Palpations

Question 1

Palpate the Suprasternal Notch

Answer 1

• Top of the sternum

- Inferior margin of deep hollow at the base of the neck

Question 2

Palpate the Sternoclavicular Joint

Answer 2

-At the medial end of the clavicle

Question 3

Palpate the Clavicle

Answer 3

• Palpate laterally along the shaft
• Medial 2/3 convex anteriorly
• Lateral 1/3 concave

Question 4

Palpate the Corcoid Process

Answer 4

• Anterior projection below lateral part of clavicle

- Place thumb on the process and hand on the shoulder

Question 5

Palpate the Spine of the Scapula

Answer 5

-Small triangular area on scapular medially, which increases in size as you move laterally across it

Question 6

Palpate the Acromion

Answer 6

• Expanded lateral end of the spine of scapular

- Can find by palpating laterally from the clavicle or by palpating along the spine of the scapula

Question 7

Palpate the Inferior Angle of the Scapular

Answer 7

• Move along medial border of scapular until you find an inferior point (lowest point of scapular)
• The inferior angle moves laterally when the arm abducts

Question 8

Palpate the Greater Tuberosity of the Humerus

Answer 8

• Most lateral bony point at the shoulder
• Found by palpating the lateral margin of acromion and then running ringers of its edge

-Place 3 fingers along the line of the shoulder joint. Greater trochanter felt during internal rotation

Question 9

Palpate the Lesser Tuberosity of the Humerus

Answer 9

• Can be felt through the deltoid, just lateral to the tip of the coracoid process
• Can be felt to external rotation of the shoulder joint

Question 10

Palpate the Medial Epicondyle of the Humerus

Answer 10

Prominent bony point at the distal end of humerus on the medial side

Question 11

Palpate the Medial Supracondylar Line of the Humerus

Answer 11

Running upwards from medial epicondyle, the sharp ridge can be palpated

Question 12

Palpate the Lateral Epicondyle of the Humerus

Answer 12

At the base of a dimple on the lateral aspect of the elbow

Question 13

Palpate the Lateral Supracondylar Line of the Humerus

Answer 13

Running upwards from the lateral epicondyle

Question 14

Palpate the Olecranon Process

Answer 14

-Upper and posterior aspect of the elbow. Forms the point of the elbow in flexion

Question 15

Palpate the Olecranon Fossa

Answer 15

• In relaxed elbow flexion can be felt through triceps tendon
• When extending the elbow the fossa disappears as the olecranon process pushes it out

Question 16

Palpate the Ulna border to Ulna Styloid

Answer 16

• Can palpate the posterior border along its length

- Styloid is posterior part at the distal end

Question 17

Palpate the Radial Head

Answer 17

• In a dimple on the posterior aspect of the elbow (particularly in elbow extension)
• Can pronate / supinate hand to check you’re on the radial head

Question 18

Identify the surface markings of the cubital fossa

Answer 18

Triangular space

• Bordered laterally by Brachioradialis
• Medially by Pronator Teres
• Superiorly by an imaginary line drawn between the 2 epicondyles of the humerus

Question 19

Identify the groove in which the ulnar nerve sits

Answer 19

-Groove behind the medial epicondyle (ulnar nerve is known as the ‘funny bone’ - humerus)

Question 20

Identify the Biceps Tendon

Answer 20

-Best palpated in 20 degrees elbow flexion, resisting elbow flexion
From the biceps insertion draw in: (medial) median nerve/ brachial artery/ biceps insertion/ radial nerve (lateral)

Question 21

How do you find the Brachial Pulse?

Answer 21

-Medial to biceps tendon

Question 22

Palpate the Scaphoid

Answer 22

• On the lateral side of carpus, just proximal to distal wrist crease the tubercle can be palpated
• Anatomical snuff box
• Scaphoid pops up if you ulna deviate

Question 23

Palpate the Trapezium

Answer 23

• Find scaphoid, palmar side (pronation)
• Move up the thumb to the phalanges
• Trapezium is just of the scaphoid (between base of 1st metacarpal)
• If you move your thumb it doesn’t move

Question 24

Palpate the Trapezoid

Answer 24

• Between scaphoid and base of 2nd MC

- Hardest bone to find

Question 25

Palpate Capitate

Answer 25

• Slide proximally from the 3rd MC

- Dip on dorsum side of the hand

Question 26

Palpate Lunate

Answer 26

• Just medial to tubercle of scaphoid

- Proximal to capitate (with flexion of the wrist it becomes prominent)

Question 27

Palpate Triquetral

Answer 27

-Under pisiform

Question 28

Palpate Pisiform

Answer 28

-On medial side of carpus at proximal part of the hypothenar eminence

Question 29

Palpate the Hook of Hamate

Answer 29

-Immediately distal and slightly lateral to pisiform
(go from pisiform and place thumb diagonally in line with the pt’s thumb)
-This bone is uncomfortable to palpate because the ulna nerve runs closely to here

Question 30

Palpate the Radial and Ulna styloid processes

Answer 30

• Ulna styloid is posterior part of ulna at the distal end

- Radial styloid is lateral part of radius at the distal end

Question 31

Where does the flexor retinaculum attach to?

Answer 31

• Attaches medially to pisiform and the hook of hamate

- Laterally to the scaphoid tubercle and to the groove on the trapezium

Question 32

Identify the extensor retinaculum?

Answer 32

-From the radial styloid and distal 2cm of radius running obliquely to ulnar styloid and 2cm beyond (base 5th MC)

Question 33

How would you find the Radial Artery?

Answer 33

Lateral to Flexor Carpi Radialis Tendon, proximal to wrist joint

Question 34

How would you find the Ulna Artery?

Answer 34

-Just medial to pisiform