Palpation-A&P2Lab
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Scaphoid | deep in the anatomical snuffbox ("some" in SLTPTTCH) | show 🗑
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Lunate | show |
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show | just distal to ulnar styloid process ("try" in SLTPTTCH) |
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show | distal to scaphoid- begin on thumb-> move proximal= trapezium ("that" in SLTPTTCH) |
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show | just proximal to base of the 2nd metacarpal ("they" in SLTPTTCH) |
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show | just proximal to the base of the 3rd metacarpal ("can't" in SLTPTTCH) |
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show | just proximal to ases of 4th and 5th metacarpals ("handle" in SLTPTTCH) |
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Radial Artery | anterior forearm, between flexor carpi radialis and the radial shaft just proximal to wrist crease where the pulse is taken/analyzed | show 🗑
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show | anterior forearm, between flexor carpi ulnaris and palmaris longus, just proximal to wrist crease |
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show | locate distal tendon of palmaris longus and displace it laterally very superficial palpable cord | Carpal Tunnel Syndrome- #1 most common upper extremity nerve entrapment- compression of median nerve in carpal tunnel
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Ulnar Nerve | show | Cubital Tunnel Syndrome- inflammation of Ulnar nerve due to chronic compression or stretching
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Brachialis | show | strong elbow flexor
b. brachii overlies brachialis
O: distal 1/2 of humeral anterior surface
I: tuberosity and coronoid process of ulna
A: flex humeroulnar joint
N: musculocutaneous
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Pronator Teres | show | O: meidal epicondyle of humerus, common fleor tendon and coronoid process of ulna
I: middle of lateral surface of radius
A: pronate RU joint(rapid or forceful pronation); synergist to elbow flexors (very weak)
N: meidan-> actually goes through the musc
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Supinator | come directly lateral (& maybe anterior) and it will be the only thing that tenses up on supination | show 🗑
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Ulnar groove | show |
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Brachial Artery | locate medial and posterior to the tendon of b. brachii at elbow | show 🗑
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Median Cubital Vein | show |
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Radial Nerve | distal to elbow crease, just lateral to brachioradialis | show 🗑
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Pectoralis minor | show | O: ribs 3. 4. 5
I: coracoid process of scapula
A: depress ST joint, abduct scapula, assists in inhalation
N: medial pectoral
can entrap brachial plexus(TOS)
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Coracobrachialis | supine- shoulder is ext. rotated and abducted- locate coracoid, have patient horizontally adduct proximal to biceps on medial surface of mid-humerus medial aspect roll medial to short head of biceps | show 🗑
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show | coronal plane inferior to latissimus and have patient 1in. punch | accessory breathing muscle
weakness= winged scapula
test= standing (wall) push up
"boxer's muscle"
O: surfaces ribs 1-8
I: ant surface of med border of scapula
A: aBduct, depress, hold med. border of scap.
N: long thoracic
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show | prone- handcuff, come in under medial border OR arms up in EXT rotation grab hunk in coronal plane | 3 of 4 rotator cuff muscles
O: subscapular fossa of the scap
I: lesser tubercle of humerus
A: internally rotate GHJ, stabilize head of humerus in glenoid
N: subscapular nerve
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show | prone- posterior to SCM and anterior to trapezius- middle of posterior triangle- rotate head ipsilaterally | elevates scapula
O: TP of C1-C4
I: upper medial border and superior angle of scapula
A: unilaterally- elevate scapula, rotate scap downward, lat. flex neck ipsilaterally, rotate head ipsilaterally
N: dorsal scapular and cervical nerves
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Coracoid Process | hand on person's oppo. shoulder and thumb should land on coracoid | show 🗑
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Extensor Digitorum Longus | show | O: proximal ant. shaft of fibula and interosseous membrane
I: middle and distal phalanges of 2-5 digits
A: extend 2-5 digits, dorsiflex and evert foot
N: deep peroneal
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show | (most lateral above ankle- middle below ankle) pinch snuffbox- dorsiflex v. resistance mid snuffbox= EHL | O: middle ant. surface of fibula and interosseous membrane
I: distal phalange of hallux
A: extend hallux, dorsiflex and invert the foot
N: deep peroneal
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Tibialis posterior | show | too many toes test
limits pronation of foot
supinator
post. shin splints
O: prox. post. shaft of tibia, prox. tibia and interosseous membrane
I: navicular, cuneiforms, cuboid and bases of 2-4 metatarsals
A: inversion and plantarflexion
N: tibial
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show | dorsiflex & curl big toe- lat. 1/3 (L to M, FHL->TP->FDL) | O: middle 1/2 posterior fibula
I: distal phalange of hallux
A: flex hallux at MTP and IP joints, invert foot, weak plantarflexion
N: tibial
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show | flex digits, invert foot (L to M, FHL->TP->FDL) | O: middle posterior surface of tibia
I: distal phalange of 2-5 digits
A: flex 2-5 digits at MTP, PIP and DIP joints, invert foot, weak plantarflexion
N: tibial
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show | shelf-like promenence located a fingers-width below medial malleolus |
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Cuneiforms (3) | show |
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Tarsal tunnel | just posterior and inferior to the medial malleolus contains tendons of TP, FDL, and FHL, posterior to tibial artery and tibial nerve | show 🗑
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show | plantarflex and adduct foot to expose ligament runs from middle part of ant. surface of lateral malleolus and inserts into the lateral talus | #1 ankle sprain tear
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Dorsal Pedis Artery | show |
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Posterior Tibial Artery | invert foot and palpate posteriorly to the medial malleolus | show 🗑
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Sartorius | show | longest muscle in the body
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Popliteal artery | show |
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piriformis | prone- knee bent- resisted external rotation of thigh-- near distal end of glutes | show 🗑
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Adductor magnus | supine near edge of table leg in full ABduction- have patient aDduct with toe rotated outward (slightly distal and medial to longus) | show 🗑
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show | supine- leg in full ABduction- have patient aDduct with toe toward sky | most anterior of adductor group
O: pubic tubercle
I: medial lip of linea aspera
A: adduct and INT rotate hip; assist w/hip flexion
N: obturator
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Tensor Fascia Lata and Iliotibial tract | show | TFL controls IT Band
O: iliac crest, posterior to ASIS
I: iliotibial tract
AL flex hip, abduct hip, internal rotation of hip
N: superior gluteal
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Gracilis | show | O: inferior ramus of pubis and ramus of ischium
I: proximal medial shaft of tibia at pes anserine tendon
A: adduct hip, internally roatate hip, flex knee, and internally rotate flexed knee
N: obturator
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show | with hip in neutral position, palpate 1/2way b/t the ASIS and pubic symphysis with light pressure and feel for the pulse |
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femoral nerve | show |
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sciatic nerve | with patient sidelying or prone, palpate 1/2way b/t with greater trochanter and the ischial tuberosity the nerve is approx. the width of finger and easy to feel (deep) | show 🗑
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show | prone- paraspinal gutter- L2 find spinous process-> gutter, bottom out- feel structure of multifidus sup-med,inf-lat like little chevrons S1 base of sacrum- paraspinal gutter- deep to erector spinae | deep to erector spinae, span 3-4 levels above, TP locales C3, T4-5, L2, S1
O: sacrum and transverse process of L-C vert.
I: spinous processes of L-2nd C vert.
A: uni-rotate spine contralat
bi- extend spine
N: dorsal rami of lacal spinal nerves
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show | supine with knees bent 3 fingers palpate 1 fingerbreadth lateral to linea alba just above umbilicus | favors left side
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show | locate spinous processes- A&P 1 |
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sacral base | prone- palpate the superior aspect of the sacrum | show 🗑
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medial sacral crest | middle posterior aspect of sacrum- use broad fingertip contact | show 🗑
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show | depression at caudal end of medial sacral crest |
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lateral border of sacrum | prone- approach medially with prone patient's gluteal muscle relaxed | show 🗑
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show | mouth open 1 inch anterior to mandibular condyle | temporalis attaches here
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show | band slightly proximal to wrist crease-shake hands v. resistance | O: med. ant. surface of distal ulna
I: lat. ant. surface of the distal radius
A: PRONATE Radiounlar joint
N: MEDIAN
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Created by:
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