Functional Exam 3 Palpations

Question 1

ASIS

Answer 1

standing hand on side of abdomen below umbilicus. compress inferiorly feel superficial tip of ASIS. compare sides.

Question 2

Iiac Crest

Answer 2

side lying locate ASIS. slide posteriorly along iliac crest.

Question 3

PSIS

Answer 3

follow iliac crests posteriorly. shallow hump surrounded by thicker tissue. visibly locate dimples sof low back and explore surrounding region.

Question 4

Ischial Tuberosity
prone/side
with hip/knee flexed

Answer 4

prone gluteal fold. fingers at center press superiorly/medially.
side top hip flexed hand on med thigh slide prox to glut fold/isch tuberosity

Question 5

Greater Trochanter

Answer 5

-Ask patient to internally and externally rotate hip in short seated position to identify location of greater trochanter.

Question 6

Sacrum/SI joint

Answer 6

prone thumb and finger upon PSIS explore between. midline of sacrum. palmate to the sides of crest.
prone locate PSIS. slightly inferior and medial. small widening by keeping one hand upon it with other hand flex knee to 90. passivly rotate hip med, small opening (can lat rotate)

Question 7

Gluteus maximus

Answer 7

prone. locate coccyx, edge of sacrum, PSIS, and posterior two inches of iliac crest to isolate landmards of GM. locate insertion of GM at gluteal tuberosity. connect origin to insertion paplate thick superficial fibers. they can extend hip.

Question 8

TFL

IT band

Answer 8

supine ASIS flad had posterior and distal to ASIS and iliac crest. above knee and ASIS. alternate medial rotation with relax. med rotaton TFL will contract to solid oval mound. distally will blend w. IT.
side lying locate biceps femoris. have abduct.

Question 9

Biceps femoris

Answer 9

-Differentiate between vastus lateralis and biceps femoris on lateral thigh by providing slight resistance in both knee flexion and extension in a side lying position.
lateral part of hamstrings leading to head of fib

Question 10

semimembranosus

Answer 10

medial hamstrings. turn partner supine and follow it distally to pes anserinus tendon.

Question 11

semitendinosus

Answer 11

same as semimemb but deep and difficult to isolate.

Question 12

rectus femoris

Answer 12

-Differentiate between rectus femoris and iliopsoas at the hip by performing resisted hip flexion with knee flexed (iliopsoas) and knee straight (rectus femoris). Also can ask patient to lean forward (iliopsoas) or backward (rectus femoris).
supine w.knee bolstered. line between AIIS and patella. flex hip and lift foot off table.

Question 13

vastus medialis

Answer 13

supine knee bolstered. extend knee. palpate medial and proximal to patella. sartorius and RF form teardrop.

Question 14

vastus lateralis

Answer 14

-Differentiate between vastus lateralis and biceps femoris on lateral thigh by providing slight resistance in both knee flexion and extension in a side lying position.
side lying. flat hand on lateral thigh extend relax knee.

Question 15

vastus intermedius

Answer 15

(difficult to palpate due to its depth but edges can be accessed if R.F. is moved)

Question 16

sartorius

Answer 16

supine. rest foot on op knee (hip flex/lat rotated). hand middle of med thigh. raise knee to sceiling. ASIS-med tib.

Question 17

hamstrings group

Answer 17

prone hand on posterior thigh. flex knee holding foot off table. Ischial tuberosity, distally 1 inch and palpate tendon to seperate bellies.

Question 18

quads group

Answer 18

seated hands flat on thigh above knee below hip. extend and relax knee slowly.

Question 19

adductors group

Answer 19

supine hip slightly flexed and laterally rotated. hand on med thigh, adduct hip against resistance. adduct/relax.

Question 20

iliopsoas

Answer 20

-Differentiate between rectus femoris and iliopsoas at the hip by performing resisted hip flexion with knee flexed (iliopsoas) and knee straight (rectus femoris). Also can ask patient to lean forward (iliopsoas) or backward (rectus femoris).