Surface Palpation - Head and Neck - Muscles
Levator Labii Superioris Alaeque Nasi
Sitting or standing
 
Anterior to the patient
 
Please sit (or stand). I would like to check the function of a muscle on the side of your nose. Please look at this picture of a person sneering. (Or . . . Please look at me while I sneer.) May I touch the side of your nose?
(If the answer is yes) I will gently place my fingers on the side of your nose while you sneer. Please sneer, then relax and then sneer again.
(If the answer is no) Please sneer, then relax and then sneer again while I observe.
The patient/client is sitting (or standing) and either facing a mirror or facing the person who will mimic sneering with the upper lip pulled upward. After showing a picture or demonstrating the expression, ask the patient/client to sneer. With the muscle relaxed initially and with permission, gently place one or two fingers on the skin lateral to the inferior aspect of the patient/client's nose and adjacent face and ask the person to sneer. Ask the person to relax and repeat these motions if necessary.
If permission is not granted, then observe as the person sneers, relaxes and then sneers again.

In the video, both the levator labii superioris alaeque nasi and the levator labii superioris are palpated. The levator labii superioris alaeque nasi is palpated on the lateral side of the nose and immediately adjacent face, medial to the levator labii superioris, and superficial to the lateral part of the nasalis. The fiber direction of the levator labii superioris alaeque nasi is superomedial from the upper lip to the nose. The medial slip can help dilate the nostrils. The levator labii superioris is palpated superior to the upper lip between the levator labii superioris alaeque nasi and the levator anguli oris and has a superolateral fiber direction between the upper lip and the infraorbital region. The levator labii superioris alaeque nasi and levator labii superioris elevate the upper lip, as occurs with sneering.

These palpations demonstrate finger placement after muscle activation to allow better viewing, as well as finger placement before muscle activation. The correct technique of palpation of muscle includes the sequence of muscle activation, relaxation of the muscle, placement of the fingers on the muscle before the muscle is activated, activation of the muscle, and relaxation of the muscle.