BMS Palpation Exam 2024 Muscles PDF

BMS Palpation Exam 2024 Muscles Muscle Origin Erector Spinae Muscles - Spinal N. Broad tendon from posterior iliac crest and sacrum. Sacral and inferior lumbar SPs Supraspinous ligament. Sternocleidomastoid - CN XI Manubrium of sternum. Medial 1/3 of clavicle. Insertion Actions Palpation tips Erecto...

BMS Palpation Exam 2024 Muscles Muscle Origin Erector Spinae Muscles - Spinal N. Broad tendon from posterior iliac crest and sacrum. Sacral and inferior lumbar SPs Supraspinous ligament. Sternocleidomastoid - CN XI Manubrium of sternum. Medial 1/3 of clavicle. Insertion Actions Palpation tips Erector spinae and neck muscles Spinalis: SPs of thoracis, Bilateral: extend Prone position. Ask the person to lift their upper body and legs. (superman position) cervicis, capitis. vertebral column. Longissimus: thoracis, This is the palpation for spinalis… cervicis, capitis. Between Unilateral: flexion tubercles and TVPs to (bending body side https://youtu.be/jc5MoQ7nqs4?si=pZkHbb1W3He9-cYe mastoid process. to side). Iliocostalis: lumborum, thoracis, cervicis. Lower ribs and cervical TVPs. Mastoid process. Unilateral: lateral Supine position. Lift head and turn to one side. flexion of head and neck; contralateral rotation of head and neck. Bilateral: extension of head and upper neck; flexion of lower neck. Scalene Group - Cervical spinal N. Anterior: TVPs of C3C6. Middle & Posterior: TVPs of C5-C7 Temporalis - CN V3 Temporal fossa and fascia. Anterior &middle: 1st rib. Lateral neck Posterior: external border flexion; elevates rib of 2nd rib. 1&2 during forced inspiration. Facial muscles Coronoid process, Elevation and anterior border of ramus retraction of of mandible. mandible. Supine. Lateral flex head. Posterior to SCM and anterior to bony vertebra. Seated position. Clench teeth. Masseter - CN V3 Zygomatic arch. Lateral surface of ramus of mandible. Rectus Abdominis - Intercostal nerve (T6-T12) Pubic crest, symphysis pubis. Xiphoid process, cartilages of ribs 5-7. Elevation and protraction of mandible. Seated position. Clench teeth. Abdominal muscles Flexion of trunk; Supine position. Flex trunk (sit-ups) weak posterior tilt of the pelvis. Quadratus lumborum - Ventral rami of spinal nerves (T12-L4) Iliac crest, iliolumbar ligament. Rib 12, TVPs of L1-L4. Extend, lateral flexion of trunk; holds rib 12 during breathing. Prone position. Ask the person to lift only one side of their hips External Oblique Muscle - Intercostal nerves (T7-T12) External surface of lower 8 ribs. Linea alba, pubic tubercle, anterior half of iliac crest. Flexion; contralateral rotation of trunk. Supine position. Find the space between iliac crest and inferior rib cage. Ask the person to curl the trunk and lift shoulder towards the opposite hip. Iliacus - Femoral nerve Iliac fossa, sacral ala. Lesser trochanter of femur. Flexion, lateral rotation of thigh. Supine position. Find ASIS press into pelvis. Ask the person to lift one leg. Rhomboid Major & Minor - Dorsal scapular nerve SP of C7-T5 Medial border of scapula Back muscles Retraction, elevation, and downward rotation of scapula. Prone position. Put the person’s hand on their back and lift elbow. https://youtu.be/bQ5kwSYfHHQ?si=bvd7i7zX3AItXBFB Trapezius - CN XI Upper: back of the head, the ligamentum nuchae, the SP of C7. Mid: Sp of T1-T5 Lower: Sp of T6-T12 Lateral 1/3 of clavicle, acromion, spine of scapula. Latissimus Dorsi - Thoracodorsal nerve Sp of T7-L5, crests of Floor of the ilium and sacrum, lowest intertubercular groove of four ribs the humerus Serratus Anterior - Long thoracic nerve (C5-C7) Upper nine ribs Anterior surface of vertebral border of scapula Upper: ext & lateral flex. Of head and neck. Contralateral rotation of head and neck. Elevation, upward rotation of scapula. Mid: retraction of scapula. Lower: depression, upward rotation of scapula. Extension, adduction and medial rotation of the arm. Anterior tilt of the pelvis. Prone position. Diamond shaped. Retract shoulders. Protraction and upward rotation of scapula. Side lying. Flex arm to 130 degrees. https://youtu.be/cOZiYJOR4b8?si=1MHYvt_uMUOnHIT4 Prone position. Flex arm and medial rotate. https://youtu.be/LVMKzmDIjgM?si=2FdwY560cK5HNNYg https://youtu.be/bSN2JHthiZg?si=_Q06TBsp9avqDwn8 Pectoralis Major - Medial and lateral pectoral Medial half of clavicle, sternum, costal cartilages of 1st to 7th ribs. Lateral lip of intertubercular groove of the humerus. Flexion, adduction, medial rotation and horizontal adduction of arm. Shoulder muscles Supine position. Feel the contraction when horizontally adducting the person’s arm. Deltoid - Axillary Lateral clavicle, acromion, spine of scapula. Deltoid tuberosity of humerus Abduction, flex/ext and medial/lateral rotation of shoulder Seated position. Abduct shoulder. Subscapularis - Upper and lower subscapularis Subscapular fossa Lesser tubercle of humerus Medial rotation of shoulder Supine position. Dig into armpit anterior to lateral border of scapula. Supraspinatus - Suprascapular Supraspinous fossa Greater tubercle of humerus Abduction of shoulder joint Seated position. Along the spine of scapula. Infraspinatus - Suprascapular Infraspinous fossa Greater tubercle of humerus Lateral rotation and horizontal abduction of shoulder Prone position. Ask the person to hang their arm off the bed and do lateral rotation. Teres major - Upper and lower subscapular The inferior lateral border of scapula Medial lip of intertubercular sulcus of humerus Extension, adduction, medial rotation of shoulder Prone position. Find lower 2/3 of inferior border of scapula. Hand hanging from the bed and do medial rotation. Teres minor - Axillary The superior lateral border of scapula Greater tubercle of humerus Lateral rotation of shoulder joint Prone position. Same as teres major, but along upper 1/3 of inferior border. Upper arm muscles Flexion, supination Seated position. Flex arm in supination. of the forearm. Flexion of arm. Biceps brachii Short head: coracoid - Musculocutaneous process of scapula. Long head: supraglenoid tubercle of scapula. Radial tuberosity and fascia of forearm via bicipital aponeurosis. Triceps Brachii - Radial Olecranon process of ulna Extension of the forearm. Extension of the arm (long head only). Seated position. Extend arm. Middle third of the medial surface of humerus Flexion, adduction of arm (especially horizontal adduction) Supine position. Bring arm to 90 degrees and fully flex the forearm. The muscle contacts on the proximal medial side of the humerus. Long head: infraglenoid tubercle. Lateral head: lateral, posterior humerus. Medial head: posterior surface of humerus. Coracobrachialis Coracoid process of - Musculocutaneous scapula Common flexor tendon - Median Medial epicondyle of humerus / Pronator Teres - Median Humeral head: Medial epicondyle of humerus. Ulnar head: coronoid process of ulna. Middle of the lateral surface of radius. Anterior forearm muscles Origin of most Seated position. flexor-pronator muscles. Pronation, weak Seated position. The only anterior muscle with oblique fibres. flexion of forearm. Palmaris longus - Median Medial epicondyle of humerus. Palmer aponeurosis, flexor retinaculum Flexion of hand. Weak flexion of forearm. Seated position. Flex wrist and find the PL tendon, trace back to the medial epicondyle. Flexor Carpi Radialis - Median Medial epicondyle of humerus. Base of the 2nd and 3rd metacarpals Flexor Carpi Ulnaris - Ulnar Humeral head: medial epicondyle of humerus. Ulnar head: olecranon process and posterior border of ulna. Base of 5th metacarpal, hook of hamate, pisiform. Flexion, abduction (radial deviation) of hand. Weak flexion of forearm. Flexion, adduction of hand. Weak flexion of forearm. Seated position. Find the FCR tendon lateral to the PL tendon and trace back to medial epicondyle. Seated position. Start from olecranon, ask the person to ulnar deviate their wrist. Flexor Digitorum Superficialis - Median Humero-ulnar head: medial condyle of humerus, coronoid process of ulna. Radial head: proximal of anterior border of radius. Base of middle phalanges Flexion of fingers of fingers #2-5. #2-5. Flexion of hand. Weak flexion of forearm. Common extensor tendon Lateral epicondyle of humerus. / Seated position. Find PL tendon first, ask the person to flex their fingers and palpate the tendon contracting medial to the PL tendon. Trace FDS tendon back to origins. Posterior forearm muscles Origin of extensor Seated position. muscles. Extensor Carpi Radialis Longus - Radial Distal 1/3 of lateral supracondylar ridge of humerus Base of 2nd metacarpal bone Extend the wrist on radial side. Radial deviation/abduction of wrist. Weak flexion of elbow. Seated position. Part of mobile wad of three. Ask the person to radial deviate and extend the wrist. Brachioradialis - Radial Distal 1/3 lateral supracondylar ridge of humerus Lateral surface of distal end of radius proximal to styloid process Flexion of forearm. Seated position. Beer drinking. Extensor Digitorum - Radial Lateral epicondyle of humerus Distal and middle phalanges of fingers #2-5 Extension of fingers Seated position. Pronation of hand on table, ask the person to extend their wrist (lift #2-5 at MCP, PIP up fingers) and put resistance on their fingers. and DIP joints. Extension of hand at wrist. Weak extension of elbow. Extensor digiti minimi - Radial Lateral epicondyle of humerus Middle and distal phalanges of little finger Extension of finger #5 at MCP, PIP and DIP joints. Extension of hand at wrist. Weak extension of elbow. Seated position. Pronation. Put resistance on pinky. Extensor carpi ulnaris - Radial Lateral epicondyle of humerus. Posterior border of ulna Base of 5th metacarpal bone Extension of hand. Ulnar deviation/adduction of hand at wrist. Weak extension of elbow. Seated position. Extend and ulnar deviate the wrist. Abductor Pollicis Longus - Radial The middle of posterior surface of radius, ulna and interosseous membrane Base of 1st metacarpal. Abduction, extension of thumb at CMC joint. Weak Radial deviation/abduction of hand at wrist. Seated position. Abduct the thumb. From posterior side of the radius and ulna going more anterior. https://youtu.be/w_ZE4zPlgs0?si=J1RzjVSZ2J87ZSVC Extensor pollicis brevis - Radial Distal 1/3 of posterior surface of radius and interosseous membrane Abductor Pollicis Brevis - Median Flexor retinaculum. Tubercle of scaphoid. Tubercle of trapezium. Flexor Pollicis Brevis - Median Flexor retinaculum. Trapezium. Abductor digit minimi - Ulnar Pisiform. Dorsal Interossei - Ulnar Adjacent sides of metacarpals Tensor Fascia Lata - Superior gluteal nerve (L4-S1) Lateral side of ASIS, anterior part of iliac crest. Gluteus maximus - Inferior gluteal nerve Posterior iliac crest, sacrum, coccyx, sacrotuberous ligament. Base of proximal phalanx Extension of thumb of thumb at CMC and MCP joint. Extension of wrist. Weak radial deviation/abduction. Hand muscles Lateral side of the base Abduction of of proximal phalanx of thumb. thumb. Seated position. Extend thumb, find EPB tendon at anterior border of the snuffbox, trace back to the radius origin. Lateral side of the base of proximal phalanx of thumb. Seated position. Flex thumb. (medial to abductor pollicis brevis) Flexion of thumb. https://youtu.be/4BG7BQZWPFg?si=iSirFl2k6oIpN1AP Seated position. Abduct thumb. https://youtu.be/4BG7BQZWPFg?si=uk_ZtYlXY4TW-Um6 https://youtu.be/I2gFPP6cksE?si=VsT6_KYDBFqufNBI Medial side of base of Abduction of 5th Seated position. Abduct pinky. th proximal phalanx of 5 finger. finger https://youtu.be/ETUXJn8EK8E?si=A5OAZ08P5hJnLqDm Base of proximal Abduction, flexion Seated position. Abduct fingers phalanges and dorsal of fingers #2-4 at digital expansion of MCP. Extension of https://youtu.be/YmgOIatrz5Y?si=QiWPivHxHx3XoQ5q fingers #2,3,4. fingers #2-4 at PIP #1 to lateral side of and DIP. finger #2. #2 to lateral side of finger #3. #3 to medial side of finger #3. #4 to medial side of finger #4. Gluteal and posterior thigh muscles Blend into ITB around Flexion, abduction Side lying. Medially rotate hip against resistance. greater trochanter. and medial rotation of thigh; anterior tilt https://youtu.be/BK-dx1SdfYE?si=1RZNiazShdXdxJ1L of pelvis; tense ITB to support femur on tibia during standing. ITB, gluteal tuberosity of Extension, Prone position, bend the person’s knee and ask them to lift their left to activate the femur. abduction/ muscle. adduction, lateral rotation of thigh; posterior tilt of pelvis; helps lock knee in extension. Gluteus Medius - Superior gluteal nerve External surface of ilium between anterior and posterior gluteal lines. Lateral surfaced of greater trochanter. Abduction, flexion/extension, Side lying. Ask the person to lie on their side and lift their leg up. medial/lateral rotation of thigh. Iliacus Biceps Femoris - tibial and common fibular Long head: ischial tuberosity. Short head: linea aspera. Head of fibula, lateral condyle of tibia. Flexion of leg; extension of thigh; lateral rotation of leg. Prone position, flex knee. Externally rotate the leg to find the tendon and trace back to it origin. Semitendinosus - sciatic nerve Ischial tuberosity Proximal part of medial surface of shaft of tibia. Semimembranosus - sciatic nerve Ischial tuberosity Posterior aspect of medial condyle of tibia. Sartorius - femoral ASIS Proximal part of medial surface of shaft of tibia. Flexion of leg; Prone position, flex knee. Find the tendon medial to the iliacus biceps femoris extension of thigh; tendon and trace back to origin. medial rotation of leg. Flexion of leg; Prone position. Find semitendinosus tendon and go wider and sink in more to find extension of thigh; semimembranosus. medial rotation of leg. Anterior thigh muscles Flexion, abduction, Supine position. Flex the person’s leg and externally rotate it lateral rotation of thigh; flexion, Bend leg like this to create straight line for origin and insertion... medial rotation of leg. Rectus femoris - femoral Anterior head: AIIS, Posterior head: groove above the brim of acetabulum. Base of patella via the quadriceps tendon and then to tibial tuberosity via the patellar ligament. Extension of leg, flexion of thigh. Supine position. Flex at knee and lift up the leg. Vastus lateralis - femoral Intertrochanteric line, gluteal tuberosity, lateral lip of linea aspera. Lateral border of patella Extension of leg. via the quadriceps tendon and then to tibial tuberosity via the patellar ligament. Supine position. On the lateral side of the thigh. Between biceps femoris and rectus femoris. Vastus Medialis - femoral Intertrochanteric line, media lip of linea aspera. Medial supracondylar line. Meidal border of patella Extension of leg. via the quadriceps tendon and then to tibial tuberosity via the patellar ligament. Supine position. Lock knee, start from patella. Adductor Muscles – As a Group - obturator nerve Pubis. Femur. Side lying. Adduct thigh. Medial side of thigh. Gastrocnemius - Tibial Soleus - Tibial Medial head: medial condyle of femur. Lateral head: lateral condyle of femur. Soleal line of tibia, head of fibula, proximal posterior surface of body of fibula. Adduction, flexion of thigh. Calcaneus via calcaneus tendon. Leg muscles Plantar flexion of foot; flexion of leg. Prone position, extend knee and dorsi flex the foot. Calcaneus via calcaneus tendon. Plantar flexion of the foot. Prone position, flex knee and do plantar flexion. Feel for head of tibia while doing the action and soleus pushes the fingers off tibia. Joints Joint Classification Movement Ligaments Sternoclavicular Modified saddle 3 degrees: elevation/depression, protraction/retraction; rotation. Sternoclavicular, interclavicular, costoclavicular. Acromioclavicular Plane 1 degree: glide and slide. Acromioclavicular, trapezoid, conoid. Shoulder Ball and socket 3 degrees: flexion/extension, adduction/abduction, rotation. The capsular ligaments, transverse humeral, coracohumeral. Elbow Hinge 1 degree: flexion/extension. Radiocarpal (wrist) Condyloid 2 degrees: flexion/extension, abduction/adduction. First carpometacarpal Saddle Metacarpophalangeal Condyloid 3 degrees: flexion/extension, adduction/abduction, opposition. 2 degrees: flexion/extension, adduction/abduction. The collateral ligaments, anterior and oblique anterior ligaments. The radioulnar ligaments, the collateral ligaments, dorsal radiocarpal, dorsal ulnocarpal. Anterior and posterior oblique ligaments, ulnar collateral ligament. Medial and lateral collateral ligaments, palmer plates. Proximal Interphalangeal Distal Interphalangeal Hip Hinge Hinge Ball and socket 1 degree: flexion/extension. 1 degree: flexion/extension. 3 degrees: flexion/extension, adduction/abduction, rotation. The collateral ligaments, palmer plates. The collateral ligaments, palmer plates. Acetabular labrum, transverse acetabular, ligamentum teres, iliofemoral, pubofemoral, ischiofemoral. Knee Modified hinge 2 degrees: flexion/extension, rotation. Ankle Hinge 1 degree: flexion/extension. Oblique popliteal, arcuate popliteal, the collateral ligaments, cruciate ligaments, Deltoid ligament, posterior talofibular, calcaneofibular.