Some Clinically Relevant Bony Landmarks

clavicle

used to locate the subclavian vein for insertion of

also used to find jugular veins.

xiphoid process

used to position stethoscope to auscultate the tricuspid valve; process used as a landmark to measure length of NG tubes. 

greater trochanter, anterior superior iliac spine (ASIS) and iliac crest         

used to locate IM injections in the hip

ASIS

used to locate McBurney’s point for assessment of appendicitis   (McBurney’s point is halfway between the ASIS and umbilicus)

sternal angle

used to locate proper position for CPR

used to count ribs (2^nd rib joins sternum at the sternal angle)

spinous processes

used to locate points for lumbar punctures and epidurals.  

greater tubercle and deltoid tuberosity

used to locate IM (intramuscular) injections in the shoulder

inferior costal margin

used to assess pathology of internal organs (e.g. hepatomegaly)

occipital bone, spine of the scapula, olecranon process, sacrum, coccyx, ischialtuberosity, greater trochanter,  calcaneus, lateral and medial malleolus, medial condyle of tibia

all are common sites for pressure sores (“bed sores”)

styloid process of radius

used to locate site for radial pulse

supraorbital ridge and zygomatic bones

palpated to assess sinus infections

vertebra prominens

used to find the end of the cervical spine and beginning of thoracic spine.  Can be used to count ribs.

sternum, clavicles, scapula, and spinous processes of vertebra

used to identify location of the midsternal, midclavicular, scapular and vertebral lines of the thorax.

medial malleolus

used to locate posterior tibial pulse.

posterior superior iliac spine

site of bone marrow biopsy.

spinal curvatures

used to assess for kyphosis and lordosis .

pubic symphysis

used to locate incision for placement of catheter for suprapubic bladder drainage.

olecranon process

used to locate triceps tendon for reflex testing.

patella

used to locate patellar tendon for reflex testing

any bony point at joints

used to assess joint health.  Obscured bony landmarks may suggest joint swelling.  If bony points are misaligned a fracture  or dislocation in suggested.