surface anatomy

Question 1

apophyseal joint palpation L3/4

Answer 1

difficult to palpate / lie just lateral to lower third of the spinous process i.e. L3/4 apophyseal joint lies level with the lower third of L3’s spinous process, approx

Question 2

How can we palpate erector spinae

Answer 2

patient lies in prone, arms by side

have patient raise upper part and legs down

Question 3

How can we palpate external oblique

Answer 3

have patient in midprone position

Question 4

how to palpate cervical spine

Answer 4

run hand down the back of head with two thumbs
feel a bony prominence in the distal end of occiput
then feel a gap = C1, has no spinous process
followed by another small bony prominence is C2

Question 5

apophyseal joint and how to palpate it

Answer 5

difficult
joint of superior articular process and inferior articular process
once you feel the spinous process move laterally and inferiorly from it.

Question 6

parts of the lung

Answer 6

apex - top
base - bottom
mediastinal surface - part of lung interacting with heart
hilum - root of lung
costal surface - anterior surface
part of anterior surface of left lung with a crevice for the heart

Question 7

manubriosternal joint content and vertebral level

Answer 7

manubrium (top part of sternum) + and sternum body

level T4/5

Question 8

xiphosternal joint and vertebral level

Answer 8

xiphoid process (bottom tip of sternum) and sternum 
T9

Question 9

sternocostal/chondrosternal joint

Answer 9

medial costal cartilages of first 1-7th ribs and sternum

Question 10

costochondral joint

Answer 10

transition between bone to cartilage attached to the sternum
at the anterior end of each rib

Question 11

interchondral joint

Answer 11

tips of costal cartilages 8th, 9th 10th / lower border of cartilage

Question 12

costovertebral joint

Answer 12

convex facet of the posterior aspect of ribs with concave facet of vertebrae

Question 13

costotransverse joint

Answer 13

articular facet of transverse process of vertebrae and tubercle of ribs

Question 14

palpate suprasternal/ jugular notch

Answer 14

upper border of manubrium at T2 level

Question 15

thoracic inlet

Answer 15

T1, 1st rib and manubrium

Question 16

palpate apex of heart

Answer 16

6th rib
5th intercostal space
midclavicular line

Question 17

palpate costal margin

Answer 17

cartilage connecting to the sternum and to each other from rib 7-10

Question 18

costal angle

Answer 18

costal cartilage 7-10th ribs, running inferolaterally from xiphisternal joint, together form costal arch, converge L1 = 12th ribs

Question 19

thoracic outlet

Answer 19

T12, 
full length R12, 
tip R11, 
costal cartilages of R7,8,9,10
Xiphoid process

Question 20

palpate right border of the heart

Answer 20

3rd costal cartilage to 6th costal cartilage

left border of sternum (your left NOT patient’s left)

Question 21

palpate left border of the heart

Answer 21

2nd intercostal space to 5th intercostal space (apex of heart)
further right of the sternum

Question 22

auscultation for aortic valve

Answer 22

2nd intercostal space

right of sternum - patient’s right

Question 23

auscultation for pulmonary valve

Answer 23

2nd intercostal space

left of sternum - patient’s left

Question 24

horizontal fissure

Answer 24

4th rib

Question 25

oblique fissure

Answer 25

4th to 6th rib

Question 26

auscultation for tricuspid valve

Answer 26

5th intercostal space | left of sternum - patient's left

Question 27

auscultation for mitral valve valve

Answer 27

apex of heart 5th intercostal space midclavicular line of left side of rib - patient's left

Question 28

palpate first rib

Answer 28

find clavicle and attachment to manubrium of sternum move slightly below and feel start of first rib crosses below clavicle

Question 29

how to palpate pectoralis major

Answer 29

90 abduction | add resistance

Question 30

vertebral level of spine of scapula

Answer 30

T3

Question 31

vertebral level of inferior angle of scapula

Answer 31

T7

Question 32

Detect valves in retrosternal

Answer 32

3344 (PAMT)

Question 33

location of pleura

Answer 33

8th cc midclavicular line 10th rib midaxillary line 11th rib line of inferior angle of scapula 12th thoracic spine

Question 34

Muscles connecting the upper limb to the vertebral column

Answer 34

``` Trapezius Latissimus Dorsi Levator Scapulae Rhomboid Major Rhomboid Minor ```

Question 35

Muscles connecting limb to the thoracic wall

Answer 35

Pectoralis Major Pectoralis Minor Subclavius Serratus Anterior

Question 36

muscles of the shoulder

Answer 36

``` Deltoid Subscapularis Supraspinatus Infrapinatus Teres Minor Teres Major ```

Question 37

origin and insertion of anterior head deltoid

Answer 37

origin - lateral third of clavicle | insertion - deltoid tuberosity lateral side of humerus

Question 38

origin and insertion of middle head deltoid

Answer 38

origin - acromion | insertion - deltoid tuberosity lateral side of humerus

Question 39

origin and insertion of posterior head deltoid

Answer 39

origin - spine of scapula | insertion - deltoid tuberosity lateral side of humerus

Question 40

origin and insertion of infraspinatus

Answer 40

origin - posterior surface of scapula | insertion - middle facet of humerus

Question 41

origin and insertion of supraspinatus

Answer 41

origin - supraspinatus fossa of scapula | insertion - superior facet of humerus

Question 42

origin and insertion of teres minor

Answer 42

origin - lateral border of scapula | insertion - inferior facet of humerus

Question 43

origin and insertion of teres major

Answer 43

origin - inferior angle of scapula | insertion - intertubercular groove of humerus

Question 44

origin and insertion of subscapularis

Answer 44

origin - subscapular fossa of scapula | insertion - lesser tubercle of humerus

Question 45

how to palpate trapezius

Answer 45

patient lying in position have patient do abduction add resistance beyond 90 degree abduction

Question 46

palpate serratus anterior

Answer 46

patient lying in supine position shoulder flexion with a clenched fist add resistance to fist feel lateral side of chest

Question 47

palpate rhomboids

Answer 47

patient sitting up dorsum of hand touch lumbar of spine feel space between vertebrae and lower scapula

Question 48

palpate latissimus dorsi

Answer 48

patient lying in prone position | shoulder extension

Question 49

palpate deltoids

Answer 49

patient sitting and 90 degree abduction anterior deltoid - move arm forward posterior deltoid - move arm backward

Question 50

palpate supraspinatus

Answer 50

shoulder abduction | palpate muscle above spine of scapula

Question 51

palpate infraspinatus

Answer 51

elbow flexion and shoulder abduction - external rotation lag test palpate hand below spine of scapula tell patient to move arm back

Question 52

ratio of degrees of movement between glenohumeral joint and scapulothoracic

Answer 52

Ratio of 2:1

Question 53

pulses of upper arm

Answer 53

``` Subclavian artery Axillary artery Brachial artery Radial artery Ulnar artery ```

Question 54

content of carpal tunnel

Answer 54

median nerve flexor digitorum superficialis flexor digitorum profundus flexor pollicis longus

Question 55

palpate bicep

Answer 55

patient sitting dorsum of hand resting on patients thigh - supination resisted elbow flexion palpate in upper arm

Question 56

palpate brachialis

Answer 56

patient sitting palm of hand resting on patients thigh - pronation resisted elbow flexion palpate in upper arm

Question 57

palpate brachioradialis

Answer 57

patient sitting hand resting on patients thigh in mid prone resisted elbow flexion palpate in lower arm - from wrist to proximal part of arm

Question 58

palpate tricep

Answer 58

patient sitting hand resting on patients thigh in prone resisted elbow extension palpate in back of upper arm -

Question 59

palpate pronator teres

Answer 59

patient sitting hand resting on patients thigh in supine with elbow in flexion resisted supination palpate in front of lower arm in proximal region

Question 60

palpate FCR/FCU

Answer 60

patient sitting hand resting on patients thigh in supine with elbow in flexion resisted wrist flexion feel in wrist

Question 61

palpate EPL/EPB/APL

Answer 61

extend the thumb | feel in back of arm