SURFACE ANATOMY/PALPATIONS

palpation of quadriceps as a group
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palpation of quadriceps as a group
1. partner seated. lay the flat of your hands on the anterior surface of the thigh.
2. ask partner to alternately extend and relax his knee slowly. explore the lateral and medial sides of the thigh. for greater contraction, provide a little resistance below knee as partner tries to raise it
rectus femoris palpation
1. supine with knee bolstered. locate AIIS and the patella
2. draw an imaginary line between these two points and follow the path of the rectus femoris
3. palpate along this line and strum across the rectus fibers (2-3 fingers wide)
4. ask your partner to flex his hip and hold his foot up off the table. this position contracts the rectus femoris, making it more pronounced.
vastus medialis palpation
1. supine with the knee bolstered. ask partner to fully contract quadriceps by extending knee. palpate just medial and proximal to patella for bulbous shape fo medialis
2. locate rectus femoris and sartorius, noting how these muscles surround medialis to form its long "teardrop" shape
vastus lateralis palpation
1. partner side lying (make sure pillow is between the legs). place flat of your hand on the lateral side of the thigh while your partner slowly extends and relaxes his knee. notice the vastus lateralis contracting and relaxing.
2. palpate entire belly - posteriorly to the biceps femoris and proximally to the greater trochanter. with the thigh relaxed, identify the direction and depth of the lateralis fibers and the superficial IT tract.
hamstrings as a group
1. prone. place hand on the posterior thigh, between the buttocks and the knee. ask partner to flex knee, holding foot off the table. as the hamstrings contract, explore mass and width.
2. locate ischial tuberosity. slide fingertips distally ONE INCH and strum across the large, solid tendon of the hamstrings.
3. follow tendon distally as it spreads out into the separate bellies of the hamstrings
Individual hamstring bellies and distal tendons
1. partner prone. ask to hold knee in a flexed position. again, explore the bellies of the hamstrings.
2. the lateral half of the hamstring belly is the biceps femoris. its belly will lead toward the head of the fibula.
3. medial head of half of hamstrings consists of the layered bellies of semitend and semimemb. move to medial side of the knee and palpate for the tendons of these muscles
4. most superficial tendon: semitendonosis. turn partner supine and follow distally til it merges with pes anserine tendon.
gluteus maximus
1. prone. locate coccyx, edge of sacrum, PSIS, and posterior 2 inches of the iliac crest to isolate the landmarks that form the origin of the maximus
2. locate insertion at gluteal tuberosity
3. connect origin to insertion by drawing the fiber direction on your partner. palpate thick fibers. notice differences in depth between adipose tissue and muscle fibers
glute medius and minimus
1. side lying. isolate shape of the glute medius by placing webbing of one hand along iliac crest (PSIS to about ASIS) while other hand finds greater troch
2. hands form a shape that looks like a slice of pie.
3. palpate area from below iliac crest to greater troch for dense fibers of glute med.
4. sink fingers deep to glute med to look for min.
gracilis and adductor longus
1. supine with hip slightly flexed and ER. place hand at middle of medial thigh. ask partner to adduct hip slightly.
2. slide fingers proximally to pubic bone and locate tendons of gracilis and adductor longer off pubic tubercle.
3. strum fingers across tendon and dollow distally as it dev