L-Spine

Question 1

LOOK

Adequate exposure‼️

Answer 1

Orthotics
Lumbar brace
AFO & shoes

Front- quads wasting, VASTUS MEDIALIS OBLIQUCUS
- LLD
Side- T kyphosis and L lordosis
Back- scoliosis, scars, spinal dysraphysm (tuft of hair @ cleft/ bump @ cleft) wasting @ buttocks, thighs and calves

Question 2

Feel

Answer 2

Tenderness
Vertebral spinous processes
SI joints

Question 3

Move

Answer 3

Forward flexion- pain, level reached, unrolling of L spine
Schöber’s test- thumb @ lumbo sacral junction➡️ dimples of venous, is pelvis level, measure upwards 10cm ➡️ flex
Extension- one hand on small of back, other hand supporting the shoulder
Rotation

Question 4

Gait

Answer 4

Tiptoes S1
Heel L4
Squat L3

Question 5

Tension testing

perform when supine

Answer 5

Hip ROM- flex @ 90^ and rota
Straight leg raise nb! @ angle wherewithal flex pain is repro➡️ must be in sciatic region below knee
Lasegue- lower leg until pain disappears the force ably dorsi flex foot and see if pain re-occurs

Question 6

Neuro

ask about bowel and bladder function‼️

Answer 6

Tone- in leg and ankle clonus
Power- L2 flex hip to chest
L3 knee extension, hold knee straight (seated)
L4 ankle dorsi, tib ant
L5 hallux dorsiflex FHL
S1 ankle plantarflex
Reflexes- L4 knee jerk, S1 ankle jerk, babinski UMN
Sensation- L1 groin
L2 ant thigh
L3 over knee
L4 medial malleolus
L5 bunion/dorsum of foot
S1 sole/ lat foot
S2 post calf
S3&4 perinium/ bullseye