Palpation Quiz (pelvic procedures, thoracolumbar landmarks)

Knee raiser PP and DS

PP - standing and supported

DS - standing behind patient

Knee raiser CP and SCP

CP - thumb pads

SCP - inferiomedial PSIS

Knee raiser procedure

Dr thumb pads on inferiomedial PSIS, hands on iliac crest

patient raises (flexes) knee to 90 degrees

Knee raiser interpretations - Ipsilateral

posterior, inferior, medial (PIM)

Knee raiser interpretations - Contralateral

anterior and superior

Seated sacroiliac flexion PP and DS

PP - seated at front of chair

DS - seated behind patient

Seated sacroiliac flexion CP and SCP

CP - thumb pads

SCP - inferior PSIS

Seated sacroiliac flexion procedure

Dr thumb pads on inferior PSIS and follows flexion of patient

Seated sacroiliac flexion interpretation

thumb with greatest excursion = fixation

Sacroiliac fluid motion PP and DS

PP - prone with feet raised and ankles off the edge

DS - modified scissored stance

Sacroiliac fluid motion CP and SCP

CP - hook of hamate

SCP - superior medial PSIS

Sacroiliac fluid motion CH and TP

CH - caudal/superior hand

TP - S->I and M->L

Sacroiliac fluid motion procedure

Dr on contralateral side of test leg with inferior leg across from PSIS and angled toward acetabulum

Stabilization hand TP and places hook of hamate on superior medial PSIS (wrapping CH around SH)

Press into joint at 45 degrees toward acetabulum

Sacroiliac fluid motion interpretation

leg tested should lengthen (opposite should NOT)

Seated sacroiliac axial rotation PP and DS

PP - seated

DS - ipsilateral side of which patient will rotate

Seated sacroiliac axial rotation CP and SCP

CP - pads 2, 3, 4 digits

SCP - sacral interspace

Seated sacroiliac axial rotation procedure

Dr contacts sacral interspace on ipsilateral side with stabilization hand on Pt shoulder

Rotate patient

Seated sacroiliac axial rotation interpretations - ipsilateral

lateral -> medial

Seated sacroiliac axial rotation - contralateral

medial -> lateral

Seated lumbopelvic lateral bend PP and DS

PP - seated

DS - ipsilateral side of which patient will bend toward

Seated lumbopelvic lateral bend CP and SCP

CP - pads 2, 3, 4 digits

SCP - sacral interspace

Seated lumbopelvic lateral bend procedure

Dr contacts sacral interspace on ipsilateral side with stabilization hand on Pt shoulder

Lateral bend

Seated lumbopelvic lateral bend interpretations - ipsilateral

lateral -> medial

Seated lumbopelvic lateral bend interpretations - contralateral

medial -> lateral

Leg fanning PP and DS

PP - seated at front of chair

DS - seated behind patient

Leg fanning CP and SCP

CP - thumb pads

SCP - sacral interspaces

Leg fanning procedures

Dr contacts interspaces with thumb pads and instructs Pt to abduct and adduct their thighs

Leg fanning interpretations - abducts

PSIS lateral -> medial

Sacrum - anterior (nutation)

Leg fanning interpretations - adducts

PSIS medial -> lateral

Sacrum - posterior (counternutation)

Thoracic Landmarks - T1

vertebral prominence

Thoracic Landmarks - T3

root of spine of scapula

Thoracic Landmarks - T4

most prominent thoracic spinous

Thoracic Landmarks - T5-9

imbricated spinouses

Thoracic Landmarks - T6

inferior angle of scapula in prone position

Thoracic Landmarks - T7

inferior angle of scapula in seated position

Thoracic Landmarks - T9/10

closest thoracic spinouses

Thoracic Landmarks - T12

may have blade like spinous

Thoracic TVPs - T1-3

TVP up ONE ISS

Thoracic TVPs - T4

TVP across from T3 spinous

Thoracic TVPs - T5-9

TVP up TWO ISS

Thoracic TVPs - T10

TVP across from T9 spinous

Thoracic TVPs - T11-12

TVP up ONE ISS

Lumbar Landmarks - L4

iliac crest

- male = L3/4 ISS

- female = L4/5 ISS

Lumbar Landmarks - L5

smallest lumbar spinous

Lumbar Mamillary processes - L1-5

MP up ONE ISS