ATTR 280

levator scapula

1. client prone 2. stand beside client's head and find the superior angle of the scapula on the same side 3. find the transverse processes of the upper cervical vertebrae with the fingertips of your other palpating hand 4. follow the muscle belly of the levator scapula toward the scapula 5. resist as client performs scapular elevation to assure proper location

teres major

1. client prone with arm at side 2. locate lateral border of the scapula with thumb 3. palpate muscle belly just inferior and lateral to the lateral border of the scapula 4. follow the thick, round muscle belly as it helps form the posterior border of the axilla 5. resist as client performs shoulder extension to ensure proper location

trapezius

1. client prone with arm at side 2. locate spine of the scapula with your thumb 3. move thumb superior to spine and wrap fingers anteriorly around muscle to just above the clavicle 4. pincer grasp with the thumb and fingers together to locate the fibers of the upper trapezius 5. resist as client performs scapular elevation to ensure proper location

rhomboids

1. client prone with arm at side 2. locate spinous processes of C7-T5 3. palpate to the medial border of the scapula with tips of the four fingers 4. notice that the muscle belly is flat and the fiber direction is oblique and inferior 5. resist as client performs scapular retraction and elevation to ensure proper location

latissimus dorsi

1. client prone with arm at side 2. locate spinous processes of lumbar vertebrae with palm of hand 3. palpate laterally toward the inferior angle of the scapula 4. locate the broad muscle belly, beginning on the posterior iliac crest and sacrum and ending on the proximal humerus 5. resist as client performs shoulder extension and adduction to ensure proper location

subscapularis

1. client prone with arm at side 2. palpate the lateral border of the scapula with the palmar side of the four fingers 3. press posteriorly and medially to the latissimus dorsi 4. use your other hand to scoop the scapula laterally, improving access to the anterior surface of the scapula. 5. resist as client performs shoulder internal rotation to ensure proper location.

supraspinatus

1. client prone with arm at side 2. palpate the spine of the scapula with thumb 3. move thumb superiorly above the spine to locate the supraspinous fossa 4. locate the muscle belly in the supraspinous fossa 5. follow the tendon of supraspinatus under the acromion process to the greater tubercle of the humerus 6. resist as client performs shoulder abduction to ensure proper location

triceps

1. client prone with arm at side and pronated 2. locate olecranon process 3. palpate superiorly along muscle belly with thumb and fingers toward the shoulder 4. locate the muscle belly in pincer grasp where it becomes horseshoe-shaped as the three heads merge 5. follow the medial and lateral heads to their attachments on the humerus, and the long head until it continues under the deltoid and onto the scapula 6. resist as client performs shoulder extension and elbow extension to ensure proper location

infraspinatus

1. client prone with arm off edge of table 2. palpate the lateral border of the scapula with your thumb 3. place fingers of that same hand medially and superiorly to find infraspinatus 4. locate the muscle belly in the infraspinous fossa of the scapula 5. follow the tendon of infraspinous superiorly and laterally around the head of the humerus to the greater tubercle of the humerus 6. resist as client performs shoulder external rotation to ensure proper location

teres minor

1. client prone with arm off side of table 2. palpate the lateral border of the scapula with thumb 3. move thumb medially and superiorly to locate teres minor 4. locate the small round muscle belly lateral to the infraspinous fossa 5. follow tendon of teres minor along lateral border of scapula superiorly and laterally around the head of the humerus to the greater tubercle of the humerus 6. resist as client performs shoulder external rotation to ensure proper location

abduction pollisis longus

1. client seated with forearm neutral (thumb up) 2. passively ulnar deviate the wrist to tension tissue 3. locate radial styloid process with thumb and slide distally onto tendon of abductor pollicis longus 4. resist as client performs thumb abduction to ensure proper location

pronator teres

1. client seated with forearm supinated 2. passively flex elbow and pronate forearm to slack tissue 3. locate medial epicondyle with thumb 4. slide thumb distally and laterally onto belly of pronator teres 5. resist as client performs forearm pronation to ensure proper location

serratus anterior

1. client side-lying with arm forward 2. stand behind client and find the most lateral portion of the scapula 3. use your 4 fingers to palpate from the lateral edge of the scapula anterior and inferiorly toward the ribs 4. follow each section of the muscle belly toward its insertion on individual ribs 5. resist as client performs scapular protraction to assure proper location

subclavius

1. client supine 2. find the inferior edge of the clavicle halfway between the medial and lateral ends 3. slide thumb inferiorly and deep to the clavicle 4. resist as client performs scapular depression to assure proper location

pectoralis minor

1. client supine 2. passively abduct humerus to slack tissue 3. slide fingers into axilla from lateral to medial 4. find the coracoid process of the scapula and slide medially and inferiorly along the anterior ribs and onto the fibers of pectoralis minor 5. resist as client performs scapular depression to assure proper location

Splenius cervicis

1. client supine 2. sitting at clients head, place both hands palm up under clients neck. find the spinous processes of t3-t6 with fingertips 3. slide fingertips laterally into the lamina groove 4. follow oblique muscle fibers on same side toward the cervical transverse processes 5. resist as client looks up and rotates neck to ensure proper location

lateral pterygoid

1. client supine 2. sitting at the clients head locate the inferior surface of the zygomatic arch with your fingertips 3. slide your fingertips slightly inferiorly between the condyle and coronoid process of the mandible onto horizontal fibers of lateral pterygoid 4. client gently moves jaw side to side to ensure proper location

Splenius Capitis

1. client supine 2. sitting at the clients head place both hands palm up under clients neck. find the spinous processes of upper thoracic and lower cervicals with fingertips 3. slide fingertips laterally into the lamina groove 4. follow oblique muscle fibers on same side toward the mastoid processes 5. resist as client looks up and rotates head to ensure proper location

medial pterygoid

1. client supine 2. sitting at the clients head, locate the inner surface of the angle of the madible with your fingertips 3. hook your fingertips deeply onto the inner surface of the mandible 4. follow the oblique fibers of the medial pterygoid medially toward the sphenoid 5. have the client clench the teeth elevating the mandible to ensure proper location

temporalis

1. client supine 2. sitting at the clients head, locate the superior edge of the zygomatic arch with your fingertips 3. slide your fingertips superiorly toward the temple and onto the fibers of temporalis 4. follow the fibers of temporalis as they fan out across the frontal parietal and temporal bones 5. client gently opens and closes the mouth and.or clenches the jaw to ensure proper location

sternocleidomastoid

1. client supine 2. sitting at the clients head, slightly rotate the head to the opposite side to slack tissue 3. locate the mastoid process with the thumb and slide anteriorly and caudally onto the thick sternocleidomastoid muscle 4. gently pincer-grasp the muscle belly and follow it caudally toward the sternum, differentiating between the medial sternal head and lateral clavicular head 5. resist as client performs flexion to ensure proper location

Scalenes

1. client supine 2. sitting at your clients head, locate with your fingertips the cervical transverse procresses in the space between the trapezius and sternocleidomastoid 3. slide your fingertips caudally, following the slender stringy fibers of the scalenes 4. follow the fibers of the scalenes toward their attachments on the 1st and 2nd ribs 5. resist as client performs lateral flexion of the neck to ensure proper location

masseter

1. client supine 2. sitting at the clients head locate the inferior edge of the zygomatic arch with your fingertips 3. slide fingertips inferiorly toward the angle of the mandible and onto the fibers of masseter 4. follow the fibers of masseter to its insertion on the inferior edge of the mandible 5. client gently opens and closes the mouth and/or clenches the jaw to ensure proper location

semispinalis

1. client supine 2. sitting at the clients head, place both hands palm up under clients head. find the external occipital protuberance with fingertips 3. slide fingertips caudally and laterally into the suboccipital region and lamina groove 4. follow vertical muscles fibers caudally within the lamina groove as the client tucks the chin to slack superficial structures 5. resist as client looks up to ensure proper location

coracobrachialis

1. client supine with arm at side 2. locate anterior border of axilla 3. palpate posteriorly and laterally along the medial surface of the humerus 4. locate the muscle belly deep to the biceps brachii and follow toward its insertion on the medial shaft of the humerus about the same distance distally as the deltoid 5. resist as client performs shoulder adduction to ensure proper location

pectoralis major

1. client supine with arm at side 2. locate inferior clavicle 3. palpate inferiorly along the muscle belly with palm toward the sternum and costocaritlage 4. follow muscle belly to its attachments on the clavicle, costocartilage, and sternum 5. resist as client performs shoulder internal rotation to ensure proper location

biceps

1. client supine with arm at side and forearm supinated 2. locate muscle belly in center of anterior upper arm 3. pincer grasp the muscle belly halfway between the shoulder and elbow 4. resist as client performs elbow flexion and supination to ensure proper location

extensor carpi radialis brevis

1. client supine with forearm neutral 2. passively flex the elbow and radially deviate the wrist to slack tissue 3. locate lateral epicondle of the humerus with thumb 4. slide thumb distally onto extensor carpi radialis longus 5. resist as client performs wrist extension and radial deviation to ensure proper location

extensor pollisis longus

1. client supine with forearm neutral 2. passively ulnar deviate wrist to create tension in the tissue 3. locate radial styloid process with thumb and slide laterally onto tendon of extensor pollicis longu 4. resist as client performs thumb extension to ensure proper location

extensor pollisis brevis

1. client supine with forearm neutral 2. passively ulnar deviate wrist to create tension in the tissue 3. locate radial styloid process with thumb and slide distally onto tendon of extensor pollicis brevis 4. resist as client performs thumb extension to ensure proper location

extensor carpi radialis longus

1. client supine with forearm neutral (thumb up) 2. passively flex the elbow and radially deviate the wrist to slack tissue 3. locate lateral epicondyle of the humerus with thumb 4. slide thumb distally onto extensor carpi radialis longus 5. Resist as client performs wrist extension and radial deviation to ensure proper location

brachialis

1. client supine with forearm pronated 2. passively flex elbow to slack tissue 3. on anterior arm find the medial and lateral borders of the elbow flexors in a pincer grasp 4. gently slide fingers distally toward the elbow crease stopping a few inches above

extensor digitorum

1. client supine with forearm pronated 2. passively flex the elbow and extend the wrist to slack tissue 3. locate the olecranon process with thumb then follow distally along lateral edge of ulna 4. slide thumb anteriorly and medially onto extensor carpi ulnaris then farther medially onto extensor digitorum 5. resist as client performs finger extension to ensure proper location

extensor digiti minimi

1. client supine with forearm pronated 2. passivley flex elbow and extend wrist to slack tissue 3. locate the olecranon process with thumb then slide distally along lateral edge of ulna 4. slide thumb medially past the extensor carpi ulnaris onto extensor digiti minimi 5. resist as client performs extension of the little finger to ensure proper location

extensor indicis

1. client supine with forearm pronated 2. passively extend wrist to slack tissue 3. locate the ulnar styloid process with thumb then slide proximally and laterally onto extensor indicis 4. resist as client performs extension of the index finger to ensure proper location

flexor carpi radialis

1. client supine with forearm supinated 2. passively flex elbow and wrist to slack tissue 3. locate belly of brachioradialis distal to lateral epicondyle with thumb 4. move thumb medially onto flexor carpi radialis, staying distal to the elbow crease 5. resist as client performs wrist flexion and radial deviation to ensure proper location

palmaris longus

1. client supine with forearm supinated 2. passively flex elbow and wrist to slack tissue 3. locate muscle belly of flexor carpi radialis with thumb 4. move thumb medially onto muscle belly of palmaris longus 5. client makes a fist and resists wrist flexion flexion to ensure proper location

flexor carpi ulnaris

1. client supine with forearm supinated 2. passively flex elbow and wrist to slack tissue 3. locate muscle belly of palmaris longus with thumb 4. move thumb medially onto muscle belly of flexor carpi ulnaris 5. resist as client performs wrist flexion and ulnar deviation to ensure proper location

extensor carpi ulnaris

1. client supine with forearrm pronated 2. passively flex the elbow and ulnar deviate the wrist to slack tissue 3. locate the olecranon process with thumb then follow distally along lateral edge of ulna 4. slide thumb anteriorly and laterally onto extensor carpi 5. resist as client performs wrist extension and ulnar deviation to ensure proper location

brachioradialis

1. client supine with neutral forearm 2. passively flex elbow to slack tissue 3. palpate the lateral forearm distal to the lateral epicondyle 4. pincer grasp muscle belly just distal to lateral epicondyle and follow toward insertion on radial styloid process 5. resist as client perfomrs elbow flexion to ensure proper location

Deltoid

client supine with arm at side 1. locate acromion process 2. palpate inferiority along muscle belly with palm of hand 3. continue palpating the muscle belly as it converges about half way down the lateral humerus 4. resist as client performs shoulder flexion and/or abduction to ensure proper location