surface anatomy Flashcards
apophyseal joint palpation L3/4
difficult to palpate / lie just lateral to lower third of the spinous process i.e. L3/4 apophyseal joint lies level with the lower third of L3’s spinous process, approx
How can we palpate erector spinae
patient lies in prone, arms by side
have patient raise upper part and legs down
How can we palpate external oblique
have patient in midprone position
how to palpate cervical spine
run hand down the back of head with two thumbs
feel a bony prominence in the distal end of occiput
then feel a gap = C1, has no spinous process
followed by another small bony prominence is C2
apophyseal joint and how to palpate it
difficult
joint of superior articular process and inferior articular process
once you feel the spinous process move laterally and inferiorly from it.
parts of the lung
apex - top
base - bottom
mediastinal surface - part of lung interacting with heart
hilum - root of lung
costal surface - anterior surface
part of anterior surface of left lung with a crevice for the heart
manubriosternal joint content and vertebral level
manubrium (top part of sternum) + and sternum body
level T4/5
xiphosternal joint and vertebral level
xiphoid process (bottom tip of sternum) and sternum T9
sternocostal/chondrosternal joint
medial costal cartilages of first 1-7th ribs and sternum
costochondral joint
transition between bone to cartilage attached to the sternum
at the anterior end of each rib
interchondral joint
tips of costal cartilages 8th, 9th 10th / lower border of cartilage
costovertebral joint
convex facet of the posterior aspect of ribs with concave facet of vertebrae
costotransverse joint
articular facet of transverse process of vertebrae and tubercle of ribs
palpate suprasternal/ jugular notch
upper border of manubrium at T2 level
thoracic inlet
T1, 1st rib and manubrium
palpate apex of heart
6th rib
5th intercostal space
midclavicular line
palpate costal margin
cartilage connecting to the sternum and to each other from rib 7-10
costal angle
costal cartilage 7-10th ribs, running inferolaterally from xiphisternal joint, together form costal arch, converge L1 = 12th ribs
thoracic outlet
T12, full length R12, tip R11, costal cartilages of R7,8,9,10 Xiphoid process
palpate right border of the heart
3rd costal cartilage to 6th costal cartilage
left border of sternum (your left NOT patient’s left)
palpate left border of the heart
2nd intercostal space to 5th intercostal space (apex of heart)
further right of the sternum
auscultation for aortic valve
2nd intercostal space
right of sternum - patient’s right
auscultation for pulmonary valve
2nd intercostal space
left of sternum - patient’s left
horizontal fissure
4th rib
oblique fissure
4th to 6th rib
auscultation for tricuspid valve
5th intercostal space
left of sternum - patient’s left
auscultation for mitral valve valve
apex of heart
5th intercostal space
midclavicular line of left side of rib - patient’s left
palpate first rib
find clavicle and attachment to manubrium of sternum
move slightly below and feel start of first rib
crosses below clavicle
how to palpate pectoralis major
90 abduction
add resistance
vertebral level of spine of scapula
T3
vertebral level of inferior angle of scapula
T7
Detect valves in retrosternal
3344 (PAMT)
location of pleura
8th cc midclavicular line
10th rib midaxillary line
11th rib line of inferior angle of scapula
12th thoracic spine
Muscles connecting the upper limb to the vertebral column
Trapezius Latissimus Dorsi Levator Scapulae Rhomboid Major Rhomboid Minor
Muscles connecting limb to the thoracic wall
Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior
muscles of the shoulder
Deltoid Subscapularis Supraspinatus Infrapinatus Teres Minor Teres Major
origin and insertion of anterior head deltoid
origin - lateral third of clavicle
insertion - deltoid tuberosity lateral side of humerus
origin and insertion of middle head deltoid
origin - acromion
insertion - deltoid tuberosity lateral side of humerus
origin and insertion of posterior head deltoid
origin - spine of scapula
insertion - deltoid tuberosity lateral side of humerus
origin and insertion of infraspinatus
origin - posterior surface of scapula
insertion - middle facet of humerus
origin and insertion of supraspinatus
origin - supraspinatus fossa of scapula
insertion - superior facet of humerus
origin and insertion of teres minor
origin - lateral border of scapula
insertion - inferior facet of humerus
origin and insertion of teres major
origin - inferior angle of scapula
insertion - intertubercular groove of humerus
origin and insertion of subscapularis
origin - subscapular fossa of scapula
insertion - lesser tubercle of humerus
how to palpate trapezius
patient lying in position
have patient do abduction
add resistance beyond 90 degree abduction
palpate serratus anterior
patient lying in supine position
shoulder flexion with a clenched fist
add resistance to fist
feel lateral side of chest
palpate rhomboids
patient sitting up
dorsum of hand touch lumbar of spine
feel space between vertebrae and lower scapula
palpate latissimus dorsi
patient lying in prone position
shoulder extension
palpate deltoids
patient sitting and 90 degree abduction
anterior deltoid - move arm forward
posterior deltoid - move arm backward
palpate supraspinatus
shoulder abduction
palpate muscle above spine of scapula
palpate infraspinatus
elbow flexion and shoulder abduction - external rotation lag test
palpate hand below spine of scapula
tell patient to move arm back
ratio of degrees of movement between glenohumeral joint and scapulothoracic
Ratio of 2:1
pulses of upper arm
Subclavian artery Axillary artery Brachial artery Radial artery Ulnar artery
content of carpal tunnel
median nerve
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
palpate bicep
patient sitting
dorsum of hand resting on patients thigh - supination
resisted elbow flexion
palpate in upper arm
palpate brachialis
patient sitting
palm of hand resting on patients thigh - pronation
resisted elbow flexion
palpate in upper arm
palpate brachioradialis
patient sitting
hand resting on patients thigh in mid prone
resisted elbow flexion
palpate in lower arm - from wrist to proximal part of arm
palpate tricep
patient sitting
hand resting on patients thigh in prone
resisted elbow extension
palpate in back of upper arm -
palpate pronator teres
patient sitting
hand resting on patients thigh in supine with elbow in flexion
resisted supination
palpate in front of lower arm in proximal region
palpate FCR/FCU
patient sitting
hand resting on patients thigh in supine with elbow in flexion
resisted wrist flexion
feel in wrist
palpate EPL/EPB/APL
extend the thumb
feel in back of arm
