MSK - Spine

Question 1

Prepare the patient

Answer 1

Check for any pain

Expose patient: bare above the waist (apart from underwear)

Question 2

Procedure of examination

Answer 2

Inspect
Palpate
Move

Question 3

2 parts to inspection

Answer 3

from behind

from the side

Question 4

Inspection- from behind

Answer 4

posture of head, neck and shoulders

thoraco-lumbar scoliosis? (on standing or bending forward)

Question 5

Inspection- from the side

Answer 5

Cervical lordosis
Thoracic kyphosis
Lumbar lordosis

Question 6

Palpation

Answer 6

Supraclavicular fossae
Spinous processes
Para-spinal muscles
Iliac crest height
Sacroiliac joints
Chest expansion

Question 7

Why do we palpate the supraclavicular fossae?

Answer 7

For cervical ribs or enlarge lymph nodes

Question 8

Why do we palpate para-spinal muscles?

Answer 8

Muscle bulk and note any spasm

Question 9

What does excessive cervical lordosis suggest?

Answer 9

Osteoporosis
Spondylolisthesis
Discitis

Question 10

What does hyperkyphosis suggest?

Answer 10

Vertebral fracture

Question 11

2 parts to movement

Answer 11

Cervical spine

Lumbar spine

Question 12

Cervical spine movements

Answer 12

Flexion/extension
Rotation
Lateral flexion (ear to shoulder)

Question 13

If their is restricted passive movement you can…

Answer 13

try active movement

Question 14

Lumbar spine movements

Answer 14

Flexion (Schober’s test)
Extension
Lateral flexion

Question 15

Describe Schober’s test

Answer 15

Put a dot over each SI joint
Measure 10 cm above and 5cm below
Ask patient to touch toes and measure increase in length of tape between two points

Question 16

In a normal Schober’s test how much should the measurement increase by?

Answer 16

> 20cm

Question 17

On Schober’s test, length does not increase above 20… what could this suggest?

Answer 17

Ankylosing Spondylitis

Question 18

Suggestion for further examination

Answer 18

Full neurological exam