Class #1

Question 1

lateral border of scapula

Answer 1

prone. Drape the arm off the side of the table. Slide your thumb from the inferior angle superiorly along the lateral border. Follow the border in the direction of the axilla

Question 2

superior angle

Answer 2

prone. Scoop the shoulder with you hand to raise it off the table. this will soften the overlying muscles. locate the medial border. slide your fingertips superiorly along the border to find the superior angle.

Question 3

infraglenoid tubercle

Answer 3

prone. locate the lateral border. slide along the lateral border to its most superior portion. to access the landmark directly, you can either compress through the overlying muscles or curl underneath them.

Question 4

infraspinous fossa

Answer 4

prone. palpate the spine of the scapula, its medial border and its lateral border to isolate the infraspinous fossa

Question 5

supraspinous fossa

Answer 5

prone. lay your thumb along the spine of the scapula and raise it superiorly into the fossa.

Question 6

subscapular fossa

Answer 6

side lying. flex your partner’s shoulder and lay your fingertips along the medial border. with the other hand, move the scapula posteriorly (bringing the medial border off the ribs). slowly curl your finges through the rhomboid and trapezius muscles, under the scapula and onto the fossa.

Question 7

deltoid

Answer 7

O: lateral one-third of clavicle, acromion and spine of scapula
I: deltoid tuberosity
Palp: seated. locate the spine of the scapula, the acromion and the lateral one-third of the clavicle. not the “v” shape these landmarks form. locate the deltoid tuberosity. palpate between these landmarks to isolate the superficial, convergent fibers of the deltoid.

Question 8

trapezius

Answer 8

prone. fibers along neck- have partner elevate head off table about an inch and follow fibers inferiorly to the lateral clavicle. middle fibers - locate spine of scapula and slide medially onto the trapezius. lower fibers - ask partner to hold superman position and feel for superficial fibers

Question 9

latissimus dorsi

Answer 9

prone with the arm off the side of the table. locate the scapula’s lateral border. using your fingers and thumb, grasp the thick wad of muscle tissue lateral to the lateral border. feel the latissimus fibers contract by asking your partner to “swing your hand up toward your hip” against your resistance. as this occurs, follow the latissimus fibers superiorly into the axilla and inferiorly on the ribs

Question 10

teres major

Answer 10

prone with the arm off the side of the table. locate and grasp the latissimus dorsi fibers between your fingers and thumb. move your fingers and thumb medially to where you feel the scapula’s lateral border. the muscle fibers that lie medial to the latissimus and attach to the lateral border will be the teres major. follow these fibers toward the axilla where they blend with the latissimus dorsi

Question 11

supraspinatus

Answer 11

prone. locate the spine of the scapula. slide your fingers up into the supraspinous fossa. palpate through the trapezius and onto the supraspinatus fibers. as you palpate, note how the fibers run parallel to the spine. folllow the belly laterally until it tucks under the acromion.

Question 12

infraspinatus

Answer 12

prone, with the forearm off the side of the table. locate the spine, medial border and lateral border of scapula. form a triangle around the infraspinatus by laying a finger along each of these landmarks. palpate in the triangle and strum across the infraspinatus fibers. follow them laterally as they converge underneath the deltoid to attach to the humerus.

Question 13

teres minor

Answer 13

prone with the arm off the side of the table. locate the lateral border of the scapula, specifically, its superior half. slide laterally off the lateral border onto the surface of the teres minor. compress into and across its tube-shaped belly. reach thumb up into axilla and grasp the belly of the teres minor as you would a hamburger. ask your partner to “swing your hand up toward your head” to contract muscle.

Question 14

subscapularis

Answer 14

side lying. flex the shoulder and pull the arm anteriorly as much as possible. this will allow easier access to the scapula’s anterior surface. hold the arm with one hand while the thumb of the other locates the lateral border. slowly and gently curl your thumb onto the subscapular fossa.
alternate: supine. cradle the arm in a flexed position and locate the lateral border. slowly sink your thumbpad onto the subscapular fossa, adjusting the arm and scapula as you progress.

Question 15

supraspinatus tendon

Answer 15

the attachment of the tendon will be located just distal to the acromion on the greater tubercle. supine or seated, with the arm at the side of the body. locate the acromion and slide inferiorly onto the surface of the greater turbercle.
alternate: seated. place your parnter’s arm behind her back. this position will medially rotate and extend the humerus. passively extend the arm as far as is comfortable for your partner

Question 16

infraspinatus tendon and teres minor tendens

Answer 16

prone. with the arm off the side of the table. locate the bellies of these muscles. strumming across their fibers, follow their bellies laterally as they pass inferior to the acromion. palpating through the deltoid, roll across their slender tendinous attachments at the great tubercle.
alternate: supine or seated. flex the shoulder to 90 degrees. then horizontally adduct and laterally rotate slightly (10-20). although deep to the posterior deltoid, this position causes the infraspinatus tendon to move below the acromion and be accessible. locate the acromial angle. drop inferiorly off the angle and explore this region.

Question 17

subscapularis tendon

Answer 17

seated or supine. place the arm next to the trunk in anatomical position. locate the coracoid process of the scapula. slide one in inferiorly and laterally from the coracoid. palpate through the deltoid fibers, exploring the deeper tissue which lies along the lesser tubercle of the humerus. this is the location of the subscapularis tendon.

Question 18

rhomboids

Answer 18

prone. locate the scapula’s medial border and the spinous processes of C-7 through T-5. palpating through the thin trapezius, explore the area you have identified and strum vertically across the fibers of the rhomboids.

Question 19

levator scapulae

Answer 19

prone, supine or side lying. palpating through the trapezius, locate the superior angle of the scapula and the upper region of the medial border. place your fingers just off the superior angle and fibers will likely have a ropy texture. follow these fibers superiorly as they extend to the later side of the neck to TP’s of the cervical vertebrae.
alternate: prone. locate the upper fibers of the trapezius. roll two fingers anteriorly off the trapezius and press into the tissue of the neck. gently strum your fingers anteriorly and posteriorly across the levator fibers. place your fingertips on the levator and ask your partner to alternately elevate and relax the scapula.

Question 20

serratus anterior

Answer 20

supine. isolate the location of the serratus by abducting the arm slightly and locating the lower edge of the pectoralis major. then locate the anterior border of the latissimus dorsi. place your fingerpads along the ribs between the pectoralis major and latissimus dorsi

Question 21

pectoralis major

Answer 21

supine. begin with partner’s hand raised up toward ceiling. as you create resistance, ask your partner to flex his shoulder “meeting my reistance, try to bring your hand over your head” the upper fibers will contract while the lower fibers remain lax. ask him to extend against your resistance “now try to bring your hand toward your hips” here the lower fibers will contract while the upper fibers relax
side lying: flex the shoulder and pull it anteriorly toward you. this position not only brings the pectoralis major off the chest wall. grasping the pectoralis major, explore its mass from the ribs to the humerus

Question 22

pectoralis minor

Answer 22

supine. abduct the arm and place your fingerpads at the lateral edge of the pectoralis major. slowly and gently slide under the pectoralis major, following along the surface of the ribs.
side lying: support the arm in a flexed position and pull it anteriorly. this brings the pectoralis major off the chest wall and allows the breast tissue to fall away from the area you are palpating. slowly slide your thumb under the pec major, following along the surface of the ribs. your thumb will press into the side and onto the surface of the pec minor. then ask your partner to gently depress his scapula while you feel for the minor’s contraction

Question 23

biceps brachii

Answer 23

seated. bend the elbow and shake hands with your partner. ask your partner to flex his elbow against your resistance. palpate the anterior surface of the arm and locate the hard, round surface of biceps. follow the belly distally to the inner elbow. then follow proximally to where it tucks beneath the anterior fibers of the deltoid.

Question 24

triceps brachii

Answer 24

prone. place one hand on the proximal elbow and ask your partner to bring his elbow toward the ceiling against your resistance. this action will contract the long head of the triceps. follow up and under deltoid.

Question 25

coracobrachialis

Answer 25

laterally rotate and abduct the shoulder to 45 degrees. locate the fibers of the pectoralis major. this tissue forms the axilla’s anterior wall and will be a reference point for locating coracobrachialis. lay one hand along the medial side and move your fingerpads into the armpit. have your partner horizontally adduct gently against your resistance. isolate the solid edge of the pectoralis major then slide off the pectoralis major fiber posteriorly (into axilla) and explore for the slender, contracting belly of the coracobrachialis.

Question 26

structures surrounding axilla

Answer 26

biceps and coracobrachialis, pec major, lats and subscapularis, and ribcage and serratus anterior

Question 27

coracoclavicular ligament

Answer 27

between