# SURFACE ANATOMY // FINAL EXAM

Term
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spine of the scapula
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Terms in this set (80)
*runs at an oblique angle to the body from acromion to the medial border.
*attachment site for posterior deltoid (origin) and middle and lower fibers of trapezius (insertion)
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Palpation:
1. prone. lay hand across upper back and slide your fingertips inferiorly until they roll over the superficial spine.
2. strum your fingers vertically, palpating its width and edges. palpate laterally to acromion and medially toward vertebral column
*parallel to vertebral column
*measure 5-7inches long
*attachment site for rhomboids and serratus anterior
*deep to trap
*winged scapula: medial border falls away from the rib cage and visibly protrudes posteriorly
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Palpation:
1. prone. place pt hand in the small of his back to raise the medial border off the ribs. for more exposure, scoop and raise the shoulder with one hand.
2. locate the spine of the scapula and glide fingertips medially until they slide off the spine onto the medial border.
3. follow medial border inferiorly and superiorly; note that it extends further inferiorly from the spine of the scapula than superiorly
*superficial and located at medial borders lower end
*attachment of teres major
*at the level of T7
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Palpation:
1. prone. Place pt hand in the small of their back. glide fingers inferiorly along the the medial border
2. at the end of the medial border, the edge of the scapula will turn a corner and start to rise superiorly and laterally. this corner is the inferior angle
*located at the superior end of medial border
*attachment site for levator scapula
*deep to the traps
*level of T2
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Palpation:
1. prone. scoop the shoulder with your hand to raise it off the table. this will soften the overlying muscles.
2. locate the medial border. slide your fingertips superiorly along the border to find the superior angle.
3. you may need to move an inch superior to the spine of the scapula to reach the superior angle.
*extends superiorly and laterally from the inferior angle toward the axilla.
*attachment for teres major and teres minor
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Palpation:
1. prone. drape the arm off the side of the table. slide your thumb from the inferior angle superiorly along the lateral border.
2. follow the border in the direction of the axilla. if the musculature is too thick to palpate through, try curling your thumb underneath the tissue.

**[can try with arm in small of back]
*most superior aspect of the lateral border.
*attachment for long head of the triceps
*deep to teres minor and deltoid muscles
Palpation:
1. prone. locate lateral border
2. slide along lateral border to its most superior portion. to access landmark directly, you can compress overlying muscles or CURL UNDERNEATH THEM
*infraspinatus attachment
*triangular area inferior to spine of the scapula
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Palpation:
1. prone. palpate spine of the scapula, its medial border and its lateral border to isolate the infraspinous fossa
2. cradle the inderior angle in the webbing between your index finger and thumb. Your index finger will rest along the medial border, your thumb along the lateral border.
3. place a finger of the opposite hand along the length of the spine of the scapula. the triangular -shaped area you isolate is the infraspinous fossa
*have to go through upper trap to get to this area
Palpation:
1. prone. drop thumbpad inferiorly and laterally from the superior angle into the fossa, or lay your thumb along the spine of the scap and raise it superiorly into the fossa.
2. although the fossa is covered by the trapezius and suprasinpatus muscles, explore as much as you can of its size and shape
3. slide your thumbs laterally, nothing how the fossa becomes thinner and finally ends at the junction of the acromion and the clavicle. (does continue under the acromion but it is inaccessible)
*located on the scapula's anterior (underside) surface next to the rib cage
*attachment of subscapularis
*location of serratus anterior
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Palpation 1 (lateral portion)
1. side lying. allows the scapula to slide away from the rib cage for easier access
2. place thumb at the middle of lateral border. be sure to position thumb anterior to the large mass of muscles along the lateral border
3. FLEX SHOULDER AND PASSIVELY PROTRACT ; slowly sink and curl your thumbpad onto the surface of the fossa. use your other hand to maneuver the arm and scapula for a position that best allows thumb to sink into tissue
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Palpation 2 (medial portion)
1. side lying. flex partners shoulder and lay fingertips along medial border. move scapula posteriorly (RETRACTION) bringing medial border off the ribs
2. slowly curl fingers through the rhomboid and trap muscles, under scap and onto fossa
*lateral aspect of the spine of the scapula
*located at the top of the shoulder
*flat surface