Palpatable Flashcards
Levator palpebrae superioris
Palpate supine.
Anterior surface of lesser wing of sphenoid –> fascia and skin of upper eyelid.
Elevates eyelid.
OCCULOMOTOR nerve
Opthalmic artery.
Orbicularis occuli
Palpate supine. Contract by closing eye.
Three sections: orbital, palpebral and lacrimal.
Orbital encircles eye
Palpebral: through connective tissue of eyelid
Lacrimal: lacrimal bone –>. Deep
Actions: closes and squints eye
Facial nerve
Facial and superficial temporal artery. (Both branches of external carotid)
Corrugated supercilli
Palpate supine
Inferior frontal bone –> fascia of medial eyebrow.
Draws eyebrows inferiorly and medially
Facial nerve
Opthalmic artery.
Procerus
Palpate supine
Fascia and skin of nasal bone –> fascia and skin of medial eyebrow
Draws medial eyebrows inferiorly and wrinkles skin of nose upwards.
Facial nerve
Facial artery
Nasalis
Palpate supine
Two parts:
Transverse: maxilla, lateral to upper nose –> opposite nasalis, cartilage mid-nose
Alar: maxilla, lateral to nostril –> alar cartilage
Transverse: Constricts nostrils.
Alar: flares nostrils
Facial nerve
Facial artery
Depressor septi nasi
Supine.
Right underneath nostril.
Incisive fossa of maxilla –> cartilage and septum of nose
Constricts nostrils by pulling septum down
Facial nerve
Facial artery.
Levator Labii Superioris Aleque Nasi
Supine
Frontal process of maxilla –> lateral part of upper lip AND cartilage of nose. Flares nostril and elevates upper lip.
Facial nerve
INFRAORBITAL ARTERY
Levator labii superioris
Supine
Inferior orbital margin of maxilla –> lateral part of upper lip.
Elevates upper lip
Facial nerve
Facial artery
Zygomaticus major
Supine
Zygomatic bone, close to zygomatic-temporal suture –> modiolus.
Elevate angle of the mouth
Facial nerve
Facial artery
Zygomaticus minor
Supine
Zygomatic bone, close to zygomatic-maxilla suture –> upper lip
Elevates upper lip
Facial nerve
Facial artery
Levator anguli oris
Supine
Canine fossa of maxilla –> modiolus
Elevates angle of mouth
Facial nerve
Facial artery
Risorius
Supine
Fascia of mandible –> modiolus
Draws angle of mouth laterally
Facial nerve
Facial artery
Depressor anguli oris
Supine
Oblique line of mandible –> modiolus
Depresses angle of the mouth.
Facial nerve
Facial artery
Depressor labii inferiorus
Supine
Medial oblique line of mandible –> lower lip (midline)
Depresses lower lip
Facial nerve
Facial artery
Mentalis
Supine
Incisive fossa of mandible –> skin of chin
Elevates, everts and protracts lower lip
Facial nerve
Facial artery
Buccinator
Supine
Maxilla and mandible –> lips and modiolus
Deep to anguli oris
Compresses cheek against lips
Facial nerve
Facial AND MAXILLARY artery
Obicularis oris
Supine
Surrounds mouth
Closes mouth, protracts lips
Facial nerve
Facial artery
Occipitofrontalis
Supine
Two sections:
Occipital: occipital and temporal –> galea aponeurotica.
Draws scalp posteriorly
Frontal: galea aponeurotica –> fascia and skin of eyes and nose
Draws scalp anteriorly.
Facial nerve
Occipital, posterior auricular and opthalmic arteries.
Temporalis
Supine
Temporal fossa –> coronoid process and Ramus of mandible
Elevates and retracts jaw
Trigeminal nerve
Maxillary and superficial temporal artery
Masseter
Supine
Two layers:
Superficial: zygomatic bone and zygomatic arch –> angle and Ramus of mandible
Elevates and protracts
Deep: inferior margin and deep surface of zygomatic arch –> coronoid process and Ramus of mandible.
Elevates and retracts
Trigeminal nerve
Maxillary artery
Trapezius
Prone. Slight extension of head and neck will help it pop.
Upper: EOP and medial 1/2 of superior
Nuchal line, nuchal ligament and SP of C7 –> lateral clavicle and acromion process
Elevates, retracts, upwardly rotates scapula
Middle: SPs of T1-5 –> acromion process and spine of scapula
Retracts scapula
Lower: SPs of T6-12 –> root of scapular spine
Retracts and depresses scapula.
Spinal accessory nerves (CN XI)
Transverse cervical and dorsal scapula arteries
Levator scapula
Seated. Prone. Sidelying.
TVPs of C1-4 –> superior angle and superior aspect of medial border of scapula.
Elevates scapula. Lateral flexion and extension of neck.
Dorsal scapular nerve
Dorsal scapular artery.
Rectus capitis posterior minor
Supine
Posterior tubercle of C1 –> medial half of Inferior nuchal line.
Extension and protraction of head.
Suboccipital nerve
Occipital and vertebral arteries
Rectus capitis posterior major
Prone or supine.
SP of C2 –> lateral 1/2 of inferior nuchal line
Extension of head
Suboccipital nerve
Occipital and vertebral arteries
Obliquus capitis inferior
Supine
SP of C2 –> TVP of C1
Ipsilateral rotation of atlas
Suboccipital nerve
Occipital and vertebral arteries
Obliques capitis superior
Prone
TVP of c1 –> in between nuchal lines
Prostration and contralateral rotation of head
Suboccipital nerve
Occipital and vertebral arteries
Platysma
Seated or supine
Subcutaneous fascia of pectoralis and deltoid –> mandible and subcutaneous fascia of lower face
Draws up skin of superior chest and neck; creates ridges of neck; depresses mandible
Facial nerve
Facial artery
Sternocleidomastoid
Supine. Rotate head contra laterally. Lift head and neck air.
Two head:
Sternal (manubrium) and clavicular (medial 1/3 clavicle). Inserts into mastoid process and lateral 1/2 of superior nuchal line.
Flexion of lower neck.
Extension of upper neck.
Lateral flexion and contralateral rotation.
Spinal accessory nerve (CN XI)
Occipital and auricular arteries.
Sternohyoid
Supine.
Sternum (manubrium and part of clavicle) –> hyoid
Depresses the hyoid. Flexion of neck and head
Cervical plexus (ansa cervicalis) Superior thyroid artery.
Sternothyroid
Supine.
Sternum (posterior manubrium and clavicle) –> thyroid
Depresses thyroid cartilage. Flexion of neck and head.
Cervical plexus (ansa cervicalis) Superior thyroid artery,
Thyrohyoid
Supine
Thyroid cartilage –> hyoid
Depresses hyoid. Flexion of neck and head
Cervical plexus (ansa cervicalis) Superior thyroid artery
Omohyoid
Supine. Start lateral to SCM. Feel for horizontal fibres
Two bellies:
Inferior: Superior border of scapula –> clavicle via central tendon
Superior: Clavicle via central tendon –> hyoid
Depresses hyoid. Flexion of head and neck
Cervical plexus (ansa cervicalis) Superior thyroid artery AND transverse cervical.
Digastric
Supine. Start in between SCM and ramus of mandible. Depress mandible with resistance.
Two bellies.
Posterior: mastoid notch of temporal bone
Anterior: Digastric fossa of mandible
Insert into hyoid bone via central tendon
Elevates hyoid
Depresses mandible
Flexion of head and neck
Posterior: Facial nerve (CN VII)
Anterior: trigeminal nerve
Occipital, posterior auricular and facial arteries
Stylohyoid
Supine. Fingers between SCM and posterior ramus of mandible. Swallow.
Styloid process of temporal bone –> hyoid
Elevates hyoid
Facial nerve (CN VII) Occipital, posterior auricular and facial arteries.
Mylohyoid
Supine. Fingers under chin. Depress mandible with resistance.
Inner surface of mandible (mylohyoid line) –> hyoid
Elevates hyoid
Depresses mandible
Flexion of head and neck
Trigeminal nerve (CN V) Inferior alveolar artery
Geniohyoid
Supine. Depress mandible. Deep to mylohyoid
Inner surface of mandible (inferior mental spine) –> hyoid
elevates the hyoid
Depresses mandible
Flexion of head and neck
Hypoglossal nerve (CN 12) Lingual artery
Anterior Scalenes
Seated or supine. Palpate superior to clavicle and lateral to clavicular head of SCM. Sniff.
Anterior tubercles C3-6 –> R1
flexion, lateral flexion
elevation of R1
Cervical spinal nerves (ventral rami)
Ascending cervical artery
Middle Scalenes
Seated or supine. Palpate superior to clavicle, in middle of posterior triangle (in between SCM and upper traps). Sniff
Posterior tubercles C2-7 –> R1
flexion, lateral flexion
elevation of R1
Cervical spinal nerves (ventral rami)
Transverse cervical artery
Posterior Scalenes
Seated. Palpate superior to clavicle, medial to clavicular attachment of trapezius. sniff
Posterior tubercles c5-7 –> R2
Lateral flexion of neck
Elevation of R2
Cervical spinal nervers (ventral rami)
Transverse cervical artery.
Latissimus Dorsi
Standing. Client’s hand on examiner’s shoulder. Extend and adduct.
SPs of T7-L5. Posterior Iliac crest. Sacrum. Lower four ribs. Maybe inferior angle of scapula.
–> medial lip of bicipital groove
Adducts, extends, medially rotates, APT
Thoraco dorsal nerve
Thoraco dorsal and posterior intercostal arteries.
Rhomboid Major
Seated or prone
SPs T2-5 –> medial border of scapula (inferior portion)
Elevates and retracts scapula.
Dorsal scapular nerve
Dorsal scapular artery
Rhomboid Minor
Seated or prone
SPs C7-T1 –> medial border of scapula (superior portion)
Elevates and retracts scapula
Dorsal scapular nerve
Dorsal scapular artery.
Quadratus Lumborum
Prone. Palpate superior to iliac crest, lateral to erector spinae. Hike hip
Posterior portion of the iliac crest –> R12 and TVPs of L1-4
Extension, lateral flexion, hip hike. APT
Lumbar plexus
Subcostal intercostal and Iliolumbar
Iliocostalis
Prone. Most lateral erector spinae. Palpate from pelvis to ribs
Medial sacral and iliac crests and angles of ribs 3-12 –> Angles of ribs plus TVPs of C4-7
Extension, lateral flexion, ipsilateral rotation, APT
Spinal nerves
Posterior intercostal and lumbar arteries
Longissimus
Prone.
Runs from pelvis (medial iliac crest, sacrum), following Ribs 3-12, TVPS and APs of C4-7, to mastoid process,
Extension, lateral flexion, ipsilateral rotation, APT
Spinal nerves
Posterior intercostal and lumbar arteries
Spinalis
Really two discrete sections. Palpate prone. Difficult to distinguish.
Thoracis: Connecting the SP of inferior Thoracic spine to mid Thoracic spine. (T11-L2 –> T4-8)
Cervicis: Runs from inferior Nuchal ligament and SP of C7 –> SP of C2
Extension, lateral flexion.
APT
Spinal nerves (thoracic and cervical) Posterior intercostal and lumbar arteries.
Serratus Anterior
Supine, arm flexed to 90 at GHjt, hand toward ceiling. Palpate lateral rib cage. Push hand toward ceiling.
Anterio-lateral portion of R1-9 –> medial scapula
Protraction and upward rotation of scapula
Long thoracic nerve Dorsal scapular (subclavian) and lateral thoracic (axillary) arteries.
Pectoralis Major
Supine, arm abducted to 90.
Two heads:
Clavicular: medial 1/3 of clavicle
Sternal: sternum and costal cartilage 1-7
Inserts into lateral lip of bicipital groove.
Flexion, adduction and medial rotation. Horizontal adduction.
Medial and lateral pectoral nerves.
Thoraco-acromial artery (branch of axillary)
Pectoralis Minor
Seated, hand behind back. Palpate inferior to coracoid process. elevate hand.
Ribs 3-5 –> coracoid process
Protraction and depression of scapula. Elevates R3-5.
Medial and lateral pectoral nerves
Thoraco-acomial artery (branch of axillary)
Subclavius
Supine, arm medially rotated. Palpate inferior to middle third of clavicle. Depress scapula.
R1 –> middle of inferior surface of clavicle
Depresses clavicle. Elevates R1
Brachial plexus
Suprascapular and axillary arteries.
Rectus abdominus
Supine, pillow beneath knees. Palpate xiphoid process and ribs, and pubis. Flex trunk just a wee bit.
Pubis (symphysis and crest) –> xiphoid process and costal cartilage 5-7
Flexion, PPT
Intercostal nerves
Superior and inferior epigastric, and posterior intercostal arteries
Transversus abdominus
Supine, pillow under knees. Palpate abdomen between iliac crest and lower ribs. Exhale forcefully.
Inguinal ligament, iliac crest, thoracolumbar fascia, costal cartilage –> abdominal aponeurosis.
Intercostal nerves
Posterior intercostal, subcostal, inferior epigastric and deep circumflex arteries.
External abdominal obliques
Supine, pillow under knees. Palpate anterolateral abdomen between iliac crest and lower ribs. flex obliquely
Pubic bone (crest and tubercle), anterior iliac crest and abdominal aponeurosis –> inferior border of lowest 8 ribs (5-12)
Flexion, lateral flexion, contralateral rotation, PPT
Intercostal nerves
Posterior intercostal, subcostal, inferior epigastric, deep circumflex arteries.
Internal abdominal obliques
Supine, pillow under knees. Palpate anterolateral abdomen between iliac crest and ribs. Flex to same side.
Inguinal ligament, pelvic crest, thoracolumbar fascia –> abdominal aponeurosis and R10-12
Flexion, lateral flexion, ipsilateral rotation.
Intercostal nerves
Posterior intercostal, subcostal, deep circumflex and inferior epigastric arteries.
Diaphram
Supine with pillow under knees. Palpate inferior margin of anterior ribs. Breathe. On exhalation, curl fingers under.
Lumbar spine (L1-3), Internal surfaces of R7-12 and their costal cartilages, and Xiphoid process. --> central tendon of diaphragm
Increases volume of thoracic cavity
Phrenic nerve
Branches of aorta and internal thoracic arteries.
