Back and Arm Palpations

Question 1

Serratus Anterior

Answer 1

Pt’s arm @ nazi salute position (130°) & reach forward (protracting shoulder);
OT palpates on muscle belly under armpit to feel for contraction

Question 2

Upper Trapezius

Answer 2

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

Question 3

Middle Trapezius

Answer 3

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

Question 4

Lower Trapezius

Answer 4

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

Question 5

Rhomboids (alone)

Answer 5

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)

Question 6

Levator Scapulae

Answer 6

Pt: arm in small of back

OT touches just above superior angle of scapula (toward neck) & asks client to weakly, quickly shrug.

Question 7

Latissimus Dorsi

Answer 7

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)

Question 8

Infraspinatus (lateral rotator)

Answer 8

Pt standing, flex trunk, @ let arms hang (AKA dive position)
OT palpates lateral border of scapula just below spine
- ask pt to externally rotate

Question 9

Teres Minor (lateral rotator)

Answer 9

Pt standing, flex trunk, @ let arm hung

OT moves finger down approximately 1” and ask client to externally rotate

Question 10

Teres Major (internal rotator)

Answer 10

Pt standing, flex trunk, @ let arm hung

OT moves finger down approximately 1” and ask client to internally rotate

Question 11

Subscapularis (internal rotator)

Answer 11

Pt standing, flex trunk, @ let arm hang

OT asks pt to internally rotate and palpates fingers up in armpit on costal side of scapula

Question 12

Pec Minor

Answer 12

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.

Question 13

Pectoralis Major

Answer 13

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

Question 14

Middle deltoid

Answer 14

Abduct arm, give resistance to horizontal adduction

Question 15

Supraspinatus

Answer 15

Short bursts of abduction to about 30-40 degrees, move fingers around supraspinous fossa position fingers in best spot to feel contractions

Question 16

Anterior Deltoid

Answer 16

Resistance to posterior. Move arm anteriorly with little ex rotation

Question 17

Posterior Deltoid

Answer 17

if posterior, move arm posterior and a little internally rotated

Question 18

Coracobrachialis

Answer 18

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

Question 19

Brachioradialis

Answer 19

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)

Question 20

Biceps

Answer 20

Pt flexes elbow in forearm supination

OT little resistance to flexion; palpate on muscle belly

Question 21

Brachialis

Answer 21

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

Question 22

Triceps brachii

Answer 22

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

Question 23

Supinator

Answer 23

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

Question 24

Pronator Teres

Answer 24

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