palpation test muscles Flashcards
sternocleidomastiod
turn head to side is long and tubular on neck. action flexion and rotates opposite side.
proximal: manubrium and clavicle. distal: mastoid process
Scalenes
Action: lateral bending. A small group of muscles located between the upper traps and the sternoclediomastoid. Resist gently brachial plexus runs thru this area.
Carotid Artery
below the mandible and anterior SCM. test one side at a time.
Muscles of mastication:
Temporalis: open close jaw,, palpate temple area and Masseter close jaw tightly, palpate superior mandibular angle.
Rectus abdominus
position: supine action: trunk flexion and palpate from proximal pubis symphysis to xiphiod process, 5th and 7th costal.
External Oblique
position: supine action: flexes and rotates trunk
proximal: 5th to 12th ribs.
distal anterior iliac crest
Reach to opposite side the muscle is in V in upward.
Internal oblique
position: supine
action: flexes and rotates trunk
proximal:anterior iliac crest
Distal: inferior border of 10th to 12th ribs.
Reach to opposite side the muscle is in V in downward
Transverse Abdominus
Position: supine ( a band across the belly)
action: compresses and supports abdominal viscera. helps cough
proximal: 7th to 12th costal, iliac crests and inguinal ligament area.
Distal linea alba
palpate on the lateral aspect of the abdomen between ribs and iliac crest and have them cough.
pectoralis major
action: horizontal adduction
proximal: medial half of clavicle; sternum
distal: lateral lip of intertubercular groove
For the clavicular head, have partner move arm medially and upward and apply resistance. For the sternal head, move arm medially and downward and apply resistance.
pectoralis minor
action: draws scapula inferiorly and anteriorly against the thoracic wall
proximal: 3rd to 5th ribs
Distal: coracoid process
palpate: have partner put their hand behind their back with elbow flexed and shoulder internally rotated. then have them raise hand away from back. palpate at coracoid
Serratus Anterior
action: scapula protraction and upward rotation
proximal: 1st to 8th ribs
distal: medial border of scapula
palpate: . You will feel tension and not protrusion of this flat muscle. Punch arm out make fist, push fist back for resistance. palpate under breast rib area.
Anterior, Middle, Posterior Deltoid
Anterior: FW flexion or horizontal adduction
proximal: lateral 3rd of clavicle
distal: deltoid tuberosity
palpate: shoulder flexion, palpate anterior more middle
Middle: action: abduction
proximal: acromion
distal: deltoid tubercle
palpate: lift arm up laterally ( shoulder meat)
Posterior: action: extension or horizontal abduction
proximal: spine of scapula
distal: deltoid tubercle
palpate: lift arm up pull back and push FW palpate posterior part of shoulder.( tear drop muscle)
Upper trapezius
action: scapular elevation
proximal: occipital protuberance
distal: lateral 1/3 of clavicle, spine of scapula inserts on acromion.
Palpate: have partner elevate shoulder. resist at acromion. Walk fingers from acromion to baseline of hair.
middle trapezius
position: prone
action: scapular adduction
proximal: spinous process of C7 to T4
distal: acromion and spine of scapula
palpate: partner abduct arm, place your fingers between the vertebral column and scapular spine. Have partner retract scapula by lifting arm away from mat. OR (Lift elbow up and push against)
rhomboids
position: sitting or prone
action: scapular adduction and downward rotation
proximal: spinous process C7 to T5
distal: base of spine of scapula to inferior angle
palpate: hand behind back, upper part of scapula. have partner push fist posteriorly while you reist motion. Palpate the muscle obliquely and downward across the 2 inch space between spinous process and medial border of the scapula
Lower Trapezuis
position: prone
action: scapular depression and adduction
proximal: spinous process T5-T12
distal: spine of scapula
palpate: have partner position arm parallel to head , place your hand on the lower medial aspect of scapular spine with fingers diagonally downward toward the vertebral column. Ask them to lift their hand off the matt.
Supraspinatus (rotator cuff)
action: shoulder abduction
proximal: supraspinatus fossa
distal: greater tubercle of humerus
palpate: Have partner abduct shoulder while palpating muscle belly above the scapular spine.(arm up like lever push and palpate)
Teres minor and infraspinatus ( rotator cuff)
position: stand
action: shoulder external rotation
proximal Teres minor: superior lateral border od scapula and distal: intertubercular groove
palpate: Teres minor, roll shoulder out into rotation
Infraspinatus: have partner bend over and exteranll rotate at glenohumeral joint, turning palm as far as possible. Palpating on infraspinatus fossa and on lateral border of scapula
proximal attachment: infraspinatus fossa
distal: greater tubercle
Subscapularis
position: stand
action: shoulder internal rotation
proximal: subscapular fossa
distal: lesser tubercle of humerus
palpate: Therapist hand in axilla region ( arm pit) have partner rotate hand internal rotation
Teres major ( swimmer muscle)
position: stand
action: shoulder internal rotation and adduction
proximal : inferior angle of scapula
distal: intertubercular groove
palpate: partner place arm flexed at shoulder, extended at elbow, in some abduction on shoulder. contract and relax rib cage area then palpate lateral border of scapula and posterior fold of axilla. The teres major is superficial and latissumus dorsi angles more caudally.
Latissimuss Dorsi
Position; Stand
action: shoulder internal rotation and adduction
proximal: thoracolumbar fascia, spinous processes
distal: intertubercular groove
palpate: partner place arm flexed at shoulder, extended at elbow, in some abduction on shoulder. contract and relax rib cage area then palpate lateral border of scapula and posterior fold of axilla. The ters major is superficial and latissumus dorsi angles more caudally
biceps brachii
action: elbow flexion
proximal: short head: coracoid process
Long head: supraglenoid tuberosity
distal: radius
palpate: flex elbow against resistance. Biceps more prominent when flexed at 90 degree. Begin palpation distally where the muscle is tendinous, then palpate proximally until you feel the bicpital groove and tendon of the long head.
Brachialis
action; elbow flexion
proximal: anterior aspect of humerus
distal: ulna. tuberosity and coracoid process
palpate: deep to tendon of biceps. patient flex elbow with forearm in pronation
Brachioradialis
action: elbow flexion
proximal: lateral supracondylar ridge of humerus
distal: radial styloid process
palpate: close fist, place the forearm in neutral position under the edge of table, and then lift up against the weight of the table.
Ulnar nerve
The ulnar nerve is situated in the sulcus (groove) between the medial epicondyle and the olecranon process.
palpate: by gently rolling it under the index and middle finger.
Brachial artery
The pulse of the brachial artery can be felt directly medially to the biceps tendon.
Triceps bracheii
action: elbow extension
proximal: long head: infraglenoid tubercle
lateral head: posterior surface of humerus superior to radial groove
medial head: posterior surface of humerus inferior to radial groove.
distal: olecranon
palpate: patient lean on a table as if supporting weight on a crutch.
pronator teres
action: pronation
proximal: medial epicondyle of humerus
distal: middle of radius
Supinator
action: Supination
proximal: lateral epicondyle
distal: lateral 1/3 of radius
Flexor carpi radialis
action: wrist flexion, radial deviation
proximal: medial epicondyle humerus
distal: base of 2nd metacarpal
palpate: flex and make fist then partner resists and it pops up
Palmaris longus
action: wrist flexion with thumb and little finger opposition
proximal: medial epicondyle
distal: flexor retinaculum and palmer aponeurosis
palpate: thumb opposition palmaris pops out
flexor carpi Ulnaris
action: ulnar deviation
proximal: epicondyle
distal: base of 5th metacarpal, includes pisiform tendon.
palpate: make fist and flex then partner resists. Muscle pops up on pinky side
flexor digitorum superficialis
position: sitting with forearm supinated resting on table.( PIP)
action: finger flexion, wrist flexion
proximal: medial epicondyle
distal; middle phalanges of fingers
palpate: hold finger at base, resist feel just proximal to wrist
have partner flex the pip joint of each finger to activate the FDS
flexor digitorum profundus
position: sitting with forearm supinated resting on table.( DIP)
action: finger flexion, wrist flexion
proximal: ulna, interosseous membrane
distal: distal phalanges of fingers
palpate: block everything but DIP resist, feel muscle bulk in forearm.
have partner flex the DIp of each finger to activate the FDP.
radial artery
lateral to the flexor carpal;radialis, just proximal to the wrist.
ulnar artery
less prominent than the radial pulse. Located proximal to the tunnel of guyon
Extensor Carpi radilais longus
action: wrist extension, radial deviation
proximal: lateral supracondylar ridge of humerus
distal; base of 2nd metacarpel bone
palpate: extend wrist and ulnarly deviate. The muscle follows the ulnar border of the forearm to its proximal attachment. feel all the way to lateral epicondyle. The ECU passes over the ulnar styloid process.
Extensor Digitorum Communis
position: forearm pronated and resting on table
proximal: lateral epicondyle
distal: fascia of fingers
palpate: extend fingers like a cat clawing couch!
will see them coming off the fingers to wrist.Each of the extensor tendons should be palpated between the carpals and the Mp joints follow it to the muscle belly of the arm.
Extensor digiti minimi
position: forearm pronated and resting on table
proximal: lateral epicondyle
distal: fascia of the 5th finger
palpate: wiggle and extend pinky finger follow it proximally into the forearm.
extensor indicis
position: forearm pronated and resting on table
proximal; ulna
distal: fascia of index finger
palpate; pick pointer finger up and down can see muscle move by epicondyle.
Anatomic snuffbox
the radial border of the box is composed of abductor pollicis longus( more palmer), and the extensor pollicis brevis ( more dorsal) tendons.
palpate: wiggle thumb anterior/posterior to distinguish between the two. the ulnar border is the extensor pollicis longus palpate to midarm ulnar side.
flexor pollicis longus
To palpate tendon feel at MP joint while partner flexes IP joint
abductor pollicis brevis A thenar
palpate radial surface of thenar eminence while partner abducts thumb with resistance.
Flexor pollicis Brevis F thenar
palpate medial thenar eminence while partner flexes MCP joint. Flex at MCP joint and resist (block IP joint with finger)
opponens pollicis O thenar
palpate middle of thenar eminence while partner opposes thumb and fifth digit. ( pull thumb out and resist with pointer finger)
Adductor pollicis
palpate in web space between metacarpals of 1 and 2 while partner adducts thumb.Resist at IP
Abductor digiti minimi A hypothenar
most medial.To palpate resist abduction to pinky finger and palpate ulnar border of the hand.
Flexor digiti minimi F hypothenar
middle section. To palpate flex pinky resist at MCP joint. Palpate at the head of the 5th metacarpal while partner flexes MP joint.
opponens Digiti minimi O hypothenar
most inside when cup hand. palpate over the radial side of the hypothenar eminence while partner opposes thumb to 5th digit.
