Muscle and bone palpation 

1) Right biceps brachii

Origin: short head of coracoid process
Insertion: radial tuberosity of radius
Model sitting
Whole upper limb is well supported
One hand resist, one hand stabilize
Ask model to bend the elbow
Palpate on the muscle belly( prominence part)

2) Brachialis
(can use pillow) Model sitting
Forearm pronated to relax the biceps
Resist elbow flexion
Laterally and medially to biceps at the lower half of forearm
Resistance on the back of the forearm
Palpate laterally and medially to biceps

3) Brachioradialis
(can use pillow)
Insertion: superior to styloid process of radius Model sitting
Flexion of elbow 90 degrees while forearm in mid position between
supination and pronation
PT stand on the side
One hand resist, one hand stabilize
Ask model to flex the elbow
palpate the muscle

Triceps 
Insertion: olecranon of ulna Subject sitting with right upper limb
supported on table
PT sit and face the subject
PT left hand on the belly of the triceps for palpation
Right hand at the back of the forearm for resistance
Extends/straighten elbow while giving resistance

Right flexor digitorum profundus Subject sitting

PT sit in front of the model
Upper limb supported
PT left hand stabilize middle phalanges, right hand resist distal IP
flexion 

Right flexor digitorum superficialis

Subject sitting
PT sit in front of the model
Upper limb supported
PT left hand stabilize proximal part of finger, right hand resist the middle
part of finger

Right flexor carpi ulnaris PT sit in front of the patient

Palm and fingers of the PT is on the model’s palm
Palm at the radial side of model’s hand 
Left hand resist the palm with fingers on the radial border on the hand
Ask model to flex hand and ulnar deviated
Right flexor carpi radialis
Origin: medial epicondyle of humerus
Insertion: 2nd and 3rd metacarpal PT sit in front of the patient
Palm of the PT is on the ulnar side of model’s hand
Right hand resist the palm with fingers on the ulnar border on the hand
Ask model to flex hand and radial deviated while PT resist
Palmaris longus Subject sitting
PT sit in front of the subject
PT resist on the model’s palm and ask the model to radial deviated
Right extensor digitorum
Origin: lateral epicondyle of humerus
Insertion: distal and middle phalanges of each fingers Subject sitting
PT sit in front of the subject
Wrist is gently extended
Left hand on the palm, another hand stabilize on the forearm
Flexor pollicis longus Subject sitting
PT one hand resist on the distal phalanges, one hand stabilize
Palpate and hold the muscle
Extensor pollicis longus Subject sitting 
PT one hand resist on the finger, another hand stabilize 
Palpate and hold the muscle
Abductor pollicis longus and extensor pollicis brevis Subject sitting
PT sit in front of model
Thumb abducted and extended
Palpate the muscle
Extensor digiti minimi
Origin: lateral epicondyle of humerus
Insertion: tendon of extensor digitorum of 5th phalanx Subject sitting
PT sit in front of model
One hand stabilize 2-5 finger and one hand resist the flexion at the
distal phalanx of digiti minimi
Palpate on the ulnar side of 5th phalanx
Serratus anterior Subject standing
Right 135 degrees of shoulder elevation and abduction
PT hand resist the forward movement of the hand
Palpate on the side of the ribs
Pectoralis minor Subject standing
Back of forearm placed on the small on the back of lumbar area to relax
the pect major
1 finger below the corocoid process and lift the forearm backward
Raises the forearm on the back and 
palpate the tendon of pect minor
Pectoralis major PT stand by the side
Both portion: Left hand stabilize the trunk of the shoulder joint
Right hand resist shoulder horizontal adduction at the arm with elbow
semi flex and against resistance
Sternal and clavicular portion: bring the hand upward and oblique
Greater tuberosity(lower portion): arm is adducted in lower portion
Anterior deltoid PT stand in front
Arm by the side 
Resist one hand on the anterior part of the arm, one hand stabilize the
trunk above the shoulder joint
Lateral deltoid PT stand by the side
Resist lateral side of the arm, above the elbow joint
Subject open his arm
Posterior deltoid PT stand behind 
Resist posterior side of the arm above the elbow joint
Subject bring arm backward
Coracobrachialis Elevate the arm above horizontal
Palpation in the axillary region
Gluteus maximus Subject prone lying
PT resist at the thigh
Hip extend and externally rotated
Hamstring (3 muscles)
Subject prone lying
Flex the knee against resistance 
Biceps femoris of hamstring Subject prone lying
Flex and internally rotate with against resistance
Palpate tendon on the lateral side of the knee 
Semimembranosus of hamstring
Origin: ischial tuberosity
Insertion: medial condyle of tibia Subject prone lying
Flex and laterally rotate with against resistance
Palpate tendon on the lateral side of the knee and lateral to
semimembranosus tendon 
Semitendinosus of hamstring
Origin: ischial tuberosity
Insertion: proximal part of medial surface of shaft of tibia
Subject prone lying
Flex and laterally rotate with against resistance
Palpate tendon on the lateral side of the knee 
Quadriceps Model high sitting
PT sit in front
Stabilize the hip flexion and externally rotate
Sartorius Model high sitting
PT sit in front
Left hand stabilize the pelvis
Right hand resist the hip flexion and laterally rotate above the ankle
Can be easily palpate at its proximal ends just below the ASIS
Tensor fasciae latae (cross 2 joints)
*change hand placement High sitting 
Lateral to origin of sartorius
Flexion and internally rotate the hip against resistance
Rectus femoris 
Origin : AIIS

Subject standing 
Origin:Hip flexion and knee extension against resistance 
Tendon is between the tensor fasciae latae and sartorius
Insertion: sitting
Palpate the attachment of patella
Its belly appears as fusiform shape on front of the thigh
Soleus Subject prone lying
Fully flexes the knee and plantarflexes the foot against resistance
Palpate the soleus at adjacent to muscle belly either side of aponeurosis
of tendo calcaneus
Tibialis anterior Subject lying supine and the foot dorsiflexed against
resistance above the dorsum of the foot around the ankle
Palpate most medial tendon
Gastrocnemius
Origin: lateral and medial condyle of femur
Insertion: calcaneus by the way of achillis tendon 1) Subject stand on
the tip of the toe
2) Begin at posterior aspest of the knee and locate the tendo calcaneus
Follow tendon upward for some 8cm as it narrows to a width
approximately 1cm
After rapidly widens into an aponeurosis into an aponeurosis about 8cm
and muscle fibers of gastrocnemius
Two large bellies is easily palpable in well-developed calf
Extensor digitorum longus Subject long sitting
Extends the four toes against resistance 
Palpate the four separate tendon which can be traced to the dorsal
surface of the lateral four toes
Tibialis posterior Subject long sitting
Resist plantar flexion and inversion
Locate the medial malleolus
Palpate the tendon medial to medial malleolus
(after the palpated tendon is tendoachilis) 
Extensor hallucis longus
Insertion: distal phalanges of great toe Subject supine lying
Extends the great toe against the resistance
Palpate the tendon lateral to tibialis anterior at the ankle joint
Flexor digitorum longus
Insertion: distal phalanges of toes 2-5 Subject prone lying
Flex the distal IP joint against resistance at the distal phalanx
Papate the tendon at the proximal phalanx
tricep Sitting, R ul supported wit elbow flex
PT sit in front of pt
PT L hand on bally of tricep for palpation
R hand back of forearm to give resistance when pt extend elbow
Extensor digiti minimi of hand Sit with 4-arm supported and pronated
PT sit in front of pt
Stabilist other 4 fingers, resist distal phalanges of digiti minimi
Flexor digitorium longus of toes Pr ly, flex distal IP joint of againstance
at distal phalanx
Palpate tendon at proximal phalanx
References
Anatomy, palpation and surface markings,3rd edition by Derek field
UPPER LIMB
Sternal notch In front of the neck and below
Borders of manubrium and medial ends of two clavicles
clavicle Lateral to sternal notch
Medial two third is convex
Below is first rib
Medial 2/3 is the concave surface
Lateral 1/3 is concave surface 
Tip of corocoid process Approximately 3cm below the junction of middle
third and lateral third of clavicle
Lesser tuberosity Moving lateral to corocoid process, slightly pointed
projection
Greater tuberosity Lies laterally to lesser tuberosity
Bring the thumb just below and lateral to the angle of acromion
Intertubercular groove
Between lesser and greater tuberosity
Inside is biceps tendon 
scapula Three angles
Three borders
Two surfaces
(only inferior angle can be palpated)
Spine of scapula Between acromion process and medial border of
scapula
Acromioclavicular joint A small gap between the lateral end of clavicle
and the acromion
Acromion process Lateral end of the spine of scapula
Superior angle of scapula Not palpable
Inferior angle of scapula At the seventh and eighth ribs
Lateral supracondylar ridge of humerus Inferior to attachment of the
deltoid and ends before the lateral epicondyle
Lateral epicondyle of humerus At the end of lateral supracondylar ridge
Olecranon (ulna) Flexes the elbow and palpate the most prominent bone
Head of radius Extends the elbow
feel the button-shaped on the lateral side to olecranon
immediately below the epicondyle
Medial epicondyle( humerus) Large projection of the medial condyle
from medial supracondylar ridge, 2cm above the elbow joint
Coronoid process (ulna) elbow fully extended 
find medial epicondyle
move 2.5 cm below and 2.5 cm lateral to the medial epicondyle
Head of ulna At wrist joint on the medial side
triquetrum Immediately distal to head of ulna
pisiform Lying on the anterior surface of the triquetrum
Hook of hamate 1 cm distal and lateral to pisiform
Radial styloid process Lateral side of the wrist 
scaphoid 1) Distal to styloid process
2) 1cm medial to the tip of the radial styloid process
3) Easy to palpate in extended wrist
trapezium Distal to scaphoid and above first metacarpal
Ulna styloid process Posterior medial to radial styloid process
Easy to palpate when really deviated the wrist
Scaphoid, Lunate, Triquetral Flexes/bend the wrist palpate at the
posterior surface from radial styloid process and ulna styloid process
Bone arrangement is Scaphoid, Lunate, Triquetral
Sternoclavicular joint Palpate the sternal notch
Small space Between the sternum and clavicle
LOWER LIMB
Iliac crest Subject standing
PT stand in front of patient and place hand at the waist
Slide hands downwards on bony ridge
ASIS(anterior superior iliac spine) Move thumb forward until you feel the
well- defined projection
AIIS (Anterior inferior iliac spine) From ASIS trace downward to less
well-defined projection
Lies about 2cm above the rim of acetabulum
Pubic tubercle 4cm above genitalia
1cm on the side of the midline on the upper border of pubis(1cm is the
cartilage)
Greater trochanter In line with pubic crest extended laterally beyond the
hip joint to the lateral aspect of the upper thigh
approximately 10 cm below the lateral aspect of iliac crest 
PSIS(posterior superior iliac spine) Put hand on the iliac crest
Move backward and medially until reach the prominence(in the small
sacral dimple)
PIIS(posterior inferior iliac spine) From PSIS move downward and
medially about 2.5 cm below
Sacrum 2cm above the level of PSIS 
5 tubercles of sacrum Run hand down the centre of sacrum posteriorly
Ischial tuberosity of femur Sit on hands, large round process is felt
More prominent when transfer weight from one tuberosity to the other
Medial condyle Sitting with flexed knee 90 degrees
Palpate medial to patella
Lateral condyle Sitting with flexed knee 90 degrees
Palpate lateral to patella
Medial epicondyle Sitting with flexed knee 90 degrees 
Most palpable projection on the medial surface of medial femoral
condyle
Adductor tubercle Sitting with flexed knee 90 degrees 
2cm proximal to the medial epicondyle
(Attachment for the adductor magnus muscle)
Most distal part of the medial supracondylar ridge 
Medial tibial condyle Sitting with flexed knee 90 degrees 
Below the femoral condyle 
Can be traced around the medial side
lateral femoral condyle Model at standing position
At the lateral border of the patella can feel a flat surface
Lateral epicondyle of femur Standing 
Tubercle at the centre of lateral surface of lateral condyle 
Lateral tibial condyle Standing 
2cm below the lateral epicondyle of femur 
Head of fibula Standing
1cm below rim of the lateral tibial condyle
Anterior aspect of foot
Mortice( lower end of tibia) Subject high sitting
PT on the chair
Upper part of ankle joint which lower end of fibula and tibia
Medial malleolus(lower end of tibia) Large projection on the medial side
of mortice
Lateral malleolus(lower end of fibula) At pointed end of the lower end of
fibula
Head of talus(lower end of fibula) Index finger on lateral malleolus,
thumb at medial malleolus
Draw the thumb and finger forward into the hollow and fill it
Neck of talus Find the head of talus first
Plantar flexes the foot 
Tubercle of navicular(posterior) Evert foot, find a small gap between the
calcaneus and navicular and there is a prominence part
Medial(1st) cuneiform Evert the foot, immediately distal to navicular
Middle(2nd) cuneiform Move lateral to medial cuneiform
Lateral(3rd) cuneiform Lateral to middle cuneiform 
1st metatarsal Find medial cuneiform 
Go down from medial cuneiform and find base of 1st metatarsal, go
lower down is the 1st shaft and go lower down again is the 1st head
Medial tubercle of calcaneus Medial plantar of calcaneus
(attachment of flexor digitorum brevis and plantar aponeurosis)