Shoulder Palpation

Question 1

Serratus Anterior

Answer 1

1. Place hands on the side, at the ribs (about halfway of the ribs).
2. Ask patient to raise hand forward and push their hand forward (like heil hitler).
3. Provide resistance if necessary

Question 2

Upper Trapezius

Answer 2

1. Patient lies face down on plinth with both arms beside body
2. Palpate the top of shoulder (b/w the neck and shoulder joint)
3. Ask patient to shrug the shoulders

Question 3

Middle Trapezius

Answer 3

1. Patient lies face down on the plinth
2. Place patient’s arm at 90 degrees abduction (bring arm outwards and off the plinth with the humerus supported and lower arm hanging)
3. Palpate to the medial side of the scapula?
4. Ask patient to lift arm off the bed

Question 4

Lower Trapezius

Answer 4

1. Patient lies face down on the plinth
2. Place arm up (shoulder flexion) a bit diagonally
3. Have patient point their thumb up (good job thumb)
4. Palpate near the bottom of the scapula, closer to the spine
5. Ask patient to lift the arm off the bed

Question 5

Rhomboids Minor

Answer 5

Palpated with Rhomboid Major:
1. Patient sits on plinth (ensure femur fully supported.)
2. Palpate at the lower part of the medial border (dig inwards, like a bit under the scapula).
3. Ask patient to put one hand behind the back (like getting arrested), then ask patient to move hand away from body (like push backwards) - basically shoulder extension

Question 6

Rhomboids Major

Answer 6

Palpated with Rhomboid Major:
1. Patient sits on plinth (ensure femur fully supported.)
2. Palpate at the lower part of the medial border (dig inwards, like a bit under the scapula).
3. Ask patient to put one hand behind the back (like getting arrested), then ask patient to move hand away from body (like push backwards) - basically shoulder extension

Question 7

Levator Scapulae

Answer 7

1. Patient sits on plinth (ensure femur fully supported)
2. Palpate at the lateral side of the neck, slightly behind
3. Ask patient to put one hand behind the back (like gettiing arrested), then ask patient to move hand away from body (like pushing backwards) - shoulder extension

Question 8

Pectoralis Minor

Answer 8

1. Patient sits on plinth (ensure femur fully supported)
2. Palpate over the coracoid process
3. Ask patient to put one hand behind the back (like getting arrested), then ask patient to move hand away from body (like pushing backwards (frm the lower back region)

OR

3. Ask patient to push down on the table as if to elevate the body (push down where tho? where should the hand be placed?)

Question 9

Supraspinatus

Answer 9

1. Patient lies on plinth in prone (face down) with arm over edge of plinth (over the side)
2. Palpate in the supraspinous fossa
3. With one hand, hold the patient’s arm in neutral position
4. Ask patient to perform abduction (bring their arm forward - keep your hand holding the patient’s arm in ~90 degrees)

Question 10

Infraspinatus

Answer 10

1. Patient lies on plinth in prone (face down) with whol arm over side of plinth (whole arm hanging)
2. Palpate in the infraspinatus fossa or at the lateral border of scapula
3. With one hand, hold the patient’s arm in neutral position (90 degrees, unless its alr supported by the plinth)
4. Ask patient to turn palm outwards (externally rotate)

Question 11

Teres Minor

Answer 11

1. Patient lies on plinth in prone (face down) with whole arm over the side of plinth (whole arm hanging)
2. Palpate at the lateral border of scapula more laterally than infraspinatus
3. Ask patient to turn palm outwards (externally rotate)

Question 12

Subscapularis

Answer 12

1. Patient lies on plinth in prone (face down), closer to one side of thte plinth with arm over the side of plinth (whole arm hanging. down)
2. Dig your finger into the armpit towards the back (maybe can feel where the lateral border of scapula is from the outside before digging in so you know what kind of direction you need to go) & try and find the anterior part of the scapula
3. Ask patient to turn the arm inwards (internal rotation)

Question 13

Latissimus Dorsi

Answer 13

1. Patient lies on plinth in prone (face down) with arms on the plinth
2. Palpate below the scapula (can fit whole hand below the scapula, then arorund there)
3. Ask patient to lift up the arm (shoulder extension), provide resistance if needed

Question 14

Teres Major

Answer 14

1. Patient lies on plinth in prone (face down) with whole arm over the side
2. Palpate at the at/over the inferior angle
3. Ask patient to turn arm inwards (internal rotation)

Question 15

Anterior Deltoid

Answer 15

1. Have patient sit on the plinth (femur fully supported)
2. Palpate the front part of the shoulder joint (a bit medially)
3. Ask patient to bring arm up (shoulder flexion)

Question 16

Middle Deltoid

Answer 16

1. Have patient sit on the plinth (femur fully supported)
2. Palpate the middle part of the shoulder (lateral side)
3. Ask patient to lift arm sideways (shoulder abduction)

Question 17

Posterior Deltoid

Answer 17

1. Have patient sit on the plinth (femur fully supported)
2. Palpate near the spine of scapula (behind part of shoulder)
3. Hold patient’s arm bent at 90 degrees and lifted at 90 degrees (90 degrees abduction)
4. Ask patiient to do horizontal shoulder adduction (move arm backwards from step 3

Question 18

Pectoralis Major (Clavicle Head)

Answer 18

1. Patient lying supine (face up) with both arms on plinth
2. Hold patient’s arm up (soft bend) 60 degrees (closer to body)
3. Palpate the clavicular head at the medial part of the clavicle
4. Ask patient to do shoulder adduction

Question 19

Pectoralis Major (Sternocostal Head)

Answer 19

1. Patient lying supine (face up) with both arms on plinth
2. Hold patient’s arm up (soft bend) 120 degrees
3. Palpate around the costal cartilage areas
4. Ask patient to do should adduction