Palpation of Bony Landmarks
UPPER EXTREMITY
Scapula:
1.
Spine – From AC joint palpate across the upper part of the posterior surface of the
scapula. It is a long (3”) thin projection, which runs medial to lateral, at T3 level.
2.
Acromion process – Located on the lateral part of the shoulder, right above the shoulder
joint.
3.
Coracoid process – Palpate under the lateral part of the clavicle (about one inch below the
anterior edge of the clavicle).
4.
Medial (vertebral) border – The edge of the scapula closest to the vertebral column (about
2 inches from the spinous processes). The medial border runs in a superior-inferior
direction.
5.
Lateral (axillary) border – The lateral (or outer) edge of the scapula located between the
inferior angle and the shoulder joint.
6.
Superior medial angle – Located above the vertebral border or medial aspect of scapula,
level T2.
7.
Inferior angle – Located between vertebral and axillary borders. The “point” at the
bottom of scapula, level T7.
Clavicle:
“Collar bone” – anterior from sternum to acromion
Humerus:
1.
Greater tuberosity – Located just below acromion when arm is resting by the side.
(proximal end of humerus)
2.
Lesser tuberosity – Easiest to palpate with arm in shoulder external rotation. located
medial to greater tuberosity on proximal end of humerus.
3.
Intertubercular (Bicipital) Grove – Located between greater and lesser
tuberosity; easiest to palpate with arm in external rotation.
4.
Medial and lateral epicondyles – Palpated on medial and lateral sides,
respectively, of distal end of humerus (2 “bumps” on distal end).
5.
Medial and lateral supracondylar ridge – above the medial and lateral
epicondyles on distal end of humerus.
6.
Olecxranon fossa – indentation on posterior of elbow
Radius:
1.
Head – From lateral epicondyle of humerus move distally about 1 inch.
Head of radius palpated easiest as you pronate and supinate.
2.
Anterior border – Ridge just above wrist on lateral aspect of lower forearm.
3.
Styloid process – In the anatomic position, styloid is lateral just above wrist joint.
4.
Dorsal tubercle – On distal end of radius on posterolateral aspect of wrist. Feels like a
small longitudinal bony prominence or module.
1.
Olecranon – “Funny bone” – long protuberance on posterior of elbow.
2.
Styloid process – In the anatomic position, styloid process is on medial aspect of wrist,
also slightly posterior. Is more proximal than radial styloid process.
3.
Head – On distal end of ulna. In supination, it can be palpated on medial-anterior aspect
of wrist (just proximal to wrist). In pronation, head is the projection on posterior aspect
(ulnar side) of wrist.
Ulna:
Carpals:
1.
Pisiform – “Pea-shaped” bone on ulnar side of hand (palmar surface)
2.
Scaphoid – On radial side of wrist – easiest to palpate in “floor” of anatomical snuffbox
(proximal to thumb) as you move hand into ulnar deviation.
3.
Trapezium – On radial side of wrist where it articulates with 1st metacarpal to form saddle
joint. Easiest to palpate as you flex and extend the thumb.
4.
Hamate (hook) – Located slightly distal and radial to the pisiform.
5.
Capitata – Proximal to the base of the third metacarpal between the dorsal tubercle of the
radius and the third metacarpal. Most easily palpated as you flex the wrist.
6.
Triangular – Located just distal to the ulnar styloid process. To palpate, radially deviate
the hand.
7.
Base, body, head of metacarpals and phalanges.
LOWER EXTREMITY
Femur:
1.
Greater trochanger – lateral aspect of thigh just distal to hip joint.
2.
Medial and lateral condyles – on distal end of femur
3.
Medial and lateral epicondyles (Epicondyles)
Patella:
“Knee cap” – anterior aspect of knee (a sesamoid bone located in quadriceps tendon).
Tibia:
1.
Medial condyle – on proximal end of tibia, medial aspect.
2.
Tibial tuberosity – on proximal end, anterior aspect just below patella. (insertion for
quadriceps tendon)
3.
Tibial spine – “Shin bone” - anterior ridge along tibia.
4.
Medial malleolus – large protuberance on medial aspect of ankle.
5.
Tibial plateau
6.
Lateral condyle
7.
Shaft
1.
Head – Move distally and posteriorly from lateral femoral condyle.
2.
Lateral malleolus – Large protuberance on lateral aspect of ankle.
3.
Shaft
4.
Styloid process
Fibula:
Tarsals:
1.
Calcaneus – heel bone.
2.
Naviculr tubercle – On medial border of foot, large bony prominence.
3.
Head of the Talus – Just proximal to navicular tubercle, especially palpable in eversion.
4.
Sustentaculum tali – Located between the head of the Talus and the medial malleolus.
Feels like a small ridge.
5.
Peroneal tubercle of the calcaneus – On lateral aspect of foot just distal to lateral
malleolus.
6.
Medial tubercle of calcaneus – lies on the medial plantar surface of the calcaneus (not
usually sharp or distinct unless it is associated with a heel spur.