Trail Guide to the Body
Order and simplification are the first steps
toward the mastery of a subject - the actual
enemy is the unknown.
Thomas Mann, The Magic Mountain
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educational
“Just when you thought it couldn’t get any better! Practical
and accurate — a ‘must have’ for visual and relational learners
or anyone wishing to enjoy the journey.”
Diana L. Thompson, LMP,
educator and author of
Hands Heal: Documentation for Massage Therapy
“Trail Guide is an essential reference for any hands-on healer.
A wealth of useful detail is presented in an accessible and
easily comprehensive fashion.”
Thomas Myers, Rolfer®,
trainer of Structural Integration,
author of Anatomy Trains - Myofascial Meridians
Table of Contents
Introduction - Tour Guide Tips
How To Use This Book
Key
Palpation Hints
Creating Your Palpatory Journal
Exploring the Textural Differences of Structures
Chapter 1 - Navigating the Body
Regions of the Body
Planes of Movement
Directions and Positions
Movements of the Body
Systems of the Body
The Skeletal System
Types of Joints
The Muscular System
The Fascial System
The Cardiovascular System
The Nervous System
The Lymphatic System
Chapter 2 - Shoulder & Arm
Topographical Views
Exploring the Skin and Fascia
Bones of the Shoulder and Arm
Bony Landmarks
Bony Landmark Trails
11
12
13
14
19
20
29
30
31
31
32
40
40
42
43
46
48
50
51
53
54
55
56
57
59
Muscles of the Shoulder and Arm
Synergists - Muscles Working Together
Deltoid
Trapezius
Latissimus Dorsi and Teres Major
Rotator Cuff Muscles
Rotator Cuff Tendons
Rhomboid Major and Minor
Levator Scapula
Serratus Anterior
Pectoralis Major
Pectoralis Minor
Subclavius
Biceps Brachii
Triceps Brachii
Coracobrachialis
69
71
75
76
79
82
87
90
91
94
97
100
102
103
105
107
Other Structures of the Shoulder and Arm
108
Chapter 3 - Forearm & Hand
115
Topographical Views
Exploring the Skin and Fascia
Bones of the Forearm and Hand
Bony Landmarks
Bony Landmark Trails
116
117
118
119
121
Muscles of the Forearm and Hand
Synergists - Muscles Working Together
Brachialis
Brachioradialis
Distinguishing Between the Flexor
and Extensor Groups of the Forearm
Extensors of the Wrist and Hand
Anconeus
Extensor Indicis
Flexors of the Wrist and Hand
Pronator Teres
Pronator Quadratus
Supinator
Muscles of the Thumb
Muscles of the Hand
135
138
140
141
Other Structures of the Forearm and Hand
166
Chapter 4 - Spine & Thorax
142
143
147
147
148
154
155
155
157
163
173
Topographical Views
Exploring the Skin and Fascia
Bones of the Spine and Thorax
Bony Landmarks
Bony Landmark Trails
174
175
176
177
180
Muscles of the Spine and Thorax
Synergists - Muscles Working Together
Erector Spinae Group
Transversospinalis Group
Splenius Capitis and Cervicis
Suboccipitals
Quadratus Lumborum
Abdominals
Diaphragm
Intercostals
Serratus Posterior Superior and Inferior
Intertransversarii
Interspinalis
194
200
202
206
209
211
213
215
219
221
222
223
223
Other Structures of the Spine and Thorax
224
Table of Contents
Chapter 5 - Head, Neck & Face
231
Topographical View
Exploring the Skin and Fascia
Bones and Bony Landmarks of the Head, Neck and Face
Bony Landmark Trails
232
233
234
236
Muscles of the Head, Neck and Face
Synergists - Muscles Working Together
Sternocleidomastoid
Scalenes
Masseter
Temporalis
Suprahyoids and Digastric
Infrahyoids
Platysma
Occipitofrontalis
Pterygoids, Medial and Lateral
Longus Capitis and Longus Colli
246
248
250
252
256
257
259
261
263
263
265
266
Other Structures of the Head, Neck and Face
267
Chapter 6 - Pelvis & Thigh
273
Topographical Views
Exploring the Skin and Fascia
Bones of the Pelvis and Thigh
Bony Landmarks
Bony Landmark Trails
274
275
276
277
282
Muscles of the Pelvis and Thigh
Synergists - Muscles Working Together
Quadriceps Femoris Group
Hamstrings
Gluteals
Adductor Group
Tensor Fasciae Latae and Iliotibial Tract
Sartorius
Tendons of the Posterior Knee
Lateral Rotators of the Hip
Iliopsoas
Psoas Major
Iliacus
294
296
300
305
309
313
318
320
321
322
326
328
329
Other Structures of the Pelvis and Thigh
330
Each chapter follows a
standard format, providing
students with a rhythmic
and predictable structure
for learning.
Chapter 7 - Leg & Foot
337
Topographical Views
Exploring the Skin and Fascia
Bones of the Knee, Leg and Foot
Bony Landmarks of the Knee and Leg
Bony Landmark Trails of the Knee
Bones and Bony Landmarks of the Ankle and Foot
Bony Landmark Trails of the Ankle and Foot
338
339
340
341
343
348
350
Muscles of the Leg and Foot
Synergists - Muscles Working Together
Gastrocnemius
Soleus
Plantaris
Popliteus
Peroneus Longus and Brevis
Extensors of the Ankle and Toes
Flexors of the Ankle and Toes
Muscles of the Foot
Other Muscles of the Foot
360
362
364
364
367
368
369
371
374
377
380
Other Structures of the Knee and Leg
Other Structures of the Ankle and Foot
382
388
Synergists - Muscles Working Together
Glossary of Terms
Pronunciation and Etymology
Bibliography
Index
397
400
404
408
410
Planes of Movement
When the body is in the standard anatomical position, standing erect with the palms facing forward
(p. 29), it can be divided into three imaginary planes
(1.4). These planes help clarify and specify movements.
The sagittal plane divides the body into left and
right halves. The descriptive terms medial and lateral
correlate to the sagittal plane; the actions of flexion
and extension occur along this plane. The midline (or
midsagittal plane) runs down the center of the body,
dividing the sagittal plane in two symmetrical halves.
The frontal (or coronal) plane divides the body
into front and back portions. The terms anterior and
posterior relate to the frontal plane; the actions of
adduction and abduction happen along this plane.
Dividing the body into upper and lower parts is the
transverse plane. The terms superior and inferior refer to
the transverse plane; rotation happens within this plane.
Directions and Positions
Specific terms are used to help communicate
location, direction and position of body structures.
These terms replace more general references like “up
there” or “north of here,” which are less precise and can
be confusing. Each direction is paired up with its
complementary direction.
Superior refers to a structure closer to the head.
Inferior means closer to the feet. “The nose is superior
to the navel.” “The navel is inferior to the nose.” (1.5)
The terms cranial (closer to the head) and caudal
(closer to the buttocks) are used when referring to
structures on the trunk.
Transverse
Sagittal
Frontal
B
it is efore e
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Posterior concerns a structure further toward the
back of the body than another structure. Anterior
refers to a structure further in front. “The sternum is
anterior to the spine.” (1.5) These directions are also
referred to as dorsal (posterior) and ventral (anterior).
Medial pertains to a structure closer to the midline
(or center) of the body. Lateral refers to a structure
further away from the midline. “The last (pinkie) toe is
lateral to the big toe.” (1.6)
Superior
Inferior
Distal means a structure further away from the trunk
or the body’s midline. Proximal designates a structure
closer to the trunk. These directions are used only when
referring to the arms and legs. “The foot is distal to the
thigh.” (1.6) “The forearm is proximal to the hand.”
Superficial describes a structure closer to the body’s
surface. Deep refers to a structure deeper in the body.
“The abdominal muscles are superficial to the intestines.” “The intestines are deep to the abdominal
muscles.” (1.7)
sagittal
coronal
transverse
saj-i-tal
ko-ro-nal
trans-verse
L. arrowlike
L. crownlike
L. across, turned across
Posterior
Anterior
(1.5) Lateral view of rib cage and vertebrae
Navigating the Body 31
Scapula
Movements of the Body
(scapulothoracic joint)
Elevation
Adduction
(retraction)
Depression
Upward rotation
of left scapula
Abduction
(protraction)
The body movements,
Downward rotation
which
are clearly illustrated,
of right scapula
serve as a frame of reference
throughout the book.
Shoulder
(glenohumeral joint)
Adduction
Flexion
Extension
Abduction
Horizontal adduction
Medial rotation
(internal rotation)
Horizontal abduction
Lateral rotation
(external rotation)
Navigating the Body 35
Exploring the Skin and Fascia
1) Partner prone. Begin by gently lifting the skin and
fascia of the upper back. As you raise it away from
the thicker, deeper musculature, twist the tissue from
side to side (2.4). Compare the changes in tissue as
Palpathe top of the shoulders, arms and
you explore
upperw
chest. tion is
ith yonote of athe
botissue’s
2) Take
ut “sechanges in thickawaparticular
u
r
h
r
e
a
ness andnelasticity.
For
example,
theeskin
ingand
n
e
d
”be fascia
s
s ospine
asuperficial
,
s you tosthe
g
a
f
of
the
scapula
may
dense
i
s
n
u
i
ng
btle d
expwhile
l
begmatted,
and
the tissue
atithe
top
of
the
shoulo
r
f
e
f
erencand mobile.
. away,
insa afew
ur imay
der, only
inches O
t th
es
n be thin
meth
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odica e skin and truction
layer lly throug works
s of t
issue h the
.
(2.4) Partner prone
1) Partner supine. Slowly sink your fingers into the
skin of the upper chest. Then gently shift the
tissue from side to side (2.5). Try moving it in
all directions, sensing its mobility, resistance
and temperature.
2) Compare this tissue with other areas of the
shoulder and arm, including the axilla (armpit)
and the area near the clavicle.
(2.5) Partner supine
(2.6)
1) Partner supine. Here is an opportunity to feel the
skin and fascia shorten or stretch. Holding your
partner’s arm at the wrist, gently grasp the tissue
of the upper chest.
2) Encourage your partner to relax her arm as you
passively move it up and down (horizontal abduction and adduction). Note the changes you feel in
the tissues.
3) Try this same action while grasping the tissue near
the clavicle, sternum or latissimus dorsi. Explore
different movements at the shoulder, feeling how
virtually all the skin of the upper chest, shoulder
and arm shifts to accommodate even a simple
action (2.6).
Shoulder & Arm 55
Bones of the Shoulder and Arm
The shoulder complex is made up of three bones: the
clavicle, scapula and humerus (2.7). The clavicle or collarbone is superficial and runs horizontally along the top of
the chest at the base of the neck. It articulates laterally
with the acromion of the scapula (acromioclavicular joint)
and medially with the sternum (sternoclavicular joint).
Both joints are synovial joints. The sternoclavicular joint
is the single attachment site between the upper appendicular and axial skeletons.
The scapula is the triangular-shaped bone of the upper
back. Along with the clavicle, the scapula plays a vital role
in stabilization and movement of the arm. The scapula
has several fossae, corners and ridges which serve as
attachment sites for sixteen muscles. The scapula glides
across the posterior surface of the thorax to form the
scapulothoracic joint. However, because this articulation
does not have any of the usual joint components, it is
considered a false joint.
ught
taproximal
e
r
a
The humerus is the bone of the
arm.
The
s
t
ny
den fossa
boscaptuglenoid
nofdthe
humerus articulates with Sthe
a
s
e
n
bo The glenohumeral
ula to form the glenohumeral
to help
t
thejoint.
s
r
i
f
s
rk
joint is a synovial, ball-and-socket
ao
wide
ng the
ndmajointewith
l numera
m
range of movement. Theladeltoidemuscle
and
h
l.
traithe
uid t humerus
n
ous tendons surround thegproximal
and
o
i
t
a
p
pal
glenohumeral joint.
Sternoclavicular (S/C) joint
Cervical vertebra
Acromioclavicular (A/C) joint
Clavicle
Glenohumeral joint
Humerus
Sternum
Scapula
Ribs
(2.7) Anterior view with
ribs removed on left side
The clavicle is the first bone to start
ossifying (hardening) in a human fetus,
yet paradoxically it is the last to completely develop - often not until the
late teens or early twenties. This fact,
along with its superficial location, may
explain why the clavicle is one of the
most frequently broken bones in
the body.
56 Trail Guide to the Body
A quadruped, such as a dog or cat,
however, is not concerned with breaking its clavicle. Since a quadruped’s
scapula is positioned on the lateral side
of the trunk (as opposed to a human’s,
which lies on the posterior side of the
trunk), its clavicle is not as essential to
the movement of the shoulder complex. Actually, cats have a thin sliver
clavicle
furcula
humerus
Tips a
facdogs
d fausmall
for a clavicle and
ts tohavenjust
n
h
piece of cartilage.
mem elp wit
A bird’s clavicles areo
joined
rizattoi form ha
on.
furcula. The single unit of the furcula
acts as a strut, offering greater stability
to the large pectoral muscles during
flight. The furcula is what we split
apart when vying for the long end
of the “wishbone.”
klav-i-k’l
fur-ku-la
hu-mer-us
L. little key
L. a little fork
L. upper arm
Bony Landmarks
Coracoid process
Superior notch
Acromion
Superior angle
Supraglenoid tubercle
Medial border
bony s
d
e
t
a
ent cavity
ustr studGlenoid
l
l
i
y
l
Clear arks help ental
m
landmm strong ill later
for s that w ing
e
imag ome guid pating.
bec hen pal
sw
point
Subscapular fossa
Lateral border
Inferior angle
(2.8) Anterior view of right scapula
Superior angle
Superior notch
Acromion
Supraspinous fossa
Spine of the scapula
Acromial angle
dInfraglenoid tubercle
gy an res are
o
l
o
u
ct
tym
l
The e ion of stru dents fee g
nciat help stu e learnin
u
n
o
r border
pr ided to
hey aLateral
t
v
t
n
o
a
r
h
p
nt t nformatio start.
e
d
i
f
con
this i from the
ctly
corre
Medial border
Infraspinous fossa
Inferior angle
process
scapula
scapulae
pros-es
skap-u-la
skap-u-lay
L. going forth
L. shoulder, blade
plural for scapula
Shoulder & Arm 57
Muscles of the Shoulder and Arm
The muscles of the shoulder and arm are an amazingly
diverse group. Some of them span across the back and rib
cage, some attach at the cranium while others extend down
to the elbow. All of the muscles create movement at the
shoulder complex (formed by the scapula, clavicle and
humerus). Some also elevate the ribs, extend the head
and cervical vertebrae or bend the elbow (2.33 - 2.35).
The superficial muscles of the shoulder and back are presented first, followed by the deeper muscles of the back,
The muscles sections
begin with an overview of
the region, providing a framework for understanding the
individual muscles
Trapezius
within their context.
and lastly, the muscles of the arm. Some muscles are presented together to better understand how they function
as a group.
Although the instructions for each muscle or muscle
group specify the position in which to place your partner
(prone, supine or seated), exploration in all positions is
encouraged for a better understanding of the muscle(s)
and the surrounding structures.
Splenius capitis
Levator scapula
Rhomboids major and minor
Supraspinatus
Infraspinatus
Deltoid
Infraspinatus
Teres minor
Teres minor
Teres major
Teres major
Triceps brachii
Triceps brachii
Latissimus dorsi
Erector spinae group
Thoracolumbar
aponeurosis
Serratus posterior inferior
Thoracolumbar
aponeurosis (cut and reflected)
(2.33) Posterior view of shoulder and back.
Latissimus dorsi, trapezius and deltoid are
removed on right side.
The trapezius received its present name from
the British anatomist William Cowper (c. 1700).
Previously, it was called the musculus cucullaris
(L. muscle hood), since the two trapezius muscles together resemble a monk’s hood.
Shoulder & Arm 69
Synergists - Muscles Working Together
*muscles not shown
Flexion
Deltoid (anterior fibers)
Pectoralis major (upper fibers)
Biceps brachii
Coracobrachialis*
Shoulder
(glenohumeral joint)
The c
o
are in ncepts o
f
are shtroduced kinesiolo
work own whi as studen gy
ch
ts
tog
speci ether to muscles
fic m
p
ovem roduce
ents.
Extension
Deltoid (posterior fibers)
Latissimus dorsi
Teres major
Infraspinatus
Teres minor
Pectoralis major (lower fibers)
Triceps brachii (long head)
Posterior view
Anterior view
Horizontal Abduction
Deltoid (posterior fibers)
Infraspinatus
Teres minor
Horizontal Adduction
Deltoid (anterior fibers)
Pectoralis major (upper fibers)
Anterior view
Posterior/lateral
view of right arm
Shoulder & Arm 71
Deltoid
The triangle-shaped deltoid is located on the cap
of the shoulder. The origin of the deltoid (which is
interestingly enough identical to the insertion of the
trapezius) 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 (2.36).
The deltoid fibers can be divided into three segments:
the anterior, middle and posterior fibers. All three
groups abduct the humerus, but the anterior and posterior fibers are antagonists in both flexion/extension
and medial/lateral rotation.
Posterior
Anterior
Middle
A All fibers:
Abduct the shoulder (glenohumeral joint)
Anterior fibers:
Flex the shoulder (g/h joint)
Medially rotate the shoulder (g/h joint)
Horizontally adduct the shoulder (g/h joint)
D
infor etailed A
matio
OIN
for ea n is pro
vi
ch m
uscle ded
.
Posterior fibers:
Extend the shoulder (g/h joint)
Laterally rotate the shoulder (g/h joint)
O
Horizontally abduct the shoulder (g/h joint)
O Lateral one-third of clavicle, acromion
and spine of scapula
I Deltoid tuberosity
N Axillary from brachial plexus
I
(2.37) Origin and
insertion of deltoid
Belly of the deltoid
1) Seated. Locate the spine of the scapula, the acromion
and the lateral one-third of the clavicle. Note the “V”
shape these landmarks form.
2) Locate the deltoid tuberosity.
3) Palpate between these landmarks to isolate the
superficial, convergent fibers of the deltoid. Be sure
to explore the deltoid’s most anterior and posterior
aspects.
Are the fibers you feel superficial and do they converge
toward the deltoid tuberosity? If your partner alternately abducts and releases, do you feel the fibers contract
and relax (2.38)?
(2.38) Anterior/lateral view
deltoid
del-toid
Grk. delta, capital letter D (∆)
in the Greek alphabet
Shoulder & Arm 75
Deltoid as antagonist to itself
To feel the antagonistic abilities of the deltoid’s
anterior and posterior fibers: 1) Shaking hands
with your partner, place your other hand on the
deltoid. 2) Keeping his elbow next to his side,
ask your partner to medially and laterally rotate
his arm against your resistance. Can you sense
the anterior fibers contract upon medial rotation and relax upon lateral rotation and vice
versa for the posterior fibers?
(2.39) Lateral view of right shoulder. Use both
hands to sculpt out the edges of the deltoid,
following them down to the tuberosity.
Trapezius
Superior nuchal
line of the occiput
Spec
i
inser fic origin
t
a
clear ion diagr nd
ams
ly ou
tl
attac
hmen ine the
of ea
ch m t sites
uscle
.
Upper fibers
Spinous process
of C-7
Middle fibers
The trapezius lies superficially along the upper back
and neck. Its broad, thin fibers blanket the shoulders,
attaching to the occiput (the bone at the base of the
head, p. 237), lateral clavicle, scapula and spinous
processes of the thoracic vertebrae (2.40, 2.42).
The trapezius fibers can be divided into three
groups: upper (descending) fibers, middle fibers and
lower (ascending) fibers. The upper and lower fibers
are antagonists in elevation and depression of the
scapula, respectively. All fibers of the trapezius are
easy to palpate.
O
I
Lower fibers
O
Spinous process
of T-12
(2.40) Posterior view of trapezius
76 Trail Guide to the Body
(2.41) Origin and
insertion of trapezius
Latissimus dorsi
1) With your partner supine, cradle the arm in a flexed
position. Then grasp the tissue of the latissimus
located beside the lateral border.
2) Ask your partner to extend his shoulder against your
resistance. “Press your elbow toward your hip.” This
will force the latissimus to contract (2.51).
Teres major
1) Prone with the arm off the side of the table. Locate
and grasp the latissimus dorsi fibers between your
fingers and thumb.
2) Move your fingers and thumb medially to where you
uide The muscle fibers that
feel the scapula’s rlateral
ail Gborder.
Tlatissimus
,
p
e
t
lie medial
to
the
and
s
h attach to the lateral
ug
p bywill benthe
hromajor.
t
Steborder
s
t
teres
e
tud fibers toward
they where they blend
ads sthese
3)leFollow
ises sothewaxilla
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e
onlatissimus dorsi.
with
atithe
ng the
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g
’t
n
do
Lay your thumb on the inferior aspect of the lateral
border and have your partner medially rotate the
shoulder joint to distinguish the teres major from the latissimus dorsi (2.52). The fibers of both muscles will contract.
Those that attach directly to the lateral border belong to
teres major; the more lateral fibers belong to latissimus dorsi.
(2.51) Partner supine,
extending the shoulder
(2.52) Partner prone, medially
rotating at the shoulder
Shoulder & Arm 81
Compression or impingement of the brachial plexus
or one of its nerves can create a sharp, shooting sensation
down the arm. If this occurs, immediately release and adjust
your position posteriorly. Also, ask your partner for feedback.
l
es critica t
n
o
n
s
B
Mr. resent e stude
lly p fers th r more
a
c
i
fo
re
od
gs
peri ation, section st brin e
h
r
rm
ju
info anothe ion, or keep t
to rmat fun to ged.
info bit of r enga
in a learne
(2.112) Inferior view of right axilla
showing vessels which pass
through the axillary region
Median nerve
Brachial artery
Medial antebrachial
cutaneous nerve
Brachial veins
Basilic vein
Ulnar nerve
Triceps brachii
Sternoclavicular Joint
Interclavicular ligament
Anterior sternoclavicular ligament
Articular disc
Joint cavity
Clavicle
Costoclavicular ligament
First rib
Sternocostal synchondrosis
Costal cartilages
Second rib
Manubrium
Sternocostal joints
Radiate ligament
(2.113) Anterior view, right side shown in coronal section
brachial
gland
synchondrosis
bray-key-al
sin-con-dro-sis
L. relating to the arm
L. acorn
Shoulder & Arm 109
Ligaments of the Shoulder and Glenohumeral Joint
Coracoclavicular ligament:
{
Trapezoid
Acromioclavicular
ligament
Givin
of mu g a comp
l
s
requi culoskele ete pictur
of cle res the p tal functi e
tend ar infor resentat on
ons, l
mati
ion
as we igaments on about
ll as i
a
nner nd joints
vatio
ns. ,
Conoid
Clavicle
Acromion
Coracoacromial
ligament
Coracohumeral
ligament
}
Supraspinatus and
subscapularis tendons
(cut)
Biceps brachii
tendon (cut)
Coracoid process
Glenohumeral joint
Glenohumeral joint capsule
Humerus
Scapula
(2.114) Anterior view
of right shoulder
Acromioclavicular joint and ligament
Supraspinatus tendon
Clavicle
Acromion
Capsular ligament
Subacromial bursa
Synovial membrane
Head of humerus
Glenoid labrum
Deltoid
Glenoid cavity
Cartilage of glenoid cavity
(2.115) Cross section anterior view of right
shoulder showing acromioclavicular
and glenohumeral joints
Glenoid labrum
Articular capsule
110 Trail Guide to the Body
coracoacromial
coracoclavicular
ligament
cor-a-ko-a-kro-mi-ul
cor-a-ko-cla-vic-u-lar
lig-a-ment
L. a band
Trapezoid
Conoid
Coracoclavicular Ligament
The coracoclavicular ligament is composed of two
smaller ligaments: the trapezoid and conoid. Both
ligaments stretch from the coracoid process of the
scapula to the inferior surface of the clavicle (2.114).
Together they provide stability for the acromioclavicular joint and form a strong bridge between the
scapula and clavicle.
The coracoclavicular ligament can be accessed by
palpating between the clavicle and coracoid process
or curling under the anterior aspect of the clavicle.
(2.118) Anterior view of right shoulder
palpating coracoclavicular ligament
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2) Locate
the coracoid
process
ody. of the scapula and the
to the B
shaft of the clavicle.
3) Palpate in the space between these landmarks. Roll
your thumbpad across its fibers (2.118). Unlike the
superficial pectoralis major fibers, the ligaments will
feel like solid, taut bands.
Passively move the shoulder girdle in several directions
and see if a particular position allows you greater
access to the ligaments.
Coracoacromial Ligament
(2.119) Anterior view, palpating
the coracoacromial ligament
Acromion
Unlike most ligaments which hold two bones together,
the coracoacromial ligament attaches the scapula’s
coracoid process to its acromion (2.119). Along with the
acromion, this ligament forms the coracoacromial arch
across the top of the shoulder. This arch helps to protect
the rotator cuff tendons and subacromial bursa from
direct trauma by the acromion. The wide band of the
coracoacromial ligament lies deep to the deltoid but
is still accessible.
Coracoid process
1) Supine or seated. Locate the coracoid process.
Then locate the anterior edge of the acromion.
2) Palpating deep to the deltoid fibers, explore between these landmarks for the wide band of the
coracoacromial ligament. Strum your finger across
its fibers (2.119).
3) To bring the ligament closer to the surface, try extending the arm. This position will roll the humeral
head anteriorly and press the ligament forward.
Are you between the acromion and the coracoid process? Place one finger on the ligament and passively
move the shoulder girdle in various positions. Can you feel
how the ligament’s relationship to the surrounding tissues
changes as the position of the shoulder changes?
112 Trail Guide to the Body