Final palpation exam - how to palpate muscles of the upper and lower extremities PDF

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how to palpate muscles of the upper and lower extremities...

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Kinesiology Final Lab Performance Exam Palpation Only Exam- worth 30 points Students will receive a case example with a body segment and specific muscles to palpate in that region. You will be palpating several muscles in the region you are given. Best way to prepare is to practice the palpation for all of these regions and muscles listed. You will also need to demonstrate ROM exercise technique (handling, palpating, and moving the joint). You will need to verbalize origin, insertion, and action. Lower Extremity- you will need to know Origin; Insertion; Action for these groups- so general region as stated in the power point lecture content.  Hamstrings as a group o Prone o Have partner flex knee, holding foot off table o Runs from patella to pelvis o Action: knee flexion  Quads as a group o Partner seated o Extend and relax knee slowly o Patella to pelvis o Action: knee extensions  Adductors as a group o Supine, hip slightly flexed and laterally rotated o Have partner adduct hip against resistance o Runs from groin to knee o Action: hip adduction  Gluteus Maximus o Prone o Have partner extend hip o Action: hyper extension of hip o Runs from pelvis to side of femur, across and dips down  Hip and knee ROM movements Shoulder Girdle  Scapular mobilization of all movements for the scapula o Protraction, retraction o Elevation, depression o Scapular tilt o Upward, downward rotation  Upper Trapezius Partner prone, head facing down onto mat – put pillow under chest with head hanging off it, so they can breathe and don’t have to turn head to side o Have them lift their head up and shrug shoulders o Runs from base of skull to over on the end of the scapula o Action: elevation of scapula, extends head and neck  Middle Trapezius o

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Partner prone Locate spine of scapula – go medially

o Have partner retract shoulders o Runs from spine to scapula o Action: retraction  Lower Trapezius o Partner prone o Locate base of scapular spine and go medial from there o Have partner do superman o Runs from spine over to the bottom of the scapula o Action: upward rotation of scapula  Sternocleidomastoid o Supine with head in lap o Ask partner to raise head, can turn to side to make it easier o Runs from mastoid process to the middle of the sternum o Action: flexion of the neck  Rhomboids o o o o

Partner prone Have them do chicken wing with arm on lower back, push down on their elbow Runs from the spine to scapula Action: retraction

Shoulder Joint  Scapular Mobilization of all movements  Shoulder ROM movements  Deltoid o Partner seated on edge of mat o Have partner abduct and pinch their deltoid o From deltoid tuberosity to scapula o Action: shoulder abduction  Latissimus Dori o Partner prone with arm hanging off o Have partner try and medial rotate – move hand back toward hip o Runs from the spine over to under the armpit o Action: medial rotation  Pectoralis Major o o o o o

Partner supine and shoulder slightly abducted Right in armpit Have partner adduct Runs clavicle and sternum to the humerus Action: adduction

Elbow/Forearm  Biceps o Supine or seated o Partner flexes elbow o Runs from the front of the elbow to the humerus and scapula

o Action: flexion  Triceps o Prone with arm hanging off table o Partner extends elbow o Runs from posterior part of arm/back of elbow to scapula and humerus  Elbow movements o Flexion, extension o Forearm supination and pronation – make sure you hold elbow Wrist  Flexor Carpi Radialis o Partner’s elbow flexed to 90 and forearm supinated o Partner flexes wrist o It’s the tendon on the thumb side o Action: wrist flexion and radial deviation  Extensor Ulnaris o Shake hands with partner with elbow flexed to 90 degrees o Come right off the shaft of the ulna o Partner does ulnar deviation o Runs from the ulna/back of elbow to the pinky/hand on pinky side o Action: extension and ulnar deviation  Wrist ROM movements o Flexion, extension o Radial, ulnar deviation Hand  Extensor pollicis longus (long muscles of the thumb) o part of anatomical snuff box o partner’s wrist neutral  Flexor digitorum superficialis o have partner wiggle their fingers  Extensor digitorum o Shake hands – find the extensor carpi radialis o Have partner extend fingers – see them on back of hand o Have them wiggle their fingers – don’t need resistance  Short muscles of the thumb o Have partner do thumb opposition  Finger and thumb movements Palpation will be: - Movement of joint ROM to be completed on your partner - Palpation of muscles - Be able to verbalize action; location; and put patient in the correct position. - Grading will be: i. Can you correctly interact with your patient during palpation? Ask if you can touch them? Have appropriate touch? Make sure they are comfortable. Remove clothing on patient, but maintain privacy. ii. Locating the correct muscle

iii. Palpating the muscle belly and locating the origin and insertion area. iv. Completing the correct steps to make the muscle contract v. Completing the correct action of the joint. A FEW REMINDERS: You will palpate 3-5 muscles during this test. You don’t need to dress professional or have your name tag. You need to dress so that your partner can access your body, so wear layers of clothing. You will have 5 minutes while in the room with the instructor to prepare your palpation techniques, so you can make notes, reminders to yourself to refer to when palpating. You will palpate on your lab section classmates only.

Key things to do:  I will be looking at how you palpate- Did you ask your partner if you can touch them? do you grab the muscle belly? Do you apply good pressure? Do you follow the muscle from origin and insertion location? Can you position your partner correctly? Can you give resistance to make the muscle pop?  Slow down and think it through  Take some notes during the 5 minutes of prep time.  This is an important OT skill set to have and will help you in your summer courses....