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CERVICAL PALPATION.
- -Bony: (10).
- -Soft tissue: (9).
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CERVICALS: BONY (10).
WARN PATIENT ABOUT TOUCHING NECK.
- 1. Occiput.
- 2. EOP.
- 3. Superior nuchal line.
- 4. MP.
- 5. Cervical SP's.
- 6. Facets.
- 7. Hyoid.
- 8. Thyroid cartilage.
- 9. First cricoid ring: inferior to Adam's apple.
- 10. Mandible.
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CERVICALS: SOFT TISSUE (9).
- 1. SCM.
- 2. Anterior lymph node chain.
- 3. Posterior lymph node chain.
- 4. Thyroid gland.
- 5. Carotid pulse.
- 6. Supraclavicular fossa: L-M.
- 7. Traps.
- 8. Greater occipital N's.
- 9. Superior nuchal lig: along SP's.
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SHOULDER PALPATION.
- -Bony: 11.
- -Soft tissue: 5.
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SHOULDER: BONY (11).
- 1. SC- articulation.
- 2. Clavicle.
- 3. AC- articulation.
- 4. Acromion.
- 5. Spine/scapula.
- 6. Scapula.
- 7. Scapulothoracic articulation.
- 8. Greater tuberosity.
- 9. Bicipital groove.
- 10. Lesser tuberosity.
- 11. Coracoid process.
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SHOULDER: SOFT TISSUE (5).
- 1. Prominent muscles: SCM, deltoid, biceps, traps. rhomboid major & minor (6).
- 2. Rotator cuff muscles: SITS.
- ---Supraspinatus
- ---Infraspinatus
- ---Teres minor: below infraspinatus (chicken wing).
- ---Subscapularis
- 3. Axillary borders:
- ---Ant: pec minor.
- ---Medial: serratus anterior.
- ---Axillary lymph nodes.
- ---Post: lats.
- ---Lateral: biceps tendon.
- 4. Subarcomial bursa: move arm while finding.
- 5. Subdeltoid bursa: under the ant. deltoid.
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ELBOW PALPATION.
- -Bony: 9.
- -Soft tissue: 10.
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ELBOW: BONY (9).
- 1. Medial epicondlye.
- 2. Medial supracondylar line.
- 3. Groove for the ulnar N.
- 4. Trochlea.
- 5. Olecranon.
- 6. Olecranon fossa.
- 7. Lateral epicondyle.
- 8. Lateral supracondylar line.
- 9. Radial head.
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ELBOW: SOFT TISSUE (10).
- 1. Biceps.
- 2. Triceps.
- 3. Brachial A.
- 4. Supracondylar lymph nodes.
- 5. MCL: runs S-I, find by running fingers M-L.
- 6. LCL.
- 7. Olecranon bursa.
- 8. Wrist flexors: hand across arm trick.
- ---Pronator teres.
- ---FCR.
- ---Palmaris longus.
- ---FCU.
- 9. Elbow extensors: mobile wad of 3.
- ---Brachioradialis.
- ---ECRL.
- ---ECRB.
- 10. Ulnar N.
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WRIST & HAND.
- -Bony: 13.
- -Soft tissue: 10.
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- 1. Radial styloid process.
- 2. Scaphoid.
- 3. Trapezium: thumb.
- 4. Trapezoid: below index finger.
- 5. Lister's tubercle: base of hand.
- 6. Lunate: means moon... comes out during F&E.
- 7. Capitate: base /3rd finger... put a cap on it.
- 8. Ulnar styloid process.
- 9. Triquetrium.
- 10. Pisiform.
- 11. Hook/hamate.
- 12. Metacarpals.
- 13. Phalanges.
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WRIST & HAND: SOFT TISSUE (10).
- 1. Radial A.
- 2. Ulnar A.
- 3. Palmaris longus tendon.
- 4. Carpal tunnel region.
- 5. Thenar eminance.
- 6. Hypothenar eminance.
- 7. Palmar aponeurosis.
- 8. Tissue/PIP.
- 9. Tissue/DIP.
- 10. Distal tufts.
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LUMBAR: BONY (4).
- 1. Iliac crest.
- 2. PSIS.
- 3. Sacral tubercles.
- 4. Lumbar SP's.
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LUMBAR: SOFT TISSUE (6).
- 1. Anterior abdominal muscles.
- 2. Hamstrings:
- ---Biceps femoris.
- ---Semitendinosus.
- ---Semimembranosus.
- 3. Glute Med.
- 4. Glute Max.
- 5. Sciatic N: 1/2 way between GT & IT, then rotate leg.
- 6. Paraspinal muscles:
- ---Spinalis.
- ---Longissimus.
- ---Iliocostalis.
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HIP & PELVIS: BONY (7).
- ANTERIOR:
- 1. Iliac crest.
- 2. ASIS.
- 3. Iliac tubercle: anterosuperior aspect/crest, above ASIS.
- 4. Greater trochanter.
- POSTERIOR:
- 5. PSIS.
- 6. Ischial tube.
- 7. Coccyx.
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HIP & PELVIS: SOFT TISSUE (8).
- ANTERIOR:
- 1. Cluneal N's: N's run I-S, fanning over the iliac crest, palpate P-A.
- 2. Greater trochanteric bursa.
- 3. Femoral triangle borders:
- ---Sartorius.
- ---Adductor longus: from symphysis pubis.
- ---Inguinal ligament: leg bent to make a 4.
- 4. Quads:
- ---Vastus lateralis.
- ---Vastus intermedius & rectus femoris.
- ---Vastus medialis.
- POSTERIOR:
- 5. Glute max.
- 6. Glute med.
- 7. Sciatic N.
- 8. Hamstrings:
- ---Biceps femoris.
- ---Semitendinosus.
- ---Semimembranosus.
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KNEE PALPATION.
- -Bony: 7.
- -Soft tissue: 11.
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KNEE: BONY (7).
- 1. Patella.
- 2. Tibial tubercle.
- 3. Medial tibial plateau: knee @ 90, externally rotate & hold like rock climbing.
- 4. Medial femoral condyle: knee @ 90, in neutral.
- 5. Lateral tibial plateau: knee @ 90, internally rotate & hold like rock climbing.
- 6. Lateral femoral condyle: knee @ 90, in neutral.
- 7. Fibular head: lateral.
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KNEE: SOFT TISSUE (11).
- 1. Quads:
- ---Vastus lateralis.
- ---Vastus intermedius & rectus femoris.
- ---Vastus medialis.
- 2. Prepatellar bursa.
- 3. Infrapatellar tendon.
- 4. Superficial infrapatellar bursa.
- 5. LCL: @ 9:00, poke!
- 6. MCL: @ 3:00, find via external rotation.
- 7. Medial meniscus: @ 4:30, poke!
- 8. Lateral meniscus: @ 7:30, poke!
- 9. Pes anserine:
- ---Sartorius.
- ---Gracilis.
- ---Semitendinosus.
- 10. Popliteal fosssa.
- 11. Gastrocnemius.
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FOOT & ANKLE PALPATION.
- -Bony: 10.
- -Soft tissue: 10.
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FOOT & ANKLE: BONY (10).
- 1. Lateral malleolus.
- 2. Medial malleolous.
- 3. Calcaneus.
- 4. Sustentaculum tali: medial.
- 5. Talus.
- 6. Navicular.
- 7. Cuboid: have patient flex foot, cuboid is under the muscle mass.
- 8. Cuneiforms:
- ---Medial.
- ---Intermediate.
- ---Lateral.
- 9. Metatarsals.
- 10. Metatarsophalangeal joints.
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FOOT & ANKLE: SOFT TISSUE (10).
- 1. Achilles tendon.
- 2. Peroneous brevis: down & out.
- 3. Anterior talofibular ligament: up & in... lateral melleolus --> talus.
- 4. TA tendon.
- 5. TP tendon: behind medial malleolus.
- 6. Posterior tibial A.
- 7. Deltoid ligaments: 3 lateral ankle ligaments.
- 8. Spring ligament: calcaneo-navicular.
- 9. Plantar aponeurosis.
- 10. Dorsalis pedis A.
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