AN 1106: ICA CONTENT (MOD 1)

finding SPs

• seated or prone

C2: base of occipit

C6: find C7 and work up

C7: vertebra prominens; test with cervical extension

T1 - T7: find C7 and work down

• T4 level with root of SOS

• T7 level with inferior angle of scapula

finding TPs of cervical vertebrae

• seated

• work down from mastoid process

• use flat fingers on both sides

finding TPs of thoracic vertebrae

• prone

• about 2 fingers on either side of SP

finding supraspinous ligament

• prone

• find C7

• in between SPs (interspinous space)

• continues up as the nuchal ligament

finding articular pillars of cervical vertebrae

• seated

• about halfway between TPs and SPs

• vertical common formed by articular processes

finding a mid-thoracic rib, its adjacent intercostal spaces, angle of rib, articulating tubercle/costotransverse articulation

• prone

• start at scapula

• place fingers on either side of rib (intercostal space)

• follow towards ‘hump’ (angle of rib)

• follow to where rib meets TP (costotransverse articulation)

finding the sternum - jugular notch, costoclavicular articulation, manubrium, xiphoid process, costal cartilage

• supine

• find bump at top of sternum (jugular notch)

• move laterally (costoclavicular articulation)

• work downwards to manubriosternal joint

• move laterally to feel costal cartilage

• from midline, mark down to xiphoid process

finding PSIS, ilium, iliac crest, ASIS

• standing

• follow PSIS and ASIS off of iliac crest

finding S2 and sacral base

• prone

• find PSIS

  • line bisecting lands at S2

  • move up to sacral base

finding ischial tuberosity

• side lying

• march up to sit bone

finding dermatomes - T2, T4, T10

• seated

• T2: axilla

• T4: nipple

• T10: umbilicus

finding inguinal ligament

• supine

• find ASIS

• find pubic symphysis

• roll deep for ligament

finding trapezius

• seated or prone

• origin

  • EOP

  • superior nuchal line

  • nuchal ligament

  • SPs of C7 - T12

• insertion

  • lateral 3rd of clavicle

  • acromion

  • spine of scapula

• innervation

  • spinal accessory nerve

  • C3, C4 spinal nerve

• actions

  • shoulder elevation

  • shoulder depression

  • scapular retraction

finding latissimus dorsi

• prone

• origin

  • SPs of inferior 6 thoracic vertebra

  • thoracolumbar fascia

  • iliac crest

  • inferior 3 or 4 tibs

• insertion

  • floor of intertubercular sulcus of humerus

• innervation

  • thoracodorsal nerve

    • C6, C7, C8

• action

  • humerus adduction

  • humerus extension

  • humerus medial rotation

finding levator scapula

• seated

• origin

  • posterior tubercles of TPs of C1-C4

• insertion

  • medial border of scapula

• innervation

  • dorsal scapular nerve (C4, C5)

  • cervical nerves (C3, C4)

• action

  • scapular elevation

  • scapular inferior rotation

finding rhomboids

• seated

minor

• origin

  • nuchal ligament

  • SPs C7-T1

• insertion

  • medial border above root of SOS

• innervation

  • dorsal scapular nerve (C4, C5)

• action

  • scapular retraction

  • fixes scapula to thoracic wall

  • rotates glenoid cavity inferiorly

major

• origin

  • SPs T2 - T5

• insertion

  • medial border from root of SOS to inferior angle

• innervation

  • dorsal scapular nerve (C4, C5)

• action

  • scapular retraction

  • fixes scapula to thoracic wall

  • rotates glenoid cavity inferiorly

finding spinalis

• prone

• find bulk of erectors

  • inner third

• regions

  • thoracis

  • cervicis

  • capitis

• origin

  • broad tendon from iliac crest, SPs, supraspinous ligament

• insertion

  • upper thoracic region and cranium

• innervation

  • posterior rami of spinal nerves

• action

  • extension of vertebral column and head (bilaterally)

  • lateral flexion of vertebral column (unilaterally)

finding longissimus

• prone

• find bulk of erectors

  • middle third

• regions

  • thoracis

  • cervicis

  • capitis

• origin

  • broad tendon from iliac crest, SPs, supraspinous ligament

• insertion

  • ribs between tubercles and angle

  • TPs in thoracic/cervical region

  • mastoid process

• innervation

  • posterior rami of spinal nerves

• action

  • extension of vertebral column and head (bilaterally)

  • lateral flexion of vertebral column (unilaterally)

finding iliocostalis

• prone

• find bulk of erectors

  • outer third

• regions

  • lumborum

  • thoracis

  • capitis

• origin

  • broad tendon from iliac crest, SPs, supraspinous ligament

• insertion

  • angles of lower ribs

  • cervical TPs

• innervation

  • posterior rami of spinal nerves

• action

  • extension of vertebral column and head (bilaterally)

  • lateral flexion of vertebral column (unilaterally)

finding multifidus

• side-lying

• thickest in lumbar region

• origin

  • posterior sacrum

  • PSIS

  • aponeurosis of erector spinae

  • SI ligaments

  • mammillary processes of lumbar vertebrae

  • TPs of T1-T3

  • articular processes of C4-C7

• insertion

  • entire length of SPs

    • 2-4 segments superior to origin

• innervation

  • posterior rami of spinal nerves

• action

  • stabilizes vertebrae

finding rectus abdominis, rectus sheath, linea alba

• supine

rectus abdominis

• origin

  • pubic symphysis

  • pubic crest

• insertion

  • xiphoid process and costal cartilages 5-7

• innervation

  • thoracoabdominal nerves

    • anterior rami of T6-T12 spinal nerves

• action

  • flexes trunk

  • stablizes pelvis

linea alba

• follow down from xiphoid

rectus sheath

• lateral to rectus abdominis

finding quadratus lumborum

• prone or side-lying

• find erector spinae in lumbar region and move laterally

• origin

  • medial half of 12th ribs

  • tips of lumbar TPs

• insertion

  • iliolumbar ligament and iliac crest

• innervation

  • anterior branches of T12 and L1-L4 nerves

• action

  • extension and lateral flexion of vertebral column

  • fixes 12th rib during inspiration

finding psoas

• side lying or supine

• origin

  • TPs of lumbar vertebrae

  • sides of bodies of T12-L5 vertebrae

  • IVDs

• insertion

  • lesser trochanter of femur

• innervation

  • anterior rami of lumbar nerves L1-L3

• action

  • hip flexion

  • lateral flexion of vertebral column