Standing or supine or sitting
If you wish to palpate on the skin, provide a private room or a sheet for cover. If you think this is necessary, ask the patient if he/she is willing to uncover the area near the anterior superior iliac spine (demonstrate the area) or permit your placing your fingers on the area just distal to the anterior superior iliac spine (demonstrate the area). While the skin can not be viewed with clothes covering the area, the proximal rectus femoris should be palpable over clothing.
Anterior or lateral to the patient.
Please stand. May I touch the front of your hip bone? (or point to the demonstrated area).
Please mimic my motions (to locate the Sartorius and then Tensor fasciae latae as shown in the Pelvis and Hip section).
Now please straighten your knee (or demonstrate). (If needed, hold this
position while I try to bend your knee.)
Guide the patient to stand. With permission to touch, locate the Sartorius and Tensor fasciae latae, the muscle
bellies of which form an upside down ìV.î Note the location of this upside down V while the patient holds
the hip flexed and knee flexed position. Then place your fingers in the open space in the center of the V.
Guide the patient to extend the knee while the hip remains flexed. With unclear muscle activity, increase the contraction of the rectus femoris by asking the patient to straighten the knee while you provide a push on the leg (i.e. between the knee and the foot) in the direction of knee flexion.)
Guide the patient to extend the knee while the hip remains flexed. With unclear muscle activity, increase the contraction of the rectus femoris by asking the patient to straighten the knee while you provide a push on the leg (i.e. between the knee and the foot) in the direction of knee flexion.)
VH - Rectus femoris muscle and quadriceps tendon - on one side add the other quadriceps muscles