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AH 321
Bony Palpation Laboratory
Locate, palpate, and place an abbreviation
(acronym) on your laboratory partner in the center of the area
representing the following bony landmarks. Place an "X"
in the box after completing this for each task.
| Sesamoid
bones |
1st
metatarsal base |
Navicular
tubercle |
| Sinus tarsi |
1st
metatarsal head |
Talar dome |
| 5th
metatarsal shaft |
Medial
cuneiform |
Lateral
malleolus |
| 5th
metatarsal base |
Intermediate
cuneiform |
Medial
malleolus |
| 5th
metatarsal head |
Lateral
cuneiform |
Tibial
plafond |
| 1st
metatarsal shaft |
Cuboid |
Calcaneus |
| 3rd
metatarsal head |
Navicular |
Peroneal tubercle |
| Tibial spine |
Patella
superior pole |
Lateral
tibial plateau |
| Fibula head |
Patella
lateral facet |
Medial
femoral condyle |
| Patella |
Patella
medial facet |
Lateral
femoral condyle |
| Patella
inferior pole |
Medial tibial
plateau |
Adductor
tubercle |
| Trochlea
groove |
Tibial
tubercle |
Gerdy’s
tubercle |
| Greater
trochanter |
Posterior-superior
iliac spine |
Sternal body |
| Ischial
tuberosity |
Posterior-inferior
iliac spine |
Manubrium |
| Anterior-superior
iliac spine |
Lumbar spine
spinous process (L1-L5) |
Ribs 1-12 |
| Anterior-inferior
iliac spine |
Thoracic
spine spinous process (T1-T-12) |
Cervical
spine spinous process (C2-C7) |
| Crest of
ilium |
Xiphoid
process |
Occipital
protuberance |
| Iliac
tubercles |
Pubic
tubercles |
|
| Scapula
medial (vertebral) border |
Supraspinatus
fossa |
Acromion
process |
| Scapula
lateral (axillary) border |
Infraspinatus
fossa |
Clavicle |
| Scapula
inferior angle |
Spine of
scapula |
Clavicle
sternal end |
| Scapula
superior angle |
Coracoid
process |
Clavicle
acromial end |
| Humeral
greater tubercle |
Humeral shaft |
Medial
epicondyle |
| Humeral
lesser tubercle |
Intertubercular
groove |
Lateral
epicondyle |
| Humeral head |
Deltoid
tuberosity |
Cubital
tunnel |
| Humeral neck |
Olecranon
fossa |
Capitulum |
| Olecranon
process |
Radial shaft
in pronation |
Styloid
process-radius |
| Tuberosity of
the radius |
Ulnar shaft
in supination |
Styloid
process-ulna |
| Radial shaft
in supination |
Ulnar shaft
in pronation |
Tubercle of
the radius (Lister’s Tubercle) |
| Medial
supracondylar ridge |
Lateral
supracondylar ridge |
|
| Pisiform |
Triquetrum |
Hamate |
| Scaphoid
(navicular) in snuffbox |
Trapezoid |
Lunate |
| Scaphoid
tubercle |
Capitate |
Hamate (hook) |
| Metacarpals
1-5 |
Metacarpal
bases 1-5 |
Middle
phalanxes 2-5 |
| Metacarpal
heads 1-5 |
Proximal
phalanxes 1-5 |
Distal
phalanxes 1-5 |
| Lateral
Orbital Margins-outer margin of orbit formed by the
malar or zygomatic bone |
Lower
border of Mandible-bony ridge of the jawbone |
Angle of
Mandible-where mandible changes direction |
| Supraorbital
margin-frontal bone-ridge over each eye orbit |
Glabella-prominent
ridge just above nasion |
Zygomatic
arch-prominent cheek bone |
| Nasion-depression
just above the nose between the supraorbital margins |
Mastoid
processes |
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| To enhance
palpation & assist in locating of bones, bony
landmarks, and joint lines |
| Position body part in a totally relaxed
state where patient does not have to utilize muscle
tension to support area |
| Have patient contract, then relax
muscles to assist in finding musculotendinous landmarks |
| Apply joint stresses in various planes |
| Examine bones, bony landmarks, &
joint lines in various ranges of motion |
| When Palpating, the
Examiner Should Note |
- Differences in tissue tension and texture
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Differences in tissue thickness
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Abnormalities
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Tenderness
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Temperature variation
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Pulses, tremors, and fasciculations
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Pathological state of tissues
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Dryness or excessive moisture
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Abnormal sensation
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| Swelling |
- Comes on soon after injury- blood
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Comes on after 8 to 24 hours - synovial
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Boggy, spongy feeling- synovial
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Harder, tense feeling with warmth- blood
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Tough, dry- callus
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Leathery thickening- chronic
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Soft, fluctuating- acute
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Hard- bone
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Thick, slow-moving- pitting edema
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| Grading Tenderness
on Palpation |
| Grade I: Patient complains of pain |
| Grade II: Patient complains of pain and
winces |
| Grade III: Patient winces and withdraws
the joint |
| Grade IV: Patient will not allow
palpation of the joint |
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