Standing, sitting, or lying prone
For women, a gown over the non-examined side with the examined area exposed or a halter top is recommended.
For men, removal of the shirt is requested.
Posterior to the patient.
May I place my fingers on the top of your shoulder? (or point to the demonstrated area).
Now shrug your shoulders.
With the patient relaxed, place your fingers on the area superior to the scapula. Ask the patient to shrug his/her shoulders. Palpate the muscle contracting.
VH - close up of the posterior upper body without skin.