Back and Arm Palpations Flashcards
Serratus Anterior
Pt’s arm @ nazi salute position (130°) & reach forward (protracting shoulder);
OT palpates on muscle belly under armpit to feel for contraction
Upper Trapezius
Pts arms are up @ abducted position in 90°, bend at waist, pinch shoulder blades together hold head up;
OT feel btw shoulder blades superiorly to scapula
Middle Trapezius
Pts arms are up @ abducted position in 90°, bend at waist, pinch shoulder blades together hold head up; OT feels btw shoulder blades @ middle portion
Lower Trapezius
Pts arms are up @ abducted position in 90°, bend at waist, pinch shoulder blades together hold head up; OT feels btw shoulder blades @ lower portion of scapula
Rhomboids (alone)
Pt places arm at small of back and then pulls away slightly
OT starts @ medial border of scapula deep to trapezius
& place fingers under the shoulder blade (muscle pushing finger out = Rhom)
Levator Scapulae
Pt: arm in small of back
OT touches just above superior angle of scapula (toward neck) & asks client to weakly, quickly shrug.
Latissimus Dorsi
Pt- stands in front of OT w/their hand on your shoulder applying slight pressure
OT- puts hand under axilla but more posterior (too anterior is serratus anterior)
Infraspinatus (lateral rotator)
Pt standing, flex trunk, @ let arms hang (AKA dive position)
OT palpates lateral border of scapula just below spine
- ask pt to externally rotate
Teres Minor (lateral rotator)
Pt standing, flex trunk, @ let arm hung
OT moves finger down approximately 1” and ask client to externally rotate
Teres Major (internal rotator)
Pt standing, flex trunk, @ let arm hung
OT moves finger down approximately 1” and ask client to internally rotate
Subscapularis (internal rotator)
Pt standing, flex trunk, @ let arm hang
OT asks pt to internally rotate and palpates fingers up in armpit on costal side of scapula
Pec Minor
Pec minor tendon contraction
Find coracoid process, finger inferior to it. Arm in small of back have Pt lift off small of back. Tightening-tendon of pec minor.
Pectoralis Major
Upper fibers: raise above head give resistance. Upper fibers contract
Lower fibers: Below shoulder height horizontal adduct
All: Pt bring arms together in front of body in prayer position
Middle deltoid
Abduct arm, give resistance to horizontal adduction
Supraspinatus
Short bursts of abduction to about 30-40 degrees, move fingers around supraspinous fossa position fingers in best spot to feel contractions
Anterior Deltoid
Resistance to posterior. Move arm anteriorly with little ex rotation
Posterior Deltoid
if posterior, move arm posterior and a little internally rotated
Coracobrachialis
Pt raise arm diagonal above head, give upward pressure
OT In armpit, feel two tendons (short head of bicep)Pronate and supinate while applying up resist. Lower One not moving is coracobrachilis
Brachioradialis
Pt flexes elbow in forearm midposition muscle runs length of forearm
OT little resistance into extension; feel on forearm near proximal elbow (tendon pops out)
Biceps
Pt flexes elbow in forearm supination
OT little resistance to flexion; palpate on muscle belly
Brachialis
Pt’s sitting and arm rests in lap.
OT Palpate deep to bicep in pronation (ensure bicep relaxed, pull bicep away). Have Pt. do quick bursts of elbow flexion in pronation
Triceps brachii
Give resistance to elbow extension, tell one of heads. Long (back length of arm) or lateral (side) head easiest to find. Medial head above or superior to elbow
Supinator
Pt sitting or lying down:
Pt Arm relaxed, supinate
OT Grab extensor wad, pull laterally.
Runs Opposite direction of prontator teres
Relax forearm muscles because all above supinator
Pronator Teres
Location: Distal to antecubital fossa
Pt ask pt to pronate forearm (doesn’t matter if sitting/lying down)
OT Resistance to pronation.
-If having trouble, give resistance to wrist extension and the muscle will contract
