Week 11 Palpation of Landmarks (Upper Body) Saturday 30 April 2016 09:00-12:00 Bones to Palpate • Scapula • Clavicle • Humerus • Radius • Ulna • Carpals Scapula 1 Scapula • Spine – From AC joint palpate across the upper part of the posterior surface of the scapula. It is a long (3”) thin projection, which runs medial to lateral, at T3 level. • Acromion process – Located on the lateral part of the shoulder, right above the shoulder joint. • Coracoid process – Palpate under the lateral part of the clavicle (about one inch below the anterior edge of the clavicle). • Medial (vertebral) border – The edge of the scapula closest to the vertebral column (about 2 inches from the spinous processes). The medial border runs in a superior-inferior direction. • Lateral (axillary) border – The lateral (or outer) edge of the scapula located between the inferior angle and the shoulder joint. • Superior medial angle – Located above the vertebral border or medial aspect of scapula, level T2. • Inferior angle – Located between vertebral and axillary borders. The “point” at the bottom of scapula, level T7. Clavicle Collar bone – anterior from sternum to acromion Humerus 2 Humerus • Greater tuberosity – Located just below acromion when arm is resting by the side. (proximal end of humerus) • Lesser tuberosity – Easiest to palpate with arm in shoulder external rotation. located medial to greater tuberosity on proximal end of humerus. • Intertubercular (Bicipital) Grove – Located between greater and lesser tuberosity; easiest to palpate with arm in external rotation. • Medial and lateral epicondyles – Palpated on medial and lateral sides, respectively, of distal end of humerus (2 “bumps” on distal end). • Medial and lateral supracondylar ridge – above the medial and lateral epicondyles on distal end of humerus • Olecxranon fossa – indentation on posterior of elbow Radius & Ulna Radius • Head – From lateral epicondyle of humerus move distally about 1 inch. Head of radius palpated easiest as you pronate and supinate. • Anterior border – Ridge just above wrist on lateral aspect of lower forearm. • Styloid process – In the anatomic position, styloid is lateral just above wrist joint. • Dorsal tubercle – On distal end of radius on posterolateral aspect of wrist. Feels like a small longitudinal bony prominence or module. 3 Ulna • Olecranon – “Funny bone” – long protuberance on posterior of elbow. • Styloid process – In the anatomic position, styloid process is on medial aspect of wrist, also slightly posterior. Is more proximal than radial styloid process. • Head – On distal end of ulna. In supination, it can be palpated on medial-anterior aspect of wrist (just proximal to wrist). In pronation, head is the projection on posterior aspect (ulnar side) of wrist. Carpals Carpals • Pisiform – “Pea-shaped” bone on ulnar side of hand (palmar surface) • Scaphoid – On radial side of wrist – easiest to palpate in “floor” of anatomical snuffbox (proximal to thumb) as you move hand into ulnar deviation. • Trapezium – On radial side of wrist where it articulates with 1st metacarpal to form saddle joint. Easiest to palpate as you flex and extend the thumb. • Hamate (hook) – Located slightly distal and radial to the pisiform. • Capitate – Proximal to the base of the third metacarpal between the dorsal tubercle of the radius and the third metacarpal. Most easily palpated as you flex the wrist. • Triquetral – Located just distal to the ulnar styloid process. To palpate, radially deviate the hand. • Base, body, head of metacarpals and phalanges 4.