neck and back PE (video)

Question 1

Inspection: neck

Answer 1

asymmetry/alignment
scars from surgery
skin (bruising trauma)

Question 2

Palpation: neck

Answer 2

front and back
feel for C7 up to occipital region

Question 3

ROM: neck

Answer 3

flexion, extension, lateral flexion, rotation

Question 4

Reflexes: upper extremities

Answer 4

distal bicep, tricep, brachioradialis

Question 5

Sensation: upper extremities

Answer 5

C5: lateral shoulders
C6,7,8: fingers

Question 5

Strength: upper extremities

Answer 5

C5 - ???
6 - biceps and wrist extensors
7 - triceps and wrist flexors
8- lumbercles

Question 5

Special test: neck

Answer 5

spurlings maneuver - hold head, extend and move to one side. ask if pain in arm. move to other side and ask again

Question 6

Vascular: neck

Answer 6

capillary refills: press on fingernails for blanching, and count until redness returns
alans test: press on ulnar and radial, have pt clench and unclench hand, look for blanching, and release looking for pink in palm to return

Question 7

Inspection: back

Answer 7

gait: have patient walk away from you , walk on toes (S1), walk on heels (L5).
balance & coordination: walk heel toe

Question 8

ROM: back

Answer 8

flexion and extension - touch toes, lean back,
lateral flexion to left and right.
rotation - turn to sides

Question 9

Palpation: back

Answer 9

push on spine and ask if it hurts, all the way down to the sacrum

Question 10

Reflexes: lower extremities

Answer 10

have patient interlock fingers and pull while hitting the patella
hit achilles

Question 11

Strength: lower extremities

Answer 11

L3-5, S1 push down on legs in these positions
squat - L4
clonus

Question 12

Sensation: lower extremities

Answer 12

L3: upper thighs
L4: over knee cap
L5: tibialis anterior
S1: side of tibialis anterior

Question 13

Special test: back

Answer 13

no special test

Question 14

Vascular: back

Answer 14

capillary refill on toes
palpate dorsal pedal pulse and posterior tibial pulse and look for blanching