Techniques to Palpate and Locations of the Bony Landmarks of the Anterior Shoulder

#1: Jugular Notch

The jugular notch is located on the superior portion of the manubrium.  Palpation should be at the common junction of the interclavicular ligament and the two sternoclavicular ligaments.

#2: Sternoclavicular Ligament

The SC joints are located laterally to the jugular notch, and can be palpated at the termination point of the distal ends of each clavicle.

#3: Clavicular Shaft

The clavicular shaft can be palpated moving laterally from the SC joint to the acromion process.

#4: Coracoid Process

The coracoid process can be palpated by starting at the acromion process and dropping down about an inch or to inferiorly and medially. 

#5: Acromion Process/AC Joint

The acromion process is located at the proximal end of the clavicle, and you should be able to place your thumb over its bony prominence.  The AC joint can be palpated by flexing and extending the shoulder, looking for movement between the clavicle and the acromion process.

#6: Humeral Head

The head of the humerus can be palpated lateral and inferior to the acromion process.

#7: Greater Tuberosity

The greater tuberosity of the humerus can be palpated by bringing the shoulder into extension, and placing your finger on the bony prominence coming out anteriorly on the humerus. 

#8: Lesser Tuberosity/Bicipital Groove

The lesser tuberosity of the humerus can be palpated after using the method for the greater tuberosity.  Once the greater tuberosity is located, the shoulder should be brought back into a neutral postion, and then brought into passive shoulder external rotation.  As the shoulder is rotated externally, you should be palpated medially from the greater tuberosity, where you will eventually feel a dip (bicipital groove), and then another bony prominence (lesser tuberosity).

#9: Humeral Shaft

The shaft of the humerus can be palpated by moving inferiorly from the humeral head.  It may be obstructed by muscle tissue.

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