Palpation 3 Flashcards
What is the posterior triangle of the neck made up of? (3 things)
Clavicle, SCM and traps
T/F
TVPs are palpable deep to the multifidus.
False. Deep to erector spinae muscles.
T/F
TVPs of thoracic vertebrae are shorter and do not extend as far laterally as the TVPs of the lumbar vertebrae.
True
The vertebral column consists of ___ vertebrae?
a) 20
b) 22
c) 24
d) 26
C) 24
The ______ vertebrae are most mobile and accessible.
a) cervical
b) thoracic
c) lumbar
A) cervical
The 12 thoracic vertebrae articulate with …..
12 pairs of ribs.
Designed for minimal movement and to stabilize the thoracic area and protect internal organs.
Which set of vertebrae support the weight of the upper body?
a) cervical
b) thoracic
c) lumbar
Lumbar
When palpating the spine, what are the two types of protrusions that can be found?
Spinous processes and transverse processes
T/F
Costal cartilage is identical in shape and size to the ribs and serves as a bridge between them and the sternum.
True
Which ribs are considered “true” ribs?
a) 1-6
b) 1-7
c) 1-8
d) 1-10
b) 1-7
How do ribs 8-12 attach to the sternum?
Indirectly by means of costal cartilage.
11-12 are floating and do not attach to the sternum or costal cartilage.
Name the specific spinous process that intersects with these bony landmarks:
- The base of neck
- superior angle of scapula
- inferior angle of scapula
- 12th rib
- top of iliac crest
C7 T2 T7 T12 L4
Name the 4 natural curves of the spine.
Cervical lordosis, thoracic kyphosis, lumbar lordosis, sacral kyphosis
An abnormal lateral curvature of the spine is called…
scoliosis
T/F
At birth, the spine has a kyphotic curvature and a lordotic curvature.
False - at birth, the spine has a single kyphotic curvature.
When does cervical lordosis develop in an infant?
a) At 3 months of age
b) When they begin to crawl
c) when they can hold their head erect
d) when they begin to walk
c) when they can hold their head erect
When does the lumbar lordosis vertebrae develop?
When a child begins to stand and walk
Nape line locates the landmarks of the _____ vertebrae.
Cervical
When weight is placed on vertebral discs, what assists in compressing and distributing pressure?
when weight is placed on vertebral discs, the annulus fibrosis supports the nucleus pulposus in compressing and distributing pressure. The nucleus is mostly water.
Explain the rationale behind being taller in the morning than at night.
When you sleep, the pressure is off the spine and the vertebral discs are able to fully restore themselves – which is why in the morning you are half an inch taller than the night before.
What are the most posterior projections on the spine?
Spinous processes
T/F
The spinous processes of the lumbar spine are slightly smaller than thoracic or cerival.
False - SP of lumbar are much larger than T or C
T/F
Because of the lordotic curve in the cervical spine and the overlying ligamentum nuchae, the C-spine processes are deeper than thoracic and lumbar vertebrae.
True
Which vertebrae does not have a spinous process?
C1 - atlas
T/F
When the neck is flexed, C7 shifts superiorly while T1 is buckled in by the fist ribs and does not move.
True
T/F
C3-C6 protrude posteriorly to approximately the same extent. C2 is larger and more distinct.
True
T/F
The TVPs of the lumbar vertebrae are also deep to the erector spinae. Extending an inch or two laterally, their solid presence can be felt beneath the overlying muscle tissue.
True
Because of its superficial nature, the lamina groove is easy to access directly.
False
Because of this overlying tissue, the lamina groove is difficult to access directly but its borders (SP and TVP) are palpable.
What landmark is between the sternal heads of the clavicles?
Jugular notch
The manubrium articulates with what 3 structures?
clavicles, first rib and second rib
The junction between the manubrium and the body of sternum is called ______
Sternal angle / angle of louis
T/F
The xiphoid process is approx. 1 inch in length or completely absent.
True
T/F
The manubrium, sternal body and xiphoid process are covered by fasciae and several layers of muscle.
False.
Manubrium and the body and xiphoid process are superficial, covered only by fasciae and pec major tendon.
What attaches the ribs to the sternum?
Costal cartilage
T/F
The ribs all run at the same angle around the trunk of the body.
False
The ribs run at varying angles around the trunk of the body.
T/F
The space between the ribs are filled with thick intercostal muscles that make it difficult to palpate.
False.
Space between the ribs are filled with thin intercostal muscles that can be easily palpated.
The jugular notch is considered a beginning point for investigating other areas. How would you locate it?
Midline from chin, down the front of the neck.
If you are on the jugular notch and move slightly left or right, what will be the “bump” you feel?
The SC joint.
What is the only horizontal long bone in the body?
Clavicle
Which rib is hidden under the clavicle?
a) 1
b) 2
c) 3
a) 1
The intersection between the sternum and the manubrium is called the ______. This structure helps find the second rib.
Angle of Louis
1) Jugular notch
2) Angle of louis
3. Xiphoid process
4. Inferior angle scapula
5. Superior angle scapula
a) T7-8
b) T4 SP
c) lines up with SP of T2 roughly
d) body of T10
e) T2
1 - c 2 - b 3 - d 4 - a 5 - e
Tilting your head changes rib 1 because of what muscles that attach there?
anterior and middle scalene
T/F
Transition zones are best located when a patient is standing
False.
Best located when pt is seated or prone.
To locate the 10th rib, what would you use as a guide to help locate it?
The costal arch. Go to the lowest part of the rib-cage.
If you follow the angle of the 10th rib and come across a prominence, what would you be feeling?
Prominence of rib 11
What would be the best position to have the patient in to find ribs 11/12?
side-laying or prone
What bony prominence would you use to find the L5/S1 transitional zone?
PSIS
What happens to the SPs during flexion?
They separate. When we extend, they approximate.
T/F
Ribs are an extension of TVPs.
True
You cannot palpate a rib head. You are actually palpating the….
TVP / rib angle relationship
Where is the lamina groove located?
Between SP and TVP
To access the first rib, you must palpate through which muscles?
Scalenes
What 2 structures pass between the first rib and the clavicle?
Brachial plexus and subclavian artery.
