Question 1= Surface markings

Question 1

The glenohumeral joint

Answer 1

Position of the joint approximately 1 cm lateral to the apex of the coracoid process.
A vertical line, slightly concave laterally, through this point gives an indication of the joint line.
The humeral head can be palpated which lies lateral to the joint line
- supraglenoid fossa
- infraglenoid fossa
- joint medial to acromion process

Question 2

The sternoclavicular joint

Answer 2

Synovial saddle (sellar) joint between the medial end of the clavicle and the manubrium of the sternum.
You can palpate this joint at the upper lateral corner of the manubrium sterni. Draw a curved line concave laterally. It is approximately 1cm in length, extending over the lower half of the medial surface of the clavicle, passing inferolaterally for approximately 0.5cm.

• medial to subclavian groove

Question 3

The acromioclavicular joint

Answer 3

Between a facet on the lateral end of the clavicle and a facet on the anteromedial border of the acromion.
Is immediately lateral to the anterior concavity of the lateral one-third of the clavicle, approximately 1.5cm medial to the lateral border of the acromion process

-corocoid process (inferior/medial)

Question 4

The elbow joint

Answer 4

Draw a line from a point 2cm distal to the tip of the medial epicondyle to a point 1cm distal the tip of the lateral epicondyle of the humerus. The line passes inferiorly and medially due to the medial margin of the trochlea projecting down further than the lateral margin

• olecranon process
• anterior ulnar it coronoid process
• lateral supra-epicondylar ridge (superior)

Question 5

The proximal radio-ulnar joint

Answer 5

Anteriorly and posteriorly draw a vertical line 1cm distal from joint line of elbow and
2cm medial from lateral edge of the head of the radius
NB palpate head of radius during pronation and supination

• coronoid process (medial)
• olecranon process (posterior)

Question 6

The distal radio-ulnar joint

Answer 6

Palpate the joint line 1.5cm lateral to the medial edge of the head of the ulna running 1cm proximal to the joint line of the wrist

• either side- radial and ulnar styloid processes

Question 7

The wrist complex

Answer 7

A concave line drawn from the tips of the styloid processes of the radius and ulna. The line becomes increasingly curved as it approaches the styloid processes.

• head of the ulna (proximally)

Question 8

The 1st carpometacarpal joint (of the thumb)

Answer 8

Trace proximally along the back of the first metacarpal to its enlarged base, beyond which is a depression. At this point palpate the joint line on either side of the tendon of extensor pollicis longus

• styloid process of the radius

Question 9

The hip joint

Answer 9

Identify the inguinal ligament that lies between the ASIS and symphysis pubis
The centre of the joint lies 1-2cm distal to the mid-third of inguinal ligament

-superior pubic Ramus
Inferior pubic ramus
-iliac crest (superior)
- pubic tubercle + crest (medial)

Question 10

The knee joint

Answer 10

This is easiest in sitting or crook lying with the knee flexed to 90’:
place the thumbs either side of the patella and slide ‘upwards’ to palpate the gap between the tibial condyles and the femoral condyles
draw a line which bisects the ligamentum patella horizontally halfway between the lower tip of the patella and the tibial tuberosity
or draw a line horizontally 1cm above the tip of the styloid process of the fibula

Question 11

The patella-femoral joint

Answer 11

Articulation between posterior surface of patella and intercondylar groove of femur

• tibial lateral and medial condyles
• tibial tuberosity
• medial and lateral epicondyles of the femur

Question 12

The superior {proximal] tibio-fibular joint

Answer 12

The joint can be represented, both anteriorly and posteriorly, by a line 1.5cm in length running inferomedial to the head of the fibula

• lateral condyle of tibia
• medial and lateral epicondyles of the femur

Question 13

The inferior [distal] tibio-fibular joint

Answer 13

Draw a vertical line 2.5cm long running superiorly from the line of the ankle joint on the medial side of the lateral malleolus

• medial malleolus

Question 14

The ankle joint

Answer 14

Draw a horizontal line across the anterior surface of the ankle 2cm above the tip of the medial and 3cm above that of the lateral malleolus. This marks the superior limit of the joint. it is continued down the medial side of the lateral malleolus and the lateral side of the medial malleolus to their tips which completes the joint line

• calcenous (inferior and posterior)

Question 15

The subtalar

Answer 15

Draw a line running horizontally from 1cm distal to the tip of the lateral malleolus to a point 1.5cm distal to the medial malleolus

• calcaneous bone
• talus bone