Palpations

Clavicle - The superficial clavicle lies horizontally across the upper chest and has a gentle “S” shape. The lateral end is relatively flat and often rises slightly higher than the acromion. The medial end is round and articulates with the sternum. Have partner seated, locate the acromion and walk your fingers medially onto the shaft of the clavicle.

Acromioclavicular Joint (AC Joint) - This is the small articulation between the acromion of the scapula and the acromial end of the clavicle. Seated or supine, locate the acromion. Glide medially toward the clavicle. Your finger will feel a small “step” as your rise up onto the surface of the clavicle. Backtrack slightly, just lateral to the step will be the AC’s joint slender ditch.

Acromion Process - The lateral aspect of the spine of the scapula and is located at the top of the shoulder. Serves as an attachment site for the trapezius and deltoid muscles. Seated or supine, locate the spine of the scapula. Follow the spine as it rises superiorly and laterally to the top of the shoulder. Explore the flat surface. Explore and sculpt around all sides of the acromion and its attachment to the clavicle.

Greater Tuberosity of the Humerus - Located inferior and lateral to the acromion. It is shaped like a low mound. Is the attachment site for three of the four rotator cuff muscles- supraspinatus, infraspinatus, and teres minor. Seated or supine, locate the acromion. Slide off the acromion inferiorly and laterally approximately one inch. The solid surface located deep to the deltoid fibers will be the greater tubercle. You may feel a small dip between the acromion and the tubercle.

Spine of Scapula - The superficial ridge located just off the top of the shoulder. It runs at the oblique angle to the body, spanning from the acromion to the medial border. It is an attachment site for the posterior deltoid and the middle and lower fibers of the trapezius. Partner prone.

Lay your hand across the upper back and slide your fingertips inferiorly until they roll over the superficial spine. Explore entire width and length.

Deltoid - The triangular-shaped deltoid is located on the cap of the shoulder. The origin of the deltoid curves around the spine of the scapula and clavicle forming a “V” shape. From this broad origin, the fibers converge down the arm to attach at the deltoid tuberosity. Can be divided into three segments: the anterior, middle, and posterior fibers. All three groups abduct the humerus.

Trapezius - The trapezius lies superficially along the upper back and neck. The fibers blanket the shoulders. The upper and lower fibers elevate and depress the scapula.

Rotator Cuff Muscles: Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis (know by name, not by location)

Active/Passive Range of Motion (ROM) & Manual Muscle Tests (MMT):

  • Abduction
  • Adduction
  • Flexion
  • Extension
  • Internal Rotation
  • External Rotation

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