Skills Check #1 Palpations

Questão	Responda
Inion	Position: Standing behind a seated patient. Location: Most prominent aspect of the external occidental protuberance.
Mastoid Process	Position: Standing behind a seated patient. Location: Directly posterior and inferior to ear lobe. Caution: Avoid heavy pressure.
Temporomandibular Joint	Position: Standing behind a seated patient. Location: Pads of fifth digit facing anteriorly directly inside the external auditory meatus. or in the divot directly anterior to the tragus of the ear. Movements: Left/right deviation, protrusion/retraction, open/close with tongue on the roof of the mouth. Note: should not feel crunchy. Glove up.
Zygomatic Arch	Position: Standing in front of a seated patient. Location: Equidistant between the external auditor meatus and proximal nostril. Caution: Avoid palpating close to mouth.
Sinus Cavities	Position: Standing in front of a seated patient. Locations: Supraorbital Foramen, Infraorbital Foramen, lateral surface of Nasal bone, directly inferior to eyebrows. Movements: Apply steady and tapping pressure to see if headache symptoms change. Note: If headache symptoms change it is likely due to sinus issues.
Angle of Mandible	Position: Standing in front of a seated patient. Location: Inferior and posterior most aspect of the jaw.
Mandible Protuberance	Position: Standing in front of a seated patient. Location: Anterior most aspect of medial jaw.
Transverse Process of C 1	Position: Standing behind a seated or supine patient. Location: Equidistant between mastoid process and angle of mandible. Caution: Use light pressure, this area is sensitive and can result in nausea.
Hyoid	Position: Standing in front of a seated patient. Location: Anterior surface of neck at approximately C3, below the angle of the mandible and above the Adam's Apple. Movements: Move the Hyoid side to side. Note: Feels soft because it is embedded in soft tissue.
Cricoid Cartilage	Position: Standing in front of a seated patient. Location: Directly inferior to Hyoid. Note: Feels crunchy to patient and therapist.
Thyroid	Position: Standing in front of a seated patient. Location: Directly inferior and lateral to Cricoid Cartilage. Movements: Swallowing should cause upward and lateral deviation. Note: Should note feel swollen.
Sternoclavicular Joint	Position: Standing in front of a seated patient. Location: Lateral to the Jugular Notch. Note: Often confused with the 1st Rib which lies inferior to Clavicle. Check to be sure the Clavicle is connected to Acromion.
Trunk of the Brachial Plexus	Position: Standing in front of a seated patient in same side neck lateral flexion. Location: Posterior to SCM, anterior to Upper Trap. Caution: Avoid heavy pressure
Parotid Gland	Position: Standing in front of a seated patient. Location: Anterior and inferior to external auditory meatus. Between TMJ and angle of Mandible. Note: Feels like muscle if note swollen.
Submaxillary Gland	Position: Standing in front of a seated patient. Location: Inside of mouth, directly superior to the angle of mandible. Note: Requires pressure from both the inside and outside of mouth. Glove up.
Submandibular Gland	Position: Standing in front of a seated patient. Location: Inferior to the protuberance of the mandible, at the mid-line of the upper neck.
Lymph Node Chains	Position: Standing in front of a seated patient. Location: preperiauricular, postperiauricular, anterior cervical, posterior cervical, tonsilar, submandibular, submental, supraclavicular, occipital. Note: Should note feel anything unless swollen.
Carotid Pulse	Position: Standing in front of a seated patient. Location: Slightly inferior and anterior to the angle of the mandible. Caution: Avoid heavy pressure, could occlude blood flow and cause BP problems.
C 2 Spinous Process	Position: Standing behind a seated patient Location: First palpable spinous process directly inferior to Inion. Movements: More prominent with neck flexion.
C 7 Spinous Process	Position: Standing behind a seated patient. Location: Most prominent vertebra inferior to C2 on the mid-line of back. Movement: C 6 goes away with extension, C 7 stays with extension.
Cervical Articular Pillars	Position: Standing behind a seated patient. Location: Facet joints directly lateral to spinous process. Caution: Avoid heavy pressure Note: includes hills (facets) and valleys (body)
Cervical Transverse Processes	Position: Standing in front of a seated patient. Location: Lateral to Articular Pillars. Caution: Avoid heavy pressure. Note: C2-C7 are not as wide as C1.
Superior Angle of Scapula	Position: Standing behind a seated patient. Location: Inferior to Upper Trap, lateral to transverse processes, approximately at the level of T2.
Spine of Scapula	Position: Standing behind a seated patient. Location: Inferior to Superior Angle of Scapula, from medial border to Acromion, at approximately T3.
Inferior Angle of Scapula	Position: Standing behind a seated patient. Location: Inferior most aspect of Scapular vertebral border, approximately at the level of T7.
Posterior, Lateral, and Anterior Aspects of the Acromion	Position: Standing behind a seated patient. Location: Lateral most end of the Spine of the Scapula.
Coracoid Process	Position: Standing in front of a seated patient. Location: Medial to Humerus and shoulder joint line, inferior to Clavicle and Acromion.
Acromioclavicular Joint	Position: Standing in front of a seated patient. Location: Small divot medial to Humeral Head, and lateral to Acromion.
Tubercle of 1st Rib	Position: Standing in front of a seated patient. Location: Inferior most aspect of the anterior upper trap, half way between shoulder and neck. Movements: Will elevate and depress with respiration. Note: Traps will need to be squeezed, pressure will be firm, if one side stays elevated with expiration scalene spasm is likely.
Jugular Notch	Position: Standing in front of a seated patient. Location: inferior to Adam's Apple, medial to Clavicle, Inferior to Sternum.
Proximal Clavicle	Position: Standing in front of a seated patient. Location: Lateral to Jugular Notch and Sternoclavicular Joint.
1st Rib and Manubrium Joint	Position: Standing in front of a seated or supine patient. Location: Directly Inferior to Sternoclavicular Joint, on the superior and lateral sternum Note: Superior border is indistinguishable with the clavicle, female patients cover breasts.
2nd Rib Insertion	Position: Standing in front of a seated or supine patient. Location: Inferior to 1st Rib insertion, at the level of the angle of Louis (Sternal Angle). Note: Female patients cover breasts.
Xiphoid Process	Position: Standing in front of seated or supine patient. Location: Inferior most aspect of the Sternum. Caution: If you push hard enough to break this it could puncture the lung. Note: Female patients cover breasts.
Midaxillary, Anterior Axillary, and Posterior Axillary Line	Position: In-line few of axillary region Location: Imaginary mid-line, anterior line, and posterior line of the armpit region. Note: Don't palpate this, just identify it.
Humeral Lesser Tuberosity	Position: Standing in front of a seated patient. Location: Directly lateral to the anterior shoulder joint line. Movement: More prominent with external rotation.
Bicipital Groove	Position: Standing in front of a seated patient. Location: Lateral to the lesser Tuberosity of the Humerus on anterior arm. Note: Usually palpated after the Lesser Tuberosity.
Greater Tuberosity of the Humerus	Position: Standing in front of a seated patient. Location: Lateral to the Bicipital Groove, on the Lateral aspect of the Humerus. Note: Usually palpated after the lesser tuberosity and bicipital groove.
Supraspinatus Tendon	Position: Standing in front of a seated patient. Location: Anterior to medial Deltoid, inferior to Acromion, lateral to Supraspinatus Fossa. Note: Rub transversely.
Infraspinatus Tendon	Position: Standing in front of prone patient on adducted elbows and abducted Hands. or Standing in front of seated patient with shoulders held in adduction. Location: Inferior to posterior and lateral aspect of the Acromion. Note: Rub transversely
Deltoid Tuberosity	Position: Standing in front of a seated patient. Location: Most distal aspect of the Deltoid insertion on the lateral Humerus. Note: Contracting Deltoid makes it more prominent.
Brachial Pulse	Position: Standing in front of a seated patient. Location: Intramuscular septum on the medial arm between bicep and triceps Note: Do not press hard enough to occlude blood flow.
Medial Epicondyle of Elbow	Position: Standing in front of seated patient. Location: Just medial to the Olecranon fossa of the Humerus on the Ulnar side of the arm. Note: the Medial epicondyle is larger than the lateral.
Lateral Epicondyle of Elbow	Position: Standing in front of a seated patient. Location: Lateral to the Olecranon fossa of the Humerus, on the Radial side of the arm. Note: Smaller than the medial Epicondyle.
Olecranon Process	Position: Standing in front of a seated patient. Location: Largest protrusion on the posterior side of the Ulna. Note: If you push this, the elbow will straighten.
Radial Head	Position: Standing in front of a seated patient. Location: Directly distal to the lateral epicondyle of the Humerus on the Posterior side. Movements: More prominent with pronation and supination.
Ulnar Groove	Position: Standing in front of a seated patient. Location: Between the Medial Epicondyle and Olecranon Fossa of the Humerus. Caution: Use light pressure, this is the "funny bone"
Radial Styloid	Position: Standing in front of a seated patient. Location: Proximal and Anterior to the Snuff Box.
Ulnar Styloid	Position: Standing in front of a seated patient. Location: Medial, posterior, and most prominent bump of the distal Ulna.
Lister's Tubercle	Position: Standing in front of a seated patient. Location: Radial, dorsal bump, just proximal to the divot in the wrist that starts the carpals.
Snuff Box	Position: Standing in front of a seated patient. Location: Radial side of distal forearm. Radial Border: Add Pollicis Long, Ext Pollicis Brev. Lateral Border: Ext Pollicis Longus. Note: Deep to this is the Scaphoid, pain could signify a Scaphoid fx.
Lunate	Position: Standing in front of a seated patient with wrist flexed. Location: Just distal to Lister's Tubercle.
Capitate	Position: Standing in front of a seated patient with wrist flexed. Location: Directly distal to Lunate. Note: Presents as a divot.
Pisiform	Position: Standing in front of a seated patient. Location: Most prominent bump on palmar, ulnar side of hand, distal to the crease of the anterior wrist.
Hook of Hamate	Position: Standing in front of a seated patient. Location: Just distal and radial to Pisiform, ulnar to the middle crease of hand. Caution: Avoid heavy pressure.
Scaphiod	Position: Standing in front of a seated patient. Location: Deep to the Snuff Box Note: A fall on an outstretched arm may cause a fracture here.
Trapezium	Position: Standing in front of a seated patient. Location: Directly distal to Scaphoid, proximal to 1st Metacarpal.
Triquetrum	Position: Standing in front of a seated patient. Location: Directly posterior to the Pisiform.
Trapezoid	Position: Standing in front of seated patient. Location: Directly Ulnar to the Trapezium.
Radial Pulse	Position: Seated in front of seated patient. Location: Radial to the Palmaris Longus Tendon. Note: Do not push hard enough to occlude blood flow.
Volar Plate	Position: Standing in front of a seated patient. Location: Palmar side of Interphalangeal Joints. Note: PIP Volar plates are more prevalent, Volar plates prevent hyperextension.
Metacarpal Phalangeal Joint	Position: Standing in front of a seated patient. Location: Largest Joint distal to the Metacarpals.
Iliac Crest	Position: Squatted behind a standing patient who has just marched. Location: Widest portion of hips at the level of L4 - L5. Note: Start with hands on the lower edge of the Ilium and roll hands upward with palms facing down, check to see if one side is higher.
Posterior Inferior Iliac Spine	Position: Squatted behind a standing patient who has just marched. Location: Prominent bump on posterior Ilium, lateral to the Sacral Sulcus. Note: Usually where the thumbs are located when palpating for Iliac crest.
Sacral Sulcus	Position: Squatted behind a standing patient. Location: Small divot, medial to the PSIS. Note: Also called Fortin's Point or back dimples.
Anterior Superior Iliac Spine	Position: Squatted in front of a standing patient. Location: Anterior protrusion on the anterior side of the Iliac Crest. Note: Feel just inferior to these, one may be larger than another.
Ischial Tuberosity	Position: Standing to the side of a prone patient. Location: Mid-line of the posterior thigh, inferior to buttock and crease of buttock. Note: Origin of Hamstrings
Pubic Tubercle	Position: Standing to the side of a supine patient with lowered pants and draped with towel. Location: Directly inferior to the waist, superior to the genitalia. Note: Start with palm of the hand on the Umbilicus, heel of the hand facing inferiorly, working the way down the mid-line.
Inguinal Ligament	Position: Standing to the side of a supine patient with lowered pants and draped with a towel. Location: Between the ASIS and Pubic Tubercle. Note: Above this is the Iliac Artery, be firm but not too firm patients are ticklish and sensitive here.
Femoral Pulse	Position: Standing to the side of a supine patient with lowered pants and draped with towel. Location: Half way between ASIS and Pubic Tubercle, approximately an inch inferior to the inguinal ligament. Note: Pulse should be strong here.
Greater Trochanter of Femur	Position: Standing next to a supine, prone, or side-lying (hookline) patient. Location: Most lateral aspect of Femur, inferior to the pelvis. Movements: More prominent with internal and external rotation. Note: Be able to feel posterior, anterior, superior, and inferior aspect.
Greater Trochanteric Bursea	Position: Standing next to a supine, prone, or side-lying (hookline) patient. Location: Posterior rim of greater Trochanter of Femur. Note: Should not be tender or swollen.
Fibular Head	Position: Standing to the side of a supine hookline patient. Location: Lateral aspect of lower leg, distal to Tibial Lateral Condyle, directly distal to Tibiofibular Joint. Caution: Peroneal Tendon is posterior to this so use light pressure.
Gerdy's Tubercle	Position: Standing to the side of a supine hookline patient. Location: On the Tibia, anterior to the Fibular Head. Note: IT Band inserts here.
Lateral Femoral Condyle	Position: Standing to the side of a supine hookline patient. Location: Lateral to Patella, Proximal to knee joint.
Lateral Collateral Ligament	Position: Standing to the side of a supine hookline patient. Location: Lateral side of knee, connecting Femoral Lateral Epicondyle to Fibular Head.
Tibial Tuberosity	Position: Standing to the side of a supine hookline patient. Location: Anterior prominence on proximal Tibia. Note: Patellar Tendon inserts here.
Patella	Position: Standing to the side of a supine hookline patient. Location: Superficial to distal Femur, embedded in Tendon. Note: Be able to palpate medial, lateral, superior, and inferior aspects.
Patellar Tendon	Position: Standing to the side of a supine hookline patient. Location: Dense fiber distal to the Patella, inserting on Tibial Tuberosity.
Quadriceps Tendon	Position: Standing next to a supine hookline patient. Location: Dense Fiber proximal to the Patella.
Knee Joint Line	Position: Standing to the side of a supine hookline patient. Location: Lateral and medial to Patellar tendon. Note: Palpable around the circumference of knee except for under the LCL and MCL.
Popliteal Pulse	Position: Standing to the side of a supine patient with knees slightly bent. Location: Mid-line of posterior knee, between deep gastroc heads. Note: Deep pressure will be needed to palpate deep to the gastroc heads.
Lateral Malleolus	Position: Standing to the side of a supine patient. Location: Lateral Prominence on distal Fibula.
Anterior Tibiofibular Ligament	Position: Standing to the side of a supine patient. Position: Anterior and superior to lateral malleolus.
Calcaneofibular Ligament	Position: Standing to the side of a supine patient. Location: Directly distal to lateral malleolus. Movements: More prominent at inversion.
Anterior Talofibular Ligament	Position: Standing to the side of supine patient. Location: Anterior to lateral malleolus. Movement: More prominent with dorsiflexion and plantarflexion.
Tibial Pulse	Position: Standing to the side of a supine patient. Location: Posterior to Medial Malleolus, anterior to Achilles Tendon. Movement: Prominent with slight eversion.
Medial Malleolus	Position: Standing to the side of a supine patient. Location: Most medial prominence on the distal Tibia.
Medial and Lateral Head of Talus	Position: Standing to the side of a supine patient. Location: Anterior and inferior to malleoli. Movements: More Prominent with inversion and eversion. Notes: There could be two visible divots here.
Sinus Tarsi	Position: Standing to the side of a supine patient. Location: Lateral and distal to lateral Tarsal head. Note: Will be tender if patient has Sinus Tarsi Syndrome.
Navicular Tuberosity	Position: Standing to the side of a supine patient. Location: Largest bump on the medial side of the foot, proximal to 1st metacarpal.
Base of the 5th Metatarsal	Position: Standing to the side of a supine patient. Location: Largest bump on the lateral side of the foot. Note: Tenderness could suggest a Avulsion fracture proximally, Stress fracture distally, and Jones fracture in between.
Dorsal Pedis Pulse	Position: Standing to the side of a supine patient. Location: Between the 1st and 2nd metatarsal, proximal to the PIP of the big toe. Caution: Use very light pressure.
Spinous Process of C1-T5	Position: Standing to the side of a prone patient. Location: Mid-line of the back. Note: Thoracic spinous processes are on the same level as the vertebra body inferior to it.
Spinal Lamina	Position: Standing to the side of a prone patient. Location: Deep and lateral to the spinous process.
Interspinous Ligaments	Position: Standing to the side of a prone patient. Location: Between Spinous processes. Note: Connects one spinous process to the other.
Transverse Processes	Position: Standing to the side of prone patient. Location: Lateral to Lamina
Costotransverse Joints	Position: Standing to the side of a prone patient. Location: Lateral to transverse processes.
Angle of Ribs	Position: Standing to the side of a prone patient. Location: Lateral to transverse processes, where the ribs change direction. Note: Ask patient to Protract scapula to find angle of superior ribs.
Liver	Position: Standing to the side of a supine patient with inclined head and pillow under knees. Drape breasts and waist. Location: Upper right quadrant of abdomen, above umbilicus.
Spleen	Position: Standing to the side of a supine patient with head inclined and pillow under the knees. Drape breasts and waist. Location: Upper left quadrant of abdomen, at the level of the Umbilicus. Note: Place one hand under the back and one hand over the Spleen.
Aorta	Position: Stand to the side of a supine patient with inclined head and a pillow under the knees. Drape breasts and waist. Location: Just left of the abdominal mid-line. Caution: Do not apply heavy pressure.

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	Criado por Jordan Waugh mais de 6 anos atrás