Anatomy: Palpation List Term2
Anatomy: Palpation List Term2
HEAD, NECK, FACE
Bones
NAME
Mastoid process p.199
Styloid process p.199
Zygomatic arch p.199
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What to doÉ
á Locate the mastoid process by
placing your finger behind the ear
lobe. Sculpt around its edges,
exploring the entire surface.
á The bone should feel round
and superficial.
á You can palpate posteriorly
onto the superior nuchal line of the
occiput.
á Palpate btwn the mastoid
process and the posterior edge of
the mandible.
á It is deep to overlying muscles
and it is NOT directly palpable.
á Explore gently.
á Locate the mastoid process by
placing finger behind the ear lobe.
á Explore the zygomatic arch by
placing your finger anterior to the
ear canal. Mover anteriorly along
the arch, outlining its sides with
your thumb and finger. (diagram)
Follow it anteriorly as it merges
with the orbit of the eye.
á The ridge of the arch should
run horizontal and it should be
level with the ear canal.
á Use thumb and index finger to
trace and Ôpinch the boneÕ
What to sayÉ
á The mastoid process forms a larger,
superficial bump directly behind the ear
lobe.
á It is an attachment site for the
sternocleidomastoid, longissimuss capitis,
and splenius capitis muscles. (check
accuracy)
á The styloid process is located behind
the ear lobe bwtn the mastoid process
and the posterior edge of the mandible.
á Its fanglike shape serves as an
attachment site for several ligaments and
muscles includingÉ
á It is deep to overlying muscles and
tissue and is not directly palpable;
however, its location can be accessed.
á The styloid process of the temporal
bone is fragile and is deep to the facial
nerve, so exploration in this area should
be very gentle.
á The superficial zygomatic arch forms
the cheekbone.
á It is composed by the temporal and
zygomatic bones.
á It is an attachment site for the
masseter muscle.
á The space btwn the zygomatic arch
and the cranium is filled by the thick
temporalis muscle.
 Anatomy: Palpation List Term2
Angle of the mandible á Slide posteriorly along the
p.201-202 base of the mandible to the angle.
Clarify your location by asking
your partner to open his mouth
and noting the movement of the
angle.
á Slide superiorly from the angle
á Trace along the base of the
mandible until you reach the angle.
Condyle of the mandible á Place your fingerpad anterior
p.201-202 to the ear canal and below the
zygomatic arch.
á Ask your partner to open his
mouth fully and slowly. With this
action, the condyle will become
more palpable as it slides
anteriorly and inferiorly.
á (hint: You should be anterior
to the ear canal, below the
zygomatic arch. As your partner
opens his mouth, you should be
able to palpate both condyles
simultaneously.)
Ramus of the mandible á Slide superiorly from the angle
p.201-202 onto the ramus which is deep to
the masseter muscle.
Coronoid process of the á Place your fingerpad on the
mandible middle aspect of the zygomatic
p.201-202 arch.
á Drop half an inch inferiorly and
ask your partner to open her
mouth fully. As the jaw drops, the
large process will press into your
finger. (diagram p.202)
á With the mouth still open,
explore the surfaces of the
process.
á (hint: You should be inferior to
the zygomatic arch. When the
mouth is open, you should feel the
anterior edge of the process.)
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á The superficial angle of the mandible
is located at the posterior end of the base
Òjaw lineÓ.
á It forms part of the attachment for the
masseter.
á This is one of the 2
temporomandibular joints which
articulates the mandible with the cranium.
á The superficial condyle is located just
anterior to the ear canal and inferior to
the zygomatic arch.
á The deeper, inaccessible head of the
condyle forms the articulating surface of
the mandible at the temporomandibular
joint.
á The condyle is not conguent with itÕs
articulating surface. As such, there is a
lifesaver-shaped disc which lies on top of
the condyle which helps to create more
congruity bwtn the joint surfaces,
reducing the potential for bone
deterioration.
á The flat ramus is the posterior,
vertical portion of the mandible and is
deep to the masseter.
á The coronoid process is located an
inch anterior to the condyle of the
mandible and is the attachment site of the
temporalis muscle. When the jaw is
closed, the coronoid process lies
underneath the zygomatic arch and is
inaccessible. Opening the mouth fully,
however, will bring the coronoid process
out from under the arch and allow the
process to be accessed.
á (try and find any other m. attachments
to this process)
 Anatomy: Palpation List Term2

Digastric p.214 á Partner supine with
practitioner at head of table.
Locate the mastoid process of the
temporal bone and the hyoid bone
(see hyoid section below)
á Draw an imaginary line
between these points. Using your
index finger, palpate along this
line for the skinny, posterior
digastric (diagram p.215)
á Draw an imaginary line bwtn
the hyoid bone to the underside of
the chin and palpate for its
anterior belly.
á To feel the digastric contract,
place your finger under the chin
and ask your partner to try to open
her mough against your gentle
resistance. This contraction will
sometimes allow both of the
digastric bellies to be located
more easily.
á (hint: the muscle should be
superficial and pencil-width. It
should extend from the mastoid
process to the hyoid bone to the
chin.)
á The long, round digastric muscle is
composed of a posterior and an anterior
belly. The posterior belly runs from the
mastoid process to the hyoid bone and
then loops through a tendinous sling on
the hyoidÕs anterior surface. It continues
on as the anterior belly to attach at the
underside of the chin. (diagram p214)
á Both bellies are superficial, yet
difficult to distinguish from the deeper
suprahyoid muscles.
á (activation: Òdepress your jawÓ or
ÒswallowÓ)
á S.A. : inferior border of mandible
near symphysis
á I. A. : intermediate tendon to hyoid
á A : (1) elevates and pulls hyoid
anteriorly; (2) assists in depressing
mandible (I.A. fixed)

Hyoid p.203 á Supine or seated. Place your á The hyoid bone is horse-shoe shaped.
index finger upon the thyroid á Located superior to the thyroid
cartilage (place fingers on cartilage.
AdamÕs Apple, then ask your á It is roughly an inch in diameter and
partner to swallow, you will feel it lies parallel to the base of the mandible
move up and down.) (jaw line) and the 3rd and 4th cervical
á Roll your fingerpad superiorly vertebra.
over the thyroid cartilage and onto á It serves as an attachment site for the
the hyoid. supra and infrahyoid muscles. It is
á Then gently palpate the sides accessible and elevates upon swallowing.
of the hyoid with your first finger
and thumb. (diagram) The hyoid
will be wider than the trachea.
á Using gentle pressure, explore
the surface of the hyoid as well as
its small side to side movements.
á If you have difficulty accessing
the hyoid, ecourage your partner
to relax her tongue and jaw.
á Hint: you should be superior to
they thyroid cartilage. You should
be able to move the hyoid from
side to side.
á With your first finger and
thumb on either side of the hyoid,

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 Anatomy: Palpation List Term2
Sternocleidomastoid p.207
Temporalis p.213
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ask your partner to swallow. You
should be able to feel the hyoid
rise up and then return. (diagram)
á Supine with practitioner at
head of table. Locate the mastoid
process of the temporal bone, the
medial clavicle and the top of the
sternum.
á Draw a line btwn these
landmarks to delineate the
location of the muscle. Note how
both sides form the ÒVÓ on the
front of neck.
á Ask your partner to raise her
head very slightly off the table as
you palpate the muscle. (diagram
208) It will usually protrude
visibly. (To make the muscle
more distinct, rotate the head
slightly to the opposite side and
then ask her to flex her neck.)
á Palpate along the borders of
the muscle, follow it behind the
ear lobe, and then down to the
clavicle and sternum (diagram
208). Sculpt around the skinny
sternal tendon and the wider
clavicular tendon.
á (hint: With your partner
relaxed, you can grasp the muscle
btwn your fingers and outline its
thickness and shape. There
should be aprox. 2-3 inches btwn
the clavicular attachments of the
muscle and the trapezius.)
á Supine with practitioner at
head of table. Locate the
zygomatic arch.
á Place your fingerpads 1 inch
superio to the arch and ask your
partner to alternately clench and
relax jaw. You should feel the
strong temporalis contracting
beneath your fingers. (diagram213)
á To locate the attachment site
of the temporalis tendon, ask
partner to open her mouth wide.
á Locate and explore the
coronoid process (diagram213).
Although the coronoid process is
easily accessed, you may not be
able to isolate the tendon of the
temporalis.
á To outline the wide origin of
á The sternocleidomastoid is located on
the lateral and anterior aspect of the
neck. It has a large belly with 2 heads: a
flat, clavicular head and a slender, sternal
head. (diagram p.207)
á Both heads merge to attach behind
the ear at the mastoid process.
á The carotid artery passes deep and
medial to it;
á The external jugular lies superficial to
it.
á The sternocleidomastoid is
superficial, completely accessible and
often visible when the head is turned to
the side in Lord Byron-like fashion
(diagram 207)
á (action: Òflex your neckÓ or Òinhale
deeplyÓ)
á S.A. : mastoid process
á I. A : sternum, clavicle
á A : Bilateral:
á (1) extends the head if the head is
extended
á (2) flexes the head and neck if the
head is erect or flexed.
á (3) stabilizes the head (with the
trapezius) during movements of the
mandible (ie, talking, eating)
á (4) accessory muscle of inspiration
á A: Unilateral
á (The same cranial nerve innervates
the upper traps and SCM, so their actions
will be similar.)
á (1) contralateral rotation
á (2) ipsilateral flexion
á The temporalis muscle is located on
the temporal aspect of the cranium. Its
broad origin attaches to the frontal,
temporal, and parietal bones.
(diagram213)
á Its fibers converge into a thick mass,
reaching under the zygomatic arch to
connect at the coronoid process.
á Though deep to the temporal fascia
and artery, the temporalis is superficial
and directly accessible.
á (activation: Òclench your jawÓ)
á Trailguide:
á Origin: temporal fossa and fascia
á Insertion: coronoid process of the
mandible
á Action: (1) elevates the mandible
á (2) retracts the mandible
 Anatomy: Palpation List Term2

the temporalis, place your fingers

in various positions on the side of
the head and ask your partner to
alternately clench and relax her
jaw. If your fingers are on the
muscle, you will feel the
temporalis fibers tighten and
soften. If you are off the muscle,
you will not feel anything.
á (hint: you should be superior
to the zygomatic arch on the side
of the head. Try to discern the
muscle fiber direction and feel
them converge.)
Masseter p.212 á Supine. Locate the zygomatic
arch and angle of the mandible.
á Place your fingers btwn these
bony landmarks and palpate the
surface of the masseter.
á Ask your partner to alternately
clench and relax jaw as you sculpt
out the square shape of the belly
(diagram212)
á Clarify the masseterÕs fiber
direction by strumming your
fingers horizontally across its
muscle fibers.
á Now ask your partner to relax
and try grasping the chunky
bellies of the masseter.
(diagram212)
á (hint: as your partner
clenches, you should be able to
outline the anterior edge of the
masseter. If your partner opens
her jaw as wide as possible, you
can feel the tissue lengthen.)
á The masseter is the strongest muscle
in the body relative to its size. The two
masseters together exert a biting force of
nearly 150 pounds of pressure Ð enough
to bite off a finger! The masseter is the
primary chewing muscle and is used in
speaking and swallowing.
á Located on the side of the mandible,
the square-shaped masseter is
composed of 2 overlapping bellies. The
superficial belly can be accessed from the
face. (diagram212); the deep belly is
palpable from inside the mouth
(diagram212). The masseter is situated
deep to the parotid gland (diagram212)
yet is easily palpable.
á (activation: Òclench your jawÓ)
á Trailguide:
á O: zygomatic arch
á I: angle and ramus of mandible
á A: elevates the mandible
(temporomandibular joint)

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 Anatomy: Palpation List Term2
Middle scalene p.208-211
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á Supine, with practitioner at
head of table. Cradle the head
(passively flexing it) to allow for
easier palpation.
á Place your fingerpads along
the anterior and lateral sides of
the neck btwn the
sternocleidomastoid and trapezius.
á With the pads of your fingers,
use gentle pressure to palpate the
stringy, superficial bellies in this
triangle.
á (hint: make sure you are bwtn
the sternocleidomastoid and the
trapezius).
á Ask your partner to inhale
deeply into her upper chest. As
she fully inhales, do you feel the
muscles in this triangle contract?
(diagram210)
á Rotate the head slightly to the
opposite side to better expose it.
á Gently palpate under the
sternocleidomastoidÕs lateral
edge and roll past the belly of the
anterior scalene.
á Move laterally to explore the
middle scalene, noting its similarly
shaped belly.
á (hint: the muscle should have
a slender stringy texture. If you
follow it inferiorly, they should sink
beneath the clavicle in the
direction of the ribs.
á You can follow them superiorly
to the transverse processes of the
cervical vertebrae.
á Ask your partner to flex her
head slightly and you should feel
the scalenes contract.
á The middle scalene (all 3) are
sandwiched bwtn the sternocleidomastoid
and the anterior flap of the trapezius on
the anterior, lateral neck.
á Their fibers begin at the side of the
cervical vertebrae, dive underneath the
clavicle, and attach to the first and
second ribs. (diagram208)
á During normal inhalation, the
scalenes perform the vital task of
elevating the upper ribs.
á The middle scalene is slightly larger
than the anterior scalene and lies lateral
to it. The muscle belly is fully accessible.
á (activation: Òinhale into your upper
chestÓ or Òflex your neckÓ)
á Trailguide:
á O: TVP of 2nd to 7th cervical vertebrae
(posterior tubercles)
á I: 1st rib
á A: Bilateral
á (1) elevates the ribs during inhalation
(All)
á (2) flex the neck (anterior)
á Unilateral
á (1) With the ribs fixed, laterally flex
the neck to the same side. (All)
á (2) Rotate head and neck to the
opposite side (All)
 Anatomy: Palpation List Term2
SHOULDER AND ARM
Bicipital groove aka
intertubercular groove p.63
Coracobrachialis p.92
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〈 Place your thumb on the
greater tubercle (diagram63)
〈 Begin to rotate the arm
laterally. As the humerus
rotates, the greater tubercle will
move out from under your thumb
and be replaced by the slender
ditch of the intertubercular
groove.
〈 As you continue to laterally
rotate, your thumb will rise out of
the groove onto the lesser
tubercle.
〈 After placing thumb on the
greater tubercle, try passively
rotating the arm medially and
laterally. You should feel the
Òbump-ditch-bumpÓ sequence
as the 3 landmarks (greater
tubercle-bicipital groove-lesser
tubercle) pass beneath your
thumb.
〈 Make sure you are horizontal
to the level of the coracoid
process.
〈 Supine. Laterally rotate and
abduct the shoulder to 45
degrees. Locate the fibers of
the pectoralis major. This tissue
forms the axillaÕs anterior wall
and will be a good reference
point for locating
coracobrachialis.
〈 Lay one hand along the
medial side of the arm and move
your fingerpads into the armpit.
〈 Have your partner
horizontally adduct gently
against your resistance
(diagram92)
〈 Isolate the solid edge of the
〈 The bicipital groove aka
intertubercular groove, is situated
btwn the greater and lesser
tubercles, and is roughly a
pencilÕs width in diameter.
〈 Within the groove lies the
tendon of the long head of the
biceps brachii, which can be
tender, requiring a gentle touch
〈 The coracobrachialis is a small,
tubular muscle located in the
axilla. Sometimes known as the
armpit muscle.
〈 It is a secondary flexor and
adductor of the shoulder.
〈 In anatomical position, the
coracobrachialis is deep to the
pectoralis major and anterior
deltoid and lies anterior to the
axillary artery and brachial plexus.
〈 Abducting the shoulder
(opening up the axilla) brings the
belly of coracobrachialis to a
superficial and palpable position.
〈 (activation: Òadduct your
 Anatomy: Palpation List Term2
Latissimus Dorsi p.69-70
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pectoralis major then slide off
itÕs fibers posteriorly (into the
axilla) and explore for the
slender contracting belly of
coracobrachialis.
〈 Its belly may be visible upon
adduction.
〈 Make sure the muscle you
are palpating is on the medial
side of the upper arm.
〈 Make sure itÕs belly lie
posterior to the overlying flap of
the pectoralis major and that you
can strum along itÕs cylindrical
belly.
〈 Prone with arm off side of
table. Locate the scapulaÕs
lateral border.
〈 Using your fingers and
thumb, grasp the thick wad of
muscle tissue lateral to the
lateral border. This is the
latissimus dorsi (and maybe
some of teres major).
〈 Note how this muscle tissue
flairs off the side of the trunk.
〈 Feel the latissimus fibers
contract by asking your partner
to medially rotate his shoulder
against your resistance.
〈 ÒSwing your hand up toward
your hip.Ó
〈 As this occurs, follow the
latissimus fibers superiorly into
the axilla and inferiorly on the
ribs.
〈 Make sure you are not just
lifting the skin. Grasp the tissue
and slowly let it slip out btwn
your fingers.
〈 Supine. Cradling the arm in
a flexed position, grasp the
tissue of latissimus located
beside the lateral border.
〈 Ask your partner to extend
his shoulder against your
resistance.
〈 ÒPress your elbow toward
your hip.Ó This will force the
latissimus to contract.
shoulderÓ)
〈 PA: coracoid process
〈 DA: the middle medial surface
of shaft of humerus
〈 A: flexes and adducts GH joint
(combing your hair)
〈 The latissimus dorsi is the
broadest muscle of the back. ItÕs
thin superficial fibers originate at
the low back, ascend the side of
the trunk and merge into a thick,
bundle at the axilla. (diagram69).
〈 Both ends of the latissimus
dorsi are difficult to isolate;
however, itÕs middle portion next
to the lateral border of the scapula
is easy to grasp.
〈 The latissimus dorsi and teres
major are sometimes called the
handcuff muscles, since their
actions collectively bring the arms
into the Òarresting positionÓ (ie:
extension, adduction, medial
rotation)
〈 The latissimus dorsi not only
moves the arm, but b/c of its
broad origin, can also affect the
trunk and spine.
〈 Contraction of the left
latissimus dorsi assists in lateral
flexion of the trunk to the left. If
the arm is fixed, as when hanging
froma bar, the latissimus dorsi will
assist in extension of the spine
and tilting of the pelvis anteriorly
and laterally.
〈 (activation: Òextend and
medially rotate your shoulderÓ)
〈 MA: T6-T12 SP,
thoracolumbar fascia, iliac crest,
 Anatomy: Palpation List Term2
Teres Major p.69-70
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(diagram70)
muscle to respiration
hips to ease breathing)
〈 Prone with arm off the side of
the table.
〈 Locate and grasp the
latissimus dorsi fibers btwn your
fingers and thumb.
〈 Move your fingers and thumb
medially to where you feel the
scapulaÕs lateral border. The
muscle fibers that lie medial to
the latissimus and attach to the
lateral border will be the teres
major.
〈 Follow these fibers toward
the axilla where they blend with
the latissimus dorsi.
〈 (hint: lay your thumb on the
inferior aspect of the lateral
border and have your partner
medially rotate the shoulder joint
to distinguish the teres major
from the latissimus dorsi
(diagram70).
〈 The fibers of both muscles
will contract; those that attach
directly to the lateral border
belong to teres major; the more
lateral fibers belong to latissimus
dorsi.
〈 (hint: touch on the inferior
angle)
ribs 9-12, sometimes the inferior
angle of scapula
〈 LA: the floor (bottom surface) of
the bicipital groove
〈 A: (MA fixed) medial rotation,
extension, and adduction of GH
joint. (handcuff position)
(LA fixed) chin ups, accessory
(arms at
〈 The teres major is called Òthe
latÕs little helperÓ because it is a
complete synergist with the
latissimus dorsi. (diagram69)
〈 It is superficial and located
along the scapulaÕs lateral border
btwn the latissimus dorsi and teres
minor.
〈 Although they share names,
the teres major and teres minor
rotate the arm in opposite
directions Ð the major medially,
the minor laterally.
〈 Teres major, (along with
latissimus dorsi) are sometimes
called Òthe handcuff musclesÓ
since their actions collectively
bring the arms into the arresting
position. (extension, adduction,
and medial rotation)
〈 PA: inferior angle of scapula
〈 DA: bicipital groove, medial lip
(aka crest of the lesser tubercle)
〈 A: adduction, extension, and
medial rotation of humerus
(handcuff positon)
 Anatomy: Palpation List Term2
Levator Scapula p.79-80 〈 Prone, supine, or sidelying.
Palpating through the trapezius,
locate the superior angle of the
scapula. (diagram80) and the
upper region of the medial
border.
〈 Place your fingers just off the
superior angle and firmly strum
across the belly of the levator.
The fibers will likely have a ropy
texture.
〈 Follow these fibers superiorly
as they extend to the lateral side
of the neck to the transverse
processes of the cervical
vertebrae.
〈 Try to differentiate btwn the
fibers of levator and trapezius.
Levator fibers should lead you
toward the lateral side of the
neck.
Alternative method:
〈 Locate upper fibers of
trapezius
〈 Roll 2 fingers anteriorly off
the trapezius and press into the
tissue of the neck.
〈 Gently strum your fingers
anteriorly and posteriorly across
the levator fibers. (diagram80)
Often you will feel a distinct
band of tissue that leads
superiorly toward the lateral
neck and inferiorly under the
trapezius.
〈 Place your fingertips on the
levator and ask your partner to
alternately elevate and relax his
scapula.
〈 You should feel it contract
and relax beneath your
fingertips.
〈 ***** SUPINE. Passively
rotate the head 45 degrees
away from the side you are
palpating will shift the cervical
transverse processes further
anteriorly. Also it gives the
levator scapula more palpable
tension.
〈 Conversely, this position
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〈 Located along the lateral and
posterior sides of the neck. Its
inferior portion is deep to the
upper trapezius; however, as the
levator ascends the lateral side of
the neck, its fibers come out from
under the trapezius and become
superficial. (diagram79)
〈 Its belly is aprox. 2 fingers wide
with fibers that naturally twist
around themselves.
〈 It attaches to the transverse
processes of the cervical
vertebrae. (diagram79) Located
on the lateral side of the neck, all
of these small protuberances
extend laterally at aprox. The
same width, except for the
processes of C1 which are
broader.
〈 When accessing the processes
to locate the origin of the levator
scapula, begin by using your soft
fingerpads to avoid compressing a
brachial plexus nerve.
〈 The levator is completely
accessible by palpating either
through the upper fibers of the
trapezius or directly from the side
of the neck.
〈 The levator is situated btwn the
splenius capitis and posterior
scalene muscles on the lateral
side of the neck. (diagram79)
〈 It can be distinguished from
these neighbouring muscles
during palpation b/c it moves the
scapula.
〈 No other muscle deep to the
upper trapezius or attaching to the
lateral cervical vertebrae is
capable of this action.
〈 (activation: Òelevate your
scapulaÓ)
〈 SA: C1-C4 TVP
〈 IA: superior part of medial
border of scapula
〈 A: (SA fixed) (1) downward
rotation (medial rotation) of
scapula; (2) elevation of scapula
 Anatomy: Palpation List Term2
shortens and softens the overlying
trapezius fibers.
Serratus Anterior p.81-82
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with upper trapezius
〈 (IA fixed) (1) lateral flexion of
neck; (2) ipsilateral rotation of neck
〈 Palpating along the sides of 〈 Lies along the posterior and
the ribs can tickle, so use slow, lateral ribcage.
firm pressure. 〈 Its oblique fibers extend from
〈 If accessing the left serratus, the ribs underneath the scapula
it may be easier to stand on the and attach to its medial border.
right side of the table. 〈 Most of the serratus is deep to
〈 Supine. Isolate the location of the scapula, latissimus dorsi, or
the serratus by abducting the pectoralis major; however, the
arm slightly and locating the portion of the serratus below the
lower edge of the pectoralis axilla (armpit) is superficial and
major. (diagram82) Then locate easily accessible. (diagram81)
the anterior border of the 〈 It is unique in its ability to
latissimus dorsi. abduct the scapula, making it an
〈 Place your fingerpads along antagonist to the rhomboids.
the side of the ribs btwn pec 〈 The inferior/lateral aspect of the
major and the lat dorsi. breast covers the serratus anterior.
〈 Strum your fingers across the 〈 It supports the weight of the
ribs and palpate for the serratus trunk and stabilizes the pectoral
anterior fibers. To differentiate girdle against the thorax during a
btwn the ribs and the serratus push-up.
fibers (both have a similar 〈 (activation:Óabduct your
Òspeed bumpÓ shape), scapulaÓ)
remember that the ribs are deep
and have a solid texture while 〈 PA: lateral external surfaces of
the serratus fibers are superficial 1st 9 ribs.
and malleable. 〈 DA: anterior medial border of
〈 OrÉ ask your partner to flex scapula
his shoulder so his fist is raised 〈 A: (PA fixed): (1) abduction and
toward the ceiling. Place one protraction of scapula; (2) lower
hand upon the serratus fibers fibers may depress scapula; (3)
and your other hand on top of upper fibers may elevate scapula
his raised fist.
〈 (DA fixed): elevates ribs and
〈 Ask him to alternately abduct can assist in forced respiration.
his scapula and relax: Òreach
〈 Isometrically fixed (everything
toward the ceiling and then relax.
fixed): isometric stabilizes scapula
Ó You should fell the fibers
(ie, prevents winging). It holds the
contract and soften. You can
medial border of the scapula firmly
also follow the fibers along the
against the thorax in a properly
ribs to where they tuck
executed push-up.
underneath the lat dorsi.
〈 OrÉ turn your partner
sidelying with his arm at his
side. Locate the medial border
of the scapula to access the
insertion of the serratus
anterior.
〈 Curl your fingers beneath the
medial border onto the
 Anatomy: Palpation List Term2
Subscapularis p.71-74
Upper trapezius p.67-68
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beginnings of the subscapular
fossa and explore the area
where the serratus attaches.
〈 Sidelying. Flex the shoulder
and pull the arm anteriorly as
much as possible. This will
allow easier access to the
scapulaÕs anterior surface.
〈 Hold the arm with one hand
while the thumb of the other
locates the lateral border.
〈 Hint: slide your thumb
underneath the lat dorsi and
teres major fibers instead of
going through them. (diagram74)
〈 Slowly and gently curl your
thumb onto the subscapular
fossa. You may not feel the
subscapularis fibers
immediately, but if your thumb is
on the anterior surface of the
scapula, you will be accessing a
portion of the fibers.
〈 Hint: ask your partner to
gently rotate his shoulder
medially. You can feel the
subscapularis fibers contract
beneath your thumb.
〈 OrÉ supine. Cradle the arm
in a flexed position and locate
the lateral border. Slowly sink
your thumbpad onto the
subscapular fossa, adjusting the
arm and scapula as you
progress. (diagram74)
〈 Prone. These fibers form the
easily accessible flap of muscle
lying across the top of the
shoulder. Along the posterior
neck they are surprisingly
skinny, each being only an inch
in diameter.
〈 Grasp the superficial tissue
on the top of the shoulder and
feel the upper trapezius fibers.
Take note of their slender quality.
〈 Follow the fibers superiorly
toward the base of the head at
the occiput. To feel the fibers
along the posterior neck
〈 Part of the rotator cuff muscles
which encompass, and stabilizes
the glenohumeral joint
〈 The deep subscapularis is
located on the scapulaÕs anterior
surface and is sandwiched btwn
the subscapular fossa and the
serratus anterior muscle.
(diagram71)
〈 With only a small portion of its
muscle belly accessible,
subscapularis is the only rotator
cuff muscle that attaches to the
humerusÕ lesser tubercle.
〈 It rotates the shoulder medially
〈 (activation: Òmedially rotate
your shoulderÓ)
〈 PA: subscapular fossa
〈 DA: lesser tubercle
〈 A: medial rotation of humerus
〈 The trapezius lies superficially
along the upper back and neck. It
has broad, thin fibers.
〈 Fiber direction of the upper
traps is superomedial.
〈 The upper and lower traps are
antagonists in elevation and
depression of the scapula.
〈 Activation:Ó elevate or depress
your shoulderÓ
〈 MA: (1) medial 1/3 of superior
nuchal line of occiput; (2) inion
aka external occipital
protuberance; (3) C2-C7 SP; (4)
 Anatomy: Palpation List Term2
Lower trapezius p.67-68
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contract, stand at the head of ligamentum nuchae (a fibroelastic
the table and ask your partner to band joining C7 SP to the inion
extend his head a quarter inch and the spines of the cervical
off the face cradle. Then follow vertebrae SPs to one another.
the fibers inferiorly to the lateral 〈 LA: (1) lateral 1⁄2 of clavicle; (2)
clavicle. acromion, medial side
〈 Remember: the muscle 〈 A: (MA fixed): (1) elevates
should be thin and superficial. scapula (with levator scapulae);
Grasp the fibers along the top of (2) upward rotation of scapula
the shoulder and have your 〈 (LA fixed): (Unilateral
partner elevate his scapula movements): (1) lateral flexion of
gently toward his ear. The fibers neck (to ipsilateral side); (2)
should become taut. contralateral rotation of neck.
〈 (Bilateral insertion fixed):
extension of neck
〈 Locate the edge of the lower 〈 Same as above.
fibers by drawing a line from the
spine of the scapula to the 〈 MA: T6-T12 SP
spinous process of T12 〈 LA: root of scapula aka apex of
(diagram68) spine of scapula
〈 Palpate along this line and 〈 A: (MA fixed): (1) upward
push your fingers into the edge rotation of scapula; (2) depression
of the lower fibers. Ask your of scapula with pec minor.
partner to hold his arms out in 〈 (rotation is achieved thru a
front of him (like Superman) and force couple)
feel for the superficial fibers of
the trapezius.
〈 Attempt to lift the lower fibers
btwn your fingers, raising it off
the underlying musculature.
〈 Hint: another action would
be to ask your partner to
depress his shoulder. The lower
fibers run at a gentle angle
toward the scapula (rather than
parallel with the vertebral
column like the erector spinae
muscles)
 Anatomy: Palpation List Term2
Clavicular head of
Pectoralis Major p.83-84
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〈 Caution: palpate around
breast tissue, and not directly
into it.
〈 Remember: communicate
your intentions to your partner.
Encourage her to let you know if
at any time she wishes to stop.
〈 Positioning: Supine allows
easier access to the sternal and
upper pectoral regions, but may
crowd the axillary area. (ask her
to hold her breast medially or
use the back of your hand to
push the tissue medially)
〈 In sidelying, the breast tissue
will fall medially opening up the
axillary region. The axilla can be
opened up further by passively
shifting the shoulder anteriorly.
(diagram83)
〈 Main instructionsÉ
〈 Supine. With your partnerÕs
shoulder slightly abducted, sit or
stand facing him.
〈 Locate the medial shaft of the
clavicle and move inferiorly onto
the clavicular fibers.
〈 Explore the surface of the
pectoralis major. Follow the
fibers laterally as they blend with
the deltoid and attach at the
greater tubercle.
〈 Grasp the belly of the
pectoralis by sinking your thumb
into the axilla. Ask your partner
to medially rotate his shoulder
against your resistance. ÒPress
your hand toward your bellyÓ
(diagram84) Note the
contraction of the pectoralis.
〈 NOTE: the clavicular fibers
run parallel with the anterior
deltoid. Get a sense of its
thickness and how it lies across
the ribcage.
〈 The pectoralis major is a broad,
powerful muscle located on the
chest. Except for the part beneath
breast tissue, its convergent,
superficial fibers are accessible.
〈 It is divided into 3 segments Ð
the clavicular, sternal, and costal.
〈 The upper and lower fibers
perform opposing actions at the
shoulder joint Ð flexion and
extension, respectively Ð making
this muscle an antagonist to itself.
〈 Activation: Òadduct your
shoulderÓ
〈 NOTE: the clavicular fibers run
parallel with the anterior deltoid.
Get a sense of its thickness and
how it lies across the ribcage.
〈 MA: (clavicular fibers): medial
1⁄2 of clavicle
〈 LA: crest of greater tubercle
aka lateral lip of bicipital groove
〈 A: (of the whole muscle): (1)
adduction of the GH joint; (2)
medial rotation of GH joint; (3)
horizontal adduction aka
horizontal flexion
〈 A: (clavicular head) flexes the
humerus
 Anatomy: Palpation List Term2
Sternal head of Pectoralis
Major p.84
Triceps p.90-91
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〈 Same as above, but palpate
along the sternum.
〈 Prone. Bring the arm off the
side of the table and palpate the
posterior aspect of the arm.
Outline the edge of the posterior
deltoid and then explore the size
and shape of the triceps.
〈 Locate the olecranon process
to outline the distal tendon of the
triceps. Then ask your partner
to extend his elbow as you apply
resistance at his forearm.
(diagram91) Slide your other
hand off the olecranon process
proximally and onto the broad
triceps tendon.
〈 With your partner still
contracting, widen your fingers
and palpate the medial and
lateral heads on either side of
the tendon.
〈 Hint: the muscle should
tighten when your partner
extends his elbow. The medial
and lateral triceps heads should
bulge on either side of the distal
tendon.
〈 Same as above
〈 MA: (sternal fibers): anterior
surface of sternum
〈 LA: crest of greater tubercle
aka lateral lip of bicipital groove.
〈 A: extends humerus (brings it
back from flexion)
〈 The only muscle located on the
posterior arm.
〈 It creates extension at the
elbow and shoulder and is an
antagonist at both these joints to
the biceps brachii.
〈 It has 3 heads: long, lateral,
and medial.
〈 The long head exends off the
infraglenoid tubercle of the
scapula, weaving btwn the teres
major and minor.
〈 The lateral head lies
superficially beside the deltoid.
〈 The medial head lies mostly
underneath the long head.
〈 All 3 heads converge into a
thick, distal tendon proximal to the
elbow.
〈 Aside from its proximal portion,
which is deep to the deltoid, the
triceps is superficial and easily
accessible.
〈 PA: (long head): infraglenoid
tubercle and neck of scapula
〈 (lateral head): humerus,
posterior surface superior to the
radial (spiral) groove.
〈 (medial head): humerus,
posterior surface inferior to the
radial (spiral) groove
〈 DA: olecranon
〈 A: (whole muscle): extension at
the elbow joint
 Anatomy: Palpation List Term2

〈 (long head): extends GH joint

Tendon of the long head
of triceps brachii p.91
FOREARM AND HAND
(weak)
〈 Prone. Place one hand on 〈 Hint: it is the only band of
the proximal elbow and ask your muscle on the posterior arm that
partner to bring his elbow toward runs superiorly along the proximal
the ceiling against your and medial aspect of the arm.
resistance. This action will The deltoid fibers run at a more
contract the long head of the diagonal direction than the long
triceps. head of the triceps.
〈 Locate itÕs belly along the
proximal and medial aspects of 〈 See above for attachments.
the arm. Follow the muscle
proximally by strumming across
the belly. Note how it
disappears underneath the
posterior deltoid toward the
infraglenoid tubercle.
〈 With the arm relaxed, press
through the posterior deltoid and
strum across its skinny tendon
as it attaches to the infraglenoid
tubercle.
〈 Hint: the long head of the
triceps crosses over the teres
major and under the teres
minor. You can follow the long
head up to the division f the
teres muscles.
〈 Have your partner medially
and laterally rotate his shoulder
to differentiate the teres
muscles. (diagram91)

Head of radius p.108
〈 Shake hands and locate the
lateral epicondyle.
〈 Slide distally off the
epicondyle, across the small
ditch btwn the humerus and
radius and onto the head of the
radius. (diagram108)
〈 The head of the radius is the
only bony structure in this
vicinity. Explore its ring-shaped,
superficial surface.
〈 You should be distal to the
lateral epicondyle. Place your
thumb on the head and, with
your other hand, slowly supinate
and pronate the forearm.
(diagram108)
〈 The head of the radius is distal
to the humerusÕ lateral
epicondyle.
〈 It forms the radiusÕ proximal
end and has a circular, bell shape.
〈 The head is stabilized by the
annular ligament and is a pivoting
point for supination and pronation
of the forearm.
〈 Although it is deep to the
supinator and extensor muscles,
the headÕs posterior, lateral
aspect can be accessed.

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 Anatomy: Palpation List Term2

〈 You should be able to feel

the headÕs rotating movement
under your thumb.

Head of the Ulna p.107
〈 Slide your fingers distally
along the ulnar shaft.
〈 Just proximal to the wrist, the
shaft will bulge to become the
head of the ulna. Palpate all
sides of the bulbous head.
(diagram107)
〈 The knob you are palpating
should be connected to the shaft
of the ulna.
〈 In a neutral position, it should
be on the posterior and medial
side of the forearm.
〈 The shaft of the ulna swells to
form the head of the ulna.
〈 The head is the superficial
knob visible along the posterior,
medial side of the wrist that can
disrupt the placement of a
watchband.
〈

Lunate and Capitate p.115
〈 Locate ListerÕs tubercle and 〈 The lunate is the most
the base of the 3rd metacarpal. frequently dislocated carpal.
With the wrist sligthly extended, 〈 Located just distal to ListerÕs
lay your thumb btwn these Tubercle, it is relatively
points and notice how it falls into inaccessible when the wrist is in a
a small cavity. This is the neutral position; flexing the wrist,
location of the lunate and however, will slide the lunate to
capitate. (diagram115) the dorsal surface.
〈 Set your thumb at the 〈 It is accessible on the dorsal
proximal end of this cavity. surface and can be isolated btwn
Then flex the wrist and feel the ListerÕs Tubercle and the shaft of
lunate press into your finger the 3rd metacarpal.
(diagram115).
〈 Next, extend the wrist and
feel this carpal disappear back
into the wrist.
〈 Shift your thumb to the distal
end of the cavity and notice how
it bumps into the base of the 3rd
metacarpal.
〈 Passively flex the wrist,
noting how the capitate rolls into
your finger, ÒfillingÓ its own
cavity.
〈 You should be btwn the
ListerÕs Tubercle and the shaft
of the 3rd metacarpal.
〈 To isolate the Lunate, you
should be just distal to the edge

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 Anatomy: Palpation List Term2

of ListerÕs Tubercle.
〈 You should feel a small knob
press into your thumb upon
flexion.
Scaphoid p.113 〈 Beginning on the wristÕs 〈 The peanut-shaped scaphoid
radial surface, locate the (aka navicular) is the most
radiusÕ styloid process. commonly fractured carpal.
〈 Slide your thumb distally off 〈 It is located on the radial side of
the process, falling btwn the the hand, distal to the styloid
superficial tendons and into the process of the radius.
natural ditch where the scaphoid 〈 Although it forms the floor of
will be found. (diagram) the tendinous Òanatomical
〈 Maintain your position and snuffboxÓ,it is still accessible from
passively adduct the wrist. As the dorsal, palmar, and ulnar sides
you do so, feel for the scaphoid of the wrist.
to bulge into your thumb.
(diagram) Now abduct the wrist
and feel how the scaphoid
disappears back into the wrist.
〈 From here, explore the
scaphoidÕs dorsal and palmar
surfaces. On the palmar
surface, along the flexor crease,
is the scapoid tubercle. (diagram)
〈 You should be distal to the
end of the styloid process of the
radius.
〈 During adduction and
abduction, you can feel the
scapoid protrude and then
disappear.

Pisiform p.111 〈 Locate the flexor crease of 〈 The knobby pisiform is an

the wrist. Then slide over to the attachment site for the flexor carpi
ÒpinkyÓ side of the crease. ulnaris. Protruding along the ulnar/
〈 Move slightly distal to the palmar surface of the wrist, the
crease, rolling your thumbpad in pisiform is just distal to the flexor
small circles. Explore under the crease.
thick tissue of the palm for the
nuggetlike pisiform. (diagram)
〈 Passively flex the wrist and
notice how the pisiform can be
wiggled from side to side.
(diagram)
〈 Extend the wrist and observe
how it becomes immobile. (this
immobility is due to the tension
created by the flexor carpi
ulnaris tendon.)
〈 Then, ask your partner to

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 Anatomy: Palpation List Term2
Hook of Hamate p.112
Brachialis p.120
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actively adduct her wrist. You
should feel the tendon of flexor
carpi ulnaris as it comes down
the medial wrist and attach to
the pisiform.
〈 Locate the pisiform. Draw an
imaginary line from the pisiform
to the base of the 1st finger.
(diagram)
〈 Using your thumbpad, slide
off the pisiform along this line.
(diagram) Approximately half of
an inch from the pisiform,
explore for this subtle mound
beneath the padding of the hand.
〈 You should be btwn the
pisiform and the base of the 1st
finger.
〈 Using gentle pressure, you
should sense a small ditch btwn
the pisiform and the hamateÕs
hook.
〈 Keeping your thumbpad in
place and rolling it gently around
the hook will give you the best
sense of its shape and locale.
〈 Shake hands with your
partner and flex the elbow to
90degrees. It is important to
distinguish the muscle tissue of
the biceps brachii from that of
the brachialis. Ask your partner
to flex her elbow against your
resistance and isolate the edges
of the round biceps brachii belly.
〈 With the arm relaxed, slide
laterally half an inch off the distal
biceps. The edge of the
brachialis can be detected by
rolling your fingers across its
surface. As you strum across its
solid edge, you will feel a
pronounced ÒthumpÓ. (diagram)
〈 Continuing to strum across its
edge, follow it distally to where it
disappears into the elbow.
〈 Locate the distal biceps
tendon. Palpate along either
side of the tendon for portions of 〈
the deeper brachialis. (diagram)
〈 You should be rolling across
〈 Located distal and lateral to the
pisiform, the hamate has a small
protuberance or ÒhookÓ, that is
palpable on the handÕs palmar
surface.
〈 The pisiform and the hook of
hamate serve as attachment sites
for the flexor retinaculum, the CT
band that forms the ÒroofÓ of the
carparl tunnel.
〈 The flat surface of the
hamateÕs body is accessible on
the handÕs dorsal surface where
the bases of the 4th and 5th
metacarpals merge. When
palpated, the hook is often tender.
〈 The pisiform and hook of
hamate form a small channed
called the Tunnel of Guyon.
〈 The brachialis is a strong elbow
flexor that lies deep to the biceps
brachii on the anterior arm.
〈 It has a flat, yet thick belly.
〈 Ironically, itÕs girth only helps
the biceps to bulge further from
the arm, making it the bicepÕs
best friend.
〈 Although it lies underneath the
biceps, portions of brachialis are
accessible. Its lateral edge,
sandwiched btwn the biceps and
triceps brachii, is both superficial
and palpable. The distal aspect of
the brachialis is also accessible as
it passes along either side of the
biceps tendon.
〈 PA: distal 1⁄2 of the anterior
surface of humerus
〈 DA: ulnar tuberosity and
coronoid process
A: forearm flexion
 Anatomy: Palpation List Term2
Brachioradialis p.121
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a distinct wad of muscle on the
lateral side of the arm and be
able to follow it distally toward
the inner elbow.
〈 Locate the triceps and biceps
brachii. The brachialis fibers
should be btwn them on the
lateral arm.
〈 AlternativelyÉ locate the
deltoid tuberosity. Slide distally
straight down the lateral side of
the arm and explore for the edge
of the brachialis.
〈 (activation: Òflex your
elbowÓ)
〈 Shake hands with your 〈 The brachioradialis is
partner and flex the elbow to 90 superficial on the lateral side of
degrees. With the forearm in a the forearm.
neutral position (thumb toward 〈 It has a long, oval belly which
the ceiling), ask your partner to forms a helpful dividing line btwn
flex her elbow against your the flexors and extensors of the
resistance. wrist and hand.
〈 Look for the brachioradialus 〈 Its muscle belly becomes
bulging out on the lateral side of tendinous halfway down the
the elbow. If it is not visible, forearm. It
locate the lateral supracondylar 〈 It is the only muscle that runs
ridge of the humerus and slide the length of the forearm but does
distally. not cross the wrist joint.
〈 With your partner still 〈 Resisted flexion of the elbow
contracting, use your other hand causes it to visibly protrude on the
to palpate its superficial, tubular forearm and become easily
belly. (diagram) Try to pinch its palpable.
belly btwn your fingers and 〈 (activation: Òflex your elbow
follow it as far distally as against my resistanceÓ)
possible. As it becomes more
tendinous, strum across its distal
tendon toward the styloid 〈 PA: it forms the main fleshy
process of the radius. mass of the radial aka lateral
〈 Upon resisted flexion of the border of the forearm.
elbow, the belly should contract 〈 Proximal lateral supracondylar
and bulge out. It should be ridge of humerus.
superficial and extend off the 〈 DA: lateral distal end of radius
lateral epicondyle of the (styloid process)
humerus.
〈 A: (1) most effective in neutral
aka mid-prone position (ie, hand
shaking, beer drinking); (2) flexes
forearm
 Anatomy: Palpation List Term2

Extensor pollicis longus 〈 With the wrist in a neutral 〈 The belly of extensor pollicis
p.135-138 position, ask your partner to longus lie along the posterior
extend her thumb: ÒBring your aspect of the forearm, deep to the
thumbnail toward your elbow.Ó wrist extensors.
〈 Just distal to the styloid 〈 The distal tendons are
process of the radius will be a superficial and form the
small trough formed by the Òanatomical snuff boxÓ.
surrounding tendons. This is the
anatomical snuffbox. If not seen 〈 PA: the proximal attachment of
immediately, change the angle 3 snuff muscles, posterior of
of the thumb. forearm
〈 Follow the tendons that form 〈 DA: base of 1st distal phalanx,
the snuffbox (extensor pollicis posterior side
longus, brevis, and abductor 〈 A: extends thumb
pollicis) proximally as they slide
over the posterior surface of the
radius. Lay your fingers along
the posterior surface of the
radius as your partner
circumducts her thumb in order
to feel a portion of these
muscles contract. (diagram)

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 Anatomy: Palpation List Term2
HIP AND THIGH
Greater Trochanter p.235
Adductor Tubercle p.284
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〈 Locate the middle of the iliac 〈 Located distal to the iliac crest,
crest the greater trochanter is the large,
〈 Slide your fingerpads superficial mass located on the
inferiorly 4-6 inches along the side of the hip.
lateral side of the thigh until you 〈 It is easily palpable and serves
reach the superficial mass of the as an attachment site for the
greater trochanter. gluteus medius, gluteus minimus,
〈 Explore and sculpt around all and deep rotator muscles.
sides of its wide hump.
〈 Medially and laterally rotate
the hip as you palpate the
trochanter.
〈 You should feel its wide,
knobbly surface swivel back and
forth under your fingers.
〈 Partner supine with knee 〈 The adductor tubercle is
flexed. Locate the medial located proximal to the medial
epicondyle of the femur. epicondyle, btwn the belly of the
〈 Slide superiorly along the vastus medialis and the hamstring
medial side of the femur. As the tendons.
outline of the femur drops off 〈 Its small tip sticks out from the
into the soft tissue, explore for top of the medial epicondyle and
the small point of the tubercle. is an attachment site for the
(diagram) adductor magnus tendon.
〈 Strum across the adductor 〈 It is often tender to the touch.
magnus tendon by rubbing your
thumbpad anteriorly and
posteriorly.
〈 You should be directly
proximal to the medial
epicondyle.
〈 With your thumb on the
proximal aspect of the tubercle
(on the adductor magnus
tendon), have your partner
gently adduct his hip. The
tendon of the magnus should
become taut and press into your
finger.
 Anatomy: Palpation List Term2

Adductor Longus and 〈 Supine with the hip slightly
Gracilis p.256-258 flexed and laterally rotated.
Place the flat of your hand at the
middle of the medial thigh. Ask
your partner to adduct his hips
slightly.
〈 While your partner contracts,
slide your fingers proximally to
the pubic bone and locate the
taut, prominent tendon(s) of the
gracilis and adductor longus
extending off (or nearby) the
pubic tubercle.
〈 Strum your fingertip across
this tendon and follow it distally
as it develops into muscle
tissue. (diagram) If the muscle
belly slowly angles into the
medial thigh, you are palpating
adductor longus. If the belly is
slender and continues down the
medial thigh toward the knee,
you are accessing gracilis.
〈 Hint: you should be btwn the
hamstrings and the quadriceps
femoris group.
〈 The adductors are located
along the medial thigh btwn the
hamstrings and quadriceps
femoris muscles.
〈 Their proximal tendons attach
at specific locaions along the base
of the pelvis. Together, these
tendons forma CT drape that
extends from the superior ramus
of the pubis to the ischial
tuberosity.
〈 When the thigh is viewed
anteriorly, the muscle bellies of
the adductors lie in 3 layers.
〈 Adductor longus is one of the
most anterior muscles.
〈 Gracilis lies superficially on the
medial thigh. It is the only
adductor that crosses the knee.
〈 The superficial tendon of
gracilis and/or adductor longus is
prominent extending off of or
nearby the pubic tubercle. In
some cases, it is a merging of
both tendons.
〈 (activation: Òsqueeze your
thighs togetherÓ)

ADDUCTOR LONGUS:
〈 PA: anterior pubis
〈 DA: distal to brevis
〈 A: adduction of femur, assist in
hip flexion

ADDUCTOR GRACILIS
〈 PA: anterior pubis
〈 DA: tibia, proximal,
anteromedial
〈 A: (1) adducts at hip; (2) flexes
knee; (3) medial rotation of knee
when knee is flexed

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 Anatomy: Palpation List Term2
Biceps Femoris and
Semitendinosis p.250-252
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〈 Prone. Ask your partner to 〈 The hamstrings are located
hold his knee in a flexed along the posterior thigh btwn the
position. Explore the bellies of vastus lateralis and adductor
the hamstrings. magnus.
〈 Locate the ischial tuberosity. 〈 They are not as massive as the
Slide your fingertips distally 1 quadriceps femoris group, but
inch and strum across the large, they are strong hip extensors and
solid tendon of the hamstring knee flexors.
and follow distally. 〈 All 3 have a common origin: the
〈 The lateral half of the ischial tuberosity.
hamstring belly is the biceps 〈 Biceps femoris is the lateral
femoris. Its belly will lead hamstring
toward the head of the fibula. 〈 It has 2 heads Ð a superficial
Palpate on the lateral side of the long head and a deeper,
knee for the long, prominent indiscernible short head.
tendon of the biceps femoris and 〈 (activation: Òbend your kneeÓ
follow it toward the head of the or Òextend your thighÓ)
fibula.
〈 The medial half of the BICEP FEMORIS
hamstrings consists of the 〈 PA:
layered bellies of the 〈 short head: femur, linea aspera
semitendinosus and 〈 long head: ishcial tuberosity
semimembranosus. Move to the
〈 DA: head of fibula
medial side of the knee and
〈 A: (1) extension, hip joint; (2)
palpate for the tendons of these
flexes knee; (3) laterally rotates
muscles. (diagram)
the flexed knee
〈 The most superficial tendon
will be the semitendinosus.
Turn your partner supine and
follow it distally as it merges with
the pes anserinus tendon.
〈 Hint: the tendons along the
back of the knee should be
slender and superficial.
〈 The biceps femoris tendon
should lead to the head of the
fibula. You should be able to
follow the semitendinosus as it
disappears into the medial knee.
 Anatomy: Palpation List Term2
Gluteus medius p.253-255
Piriformis p.264-265
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〈 Sidelying. Isolate the shape
of the gluteus medius by placing
the webbing of one hand along
the iliac crest (from PSIS to
nearly the ASIS) while the hand
locates the greater trochanter.
〈 Your hands will form the pie-
shaped outline of the gluteus
medius. (diagram)
〈 Palpate in this area from just
below the iliac crest to the
greater trochanter for the dense
fibers of the gluteus medius.
〈 Sink your fingers deep to the
gluteus medius in order to
explore for the density and mass
of the gluteus minimus.
〈 Ask your partner to abduct
his hip slightly and you should
feel the medius contract.
〈 Posterior fibers: laterally rotate
〈 Prone. Locate the coccyx,
PSIS, and greater trochanter.
Together, these landmarks form
a ÒTÓ.
〈 The piriformis is located
along the base of the ÒTÓ.
(diagram)
〈 Place your fingers along this
line. Working through the thick
gluteus maximus, roll your
fingers across the belly of the
slender piriformis.
〈 Strum across the belly to
clarify its location, staying
mindful of the deeper sciatic
nerve. (diagram)
〈 Hint: with your fingers on the
piriformis, bend the knee to 90
degrees and ask your partner to
rotate his hip laterally against
your gentle resistance.
(diagram) You may feel gluteus 〈
maximus contract, but also
piriformis beneath it.
〈 The gluteus medius is located
on the outside of the hip and is
also superficial, except for the
posterior portion which is deep to
the maximus.
〈 It is a strong extensor and
abductor of the hip.
〈 It has convergent fibers that
pull the femur in multiple
directions. As such, it is often
thought of as the Òdeltoid muscle
of the coxal jointÓ.
〈 (activation: Òabduct your hipÓ)
〈 PA: ilium, external surface,
anterior 3⁄4
〈 DA: greater trochanter, lateral
surface
〈 A: hip abduction
〈 (DA fixed): stabilizes pelvis
during single limb stance (main
function)
〈 Anterior fibers: medially rotate
〈 Located deep to the gluteus
maximus and creates lateral
rotation of the hip.
〈 Attaches to aspects of the
greater trochanter and fan
medially to attach to the sacrum
and pelvis.
〈 Unlike the other lateral hip
rotators, piriformis lies superficial
to the large sciatic nerve. And if,
overcontracted, can compress it.
〈 One of the more discernible
rotators.
〈 Reptiles have very powerful
piriformis, used for extending the
femur while running.
〈 (activation: Òlaterally rotate
your hipÓ)
〈 PA: anterior sacrum
〈 DA: greater trochanter
A: lateral rotation at the hip
 Anatomy: Palpation List Term2
Rectus Femoris p. 246-248
Vastus Medialis p.246-249
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〈 Supine with knee bolstered.
Locate the AIIS and the patella.
〈 Draw an imaginary line btwn
these 2 points and follow the
path of the rectus femoris.
〈 Palpate along this line and
strum across the rectus fibers.
(It will be 2-3 fingers wide.)
〈 Ask your partner to flex his
hip and hold his foot up off the
table. (diagram) This position
contracts the rectus femoris,
making it more pronounced.
〈 Hint: you should be on the
anterior surface of the thigh.
〈 A: flexes hip, extends knee
〈 Supine with knee bolstered.
Ask your partner to fully contract
his quadriceps by extending his
knee. Palpate just medial and
proximal to the patella for
thebulbous shape of the
medialis.
〈 Locate the rectus femoris and
sartorius, noting how these
muscles surround the medialis
to form its long Òtear dropÓ
shape.
〈 Hint: you should be medial to
the rectus femoris.
〈 The cylindrical, superficial
rectus femoris is located on the
anterior thigh and is the only
quadriceps that crosses 2 joints Ð
the hip and the knee.
〈 It primarily extends the knee.
〈 All 4 quadriceps muscles
converge into a single tendon
above the knee. The tendon
connects to the top and sides of
the patella before attaching to the
tibial tuberosity.
〈 (activation: Òstraighten your
kneeÓ or Òflex your hipÓ)
〈 PA: AIIS, superior acetabular
rim
〈 DA: tibial tuberosity via the
patella
〈 Same as above.
〈 Aka Vastus Medialis Obliqus
〈 The palpable aspect of vastus
medialis forms a Òtear dropÓ
shape at the distal portion of the
medial thigh.
〈 Upon full extension of the knee,
vastus medialis extends further
distally than the vastus lateralis b/
c of the tracking of the patella. The
angle of the femur, combined with
the pull of the quadriceps, causes
the patella to track laterally. This
is prevented in 2 ways: (1) the
 Anatomy: Palpation List Term2
Tensor Fasciae Latae
p.260
Iliotibial band p.260-261
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〈 You should be able to make
out the round shape of the
vastus medialis and follow its
fibers to the patella.
〈 Supine. Locate the ASIS.
Place the flat of your hand
posterior and distal to the ASIS
and iliac crest.
〈 Ask your partner to alternate
medial rotation with relaxatio of
the hip. Upon medial rotation,
the TFL will contract into a solid,
oval mound beneath your hand.
(diagram)
〈 Palpate its vertical fibers,
outline its width, and follow it
distally until the TFL blends into
the iliotibial tract.
〈 Hint: you should be posterior
and distal to the anterior iliac
crest.
〈 If you ask your partner to
rotate the hip laterally, the TFL 〈
should not contract.
〈 Sidelying. Locate the biceps
femoris tendon just proximal to
the back of the knee.
〈 Slide anteriorly from the
biceps femoris tendon to the
lateral thigh. Roll your fingers
horizontally across the fibers of
the iliotibial tract and explore for
its tough, superficial quality. Its
most distal aspect may feel
similar in size and shape to the
biceps femoris tendon.
〈 Follow it distally as it
disappears toward the tibial
tubercle. Explore proximally and
edge of the lateral condyle of the
femur is elevated, forming a lateral
wall, and (2) the distal fibers of
vastus medialis are set at an
angle, pulling the patella medially.
(diagram)
〈 PA: medial lip of linea aspera
〈 DA: tibial tuberosity via the
patella
〈 A: extends knee
〈 The tensor fasciae latae is a
small, superficial muscle located
on the lateral side of the upper
thigh.
〈 It is aprox. 3 fingers wide, and
is easily accessed btwn the upper
fibers of the rectus femoris and
the gluteus medius.
〈 It attaches to the iliotibial band
along with gluteus maximus.
〈 (activation: Òmedially rotate
your hipÓ)
〈 PA: ASIS, external surface
〈 DA: lateral tubercle of tibia via
IT band
〈 A: (hip): medial rotation, flexion,
abduction
(knee): may assist in extension
of the knee
〈 The iliotibial tract is a
superficial sheet of fascia with
vertical fibers that runs along the
lateral thigh.
〈 It emerges from the gluteal
fascia, is wide and dense over the
vastus lateralis muscle and
funnels into a strong cable along
the side of the knee before
inserting at the tibial tubercle.
(diagram)
〈 TFL fibers and some fibers of
gluteus maximus attach to the
proximal aspect of the IT band.
〈 The iliotibial tract has a thick,
 Anatomy: Palpation List Term2

note how it becomes broader matted texture (similar to packing

and thinner as it progresses up
the thigh. Feel the tension of
the iliotibial tract change by
asking your partner to
alternately abduct and relax his
hip. (diagram)
〈 Hint: the fibers should feel
superficial and stingy compared
to the deeper, fleshier vastus
lateralis fibers.
〈 The fibers should run
vertically down the thigh and
converge into a thin, cablelike
tendon at the tibial tubercle.
tape) that makes it a strong
stabilizing component of hipand
knee.
〈 It is entierly accessible. The
distal cable portion, anterior to the
biceps femoris tendon, is the
easiest part of the iliotibial tract to
isolate.
〈 (activation: Òabduct your hipÓ)

LEG AND FOOT

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 Anatomy: Palpation List Term2
Peroneal Tubercle p.288-
289
Navicular Tubercle p.294
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〈 Supine or seated. With the 〈 The peroneal tubercle is
ankle in dorsiflexed position, located on the lateral side of the
locate the lateral malleolus. foot.
〈 Slide roughly an inch 〈 Roughly an inch distal to the
inferiorly and explore for the lateral malleolus, the tubercle is a
small, superficial tubercle. It small, superficial prominence that
may feel like a short ridge on the protrudes from the calcaneal
surface of the calcaneus. surface to help stabilize the
(diagram) Passively everting peroneal muscles. (diagram)
the foot will soften the
surrounding tissues.
〈 Sculpt around its edges,
noting the soft tissues just distal
to the tubercle.
〈 Hint: you should be distal to
the lateral malleolus.
〈 If you slide off the tubercle
distally, you should feel the thick
tissues of the foot.
〈 Ask you partner to alternately
evert and relax her foot. The
peroneal tendons should pass
along either side of the tubercle.
〈 Partner seated or supine. 〈 (The bean-shaped navicular is
Locate the base of the first sandwiched btwn the medial and
metatarsal. middle cuneiforms and the
〈 Sliding along the footÕs calcaneus. Its dorsal and medial
medial side, move proximally surfaces are superficial and
across the surface of the medial palpable.)
cuneiform and the slender joint 〈 The superficial navicular
btwn the medial cuneiform and tubercle bulges out of the medial
the navicular. side of the foot and is an
〈 As you move onto the attachment site for the tibialis
surface of the navicular, explore posterior muscle and the spring
the shape and size of the ligament. (diagram)
navicular tuberosity. (diagram)
〈 The tuberosity will lie aprox.
1-2 inches distal to the medial
malleolus.
〈 Hint: the navicular bone
should project more medially
than the surfaces of the other
bones on the medial foot.
〈 If you place a finger on the
tuberosity of the 5th metatarsal
and the navicular tuberosity
simultaneously, the metatarsal
tuberosity should lie slightly
distal to the navicular tuberosity.
(diagram)
 Anatomy: Palpation List Term2
Sustentaculum Tali p.288
Head of Fibula p.282
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〈 Supine or seated. Place the 〈 The sustentaculum tali is
ankle in a neutral position and located on the medial side of the
locate the medial malleolus. calcaneus, roughly 1 inch distal to
〈 Slide aprox. 1 inch distal to the medial malleolus. (diagram)
the small tip of the 〈 Shaped like a plank, the
sustentaculum. (diagram) sustentaculum supports the talus
〈 Passively inverting the foot on the calcaneus.
will soften the surrounding 〈 It is also an attachment site for
tissues. the deltoid ligament and is deep to
〈 Sculpt around its sides noting the flexor tendons.
the soft tissues just distal to it. 〈 Only its small tip is accessible.
〈 Hint: you should be distal to
the medial malleolus. If you
slide distally off the
sustentaculum tali, you should
feel the thick tissues at the sole
of the foot.
〈 Partner seated with knee 〈 The head of the fibula is
flexed. Locate the tibial located on the lateral side of the
tuberosity. (See frame below.) leg and sometimes protrudes
〈 Slide you fingers laterally 3-4 visibly.
inches toward the outside of the 〈 It is the attachment site for the
leg. Palpate for the head of the biceps femoris muscle and a
fibula. (diagram) portion of the soleus muscle as
〈 Explore its inch wide tip. well as the lateral collateral
〈 Hint: the knob you are ligament.
palpating should be lateral to the
tibial tuberosity. You can scuplt
a circle around it to outline its
shape.
〈 The biceps femoris tendon
will lead you to the head of the
fibula.
〈 Alternatively: partner prone,
bend the knee to 90 degrees
and follow the biceps femoris
tendon distally to where it inserts
into the head of the fibula.
 Anatomy: Palpation List Term2
Tibial Tuberosity p.281 (re:
head of fibula)
Tibialis Posterior p.307-308
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〈 Partner seated with knee
flexed. Locate the patella.
〈 Slide your fingers 3-4 inches
inferiorly from the patella and
using your thumbpad, explore
for the tuberosity (diagram)
〈 Hint: with your finger at the
tibial tuberosity, ask you partner
to extend his knees slightly.
With this action, the patellar
ligament will tighten, and you will
be able to feel where it attaches
to the tibial tuberosity.
〈 Supine, prone, or sidelying.
Locate the medial malleolus.
Slide off the malleolus
posteriorly and proximally into
the space btwn the posterior
shaft of the tibia and the
calcaneal tendon.
〈 Explore this region for the
distal bellies and tendons of
these muscles. (diagram)
Follow the tendons distally
around the back of the medial
malleolus.
〈 It is difficult to isolate specific
tendons; however, tibialis
posterior will be the most
anterior. Have your partner
invert his foot as you follow this
tendon around the ankle to the
underside of the foot.
〈 Hint: place your fingers on
the distal bellies and ask your
partner to slowly wiggle all his
toes. You should be able to feel
the muscles or tendons shift.
〈 You should be able to locate
the malleolar groove and feel
the tendons in and posterior to it.
〈 You may be able to locate
the pulse of the tibial artery.
〈 TD anÕ H = Tom, Dick anÕ,
Harry corresponds to the initials
of the tendons and vessels in
the order that they pass by the
medial malleolus:
〈 Tibialis posterior (the most
anterior)
〈
〈 Buried deep to the
gastrocnemius and soleus on the
posterior leg.
〈 Responsible for inverting the
foot and flexing the toes. (along
with flexor digitorum longus and
flexor hallucis longus)
〈 Virtually inaccessible except at
the small gap btwn the tibial shaft
and the edge of the soleus/
calcaneus tendon where the most
distal fibers and tendons of the
flexors can be palpated directly.
(diagram)
〈 The tendon curves around the
medial malleolus and passes deep
to the flexor retinaculum.
〈 The tibial artery and tibial nerve
are situated btwn the tendons at
the medial ankle.
〈 (activation: Òplant and invert
your footÓ)
〈 PA: tibia, fibula
〈 DA: navicular tuberosity and
surrounding bones
〈 A: (main): to slow down
pronation after heel contacts ground
during gait; (2) plantar flexion; (3)
inversion
 Anatomy: Palpation List Term2

〈 Flexor Digitorum longus

〈 The tibial Artery
〈 Tibial Nerve
〈 Flexor Hallucis longus
Peroneus Longus and 〈 Supine, prone, or sidelying. 〈 The slender peroneal muscles
Brevis p.302-303 Place a finger at the head of the are located on the lateral side of
fibula and the lateral malleolus. the fibula. (diagram) More
The peroneal bellies are located specifically, they lie btwn the
btwn these 2 landmarks. extensor digitorum longus and the
(diagram) soleus.
〈 Lay your fingers btwn these 〈 A portion of the peroneus
landmarks and ask your partner brevis lies deep to the peroneus
to alternately evert and relax longus, yet both are accessible.
your foot. Feel the peroneals 〈 Their distal tendons are
tighten upon eversion. This superficial and palpable behind
action will sometimes create a the lateral malleolus and along the
visible dimple of depression side of the heel.
along the side of the leg. 〈 (activation: Òevert your footÓ)
(diagram)
〈 As your partner continues to PERONEUS LONGUS:
evert and relax her foot, follow 〈 PA: fibula, lateral, proximal
the peroneus longus proximally including head
toward the head of the fibula. 〈 DA: 1st metatarsal, lateral
Now follow both muscles distally surface; 1st cuneiform, lateral
to where their tendons wrap surface
around the back of the lateral 〈 A: plantar flexion; eversion
malleolus.
〈 Follow the peroneus brevis PERONEUS BREVIS:
tendon to the base of the 5th 〈 PA: fibula, lateral, distal
metatarsal. (dragram) 〈 DA: 5th MT, styloid process,
〈 Hint: you should be on the proximal to peroneus tertius
lateral side of the leg btwn the 〈 A: plantar flexion; eversion
head of the fibula and the lateral
malleolus.
〈 You may be able to
differentiate the slender
peroneals from the lateral edge
of the larger gastrocnemius and
soleus.
〈 You may be able to feel the
tendon of the brevis attach to
the base of the 5th metatarsal.

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 Anatomy: Palpation List Term2
Tibialis anterior p.304-305
Gastrocnemius p.297-299
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〈 Supine. Locate the shaft of
the tibia and slide off it laterally
onto the tibialis anterior.
〈 Ask your partner to dorsiflex
(or invert) his foot and palpate
its long, inch-wide belly.
(diagram)
〈 With the foot dorsiflexed,
palpate the muscle distally as it
becomes a thick, tendinous
cord. Follow it to the medial
side of the foot as it disappears
at the medial cuneiform.
〈 Hint: as your partner
alternately dorsiflexes and
relaxes his ankle, you may feel
the tendon cross the top of the
ankle.
〈 Ask your partner to invert his inversion (subtalor joint)
foot and note whether the tibialis
anterior is involved. You may
able to feel where the tendon
passes under the extensor
retinaculum.
〈 Ask your partner, supported
by a chair, to stand on her toes.
〈 Palpate the posterior leg,
sculpting out the
gastrocnemiusÕ oval heads.
Follow both heads proximally to
the back of the knee. Then
follow them distally, noting how
the medial head extends further
distal than the lateral head.
(diagram)
〈 Move distal to the
gastrocnemius and palpate the
distal portion of soleus. Also
explore the medial and lateral
sides of the soleus that bulge
〈 Located on the anterior aspect
of the leg btwn the shaft of the
tibia and the peroneal muscles.
〈 The tendon crosses beneath
the extensor retinaculum at the
ankle.
〈 The tibialis anterior is large and
superficial and the most clearly
isolated of the group. It lies
directly lateral to the tibial shaft.
〈 (activation: Òbring your foot/
toes toward your kneeÓ)
〈 PA: tibia, proximal, lateral
〈 DA: 1st MT, base, medial
surface; 1st cuneiform, medial,
plantar surface.
〈 A: dorsiflexion (talocrural joint);
〈 The large muscle mass of the
posterior leg is composed of the
gastrocnemius and the soleus
muscle.
〈 Together, they form the
Òtriceps suraeÓ that attaches to
the strong calcaneal tendon.
〈 Both muscles are easily
accessible.
〈 The superficial gastrocnemius
has 2 heads and crosses 2 joints
Ð the knee and ankle. Emerging
from btwn the hamstrings tendons,
the short gastrocnemius heads
extend halfway down the leg
before blending into the calcaneal
Anatomy: Palpation List Term2

out from the gastrocnemius. tendon. It is also quite thin when

〈 Follow both muscles distally compared to the thick soleus.
as they blend into the calcaneal 〈 The soleus is deep to the
tendon. gastrocnemius, yet its medial and
〈 Hint: you can follow the lateral fibers bulge from the sides
gastrocnemius heads proximally of the leg and extend further distal
btwn the hamstring tendons. than the gastrocnemius heads.
〈 The medial gastroc head is The soleus is sometimes called
slightly longer than the lateral the Òsecondary heartÓ b/c of the
head. You may be able to feel important role its strong
the difference in texture btwn the contractions play in returning
fleshy muscle bellies and the blood form the leg to the heart.
tough, dense calcaneal tendon. 〈 (activation for gastrocnemius:
(diagram) Òflex your kneeÓ or Òstep down
〈 AlternativelyÉ on the ball of your footÓ)
〈 Prone. Bend the knee to 90 〈 (activation for soleus: Òstep
degrees and investigate the soft, down on the ball of your footÓ)
massive bellies of the
gastrocnemius and soleus and 〈 PA: femoral condyles
the thick calcaneal tendon. 〈 DA: calcaneus
〈 When the knee is flexed, the 〈 A: knee flexion (weak); plantar
gastoc muscles is shortened flexion (talocrural joint)
and ineffectual as a plantar
flexor. Isolate the soleus by
asking your partner to gently
plantar flex against your
resistance.
〈 Notice how the thick soleus
contracts while the thin,
superficial bellies of the gastrocs
remain flaccid. (diagram)
〈 AlternativelyÉ.
〈 From an anterior angle, with
your partner standing, locate the
tibial shaft.
〈 Slide medially off the shaft
and feel the wad of muscle that
bulges along the medial side of
the leg. (diagram) This tissue is
the triceps surae.
〈 Ask your partner to lie supine
and with the tissue relaxed, note
how your thumb can sink around
the medial edge of the tibial
shaft to specifically locate the
soleus.

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 Anatomy: Palpation List Term2
SPINE AND THORAX
Longissimus p.170-171
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〈 Partner prone. Lay both
hands along either side of the
lumbar vertebrae. Locate the
region of the lower erectors by
asking your partner to
alternately raise and lower his
feet slightly. The erectors do
not, of course, raise the feet, but
they will contract in order to
stabilize the pelvis. Notice how
the strong, rounded erector
fibers tighten and relax with this
action. (diagram)
〈 As your partner maintains
this contraction, palpate
inferiorly onto the sacrum and
then superiorly along the
thoracic vertebrae. Ask your
partner to extend his spine and
neck slightly in order to contract
the erectors in the thoracic
region. (diagram)
〈 Follow the ropy fibers of the
erectors btwn the scapulae and
along the back of the neck.
These fibers are smallest in the
cervical region and are primarily
situated lateral to the lamina
groove.
〈 With your partner relaxed,
sink your fingers into the erector
fibers, feeling their ropy texture
and vertical direction.
〈 Hint: the fibers should run
parallel to the spine.
〈 SEE DIAGRAM 4.50 pg.171
〈 (unilateral): (2) lateral flexion of
spine (involves some rotation) (3)
eccentric contraction (lenghtening)
while slowing flexion of the trunk.
〈 Part of the erector spinae group
of muscles which runs from the
sacrum to the occiput along the
posterior aspect of the vertebral
column.
〈 The thick longissimus and
lateral iliocostalis form a visible
mound alongside the lumbar and
thoracic spine.
〈 In the lumbar region, the
erectors lie deep to the thin but
dense thoracolumbar
aponeurosis.
〈 In the thoracic and cervical
areas, they are deep to the
trapezius, the rhomboids, and the
serratus posterior superior and
inferior.
〈 The upper fibers of
longissimus (cervicis and capitis)
assist in lateral flexion and rotation
of the neck and head.
〈 (activation: Òextend your
spineÓ or Òraise your feet
slightlyÓ)
〈 forms the middle colum
〈 is the longest of the erector
spinae muscles
〈 likely to palpate on TVP
〈 3 parts: thoracis, cervicis,
capitis
〈 (the superior attachment of
capitis is the mastoid process)
〈 A: (bilateral): (1) extension
 Anatomy: Palpation List Term2
Multifidi p.173-174
Splenius Capitus p.175-
176
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〈 Partner prone. Locate the
spinous processes of the lumbar
vertebrae. Slide your fingers
laterally off the spinous
processes, sinking btwn them
and the erector spinae fibers.
〈 Pushing the erectors laterally
out of the way, explore deeply
for the dense, diagonal fibers of
the multifidi. (diagram) Progress
inferiorly to the sacrum, rolling
your fingers in a perpendicular
direction to the multifidi fibers.
〈 Move superiorly, exploring
the lamina groove of the thoracic
and cervical areas. Then turn
your partner supine and palpate
the cervical region.
〈 Hint: you should be bwtn the
spinous and transverse
processes. You can get a sense
of these smaller, deeper fibers
that stretch at an oblique angle.
〈 Prone. Locate the upper
fibers of the trapezius.
〈 Isolate the lateral edge of the
trapezius by having your partner
extend his head slightly.
〈 Ask your partner to relax.
Palpate just lateral to the
trapezius for the splenius
capitisÕ oblique fibers, following
them up to the mastoid process
and inferiorly through the
trapezius.
〈 Hint: the fibers should lead
toward the mastoid process.
〈 Multifidi is part of the
transversospinalis muscle group.
〈 It extends the length of the
vertebral column and consists of
many short, diagonal fibers.
〈 These fibers form an intricate
stitch-like design that links the
vertebrae together.
〈 These muscle fibers extend at
varying lengths from the
transverse and spinous processes
of the vertebrae.
〈 The surprisingly thick multifidi
are directly accessible in the
lumbar spine. They are the only
muscles with fibers that lie across
the posterior surface of the
sacrum.
〈 It can be difficult to isolate the
individual bellies of the
transversospinalis muscles as
they are closely interwoven;
however, as a group, their mass
or density can be easily felt along
the lamina groove of the thoracic
and lumbar vertebrae.
〈 (activation: Òextend and/or
rotate your spineÓ)
〈 as a group, goes from sacrum
to T2
〈 multifidi crosses 1-4 vertebrae
〈 best developed in the lumbar
region
〈 A: conventional action:
contralateral rotation
〈 The long splenius capitis
muscle is located along the upper
back and posterior neck.
(diagram)
〈 In contrast to the other neck
muscles that run parallel to the
spine the splenii fibers run
obliquely.
〈 The splenius capitis is deep to
the trapezius and rhomboids.
〈 Its fibers angle toward the
mastoid process and are
superficial btwn the trapezius and
sternocleidomastoid. (diagram)
Anatomy: Palpation List Term2

〈 You can distinguish the fibers 〈 (activation: Òrotate your headÓ

of splenius capitis by asking
your partner to rotate his head
slightly toward the side you are
palpating. You can feel these
oblique fibers contract while the
trapezius remains passive.
〈 AlternativelyÉ
〈 Locate the mastoid process
and slide medially and inferiorly 〈
onto the superficial capitis fibers. and neck
to the same side being palpated)
〈 IA: C4-T2
〈 SA: mastoid process of
temporal bone; lateral half of
superior nuchal line of occiput
〈 A: (1) ipsilateral rotation of
head (unilateral); (2)
(bilateral) extension of head

Anatomy: Palpation List Term2 1

HEAD, NECK, FACE 1

SHOULDER AND ARM 8

FOREARM AND HAND 17

HIP AND THIGH 23

LEG AND FOOT 30

SPINE AND THORAX 36

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