Surface Palp

Anterior Superior Iliac Spine ASIS

Attachment site for the sartorius muscle and the inguinal ligament. Go to crest, find tip of pelvis that sticks out anteriorly.

Iliac Crest

Attachment sites for internal and external oblique muscles, quadratus lumborum, and a hip pointer is a contusion of the iliac crest. Find ASIS, walk fingers posteriorly, it widens laterally after ASIS and ends at PSIS.

Posterior Superior Iliac Spine PSIS

The two dimples on the posterior side. No attachments and is used for alignment.

Pubic Crest

Attachment site for the rectus abdominus muscle, adductor longus inferiorly, and the inguinal ligament. Osteitis pubis is inflammation of the pubic symphysis. Lie supine, finger tips on the umbilicus, then drop the palm till the bone.

Anterior Inferior Iliac Spine AIIS

Attachment site for the rectus femoris.

Supine, flex the hip by using a bolster, locate ASIS, and move inferiorly + medially 1 inch to find AIIS.

Iliac Fossa

Attachment site for the iliacus muscle.

Supine, flex the hip by using a bolster, follow the crest posteriorly, and curl your fingers over the lip of the iliac crest into the iliac fossa.

Sacrum

Attachment site for the glute max, piriformis, and sacrotuberous ligament. Lay prone, palpate medially and inferiorly from the PSIS down the sacral crest. Then palpate laterally off the side of the sacrum, pressing fingers into its solid edge.

Coccyx

Attachment site for the glute max; also, coccydynia is pain in the tailbone. Find PSIS, then go down the sacral crest until the coccyx, which turns into the body.

Sacroiliac Joint

The junction site for the sacrum and ilium. Deep to the thoracolumbar fascia and posterior sacroiliac ligaments. Lay prone, find PSIS, move slightly inferiorly and medially to the joint, flex the knee 90, and medially rotate the hip to feel the movement or joint space open.

Greater Trochanter

Attachment site for glute med, glute min, gemellies, obturators, piriformis, and is the origin of the vastus lateralis. Partner prone, find the middle of the iliac crest and move 4-5 inches inferiorly. Trochanter Rectus inflamed bursa.

Gluteal Tuberosity

Attachment site for glute max, lie them prone, find the posterior surface of the greater trochanter, slide 1-2 inches distally until you feel a flat superficial part of the bone.

Ischial Tuberosity

Attachment site for hamstrings, adductor magnus. Iscial persitis is inflammation of the ischium. Lie them prone and find the gluteal fold, then palpate superiorly until you bump a large surface.

Quads as a group

Rectus femoris: Attaches to the AIIS and the tendon inserts into the patella via the quadriceps tendon, which continues through the patellar ligament to the tibial tuberosity. Supine, bolster knee, locate AIIS and patella, Strum down the imaginary line.

Vastus medialis: Shaped by the sartorius and rectus femoris. Important in patella tracking for patients with patellar pain. Supine, knee bolstered, ask for a contracted quad by extending the knee, palpate medial and proximal to the patella, locate the rectus femoris and sartorius because they form the teardrop shape.

Vastus lateralis: Side lying, place hand on the lateral thigha nd have partner extend and relax their knee. Palpate the belly posteriorly from the biceps femoris and proximally to the greater trochanter. Attaches to the lateral lip of the linea aspera.

Vastus lateralis

Attaches to the greater trochanter and the lateral lip of the linea aspera. Side lying, extend the knee, palpate the entire belly.

Vastus medialis

Attaches to the intertrochanteric line and medial lip of the linea aspera. Important to track the patella for patients with patella pain. Supine bolster, contract the quad, locate the sartorius because it shapes this muscle.

Hamstrings as a group

The 3 have a common origin of the ischial tuberosity, but the short head of the biceps femoris originates at the lateral lip of the linea aspera and the lateral supracondylar line. Also, the biceps femoris inserts at the lateral head of the fibula. The hamstrings help tilt the pelvis posteriorly, which puts the lumbars into flexion. Prone, have them flex the knee, locate the ischial tuberosity, slide distally, and strum. To find individual bellies, ask them to flex and feel the tendons at the knee and where they go.

Glute group

Glute med has anterior fibers that flex and medially rotate the hip, and posterior fibers that extend and laterally rotate the hip. Glute max inserts at Gerdy's tubercle.

Prone, locate coccyx, sacrum, psis, and 2 inches posterior to the iliac crest. This isolates the glute max landmark. Loacte max insertion at the gluteal tuberosity. Flex the knee to make the hamstrings actively insufficient. Strum between the located points.

For MED/Min, side lying, locates the crest (PSIS-ASIS) and greater trochanter, this forms a slice of pie, strum between the located points for medius, then deeper for min.

Adductor longus + Gracilis

ADD Supine, bolster, laterally rotate their leg, and place your hand on the medial thigh, adduct the hip against your resistance, and strum. For Gracilis, start up near the pubic bone near the pubic tubercle, and strum similarly down until the pes anserine.

TFL

Helps make up the IT band, which inserts onto Gerdys tubercle. Supine, locate ASIS, place your hand posterior and distal to ASIS and the iliac crest, and ask your partner to alternate medial rotation and relaxation. During medial rotation, the TFL will contract underneath your hand. Palpate its vertical fibers until it blends into the IT Band.

Distal end of the iliotibial tract

Side-lying, locate the biceps femoris tendon, and slide anteriorly from the biceps femoris tendon to the lateral thigh. Roll fingers across the fibers of the IT band, follow it distally until it disappears toward the tibial tubercle. Ask your partner to abduct and relax the hip to feel the tension change.

Sartorious

Connects to the ASIS and the Pes ansirine. Supine, have your partner cross their leg onto their opposite knee. To flex and laterally rotate their hip. Place your hand on their medial thigh and have them raise their knee toward the ceiling. Find what contracts and strum the tendon from its two connecting points.

Piriformis

Piriformis syndrome is when the piriformis pinches the sciatic nerve. Prone, locate the coccyx, PSIS, and the greater trochanter. This makes a T, work through the glute max and work across the deep piriformis, stay mindful of the sciatic nerve.

Iliopsoas

Psoas Major

Contributes to anterior pelvic tilt. Supine, bolster, slightly flex, and laterally rotate the hip. Find the Umbilicus and the ASIS and compress fingers in between the area when your partner exhales. Have your partner lift their leg or flex their hip to feel the muscle contract.

Iliacus

Strong hip flexor, anterior pelvic tilt is due to relative lumbar extension and hip flexion.

Partner supine, bolster to flex and laterally rotate the hip, locate the anterior iliac crest, inch to its medial ridge where you will curl your fingers into the iliac fossa, have the partner exhale and sink finger deeper, have the partner lift the leg when deep.

Inguinal ligament

A band connected to the ASIS and the pubic tubercle. It is the superior border of the femoral triangle, and the lower edge of the rectus sheath, an attachment site for the lower portion of the external oblique.

Partner supine, bolster, locate ASIS, slide diagonally to the pubic tubercle, strum gently.

Sciatic nerve

Passes through the greater sciatic notch between the ischial tuberosity and the greater trochanter.

Lay partner prone, locate the edge of the sacrum, and draw a line between the greater trochanter and ischial tuberosity. Turn partner to side lying and flex the hip, put a pillow between the legs, and palpate between the 2 areas with the thumb to avoid pinching the sciatic nerve.

Trochanteric Bursa

Posterior lateral side of the greater trochanter, which reduces friction between the trochanter and the glute max. It is common for bursitis, which is an inflamed bursa. Prone, find the greater trochanter and place your fingers on the lateral aspect gently.

Patella

The largest sesamoid bone, attachment point for the quadriceps femoris tendon and patellar ligament. Sight for patellofemoral pain, and is a landmark of the anterior surface of the knee.

-Partner supine with knee extended, locate the patella, move it around, and then flex the quad to make it immovable. Have them sit short-seated and passively flex/extend while tracking patella movement.

Tibial tuberosity and shaft

Site of Osgood-Schlatter's and apophysitis, which is common in 10-15-year-olds who are active. This is a constant pulling of the patella tendon on the tibial tuberosity.

Partner seated with flexed knee, locate the patella, slide 4 inches inferior to the patella to tibial tuberosity, explore with thumb. Continue inferiorly down the shaft palpating the edges and then all the way to the medial malleolus.

Head of fibula

Attachment site for biceps femoris, soleus, the fibular collateral ligament (LCL), and origin of fibularis longus.

Partner seated with knee flexed, locate tibial tuberosity, slide fingers laterally 3-4 inches.

Tibial plateaus

At the proximal end of the tibia. Partner seated with flexed knee, place your thumbs on either side of the patella. Slide your thumb inferiorly until you sink into the joint space and can feel the plateu edges.

Pes ansirine

Attachment site for sartorius, gracilis, and semitendinosus (SGT). Pes anserine bursitis, which is an inflamed bursa on the inside of the knee.

Partner seated with flexed knee, locate tibial tuberosity, slide medially one inch, explore the flat surface of tibia, and palpate tendons.

Edges of the femoral condyle

Plays an important role in tracking of the patella when the knee is flexed and extended.

Partner supine with knee fully extended, locate the sides of the patella, shift the patella medially and slide off of it onto the lateral condyle, do the same for the opposite side.

Epicondyles of the femur

The lateral epicondyle is an attachment site for the fibular collateral ligament, and the medial epicondyle is for the tibial collateral ligament.

Partner seated with knee flexed, locate patella, slide laterally, explore region, return, and slide medially,

adductor tubercle

Attachment site for the adductor magnus tendon, hamstring part.

Partner seated with flexed knee, find the medial epicondyle of the femur, slide along the medial side of the femur, and find the point before it drops off into soft tissue.

Lateral/medial malleoli

The lateral attaches to the fibularis longus and brevis. Medial attaches Tib post, FDL, and FHL.

-Seated palpate the bony projections of the ankle. Lateral is more distal than the medial.

malleolar grooves

Supine, locate medial malleolus, slide 1/2 an inch posteriorly to palpate the malleolus for a vertical groove. Passively invert foot to shorten the tissue, explore medial groove. Do the same for lateral but now evert.

calcaneous

Haglund's deformity, the buildup of excess bone, exostosis (bone growth). The calcaneofibular ligament attaches and is a lateral support ligament. Achilles bursa is an inflamed sac between the achilles tendon and the heel bone. -Partner seated walk fingers from malleoli to heel.

tuberosity of calcaneus

The Achilles/calcaneal tendon attaches here and Achilles tendinitis is an inflamed tendon.

- Partner seated work from malleoli to heel, move the plantar surface to isolate the tuberosity.

Sustanaculum tali

Tibialis posterior tendon and deltoid ligament attach here. Talus sits on top of it.

- Seated, find medial malleoli, move 1 inch distal, find the small tip of sustenaculum tali. Passively invert the foot to soften tissue.

Peroneal trochlea

Has no attachments, seated, dorsiflex ankle, locate lateral malleolus, slide an inch inferiorly, explore small trochlea. Passively evert the foot to soften tissue. It's a short ridge.

Still learning (42)

You've started learning these terms. Keep it up!