

How is the quadratus lumborum involved with respirations?

A

It stabilizes the origin of the diaphragm

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3
Q

What are the innervations of QL?

A

T12-L3

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4
Q

What are the two functions of QL?

A
  1. Bilateral extension

2. Unilateral extension and ipsilateral sidebending

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5
Q

What are 4 ways that QL spasm would present?

A
  1. low back pain
  2. referred pain to hip and groin
  3. exhalation 12th rib dysfunction
  4. diaphragm restriction
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6
Q

How does psoas spasm/irritation develop?

A

It usually develops as a bilateral psoas spasm, but then concentrates more on one side

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7
Q

What levels are the key somatic dysfunctions of psas?

A

L1 or L2 - may be seen in acute or chronic stage

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8
Q

Describe the origin and insertion of the psoas muscle.

A

Origin: L1-L4
Extends over the superior pubic ramus and under the inguinal ligament
Insertion: lesser trochanter on medial side of femur

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9
Q

What innervates psoas muscle?

A

lumbar nerves 2 and 3

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10
Q

What are 4 functions of the psoas muscle?

A
  1. flexes trunk on thigh
  2. flexes lumbar spine
  3. laterally flexes lumbar unilaterally
  4. shortens and externally rotates leg
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11
Q

How does the psoas muscle often go into spasm?

A

When a person sits in a flexed/bent over position for a long period of time and then rapidly returns to a neutral spine

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12
Q

What vertebral levels are key lesions of psoas syndrome?

A

L1/L2

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13
Q

How would the spine present in a left poas spasm?

A

L1 or L2 will rotate left, then sidebend left.

Then the rest of the spine sidebends left. The other vertebrae act according to Type I (sidebend left, rotate right).

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14
Q

What is the difference between neutral and non-neutral sacral torsions?

A

neutral: sacrum is flexed, lumbar is extended

non-neutral: sacrum is extended, lumbar is flexed

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15
Q

If a spastic left psoas carries through to the sacrum, the left sidebending induces a _________ sacral response which means lumbar _______.

A

1: non-neutral

2. flexed

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16
Q

What muscle may spasm on the opposite side of psoas spasm?

A

piriformis

17
Q

What nerve would be irritated on the opposite side of psoas spasm?

A

sciatic n.

18
Q

Where does pain present in psoas spasm?

A

gluteal muscular and posterior thigh pain that does not go past the knee on the opposite side of the psoas

19
Q

What side does the hip shift in a left psoas spasm?

A

hip shifts R and irritates piriformis which irritates sciatic n.

20
Q

What are Sx of left psoas syndrome?

A
  1. pain when pt sits with straight spine
  2. vague pain in lumbar or lumbosacral area
  3. soon key lesion pain leaves and moves down and over the right sacroiliac joint
  4. now pt is bent forward and to the left but doesn’t have much pain
  5. left leg is short and externally rotated
  6. right piriformis is involved so pain includes gluteal area on right
  7. then sciatic irritation occurs
  8. pain develops down posterior though
21
Q

What can happen to a spasmed psoas if left untreated?

A

muscle may get fibrosis

22
Q

What test do you use to test for a tight psoas?

A

Thomas Test

23
Q

What does weak psoas lead to?

A
  • allows excessive backward bending of the lumbar spine because of strong back muscles
  • increase lordosis, prodtruding abdomen
24
Q

What is the definition of Piriformis Syndrome?

A

peripheral neuritis of the sciatic nerve caused by an abnormal condition of the piriformis muscles

25
Q

What are the 2 origins of the piriformis muscle?

A
  1. anterolateral border of the sacrum at the sacroiliac joint capsule
  2. anterior portion of the sacrotuberous ligament
26
Q

What is the insertion of the piriformis?

A

superomedial aspect of the greater trochanter of the femur

27
Q

Where does the sciatic nerve tract pass?

A

through the greater sciatic foramen under the piriformis and the posterior thigh

28
Q

What will irritate the piriformis muscle?

A

Local trauma to the buttocks, piriformis spasm/contracture, running, sacral base unleveling, pelvic instability, excessive local pressure, anatomic variation, local perineural inflammation due to release of vasoactive subst

29
Q

What are Sx of piriformis spasm?

A

-hip and butt pain radiating down posterior thigh

30
Q

What is the function of the piriformis muscle?

A

external rotator of hip joint

31
Q

How do you assess the piriformis?

A
  1. pt supine
  2. grasp leg above ankle
  3. INTERNALLY ROTATE both hip joints until you feel resistance
  4. compare

OPP II Exam 1 (4 decks)

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