Unit 1: Quiz 1 Flashcards
Patient Position
Scapula
- Prone (except coracoid process)
- can put pt arm to side or hand behind back
Inferior angle
serves as home base for scap palpation
Medial border
palpate from inferior angle to superior angle
Superior angle
palpate from inferior angle superiorly along medial border
Root of Spine of Scapula
ROSOS
where the spine of the scapula meets the medial border
Acromion process
- lateral/distal most aspect of spine of scapula
- Sits on top of shoulder
- little shelf/table you can rest your fingers on
Lateral border
from inferior angle, move laterally and superiorly toward axilla until lose border under muscles
Infraspinous Fossa
bordered by inferior angle, spine of scapula, medial border & lateral border
Supraspinous Fossa
bordered by spine of scapula, superior angle, and medial border
subscapular fossa
entire ventral/anterior surface of scapula
Patient position
Anterior shoulder girdle & prox. humerous palpation
seated
Dr. position
Anterior shoulder girdle & prox. humerous palpation
stand behind patient, off to side being palpated
Palpation
clavicle
follow spine of scapula to acromion, palpate from distal end at AC jt to proximal end at SC jt.
palpation
jugular notch of sternum
follow spine of scapula to acromion, palpate medially along clavicle to pt’s midline to feel notch
palpation
manubrium
palpate jugular notch then drop inferiorly onto the flat surface of manubrium
Palpation
AC joint
- follow spine of scapula laterally to acromion
- as you slide slightly medial you will feel a step or a ledge - this is the distal end of clavicle
- with one finger on step and one on acromion, middle finger falls on AC jt
- have pt shrug shoulder
palpation
SC joint
- follow spine of scapula laterally to acromion, then palpate medially along clavicle to manubrium
- with one finger on manubrium and one on proximal clavicle, middle finger will be on SC jt
- have pt shrug or circle motion w shoulder
Patient position
Coracoid process
seated
Palpation
coracoid process
- drape fingers of outside hand over pt’s acromion with fingers pointing inferiorly amd slightly medial
- gently press posteriorly just below the clavicle
- should feel like a pencil eraser underneath muscle
patient position
greater tubercle, lesser tubercle, intertubercular groove
seated
Palpation
greater tubercle, lesser tubercle, intertubercular groove
- drape fingers of inside hand over acromion so fingertips fall on anterolateral surface of head of humerus
- using outside hand to turn humerus into external rotation, the first most lateral bump is greater tubercle
- followed by the groove
- followed by smaller more medial bump of lesser tubercle
- index finger will be on greater tubercle, middle finger in groove, ring finger on lesser tubercle
palpation
deltoid tuberosity
- from acromion, slide fingers laterally and drop inferiorly along lateral aspect of humerus and feel for small, low bump about 1/2 way along shaft of humerus
- pt can resist adbuction of shoulder to contract deltoid muscle
Landmark
acromion process
T2 SP
Landmark
ROSOS
interspinous space of T3/4
Landmark
inferior angle
T7 SP
Upper section of T-spine
T1-4
Middle section of T-spine
T5-8
Lower section of T-spine
T9-12
palpation
laminae
slide finger slightly lateral and superior from SP in diagonal direction 1 finger away from SP
palpation
laminae/laminae junction
facet joints
palpate superiorly to interspinous space above the more superior segment listed then directly lateral into lamina groove
palpation
transverse process
upper & lower section
palpate superiorly one level to SP above then laterally past lamina groove or 2 fingers lateral to SP (up 1 and out)
palpation
transverse process
middle section
- palpate superiorly to SP above and continue superiorly to interspinous space above that SP (up 1 1/2 and out)
- confirm by pressing on it with thumb while keeping finger on SP and feeling for motion of SP under finger
palpation
costotransverse joint
- palpate superiorly to SP above and continue superiorly to interspinous space above that SP (up 1 1/2 and out)
- confirm TP by pressing on it with thumb while keeping finger on SP and feeling for motion of SP under finger
- slide lateral from TP (finger width) to be on costotransverse joint (3 fingers from SP)
Rotator cuff muscles
SITS
- S= Supraspinatus
- I= Infraspinatus
- T= Teres minor
- S= Subscapularis
Patient/Dr position
Supraspinatus
- Pt. seated
- Dr. standing behind palpated shoulder
Origin/insertion
supraspinatus
O: supraspinatus fossa of scapula
I: greater tubercle of humerus
Fiber direction
Supraspinatus
medial to lateral, passing beneath acromion process
Patient/Dr position
Infraspinatus
Pt: seated
Dr: standing behind palpated shoulder
Origin/insertion
Infraspinatus
O: infraspinatus fossa of scapula
I: greater tubercle of humerus
Fiber direction
Infraspinatus
Medial to lateral and inferior to superior
Patient/Dr position
Teres minor
Pt: seated
Dr: standing behind palpated shoulder
orgin/insertion
teres minor
O: upper 2/3 of lateral border of scapula
I: greater tubercle of humerus
fiber direction
teres minor
medial to lateral and inferior to superior
Patient/Dr position
subscapularis
Pt: supine
Dr: seated/kneeling at pt’s side between arm and thorax
origin/insertion
subscapularis
O: subscapular fossa of scapula
I: lesser tubercle of humerus
fiber direction
subscapularis
medial to lateral and posterior to anterior, through the axilla
Patient/Dr position
deltoid muscle group
Pt: seated
Dr: standing behind palpated shoulder
orgin/insertion
deltoid group
O: lateral 1/3 of clavicle, acromion, spine of scap
I: deltoid tuberosity of humerus
fiber direction
deltoid group
proximal to distal
