Final OP Flashcards
Spinous Process of C2 TvP of C1 First Rib 11th and 12th Ribs Jugular Notch Manubrium Sternal Angle Body of Sternum Xiphoid process Hyoid Splenius Capitus Splenius Cervicis Iliocostalis Longissimus Spinalis Semispinalis Multifidus Suboccipitals Sternocleidomastoid Anterior Scalene Middle Scalene Posterior Scalene External Intercostals Internal Intercostals Diaphragm Rectus Abdominus External Oblique Psoas Major Quadratus Lumborum Sternoclavicular joint Acromioclavicular j
Posterior Scalene
O: TVP of C4-C6
I: Second Rib
A: Bi-Lat- Flex the cervicle spine , raise 2nd rib durning inhalation
Unilaterally- Lateral Flexion & rotation
FD: Inferiorly / Posteriorly
Supine
Start at mastoid process, move inf and and posteriorly onto the neck
C: Bring head to right shoulder - resisting at the head
Description: Deep or superficial tubular muscle
Finish off palpation in the junction of the first rib
Body Of Sternum
Supine
Trail: Mid shaft of clavicle medially and inf to jug notch inferiorly onto manubrium pass sternal angle - outline the whole body
Attachment: Pectoralis Major
Feel: Flat superficial bone
External Intercostals
O: Inferior border of superior ribs
I: Superior border of inferior ribs
A: Elevate the ribs durning inhalation
Supine
Iliac cres sup and slightly laterally to ribs, place fingers into spaces between ribs
C - ask to take a breath in
Feel - superficial flat muscle
Splenius Cervicis
O: Spinous process of T3-T6
I: TVP of C1-C3
A: Bilaterally - Extend the head and neck
Unilaterally- Rotate head ipsilaterally, Laterally- flex head/neck ipsilaterally
Prone
Starting Landmark: EOP
Inferiorly along the spine, until you’ve outlined t3-t6, move slightly laterally off of it onto the muscle, move back up superiorly
C: Ask to push head up into your hand
Feeling - deep broad muscle
Finish it by side of neck at tvps of c1-c3
External Oblique
O: External surfaces of 5-12 ribs
I: Anterior half of iliac crest, pubic tubercle & linea alba
A: Bilaterally: Compress & supports abdominal viscera, flexes the trunk
Unilaterally: Rotate the trunk contralaterally laterally
CONSENT BORDER
Xiphoid move slightly inf and lat onto ribs, ask to create border,
C- Ask your body to take the shoulder on the same side your palpating the muscle to their opposite hip
Feel a superficial bulky muscle
Relax and finish off palp inf generally at the pubic tubercles/crest region
Splenius Capitus
O: Inferior aspect of nuchal ligament, SP’s of C7-T3
I: Mastoid process, lateral 1/3 of nuchal ligament
A: Bilaterally: Extend head/neck
Unilaterally: Rotate head ipsilaterally, laterally flex head & neck ipsilaterally
Starting Landmark: EOP
Move inferiorly until you outline from c7-t3 (outline with your fingers) then move slightly laterally onto the muscle belly
C: Ask them to lift their head into your hand as you palpate upwards with the other (moving superiorly - backwards now)
Feeling: flat broad muscle underneath my fingers
o Follow fibers up to mastoid process and superior nuchal line (end it at the mastoid process).
Multifidus
O: TVP’s Sacrum & maxillary process of lumbar vertebrae
I: SP’s of superior vertebrae (2-4 segments)
A: Bilaterally: Extension of vertebral column & head
Unilaterally: Contralateral rotation
CONSENT, Prone
Start at PSIS move medially to midline slightly sup get to spinous proc of S2 move sup to s1 continue to Lumbar go between L3 and L4 stop there for contraction
C: Ask to lift legs, no resisting
FEEL - Deep rounded muscle
Finish where u stopped for the contraction
Xiphoid process
Subcostal border can start there
Attachment: Rectus abdominis
Feel: Deep or Superficial pointed bone
Spinalis
O: Posterior iliac crest, Posterior surface of sacrum, SacroIliac ligaments, Supraspinous ligament
and the Lumbar spinous processes
Insertion: SP’s in thoracic and cervical regions
A: Bilaterally: Extends vertebral column, chief extensor of spinal column
Unilaterally: Lateral flexion of the vertebral column
Great trochanter move superiorly and posteriorly to midline outlining all origins (lay hand flat) move superiorly to thoracic region
C: Lift both legs up no resisting
Feeling - deep flat muscle
Ask for contract once ur at upper thoraci region Move up to cervical region
C: As move superiorly ask to lift shoulders/chest off table
Feeling - deep flat
Finish off outlining the spinous processes of the thoracic and cervical regions (where you just palpated to)
Diaphragm
O: Sternal attachments: 2 muscular slips from the internal aspect of the xiphoid process
o Costal attachments: Costal cartilages of ribs 6 – 10 and ribs 10-12
o Lumbar attachment: 2 lumbar crurae (means legs) which attach to the lumbar vertebral bodies of L1-L3(4) on the right and L1-L2(3) on the left
I: Central tendon
A: Primary muscle of inspiration
Start at iliac crest move sup to subcostal border med and slightly sup to to xipohid process move off slightly laterally
C: take 2 thumbs and sink in on ribs on inf aspect (lateral to xiphoid process on both sides) as they’re inhaling ask to take deep breath in and out
Feeling - Deep flat muscle
Quadratus Lumborum
O: Medial 1⁄2 of inferior border of 12th ribs, tips of Lx TvP’s
I: Iliolumbar ligament and internal lip of iliac
crest
A: Extends and laterally flexes vert column;
fixes 12th rib during inspiration
subcostal, move posteriorly along rib 10 and slightly inf until on 12th rib
C ask them to shift/hike hip to shoulder on the same side - while youre resisting
Feel - Deep broad muscle
Can finish off palp at iliac crest
Radial (Lateral) Collateral ligament
Partner seated Bend elbow to 90
Starting Landmark: olecranon process
Move Lateral and slight anterior to find the lateral epicondyle
Move superiorly with the opposite hand to find the radial head
Strum in between head of radius and lateral epicondyle
Feel: Superficial taught band
Prevents varus force
Coracoclavicular ligament
Border
Partner supine
Confirm consent: Yes
Starting Landmark: jugular notch
Trail: Move laterally to the distal end of the clavicle. With the other hand find the coracoid
Proces moving inferiorly. Strum in between the two attachment sites.
o Strumming horizontally, you will feel two solid taut bands
Feel: Strong, taught bands
Description: Prevents superior dislocation of the clavicle
Sternal Angle
Partner supine Confirm Consent: YES
Starting Landmark: mid shaft of clav, move med and inf to Jugular Notch move inf to manubrium move slightly and inch or 2 inferiorly again until you feel change in shape then slightly laterally
Attachment: Costal cartilage of the second rib
Feel : Shallow Divot
Iliocostalis
O: Posterior iliac crest, Posterior surface of sacrum, SacroIliac ligaments, Supraspinous ligament
and the Lumbar spinous processes
I: Angles of ribs
and cervical TVP’s
A: chief extensor of the spinal column -bilaterally (extends vertebral column),
unilaterally lateral flexion of the vertebral column
CONSENT
Start at greater trochanter move sup and medially to midline, outline all origins, move to lateral sig of hum,
Lift legs feel a deep flat muscle underneath fingers
Ask continue to move sup
As move superiorly in thoracic region ask to lift chest off table
Deep flat
Finish off at the angle of ribs and cervical TVPs using both hands
(btw angles of ribs are a lil bit off of lateral to the spine sorta thing)
Rectus Abdominus
O: Pubic symphysis, pubic crest and pubic tubercles
I: Xiphoid process and 5th – 7th costal cartilages
A: Flexes trunk and compresses abdominal viscera, stabilizes and controls tilt of pelvis posteriorly
Consent and border over privates
Start at iliac crest move medially (with palm of hand not fingers) and slightly inf onto the origin (pubic crest area)
C - ask body to do a sit up/crunch for u - u can switch hand contact and support their back
Feel superficial bulky muscle
Body can Relax and you finsih off at the xiphoid process
Coracoacromial ligament
Partner supine
Confirm consent: Yes
Starting Landmark: mid shaft of the clavicle
Trail: move laterally to the anterior aspect of the acromion. With the other hand, find the
coracoid process.
o Strum cross-fibre across the wide band of ligament. Explore between these structures, and palpate this ligament deep to the deltoid muscle
Feel: Feel for a strong, deep taught band
Purpose: Prevent superior dislocation of the glenohumeral joint
Spinous Process of C2
Starting Landmark: Mastoid process,
Move posteriorly or medially and then move inferiorly intio a shallow space/valley, feel a small round bone underneath fingers
Attachment: Nuchal ligament
Feel: feel a small round bone
First Rib
Starting Landmark: mid-shaft of the clavicle
move medially and superiorly into the space over that part of the clavicle. ask to take a deep
Attachment: Anterior Saline
Feel: Deep small bone as they inhale
Acromioclavicular joint
Partner seated
Starting Landmark: Clavicle
Trail: Moving laterally and slightly posteriorly, locate AC joint by
sliding finger off
clavicle in between the clavicle and acromion
o Should feel slender ditch between the two structures
When the shoulder elevates the joint space opens, when it depresses the joint space closes
(same as above)
Elevation and depression
Ulnar (Medial) Collateral Ligament
Seated
Starting Landmark: olecranon move medially and superiorly to medial epicondyle. With other hand move to the olecranon and strum inbetween
Feel: Thick taught band
Purpose: Prevent values force
Middle Scalene
O: TVP of C3-C7
I: First Rib
A: Bilaterally- Flex cervical spine, raises first rib durning inhalation
Unilaterally- Lateral flexion and slight rotation
Supine
Start at mastoid process, move inf and slightly anteriorly onto the neck
C: Bring head to right shoulder - resisting at the head
Feel: Deep or superficial tubular muscle
Finish off palpation in the junction of the first rib
THE ONLY DIFFERENCE IS YOU WANT TO SHOW YOU’RE MORE IN THE MIDDLE (slightly, they’re all close together)
Internal Intercostals
O: Superior border of the inferior rib
I: Inferior border of the superior rib
A: Depresses the ribs durning forced expiration
Supine
Iliac crest sup and slighlty laterally to ribs, place fingers into spaces between ribs
C - ask to take deep breath in and forced breath out (forced expiration)
Feel - Deep flat muscle
Longissimus
O: Posterior iliac crest, Posterior surface of sacrum, SacroIliac ligaments, Supraspinous ligament
and the Lumbar spinous processes
I: TVP’s in thoracic and cervical regions and the mastoid process of the occiput
A: Chief extensor of the spinal column
Bilaterally: Extends vertebral column
Unilaterally: Lateral flexion of the vertebral column
Greater trochanter Superiorly and posteriorly to midline, superiorly onto muscle (on to peak of the hill) ask contract
C: Lift legs no resisting
Feel a superficial rounded muscle
As move superiorly into thoracic region
C: ask to bring shoulders/chest off the table (once you are at the upper thoracic region)
Feel superficial rounded muscle
Finish off at mastoid
