midterm Flashcards
SCM
rotate head medially/laterally, palpate SCM on opposite side of rotation
Platysma
flat M-shape covering anterior neck, px sticks their neck & jaw out
Scalenes (middle)
lateral pressure to head, palpate middle inferior neck
Scalenes (posterior)
follow trapezius m. to lower neck, apply pressure posterolateral to head, palpate anterior to trap.
Scalenes (anterior)
apply anterolateral pressure to head, palpate anterolateral inferior SCM triangle
Suboccipital
C1 & C2
Cervical paravertebral mm.
C2-C6 mm., overlying articular pillars
Trapezius (upper)
prone, arm extended @ 45 degree inferior angle, thumbs pointed posterior, px pushes posterior
Trapezius (middle)
prone, arm extended @ 90 degree angle, thumbs pointed posterior, px pushes posterior
Trapezius (lower)
prone, arm extended @ 180 degree superior angle, thumbs pointed posterior, px pushes posterior
Masseter m.
clench jaws (in cheeks)
Temporalis m.
clench jaws (in temples)
Spinalis mm.
1st/medial of 3 fingers to locate erector spinae mm.
Longissimus mm.
2nd/intermediate of 3 fingers to locate erector spinae mm.
Iliocostalis mm.
3rd/lateral of 3 fingers to locate erector spinae mm.
Rhomboid major m.
- prone, superior shoulder shrugs
- insertion: medial border to inferior angle of scapula
- ‘chicken wing arms test’
Rhomboid minor m.
- prone, superior shoulder shrugs
- insertion: medial angle of scapula
- ‘chicken wing arms test’
Levator scapulae m.
arm behind back (‘police arm bar’), shoulder shrug
Supraspinatus m.
arm straight along side, px pushes laterally
Infraspinatus m.
arm to square (as in throwing a ball), rotate posteriorly
Latissimus dorsi m.
arm straight up, px ADDUCTS arm
Teres major m.
- inferior to TERES MINOR m., acts in medial rotation
- arm at square (throwing), px rotates shoulder anteriorly
Teres minor m.
- superior to TERES MAJOR m., acts in lateral rotation
- arm at square (throwing), px rotates shoulder posteriorly
Quadratus lumborum m.
- lateral & deep to lumbar paravertebral mm
- ‘hula dance hips’ - rock hips superiorly
Gluteal maximus m.
prone, legs straight, lift (extend) straight leg
Gluteal medius m.
prone, ABDUCT at hip, medial & above femoral trochanters
Piriformis m.
- palpate bw lateral sacrum & greater trochanter
- prone, bend @ knee, external hip rotation (foot medially rotated)
Deltoid m.
- prominent during ABDUCTION of arm
- prone/standing, extend shoulder in coronal plane
Biceps brachii m.
flex bicep (elbow flexion)
Pectoralis major m.
supine, ‘bench press arms’ - push anteriorly
Pectoralis minor m.
- deep to PECTORALIS MAJOR m
- supine, arms at side, shoulder press anteriorly
Serratus anterior m.
- keeps scapula from winging
- extend arm @ 90 degrees, push shoulder anteriorly (against a wall)
- ‘boxers m.’
Coracobrachialis m.
bottom of bicep, arms to square, push elbows anteromedially
Triceps m.
- elbow extension makes prominent
- prone, arms straight @ side, px pushes posteriorly
- 3 heads:
long head (on posteromedial arm);
lateral head (on posterolateral arm);
medial/deep head (under long head but palpable near medial aspect of distal humerus)
Pronator teres m. (/elbow)
medial epicondyle to middle of radius, pronate antebrachium
Flexor carpi ulnaris m.
- runs from ulna to palmaris longus
- make fist, ulnarly deviate, flex wrist
- inline w/palmar surface of 5th digit
Flexor carpi radialis m.
- make fist, radially deviate, flex wrist
- inline w/palmar surface of index finger
Palmaris longus m.
- runs from ulna to palmaris longus
- make fist, ulnarly deviate, flex wrist
- inline w/palmar surface of middle finger
Brachioradialis m.
- with thumb pointed @ ceiling, resist elbow flexion
- ‘hammer curl’, arm @ side, bent @ elbow, flex superiorly
Extensor carpi radialis longus m.
- make fist, extend wrist
- wiggle fingers, anterior-to-bump of distal radius
Extensor carpi radialis brevis m.
- make fist, extend wrist
- wiggle fingers, anterior-to-bump of distal radius
Hyoid bone
even w/C3, palpate above the thyroid cartilage (moves w/swallowing)
Thyroid cartilage
- top part is even w/C4, bottom part is even w/C5
- palpate notch @ midline superiorly
Cricoid cartilage
- even w/C6, just inferior to lower border of thyroid cartilage
- palpate @ midline
Carotid tubercle
- the anterior tubercle of the C6 T.P.
- start even w/C6, then palpate about 1 inch lateral to 1st cricoid ring
Carotid pulse
palpate adjacent to carotid tubercle
Suprasternal notch
the notch @ the superior & medial aspect of the sternum (actually on manubrium)
Anterior cervical lymph nodes
along medial border of SCM (usually palpable when inflamed)
Angle of mandible
posterior corner of jaw, inferior (& somewhat anterior) of ears
Parotid gland
- the largest salivary glands, ‘parotid’ means ‘around the ear’
- partially covering angle of mandible, spanning the posterior area of the mouth up to the ear
Submandibular gland
- aka ‘submaxillary glands’, salivary glands located under the chin, beneath floor of the mouth
- palpated from under chin, lateral areas
Mastoid process
- large, bony protuberance behind the earlobe, on temporal bone
- attachment for SCM, splenius capitis, & longissimus capitis mm, & the digestric posterior m. belly
T.P. of C1 (lateral mass)
bw the angle of the mandible & tip of mastoid process
Supraclavicular fossa
superior to the clavicle & lateral to the suprasternal notch (depression bw clavicle, interior of AC jt, trap m, & neck)
Occiput
posteroinferior part of the skull (lower back & bottom of head)
Inion
E.O.P., midline of occiput, marks the center of the superior nuchal line, attachment point for nuchal ligament
Superior nuchal line
extends laterally from E.O.P./inion
Greater occipital nn
palpate about 1 finger width lateral to the EOP/inion
S.P.s of C2-C7
C6 dips away from palpation with cervical extension, C7 is very prominent usually
Articular pillars (cervical facet/ZP joints)
palpate about 1 inch lateral to SPs
Nuchal ligament
- runs from EOP to C7’s SP, overlying & attaching to each cervical SP, homologous to supraspinous ligaments from C7 to sacrum
- includes lamellar membrane & funicular cord
- aka ‘paxwax’
Digastric m
mm that make up the floor of the mouth, palpate from below chin
Mandible
bottom jaw bone
Coronoid process
anterior protuberance of mandible, palpable through & posterior to cheeks
Condylar process
- posterior protuberance of mandible, at head & jt of mandible
- tender to palpate, but very close to anterior/inferior entrance to ear, have px open & shut jaw
Mylohyoid m
m running from mandible to the hyoid bone, forming floor of mouth
S.P.s of T1-T12
- when standing, T7/T8 is usually medial of inferior angles of scapulae
- when prone, T6 is usually medial of inferior angles of scapulae
Interspinous spaces
gaps in between SPs, running the length of vertebral column
Thoracic T.P.s
- for T1-T4 & T8-T12: find area located up 1 interspinous space & lateral about 1 inch, to palpate
- for T5-T7: find area located 2 interspinous spaces up & lateral about 1 inch, to palpate
Rib angles
the most posteriorly prominent part of each rib
Intercostal spaces
spaces in bw ribs
Temporomandibular joint
- the lower jaw’s articulation, contains MASSETER, TEMPORALIS, DIGASTRIC, & MYLOHYOID mm, the MANDIBLE itself, which includes the CORONOID & CONDYLAR PROCESSES, which join the TEMPORAL bone.
Medial/vertebral border of scapula
most medial border, running vertically along scapula, from the inferior to the superior angles
Inferior angle of scapula
- if prone, usually level with T6 SP
- if standing, usually level w T7 SP
Lateral borders of scapulae
- aka ‘axillary border’, superior boney border of scapulae, running laterally towards shoulder
Spine of scapulae
usually level with T3 SP, separates the supraspinatus & infraspinatus mm & fossas
Supraspinatus fossa
depression superior of scapular spine, contains the supraspinatus m
Infraspinatus fossa
depression inferior of scapular spine, contains the infraspinatus m
Superior angles of scapulae
corners of the superior & medial borders of scapulae
Iliac crests
usually level with L4-L5 interspinous space, or find the superior border of hips and most prominent boney surface
PSIS
posterior superior iliac spine, located directly underneath the visible dimples just above the buttocks
PIIS
posterior inferior iliac spine, located on the ilium side of the V-shaped notch bw the ilium & the sacrum
(Long) Dorsal SI ligament
connects w/PSIS to the lateral borders of the sacrum
Sacroiliac joint
not directly palpable, bw articular surfaces of sacrum & ilia
S.P.s of L1-L5
interspinous space bw L4-L5 is usually level w/iliac crests
Mammillary processes
deep, about 3/4 inch lateral to the superior interspinous space to locate, although fairly impalpable
Interspinous/supraspinous ll.
running over SPs from C7 to sacrum, continuous w/nuchal line above C7 to EOP
Lumbar paravertebral mm
all the mm alongside the lumbar vertebrae
Sacral base
- the top of the sacrum
- palpate S1, then go up a little
Sacral apex
- narrow, inferior portion of sacrum, above coccyx
Coccyx
bottom of vertebral column, just superior to anus
Ischial tuberosity
in the middle of each buttock approximately level w/gluteal m, the bottom ‘crest’ of ilia
Sciatic n.
palpate midway bw ischial tuberosity & greater trochanter
Sternoclavicular joint
lateral to suprasternal notch, point of articulation bw manubrium & clavicle
Manubrium
- top of sternum, above the angle of Louis
- articulates w/clavicles & R1 costal cartilages
Angle of Louis
- joint bw sternum & manubrium, point of articulation w/R2 costal cartilages
Xyphoid process
- the inferior end of sternum, partial articulation w/R7
- usually level w/T9, attachment point for celiac plexus cartilage, indirectly attaching costal cartilages w/sternum
Sternum
- includes manubrium, sternum, & xyphoid process, developed from 6 ‘sternebrae’, 4 of which fuse to make sternum proper
- articulates w/manubrium & xyphoid process, also w/costal cartilages of R1-R7 directly
Costosternal joints
attachment points of costal cartilage to the sternum, palpable & usually sensitive
Costochondral junctions
attachments bw costal cartilage & ribs
AC joint
acromioclavicular joint, the distal end of the clavicle, protrudes more than the acromion, making the little bump on the superior shoulder
Acromion process
articulates w/clavicle to form acromioclavicular jt, part of superolateral shoulder
Coracoid process
palpate about 1 inch inferior to the distal end of clavicle, usually sensitive
Greater tuberosity of humerus
- just inferior to the acromion’s lateral edge when arm is neutral
- attachment pt for infraspinatus & teres minor mm
Bicipital groove
- bw greater & lesser tuberosities, superior tendon of the long head of biceps brachii m passes through here
- becomes more palpable w/external rotation
Lesser tuberosity of humerus
- medial to bicipital groove, @ same level as coracoid process
- more palpable w/external rotation
Proximal biceps tendon
- tendon @ long head of biceps brachii, runs through & palpated in bicipital groove
- tendon @ short head of biceps brachii, attaches below coracoid process
- elbow flexion makes more palpable
Subdeltoid/subacromial bursa
just inferior to the lateral & anterior edge of acromion, usually only palpable when inflamed
Brachial artery
- to palpate, apply gentle pressure against the medial humeral shaft
- also palpable medial to the biceps tendon in the cubital fossa
Medial epicondyle
- on medial, distal humerus (corner of the elbow’s ‘funny bone’)
Medial supracondylar line of humerus
bony ridge proximal to the medial epicondyle
Medial collateral ligament
connects the medial epicondyle to the ulna
Ulnar n.
- ‘funny bone’
- lies in groove bw the medial epicondyle & the olecranon process
Olecranon process
corner of elbow, arm flexion makes more palpable
Ulnar ridge
bony posteromedial edge of ulna, palpable from the olecranon to the wrist
Triceps tendon
lies over the olecranon fossa
Olecranon fossa
located on distal posterior humerus, contains the olecranon during extension, so is easier to palpate during elbow flexion
Lateral epicondyle
located on lateral distal humerus, lateral to olecranon, is smaller & less defined than the medial epicondyle
Lateral supracondylar line of humerus
bony ridge proximal to lateral epicondyle, longer & better defined than the medial supracondylar line
Radial head
- about 1 inch distal from the lateral epicondyle
- px pronates & supinates forearm slowly
Lateral collateral ligament
connects lateral epicondyle to the annular ligament which encircles the radius
Biceps brachii tendon
located on medial side of the cubital fossa, elbow flexion makes more palpable
Median n.
just medial to the brachial artery, not palpable
