Attachments
Name the attachments of the rectus abdominis
Proximal- pubic crest and pubic symphysis. Distal- xiphoid process and 5th-7th costal cartilages
What innervates the latissimus dorsi?
thoracodorsal nerve
What are the actions of the gluteus medius?
Hip ABD and IR
The Front Functional Line corresponds to what sling?
Anterior oblique sling
Which anterior muscle might be tight if your patient has an increased anterior pelvic tilt?
iliopsoas
The multifidus attaches to the mammillary processes of which vertebrae?
L1-L5
You notice your patient has diminished hip extension strength. What nerve roots could be involved?
Gluteus maximus- ventral rami of L5, S1, S2
Which intermediate muscle of the lumbar spine is responsible for pulling the ribs downwards and backwards?
serratus posterior inferior
What structures are involved in the posterior oblique sling?
latissimus dorsi, thoracolumbar fascia, contralateral gluteus maximus
What is the function of the inner unit?
stabilize the lumbar spine
These deep anterior muscles cause increased lumbar lordosis, placing pressure on the posterior column of the spine. Name their distal attachment.
lesser trochanter of the femur
Your patient has a herniation at L5/S1. What muscle(s) will be weak?
Gastrocnemius and soleus
Name all the actions/functions of the quadratus lumborum.
laterally flexes trunk to same side, prevents pelvic drop when standing on one leg, assist in extension when acting bilaterally, stabilizes the lower attachments of the diaphragm
In the back functional line, how is the latissimus dorsi connected to the contralateral gluteus maximus?
thoracolumbar fascia
What muscles are being tested with trunk rotation to the R?
R internal oblique, L external oblique
This inner unit muscle is responsible for increasing intra abdominal pressure. What are the proximal attachments?
Transverse abdominis- lower costal cartilages, thoracolumbar fascia, iliac crest, lateral third of the inguinal ligament
Your patient has weakness on the ipsilateral side when rotating his/her trunk. What innervates this muscle?
Muscular branches from the superior and inferior epigastric and deep circumflex iliac arteries
Name the action(s) of the most inferior muscle in the anterior oblique system
Adductors- hip ADD, hip IR
Which anatomy slings allows for movement in the sagittal plane while also promoting nutation of the pelvis for stability?
Deep longitudinal system
How might you test the endurance of your patients trunk extensors?
Sorenson endurance test
What are the proximal attachments of the iliococcygeus?
body of the pubis, ischial spine, fascia covering the obturator internus
This muscle along the spiral line connects with the splenius capitis and cervicis at the lower cervical/upper thoracic spine. What is it innervated by?
Rhomboids- dorsal scapular nerve (C4/C5)
What is the action of the abdominal muscle that creates a posterior rotation moment at the pelvis when the femur is fixed?
External oblique- rotates the trunk to the contralateral side, laterally flexes the spine, raises intra-abdominal pressure, assist with forced expiration
Describe how the posterior oblique sling works.
The latissimus dorsi contracts with the contralateral gluteus maximus during stance phase to extend the arm and propelling leg, causing tension in TFL and subsequent stabilization of the lumbar spine and SIJ.
Your patient has a weak lateral sling. What might you observe in your patients functional mobility?
hip drop / trendelenburg