Palpations Flashcards
Palpate the Suprasternal Notch
- Top of the sternum
- Inferior margin of deep hollow at the base of the neck
Palpate the Sternoclavicular Joint
-At the medial end of the clavicle
Palpate the Clavicle
- Palpate laterally along the shaft
- Medial 2/3 convex anteriorly
- Lateral 1/3 concave
Palpate the Corcoid Process
- Anterior projection below lateral part of clavicle
- Place thumb on the process and hand on the shoulder
Palpate the Spine of the Scapula
-Small triangular area on scapular medially, which increases in size as you move laterally across it
Palpate the Acromion
- 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
Palpate the Inferior Angle of the Scapular
- 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
Palpate the Greater Tuberosity of the Humerus
- 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
Palpate the Lesser Tuberosity of the Humerus
- 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
Palpate the Medial Epicondyle of the Humerus
Prominent bony point at the distal end of humerus on the medial side
Palpate the Medial Supracondylar Line of the Humerus
Running upwards from medial epicondyle, the sharp ridge can be palpated
Palpate the Lateral Epicondyle of the Humerus
At the base of a dimple on the lateral aspect of the elbow
Palpate the Lateral Supracondylar Line of the Humerus
Running upwards from the lateral epicondyle
Palpate the Olecranon Process
-Upper and posterior aspect of the elbow. Forms the point of the elbow in flexion
Palpate the Olecranon Fossa
- In relaxed elbow flexion can be felt through triceps tendon
- When extending the elbow the fossa disappears as the olecranon process pushes it out
Palpate the Ulna border to Ulna Styloid
- Can palpate the posterior border along its length
- Styloid is posterior part at the distal end
Palpate the Radial Head
- 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
Identify the surface markings of the cubital fossa
Triangular space
- Bordered laterally by Brachioradialis
- Medially by Pronator Teres
- Superiorly by an imaginary line drawn between the 2 epicondyles of the humerus
Identify the groove in which the ulnar nerve sits
-Groove behind the medial epicondyle (ulnar nerve is known as the ‘funny bone’ - humerus)
Identify the Biceps Tendon
-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)
How do you find the Brachial Pulse?
-Medial to biceps tendon
Palpate the Scaphoid
- 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
Palpate the Trapezium
- 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
Palpate the Trapezoid
- Between scaphoid and base of 2nd MC
- Hardest bone to find
Palpate Capitate
- Slide proximally from the 3rd MC
- Dip on dorsum side of the hand
Palpate Lunate
- Just medial to tubercle of scaphoid
- Proximal to capitate (with flexion of the wrist it becomes prominent)
Palpate Triquetral
-Under pisiform
Palpate Pisiform
-On medial side of carpus at proximal part of the hypothenar eminence
Palpate the Hook of Hamate
-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
Palpate the Radial and Ulna styloid processes
- Ulna styloid is posterior part of ulna at the distal end
- Radial styloid is lateral part of radius at the distal end
Where does the flexor retinaculum attach to?
- Attaches medially to pisiform and the hook of hamate
- Laterally to the scaphoid tubercle and to the groove on the trapezium
Identify the extensor retinaculum?
-From the radial styloid and distal 2cm of radius running obliquely to ulnar styloid and 2cm beyond (base 5th MC)
How would you find the Radial Artery?
Lateral to Flexor Carpi Radialis Tendon, proximal to wrist joint
How would you find the Ulna Artery?
-Just medial to pisiform
