OINAs Clinical Skills

Splenius Capitus

O: lower half of the nuchal ligament and the spinous process of C7-T4

o I: mastoid process

o A: lateral flexion and ipsilateral rotation of the neck

Semispinalis Capitus

O: articular process of C4-C7 and transverse process of T1-T6

o I: Occipital bone

o A: Extension of the head and neck, ipsilateral lateral flexion, contralateral rotation.

Mastoid Process

Quadratus Lumborum

O: Transverse process of L5, iliolumbar ligament, iliac crest

o I: Transverse process of L1-L4, inferior border of last rib

o A: lateral trunk flexion

Piriformis

o O: Anterior Sacrum

o I: Greater Trochanter

o A: hip ER with hip flexed less than 60 degrees, IR with hip flexed greater than 60 degrees and abduction

Bony Landmarks anterior shoulder

Bony Landmarks

• Clavicle

• Manubrium

• Sternum

• Coracoid Process

• Bicipital Groove

• Lesser Tuberosity

• Greater Tuberosity

Sternocleidomastoid

• O: Anterior aspect of the sternum, superior border of the proximal 1/3 of the clavicle

• I: Mastoid process

• A: extension, ipsilateral flexion, contralateral rotation

Biceps muscle belly

• Biceps muscle belly

• O: long head- supraglenoid tubercle of scapula, Short head- coracoid process

• I: radial tuberosity

• A: shoulder flexion, elbow flexion and supination

pectoralis major

• O: proximal clavicle, manubrium, body of the sternum and costal cartilage 1-6, recuts sheath

• I: crest of the greater tubercle

• A: shoulder adduction, horizontal adduction and internal rotation

Pectoralis Minor

• O: Ribs 3-5

• I: coracoid process

• A: scapular depression, protraction and downward rotation

Bony landmarks posterior

o C7

o Superior angle of Scapula

o Medial border of scapula

o Inferior angle of scapula

o Spine of scapula

Levator Scapulae

▪ O: Transverse process of C1-C4

▪ I: superior angle of scapula

▪ A: cervical extension, ipsilateral flexion and rotation, scapula elevation,

Rhomboid Major

▪ O: Spinous process of T2-T5

▪ I: medial border of the scapula below the spine

▪ A: adduction, elevation, and rotation of the scapula

Rhomboid Minor

▪ O: Spinous process of C7-T1

▪ I: medial border of scapula at the spine

▪ A: adduction, elevation, and rotation of the scapula

Teres Minor

▪ O: lateral border of scapula

▪ I: greater tubercle

▪ A: ER, adduction and horizontal abduction of the shoulder

Latissimus Dorsi

▪ O: Spinous process T6-L5, sacrum, iliac crest, ribs 10-12

▪ I: bicipital groove

▪ A: trunk extension, shoulder extension, adduction, IR,

Infraspinatus

▪ O: infraspinous fossa

▪ I: greater tubercle

▪ A: ER

Supraspinatus

▪ O: supraspinous fossa

▪ I: greater tubercle

▪ A: first 15 degrees of shoulder abduction

Trapezius

▪ O: medial 1/3 of superior nuchal line, external occipital protuberance, spinous process T7-T12

▪ I: lateral 1/3 clavicle, acromion, scapular spine

▪ A: upper fibers- elevation, middle fibers- scapular retraction, lower fibers- depression

Bony landmarks of Pelvis

o Iliac crest

o PSIS

o Ischial tuberosity

o Sacrum

o Greater Trochanter

TFL

▪ O: iliac crest

▪ I: IT band

▪ A: hip flexion, IR and abduction.

Gluteus Medius

▪ O: Ilium

▪ I: greater trochanter

▪ A: hip abduction, hip flexion and IR (anterior fibers), hip extension and ER (posterior fibers)

Gluteus Minimus

▪ O: ilium

▪ I: Greater trochanter

▪ A: Abduction, flexion and IR of the hip

Gluteus Max

▪ O: ilium, posterior aspect of sacrum

▪ I: Gluteal tuberosity of the femur

▪ A: hip extension, trunk extension, hip abduction (upper fibers) hip adduction (inferior fibers)

Bony Landmarks

o ASIS

Adductor Longus

▪ O: pubis

▪ I: Linea aspera (distal 1/3 posterior femur)

▪ A: adduction, flexion and ER of the hip

Rectus Femoris

▪ O: AIIS

▪ I: quadriceps tendon

▪ A: knee extension and hip flexion

Sartorius

▪ O: ASIS

▪ I: Pes Anserine

▪ A: hip flexion and ER, knee flexion and IR

Elbow Bony Landmarks

o Lateral epicondyle

o Radial head

o Medial epicondyle

Brachioradialis

▪ O: lateral supracondylar ridge of humerus

▪ I: radial styloid process

▪ A: elbow flexion when the forearm is in neutral

Common Extensor Tendon

(lateral epicondyle, origin of Extensor carpi radialis longus, extensor carpi radialis brevis, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris)

Pronator Teres

▪ O: medial epicondyle

▪ I: Body of the radius

▪ A: pronation, elbow flexion

Common flexor Tendon

(medial epicondyle, origin of pronator teres, flexor carpi radialis, palmaris longus, Flexor carpi ulnaris)

Bony Landmark

o Patella

o Tibial plateau

o Gerdy's Tubercle

o Lateral Femoral condyle

o Fibular Head

o Medial Femoral condyle

o Pes Anserine Insertion

o Tibial Tuberosity

rectus femoris

▪ O: AIIS

▪ I: quadriceps tendon

▪ A: knee extension and hip flexion

Vastus lateralis

▪ O: anterior aspect of femur

▪ I: quadriceps tendon

▪ A: knee extension

Vastus Medialis

▪ O: anterior aspect of femur

▪ I: quadriceps tendon

▪ A: knee extension

Biceps Femoris

▪ O: Ischial tuberosity (long head), lateral lip of linea aspera (short head)

▪ I: head of fibula and lateral condyle of tibia

▪ A: hip extension and ER, knee flexion and ER

Semitendinosus

▪ O: ischial tuberosity

▪ I: Pes anserine

▪ A: hip extension, knee flexion and IR

Semimembranosus

▪ O: ischial tuberosity

▪ I: medial aspect of the tibia, just below the medial condyle

▪ A: hip extension, knee flexion and IR.

Lower leg/ankle and foot

• Bony Landmarks

o Navicular

o Lateral Malleolus

o Base of the 5th metatarsal

o Calcaneus

o Sesamoid bones

o Base of the 1st MT

o Medial Malleolus

Tibialis posterior

▪ O: posterior surface of tibia and fibula

▪ I: Navicular

▪ A: plantarflexion and inversion

flexor digitorum longus

▪ O: posterior aspect of tibia

▪ I: plantar surface of distal phalanges 2-5

▪ A: toe flexion, plantarflexion and inversion

Flexor Hallucis Longus

▪ O: posterior aspect of the fibula

▪ I: plantar surface of the 1st phalanx

▪ A: first ray flexion

Pereneous Longus

▪ O: head and lateral surface of fibula

▪ I: medial cuneiform and base of 1st MT

▪ A: eversion and plantarflexion

o Peroneus Brevis

▪ O: lateral surface of fibula

▪ I: base of the 5th MT

▪ A: eversion and plantarflexion

o Tibialis Anterior

▪ O: lateral surface of the tibia

▪ I: medial cuneiform and base of the 1st MT

▪ A: inversion and DF

Gastrocnemius

▪ O: posterior surface of the femur, just above the condyles

▪ I: calcaneus

▪ A: plantarflexion and knee flexion

o Soleus

▪ O: posterior medial border of tibia and head of fibula

▪ I: calcaneus

▪ A: plantarflexion