For the full series of shoulder examination tutorials, visit the AMBOSS Library: https://go.amboss.com/OrthoShoulderExamPalpation of the shoulder region incl…
The spine of the scapula (B) can be palpated all the way to the medial border of the scapula. The spine of the scapula can be best palpated if you strum it perpendicularly by moving your palpating fingers up and down across it as you work your way posteriorly and then medially.
Palpation Note the position of the trachea in the suprasternal region. Ask the patient to relax the sternomastoid muscles by dropping their chin, and to lean slightly forward. Rest your middle finger on the suprasternal notch and pass it on either side of the trachea as deeply and inferiorly as possibly (figure 14a,b).
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The clavicle is located subcutaneously between the sternum and the scapula, and it connects the arm to the body. The clavicle is the first bone in the human body to begin intramembranous ossification directly from mesenchyme during the fifth week of fetal life.
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Palpation in all cases is painful. When pressing on the clavicle, the dislocation is quite easily eliminated, but it is necessary to stop the pressure – it reappears. This is the so-called “key symptom” – a reliable sign of the rupture of the acromioclavicular joint. Laboratory and instrumental research
Palpation for axillary and supraclavicular lymphadenopathy The axillary lymph glands form a three-sided pyramid whose apex is in the narrow gap between the first rib and the axillary vessels In order to feel for axillary lymphadenopathy, the patient’s pectoral muscles need to be relaxed
Inspect for evidence of the IJV, running between the medial end of the clavicle and the ear lobe, under the medial aspect of the sternocleidomastoid (it may be visible between just above the clavicle between the sternal and clavicular heads of the sternocleidomastoid.
Subclavius: Palpation The subclavius muscle lies directly under the collarbone and the pectoralis major. This makes it a little tricky to feel. But if you bring your arm close to your body and rotate the shoulder inwards, you may be able to feel it with your fingers underneath your collarbone.