Thoracic and Lumbar Region

Question 1

Rectus Abdominus

Answer 1

palpate anywhere on the anterior surface of the lumbar trunk and to activate ask model to perform sit up in crook lying

Question 2

Internal Oblique

Answer 2

Palpate: lies deep to external oblique. Can palpate at a point approx 2cm medial to ASIS (with Transversus Abdominis)
Crook lying: trunk flexion, ipsilateral lateral flexion and rotation to same side.

Question 3

External Oblique

Answer 3

Can be palpated laterally at outer borders of lower 8 ribs. Can sometimes see interdigitating with serratus anterior. Resist lumbar flexion, ipsilateral lateral flexion with contralateral rotation.

Question 4

Transversus Abdominus

Answer 4

forced expiration by pulling the abdominal wall inward, role in stability of the lumbo pelvic region

Question 5

ES Iliocostalis thoracis

Answer 5

have model prone and ask them to extend their spine and palpate either side of the spine

Question 6

ES Iliocostalis umborum

Answer 6

have model prone and ask them to extend their spine and palpate either side of the spine

Question 7

ES Longisimus thoracis

Answer 7

have model prone and ask them to extend their spine and palpate either side of the spine

Question 8

ES Spinalis thoracis

Answer 8

have model prone and ask them to extend their spine and palpate either side of the spine

Question 9

Multifidus

Answer 9

Prone - lies immediately adjacent to the spinous processes , deep between spinous process and erector spinae. Difficult to differentiate. Ask patient to draw anterior abdominals inwards and activate pelvic floor whilst feeling for contraction of Multifidus posteriorly

Question 10

Quadratus Lumborum

Answer 10

can be identified and palpated deeply on postero-lateral aspect of trunk between12th rib and ilium. Ask patient to in standing to hitch the hip/pelvis up. Then palpate on that side.

Question 11

Rotatores

Answer 11

too deep to palpate

Question 12

Iliacus

Answer 12

Model lying in supine with the hip and knee supported and flexed to 90 degrees. Place your fingers on the anterior aspect of the hip 3.5 cm below inguinal ligament. Ask model to flex and extend the hip slowly and palpate laterally.

Question 13

Psoas Major

Answer 13

Model lying in supine with the hip and knee supported and flexed to 90 degrees. Place your fingers on the anterior aspect of the hip 3.5 cm below inguinal ligament. Ask model to flex and extend the hip slowly and palpate laterally.

Question 14

Gluteus maximus

Answer 14

Running downwards and laterally it is emphasised with hip extension.