FINAL test: Abdomen

Question 1

Palpate:

Abdominal aorta

Answer 1

Starts at diaphragm.
Continues until it bifurcates into left and right common iliac artery at level of L4.
Umbilicus is typically at L3.
Sits side by side with inferior vena cava.
Aorta may be slightly to the left.

Question 2

Palpate and OIAN:

Quadratus lumborum

Answer 2

O: posterior iliac crest
I: last rib, TP of 1-4 lumbar vertebrae 
A: Reverse muscle action: 
Unilaterally - if trunk fixed = hike the hip/pelvis, side bend + ext to the same side. Bilaterally - ext Lspine, fi last rib during forced inhalation and exhalation
N: lumbar plexus

Palpate from side between iliac crest and 12th rib to avoid erector spinae
Can do prone or side lying
Get under erector spinae towards spine.

Question 3

Palpate and OIAN:

Rectus abdominus

Answer 3

O: pubic crest, pubic symphysis
I: cartilage of 5-7 ribs and xiphoid process
A: flex vertebral column, post pelvic tilt
N: ventral rami

Question 4

Palpate and OIAN:

External oblique

Answer 4

Hands in pockets (heel = origin, fingers = insertion).
O: external surfaces of 5-12 ribs.
I: ant. part of iliac crest, rectus sheath to linea alba
A: SF to same side, rot to opposite side, flex vertebral column, compress abdominal contents
N: don’t need to know

Find boundaries, go in middle.
Get athlete to lift off shoulder of same side towards opposite hip.

Question 5

Palpate and OIAN:

internal oblique:

Answer 5

origin inferior, insertion is superior. Hands coming out of back pockets.

O: lateral inguinal ligament, iliac crest, thoracolumbar fascia
I: internal surface of lower 3 ribs, rectus shath to linea alba
A: SF to same side, rot to same side, flex vertebral column, compress abdominal contents.
N: iliohypogastric and ilionguinal ventral rami

Question 6

Palpate and OIAN:

Transverse abdominis.

Answer 6

O: lateral inguinal ligament, iliac crest, thoracolumbar fascia, internal surface of lower 6 ribs
I: rectus sheath to linea alba
A: compress abdominal contents
N: iliohypogastric and ilioinguinal, ventral divisions.

Find ASIS, crawl medially. should not feel rec abdominis contracting (fingers will push up if they are).

Question 7

Palpate and OIAN:

psoas major

Answer 7

O: bodies and TP of Lspine vertebrae
I: lesser trochanter
A: origin fixed = hip flex, ER. 
insertion fixed = flex trunk, ant pelvic tilt. 
unilaterally = SF to same side. 
N: don't need to know 

Shortened = lordotic posture.

Need to palpate spine from the front.
Knees flexed, use exhale to go deeper.
Can use sponge or towel to disperse pressure.
Umbilicus = L3. start 2 inches higher. Lateral to this.
Lower = more lateral.
Palpate against muscle.
Get athlete to resist knee to chest, feel it contract.
Palpate with finger tips, not thumb.
Can’t follow to lesser trochanter. Go as far into pelvis as you can.

Question 8

Palpate and OIAN:

iliacus

Answer 8

O: iliac fossa (inner portion of ilium).
I: lesser trochanter
A: origin fixed = hip flex, ER. Insertion fixed = flex trunk, ant. pelvic tilt
N: femoral

Not as strong as psoas major.
Find iliac crest. Hook fingers in. Have to palpate through obliques.
Resisted hip flex.