Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Palpation of soft tissue

Feel for the pisiform bone and place the palpating finger against its proximal aspect. Ask the subject to actively abduct the little finger. The tightening of the flexor carpi ulnaris can be felt.The tendon can now be followed distal to the pisiform until its insertion on the base of the fifth metacarpal bone. The pisiform is a sesamoid bone in the tendon of the flexor carpi ulnaris.Place the thumb radial to the previous tendon at the distal part of the forearm. It now lies on the tendons of the flexor digitorum superficialis,of which the movement can be felt during active
flexion and extension of the fingers.

In a deeper layer the presence of the flexor digitorum profundus can be imagined.
Move the finger a bit more towards the radial side and ask the subject to oppose the thumb and little finger and to simultaneously flex the wrist. The thin tendon of the palmaris longus becomes prominent. It inserts into the palmar aponeurosis of the hand. (It has to be remembered that this muscle is inconstant.)Approximately 1 cm radially to the palmaris longus the strong and thick tendon of the flexor
carpi radialis is palpable, especially when the subject flexes and radially deviates
the wrist.

It inserts at the base of the second metacarpal bone.In between the palmaris longus and the flexor carpi radialis, in a deeper layer, the tendon of the flexor pollicis longus can be felt to move during flexion and extension movements of the thumb.Between the flexor carpi radialis and the abductor pollicis longus the pulsations of the radial artery can be felt.

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