Transversospinalis group

Multifidi

Rotators

Semispinalis Capitis

Multifidus

Action Bilateral contraction extends the

spine Unilateral contraction flexes to

the same side and rotates to the opposite side

Origin & insertion Course between the transverse

and spinous process (skipping 2-4 vertebrae) of all vertebrae (C2 to sacrum) most fully developed in the lumbar spine

Innervation Dorsal rami of the spinal nerve

Rotator brevis/longus

Action Bilateral contraction extends the

thoracic spine Unilateral contraction rotates it

to the opposite side

Origin & Insertion Origin and Insertion course

between the TP and next higher spinous process

Innervation Dorsal rami of the spinal nerve

Semispinalis

8. Semispinalis

thoracis

9. Semispinalis

cervicis

10. Semispinalis

capitis

Semispinalis

Semispinalis

Action Bilateral contraction extends the thoracic spine, cervical spine

and head (stabilizes the craniovertebral joint) Unilateral contraction bend the head, cervical spine and thoracic

spine to the same side and rotates them to the opposite side

Origin Thoracis: TP of the T6-T12 vertebrae Cervicis: TP of the T1-T6 vertebrae Capitis: TP of the C3-T6 vertebrae

Insertion Thoracis: SP of the C6-T4 vertebrae Cervicis: SP of the C2-C7 bertebrae Capitis: Occipital bone between the superior nuchal line and inferior nuchal line

Innervation Dorsal rami of the spinal nerve

Transversospinalis group Prone position

Slide fingers laterally off the spinous processes, sinking between them and the erector spinae fibers

Pushing the erectors laterally out of the way, explore deeply for the dense, diagonal fibers of the multifidi.

Transversospinalis group

Quadratus lumborum

A : Unilaterally – laterally tilt the pelvis, laterally flex the vertebral column to the same side, assist to extend the vertebral columnBilaterally – fix the last rib during inhalation and forced exhalation

O : Posterior iliac crest

I : Last rib and TP of first through fourth lumbar vertebrae

N : Branches of first lumbar and twelfth thoracic

Quadratus lumborum

Prone

Isolate the border the quadratus by locating the 12th rib, posterior iliac crest and transverse processes of the lumbar vertebra

Quadratus lumborum

Lay thumbpad along the lat. edge of this square.

Using slow, firm pressure, sink your thumb medially toward the lumbar vertebrae and into the edge of the quadratus

Ask pt to elevate hip in order to feel its solid contraction

Quadratus lumborum

Sidelying

This position will allow the abdominal contents to shift away from where you are accessing

Test for quadratus lumborum

Test for quddratus lumborum

• Patient:Patient: Prone

• Test movement:Test movement: Lateral elevation of the pelvis. The extremity is placed in slight extension and in the degree of abduction that corresponds with the line of fibers of the QL

• Resistance:Resistance: Given in the form of traction on the extremity, directly opposing the line of pull of the QL.

Rectus abdominis

A : Flex the vertebral column

O: Pubic crest, pubic symphysis

I : Cartilage of 5th, 6th, and 7th rib and xiphoid process

N : Branches of intercostals

Rectus abdominis - palpation

Supine with knees flexed

Locate the xiphoid process and the ribs just lat. to the xiphoid. Also locate the pubic crest

Place hand between these landmarks and ask pt to alternately flex and relax his trunk slightly. “ Do a small sit-up.”

External obliqueA : Unilaterally –

laterally flex vertebral column to the same side, rotate vertebral column to the opposite sideBilaterally – flex the vertebral column, compress abdominal contents

O : Lower 8 ribs

I : Anterior part of the iliac crest, abdominal aponeurosis to linea alba

N : Branches of intercostals

External oblique

Supine with knees flexed

Lay your hand on the left side of the abdomen and lower ribs.

Ask pt to raise his left shoulder to his rt. hip (rotating his trunk)

Palpate across the superficial fibers of the ext. oblique, noting their diagonal direction.

Rectus abdominis andexternal oblique

Test for Rectus abdominis and external oblique

• Patient:Patient: Supine

• Fixation:Fixation: An assistant stabilizes the legs

• Test:Test: The patient clasp hands behind the head. The examiner places the patient into the precise test position of trunk flexion and rotation and then asks the patient to hold that position. If the muscles are weak, the trunk will derotate and extend.

Serratus Posterior Superior

Prone with arm off the side of the table

Locate the upper portion of the medial border of the scapula

Ask pt to inhale as you sink your fingers deep to the rhomboid fibers

Serratus posterior superior

Action Elevate the ribs during

inhalation

Origin SP of C7 to T3

Insertion Posterior surface of 2nd

through 5th rib

Innervation Spinal nerves one

through 4

Serratus posterior inferior

Action Depress the ribs

during exhalation

Origin Spinous processes of

T12 to L3

Insertion Posterior surface of 9th

through 12th rib

Innervation Spinal nerves T9

through T12

Serratus Posterior Inferior

Locate the bottom of the rib cage

Ask pt to slowly exhale as you begin to roll your fingers across the muscle fibers