Athletic Training & Sports Medicine Center

AH 321 Assessment of Athletic Injuries/Illnesses Laboratory

Bony Palpation Skill Sheet

Hand & Wrist	Arm	Hip, Pelvis & Spine	Foot & Ankle
Forearm	Shoulder Girdle	Knee	Head & Face
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Foot/Ankle

Bony Landmark (include alternative name if applicable)	Related Information such as purpose, function, attachment of ligaments, tendon, soft tissues involved	Preferred Body & Joint Position best for palpation	Anatomical Description of Location relative to other structures	Skeleton Picture or Video	Model Picture or Video
Sesamoid bones	Distributes some of the weight-bearing pressure, provides mechanical advantage for the flexor tendon of the great toe	Foot in neutral	Located distally along the medial longitudinal arch past the base of the 1st metatarsal bone to the 1st metatarsophalangeal joint
Sinus tarsi	Contains the extensor digitorum brevis muscle; has an overlying fat pad	Short-sitting, foot relaxed	Anterior to the lateral malleolus
5^th metatarsal shaft	Serves as the attachment for the interphalangeal joints of the foot	Patient sitting on the edge of the table with legs relaxed	Located on the lateral side of the foot just superior to the cuboid bone
5^th metatarsal base	Also known as the styloid process; Is the insertion point for the peroneus tertius, peroneus brevis, and the tibialis posterior muscle	Foot in neutral, or sitting position	Located on the lateral side of the foot distal to the cuboid bone
5^th metatarsal head	Provides support to the lateral foot	Short-sitting with talocrural joint in neutral and phalanges in extreme extension	The distal end of the most lateral metatarsal
1^st metatarsal shaft	Insertion for tibialis anterior muscle and attachment for flexor hallucis longus tendon	Patient sitting on edge of table with legs relaxed	Located just proximal to first MP joint
3^rd metatarsal head	Morton's neuroma occurs between the 3rd and 4th metatarsal heads	Foot in neutral	Located distally by placing the thumb upon the plantar surface and your index finger upon the dorsal surface, located immediately in front of the transverse arch, and just distal to the 3rd distal phalanx
1^st metatarsal base	Articulates with medial cuneiform; site of insertion of tibialis anterior tendon	Short-sitting position	Proximal portion of 1st metatarsal
1^st metatarsal head	Serves as the attachment for the extensor hallucis longus tendon	Patient sitting on edge of table with legs relaxed	Located inferiorly to the first MP joint
Medial cuneiform	Assists in the gliding motion of the foot	Patient seated with foot relaxed	Start on the inside of the foot with the great toe, palpate until you come to the 1st metatarsal, the metatarsal flares slightly at its base until it becomes the 1st cuniform, from the 1st cuniform move laterally until you palpate the next bony prominence (medial cuniform)
Intermediate cuneiform	Attachment site of the dorsal metatarsal ligaments	Short-sitting position with talocrural joint relaxed	Lies between the medial and lateral cuneiforms and proximal to the 2nd metatarsals
Lateral cuneiform	The lateral cuneiform is directly connected to the cuboid bone by way of the dorsal cuneocuboid ligament located anteriorly	The patient should be sitting with legs hanging off the edge of table and relaxed	The lateral cuneiform is located on the lateral aspect of the foot medial to the cuboid bone
Cuboid	It is the site of attachment for the dorsal calcaneocuboid ligament	Patient seated with the foot relaxed	Located directly distal to the calcaneous bone
Navicular	Articluates with the talus and 3 cuneiform bones; tibials posterior attaches to the navicular tubercle	Short-sitting, foot relaxed	Midway between the calcaneus and the base of the 1st metatarsal
Navicular tubercle	Attachment for tibialis posterior tendon and spring ligament	Patient sitting on edge of table with legs relaxed	Bony prominence located along the medial border of the foot, proximal to the medial cuniform and distal to the talar head
Talar dome	Only a small portion of the dome can be palpated, a greater portion of its surface is palpable on its lateral side than on the medial side; It allows for anterior and posterior rocking which causes plantarflexion and dorsiflexion to occur	Can be palpated with the foot in inversion and plantarflexion; the patient needs to be seated	Palpate just inferior and medial from the lateral maleolus; you can only feel a portion of the talar dome
Lateral malleolus	Serves as a pulley for the tendons & muscles that lie posteriorly to it; site of attachment of the anterior and posterior talofibular ligaments that attach the talus and fibula; site of attachment of the anterior and posterior tibiofibular ligaments that attach the tibia and fibula	Short-sitting position	Distal end of the fibula
Medial malleolus	Serves as an attachment for the Deltoid Ligament	Patient sitting on the edge of the table with leg flexed 30 degrees and the patient being relaxed	Located at the distal end of the tibia
Tibial plafond	Anterior tibiofibular ligament and anterior joint capsule connect to the tibial plafond	Foot plantar flexed	Located on the distal surface of the tibia
Calcaneus	Supports weight transmitted from the talus during walking and running; the ligaments that attach there are the tendo calcaneus, dorsal calcaneocuboid, interosseous talocaneal, calcaneofibular, tibiocalcaneal, plantar calcaneonavicular, medial talcalcaneal, and posterior talocalcaneal; the muscles that attach are the gastrocnemius, extensor digitorum brevis, flexor digitorum brevis, soleus, abductor hallucis, and abductor digiti minimi brevis	Short-sitting with foot in neutral position	Distal to the lateral malleolus; lies beneath the talus
Peroneal tubercle	Separates the peroneus brevis and peroneus longus tendons at the point where they pass around the lateral calcaneus	Patient sitting on edge of table with feet hanging over and relaxed	Located on calcaneus, distal to the lateral malleolus	XX

Model Picture or Video