Test 1: Spine/Thorax

Question 1

Palpate:

external occipital protuberance

Answer 1

Base of occiput - midline = slight elevated bump

Superior nucal line laterally across to mastoid process

Question 2

Palpate:

mastoid process

Answer 2

bumps behind ears. Edge of the skull.

Question 3

First spinous process that we can palpate is…

Answer 3

C2

Question 4

Palpate:

Cervical spinous processes

Answer 4

.

Question 5

Palpate:

Cervical transverse processes

Answer 5

Feel small bump, push side to side to feel glide

Question 6

Palpate:

Cervical facet joints

Answer 6

Articulation between 2 adjacent vertebrae
Made up of: Inferior articular process meeting up with superior articular process of next vertebrae
Find spinous process and go lateral or go posterior from transverse process
More lateral than medial
Hard to know if you’re on them unless person has mal positioning in spine

Question 7

Rule of 3

Answer 7

T1-3, 12 - spinous process is on the same plane/level of transverse process or vertebral body. Can move directly laterally to find transverse process.
T4-6, 11 - transverse processes are coming off vertebral body, but spinous process level with facet joints (lower than vertebrae).
T7-9, 10 - spinous processes is level to the vertebral body of the vertebrae below it. To palpate TP, move up a level and go lateral.

Question 8

How can you differentiate Tspine TP from ribs?

Answer 8

Use mobility of ribs to tell where the transverse process ends and rib starts

Question 9

Palpate:

Lspine TP

Answer 9

Will not be able to feel transverse process
TP level with SP
Projects at least 1 inch on each side

Question 10

Level of spine at iliac crest:

Answer 10

L4

Question 11

Level of spine at spinous process

Answer 11

C3

Question 12

Level of spine at top of scapula

Answer 12

C2

Question 13

____ is the lowest moveable vertebrae

Answer 13

L5

Question 14

Palpate:

First rib

Answer 14

Can passively elevate shoulder/scapula to get deeper
Space between upper traps and clavicle, push down until you hit bone
If you can’t differentiate between muscle and bone, get them to breathe. The first rib should elevate as they inhale.
Side flex to opposite side will also elevate rib

Question 15

Palpate:

carotid artery

Answer 15

.

Question 16

Palpate and OIAN:

SCM

Answer 16

• 2 heads - sternal head and clavicular head
  O: top of manubrium, medial ⅓ of clavicle
  I: mastoid process, lateral superior nuchal line
  A: SF to same side, rotate to opposite side. Bilat flex neck
  N: CN 11 - accessory nerve
  Never do bilat palpation d/t carotid

Question 17

Palpate and OIAN:

anterior/middle scalene

Answer 17

Anterior scalene
O: transverse processes of C3-6
I: first rib

Middle scalene
O: transverse process of C2-7
I: second rib

A: Reverse action
If neck fixed = movement at rib
inspiration
If ribs fixed = neck movement 
SF to the same side 
Rot to opposite side 
RIGHT scalenes would RSF and LROT.

N: don’t need to know for exam

Question 18

Palpate and OIAN:

posterior scalene

Answer 18

O: TP of C6-7
I: second rib 
A: same SF
Reverse action
If neck fixed = movement at rib
inspiration
If ribs fixed = neck movement 
SF to the same side 
N: don't need to know for exam

Question 19

Palpate and OIAN:

UFT

Answer 19

O: external occipital protuberance, medial portion of superior nuchal line, ligamentum nuchae, SP of C7-T12
Ligamentum nuchae
Continuation of supraspinous ligament, broadens and fans out, attaches to nuchal line
I: lateral ⅓ of clavicle, acromion, and spine of scapula
If UFT BILAT contracted, it causes head to tilt back
If UFT contracts on 1 side = elevation of scapula, side bending towards, rotating away
If LEFT UFT contracts = LSF and RROT
N: cranial nerve 11 = accessory nerve

Question 20

Differentiate UFT from …

Answer 20

• splenus capitus/cervicus

- lev scap

Question 21

Palpate and OIAN:

Splenius capitis

Answer 21

Rotates to the same side 
O: ligamentum nuchae and SP of C7-T4
I: mastoid process, lateral superior nuchal line 
A: rotates to the same side
N: cervical

Question 22

Palpate:

Lumber spinous processes

Answer 22

.

Question 23

Palpate:

Lumbar facet joints

Answer 23

Facet joints are in between vertebrae on lateral edges or medially from transverse process

Question 24

Palpate:

Thoracic spinous process

Answer 24

Rule of 3:
T1-3, 12 - spinous process is on the same plane/level of transverse process or vertebral body. Can move directly laterally to find transverse process.
T4-6, 11 - transverse processes are coming off vertebral body, but spinous process level with facet joints (lower than vertebrae).
T7-9, 10 - spinous processes is level to the vertebral body of the vertebrae below it. To palpate TP, move up a level and go lateral.

Question 25

Palpate: | Thoracic transverse processes

Answer 25

Rule of 3: T1-3, 12 - spinous process is on the same plane/level of transverse process or vertebral body. Can move directly laterally to find transverse process. T4-6, 11 - transverse processes are coming off vertebral body, but spinous process level with facet joints (lower than vertebrae). T7-9, 10 - spinous processes is level to the vertebral body of the vertebrae below it. To palpate TP, move up a level and go lateral.

Question 26

Palpate: | Thoracic facet joints

Answer 26

Facet joints are in between vertebrae on lateral edges or medially from transverse process

Question 27

how can you differentiate posterior scalenes from other muscles?

Answer 27

find middle scalenes and lev scap, fill the space in between

Question 28

Palpate and OIAN: Levator Scapulae

Answer 28

Have to differentiate by where it runs. Anterior from UFT. O: superior angle of scapula I: C1-4 transverse processes A: Reverse muscle action If neck fixed = elevate scapula If scapula fixed = same side flex and ext Rotates to the same side How to differentiate between splenius capitus and lev scap: How the muscle runs N: dorsal scapular nerve