Kinesiology Palpitations Exam 2

Teres Major

Located: Prone with the arm off the side of the table The muscle fibers that lie medial to the latissimus and attach to the lateral border will be the teres major Follow these fibers toward the axilla where they blend with the latissimus dorsi

Ischial Tuberosity

Located: "Sit bones". Located on the most inferior aspect of the pelvis at the level of the gluteal fold Have a seat on a hard chair/surface Rock side to side Stand up and palpate the bone you were sitting on

Posterior Superior Iliac Spine (PSIS)

Located: At the posterior end of the iliac crest Standing Place your thumbs upon your iliac crests Follow the crests around the posterior hip. Note how the descend as you move medially Might feel like small humps surrounded by thicker tissues

Teres Minor

Located: Between the infraspinatus and teres major Prone, with arm off the side of the table Locate lateral border of the scapula specifically, its superior half Slide laterally off the lateral border onto the surface of the teres minor Compress into and across its tube shaped belly Move inferiorly and compare it in size to teres major Reach your thumb up into the axilla and grasp the belly of the teres minor as you would a sandwich Ask your pattern to laterally rotate their shoulder Bringing the elbow toward the ceiling forces the teres minor to contract

Rhomboid Major & Minor

Located: Between the scapula and vertebral column Prone Locate scapulas medial border and the spinous process of C7 through T5 Palpatating through the thin trapezius, explore the area you have identified and strum vertically across fibers of the rhomboids

Latissimus Dorsi

Located: Broadest muscle of the back. Fibers originate at the low back, ascend the side of the trunk and merge into a thick bundle at the axilla Prone with arm off the side of the table Locate the scapulas lateral border Using your fingers and thumb, grasp the thick wad of muscle tissue lateral to the lateral border Feel fibers contract by asking your partner to medially rotate their shoulder against your resistance As this occurs, follow the fibers superiorly into the axilla and inferiorly to the ribs

Deltoid

Located: Cap of the shoulder Seated, locate the spine of the scapula, the acromion and the lateral one third of the clavicle Locate the deltoid tuberosity Palpate these landmarks to isolate the superficial fibers of the deltoid

Infraspinatus

Located: In the infraspinous fossa Prone, with forearm off the side of the table Locate the spine, medial border and lateral border of the scapula Form a triangle around the infraspinatus by laying a finger along each of these landmarks Palpate in the triangle and strum across the infraspinatus fibers Follow them laterally as they converge underneath the deltoid to attach to the humerus

Serratus Anterior

Located: Lies along the posterior and lateral rib cage Place finger pads along the side of the ribs between the pectorals major and latissimus dorsi Strum your fingers across the ribs and palpate the fibers

Trapezius: Lower Fibers

Located: Lies superficially along the upper back and neck Prone Locate the edge of the lower fibers by drawing a line from the spine of the scapula to the spinous process of T-12 Palpate along this line and push your fingers into the edge of the lower fibers. Ask your partner to hold their arms in front of them (like superman) and feel for the superficial fibers of the trapezius Attempt to lift the lower fiber between your fingers, raising them off the underlying musculature

Trapezius: Middle Fibers

Located: Lies superficially along the upper back and neck Prone Locate the spine of the scapula Slide medially from the spine of the scapula onto the trapezius and move your fingers across its fibers Explore at a superficial level and not deeper into the rhomboids or erector spine muscle

Trapezius: Upper Fibers

Located: Lies superficially along the upper back and neck Prone These fibers form the easily accessible flap of the muscle lying across the top of the shoulder Grasp the superficial tissue on the top of the shoulder and feel the upper trapezius fibers Follow the fibers superiorly toward the base of the head at the occiput (bone at the base of the head). To feel the fibers along the neck contract, stand at the side of the table and ask your partner to extend their head a quarter inch off the face cradle Then follow the fibers inferiorly to the lateral clavicle

Levator Scapula

Located: Located along the lateral and posterior sides of the neck Prone, supine or side lying Palpatating through the trapezius, located the superior angle of the scapula and the upper region of the medial border Place your fingers just off the superior angle and firmly strum across the belly of the levator Fibers will have a ropey texture Follow the fibers superiorly as the extend to the lateral side of the neck to the transverse processes of the cervical vertebrae

Iliac Crest

Located: Long, superior edge of the ilium. Begins at the ASIS and extends around the side of the torso to end at PSIS Locate the ASIS Slowly walk your fingers around the side of your hip, pressing into the wide edge of the crest Follow the crest as it continues around the posterior side of the body and ends at the PSIS

Pectoralis Minor

Located: Next to the rib cage, deep to the pectoralis major Abduct the arm and place your finger pads at the lateral edge of the pectoralis major Slowly and gently slide under the pectoralis major, following along the surface of the ribs Your finger pads will come in contact with the small wall of muscle lying next to the ribs

Anterior Superior Iliac Spine (ASIS)

Located: On the anterior and superior aspect of the ilium. Superficial tip located below the waistline Seated Locate both ASIS' by placing your hands upon your hips with fingers in the front, thumbs behind Feel for the tip of the pelvis that sticks out anteriorly

Sternocleidomastoid (SCM)

Located: On the lateral and anterior aspect of the neck Supine Locate the mastoid process of the temporal bone, the medial clavicle and the top of the sternum

Subscapularis

Located: On the scapulas anterior surface subscapluar fossa and serrates anterior Side lying Flex the shoulder and pull the arm anteriorly as much as possible Hold the arm with one hand while the thumb of the other locates the lateral border Hint: Slide your thumb underneath the latissimus dorsi and teres major fibers instead of going through them Slowly and gently curl your thumb onto the subscaplular fossa

Pectoralis Major

Located: Powerful muscle on the chest Supine, with your partners shoulder slightly abducted, sit or stand facing them Locate the medial shaft of the clavicle and more inferiorly onto the clavicular fibers Explore the surface of the pectorals major Follow the fibers laterally as they blend with the deltoid and attach at the greater tubercle Grasp the belly of the pectoralis major by sinking your thumb into the axilla Ask your partner to medially rotate their shoulder against your resistance

Intercostals

Located: Small slender muscles between the ribs Supine Begin just inferior to the pectoralis major on the side of the rib cage Place fingers in spaces between ribs With one fingered, isolate and palpate the tissue between two ribs Roll your finger across the rib space and palpate the short dense intercostals that bridge the ribs Ask your partner to take several, slow deep breaths Note any expansion or collapse in the spaces between the ribs Turn your partner prone or side lying and continue to explore the intercostals

Supraspinatus

Located: Supraspinous fossa, deep to the trapezius upper fibers Prone Locate the spine of the scapula Slide your fingers up the supraspinous fossa Palpatate through the trapezius and onto the supraspinatus fibers. Note how the fibers run parallel to the spine Follow the belly laterally until to tucks under the acromion

Lesser tubercle and Intertubercular Groove

Place thumb on greater tubercle Begin to rotate the arm laterally As the humerus rotates, the greater tubercle will move out from under your thumb and will be replaced by the ditch of the intertubercular groove As you continue to laterally rotate your arm, your thumb will rise out of the groove and onto the lesser tubercle

Greater Tubercle

Seated or Supine Shaking hands with your partner locate the acromion Slide off the acromion inferiorly and laterally Solid surface located deep between the deltoid fibers is the greater tubercle

Coracoid Process

Seated or supine Lay your thumb along the lateral shaft of the clavicle Slide inferiorly off the clavicle no more than an inch and a half Locate the tip of the coracoid process by compressing your finger pads into the tissue

Acromioclavicular Joint

Seated or supine Locate the acromion Glide medially toward the clavicle Your finger will feel a small step as you rise onto the surface of the clavicle Backtrack slightly,. Just lateral to the step will be the AC joints slender ditch

Acromion

Seated or supine Locate the spine of the scapula Follow the spine as it rises superiorly and laterally to the top of the shoulder Use your finger pads to explore the acromions flat surface

Sternoclavicular Joint

Seated or supine Slide fingers medially along the shaft of the clavicle Just lateral to the centerline, the shaft will broaden to become the bulbous sternal end Locate the SC joint by sliding your finger medially off the sternal end Passively elevate, depress and abduct the scapula