The University of West Alabama





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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Wrist & Hand

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

Pisiform Along with the hamate, it permits passage of the ulnar nerve and artery; the flexor carpi ulnaris and abductor digiti minimi attach here; also attachment site of pisohamate ligament Arm and hand resting on table in the anatomical position On the ulnar side of the wrist, just proximal to the base of the 5th metacarpal
Scaphoid (navicular) in snuffbox The navicular forms the floor of the anatomic snuffbox. The rest of the snuffbox is formed by the abductor pollicis longus and the extensor pollicis longus and brevis tendons Patient needs to be sitting on the edge of the table with arm relaxed and abducted, with the thumb extended laterally away from the fingers The anatomic snuffbox is a small depression located immediately distal and slightly dorsal to the radial styloid process
Scaphoid tubercle Also called the "navicular" Patient's hand relaxed on the table It is situated on the radial side of the carpus, longest bone in the proximal carpal row, ulnar deviation causes the navicular to slide out from under the radial styloid process so that it becomes palpable
Triquetrum Vulnerable to injury, ranking 3rd highest of all the carpal bones in incidence of a fracture Hand must be radially deviated or abducted so the triquetrum moves from under the styloid process Lies just distally to the ulnar styloid process, in the proximal carpal row
Trapezoid   Hand relaxed on table, palm side down Lies between the capitate and trapezium
Capitate Attachment for capitotriquentral ligament Patient's wrist in neutral position Located in the depression just proximal to the base of the 3rd metacarpal and distal to Lister's tubercle XX
Hamate Forms the insertion of part of the flexor carpi ulnaris muscle Patient's hand supported by the examiner with the forearm and wrist in supination Is located slightly distal and radial to the pisiform; place the interphalangeal joint of your thumb upon the pisiform, pointing the tip of your thumb toward the web space between the patient's thumb and index finger and rest the tip of your thumb in the palm of the patient's hand, the hammate lies directly underneath the tip of your thumb, but is hard to palpate because it is buried deeply under layers of soft tissues
Lunate Articulates proximally with the radius and distally with the capitate; covered by the extensor carpi radialis brevis tendon; most frequently dislocated and 2nd most fractured bone of the wrist Wrist in flexion Follow the 3rd metacarpal to its articulation with the capitate; there will be an indention; have the patient flex the wrist; this will make the lunate palpable
Hamate (hook) Forms the lateral border of the tunnel of Guyon which transports the ulnar nerve and artery to the hand Patient sitting on the edge of the table, relaxed Located slightly distal and radial to the pisiform
Metacarpals 1-5 Insertion point for the flexor carpi radialis, palmaris longus, extensor carpi radialis brevis, extensor carpi radialis longus, and adductor pollicus longus Hand relaxed and in a neutral position Located superior to the phalange bones
Metacarpal heads 1-5 Attachment site of flexor digitorum superficialis Fingers in full extension Articulates with base of proximal phalanx
Metacarpal bases 1-5 Assist in flexion and extension of the fingers Patient's wrist in neutral position Located superiorly to the carpal bones X X
Proximal phalanxes 1-5 Classified as ginglymus joint Hand supinated or in anatomical position Located between the distal phalanxes and the MCP joint respectively 1-5
Middle phalanxes 2-5 Insertion of flexor digitorum superficialis and extensor indicis muscles Hand supinated and fingers extended Lies between proximal phalanx and distal phalanx
Distal phalanxes 1-5 serves as attachments to the DIP joint Patient sitting on table and relaxed Located superior to the DIP joint