Spine Flashcards
What do you do to start the examination?
Wash hands Introduction Identification Consent Exposure
What exposure is required for a spinal examination?
Pants
bra
What do you look for?
Skin
Cervical spine
Thoracolumbar spine
What do you look for on inspection of the skin?
Cafe au lait spot (neurofibroma)
Sacral dimple, hairy dimple (spina bifida)
Scarring
What should you feel for?
Tenderness in spine Kneck (anterior, lateral, posterior) Supraclavicular fossa Paraspinal muscles Sacrum Sacroiliac joints
What would tender sacroiliac joints suggest?
Ankylosing spodylitis
What would a step at the lumbrosacral junction suggest?
Spondylolisthethis
How do you assess active ROM of the cervical spine?
Chin should touch sternoclavicular joint
Extension to 50
Lateral flexion 45
Lateral rotation 80 both sides
What should you do if there is restriction of ROM?
Cautiously assess passive ROM
What should you assess for ROM of the thoracolumbar spine?
Touch the floor? Schober's test Extension Lateral flexion Rotation
What is a normal distance to be away from the floor with fingers?
< 7cm
What is Schober’s test?
Mark 15cm of lumbar spine (10cm above and 5cm below PSIS)
Flex spine maximally
5cm minimum increase in distance
How do you assess extension of thoracolumbar spine?
Ask patient to arch back
thoracic = 25
lumbar = 35
What does significant pain and restriction on arching back suggest?
Prolapsed disc
Spondylolysis
How do you assess lateral flexion of the thoracolumbar spine?
Ask patient to flex to one side
Distance between fingers to floor should be >10cm
Equal contribution from lumbar and thoracic spine