Spine Exam Flashcards
What is the normal range of flexion of the cervical spine?
0 - 80 degrees
How do you ask the patient to flex their cervical spine?
Ask the patient to touch their chin to their chest
What is the normal range of extension of the cervical spine?
0 - 50 degrees
How do you ask the patient to extend their cervical spine?
Ask the patient to look up to the ceiling
What is the normal range of lateral flexion of the cervical spine?
0 - 45 degrees
How do you ask the patient to laterally flex their cervical spine?
Ask the patient to touch their ear to their shoulder on each side
What is the normal range of rotation of the cervical spine?
0 - 80 degrees
How do you ask the patent to rotate their cervical spine?
Ask the patient to turn their head to the left and the right
How do you ask the patient to flex their lumbar spine?
Ask the patient to touch their toes whilst keeping their legs straight
What is the normal range of extension of the lumbar spine?
10 - 20 degrees
How do you ask the patient to extend their lumbar spine?
Ask the patient to lean back as far as they are comfortably able
How do you ask a patient to laterally flex their lumbar spine?
Ask the patient to slide their left hand down their outer aspect of their leg and vice versa
How do you ask a patient to rotate their thoracic spine?
- Get the patient to cross their arms across their chest
- Ask them to rotate left and right
What is Schober’s test used to identify?
Restricted flexion of the lumbar spine, which may occur in conditions like ankylosing spondylitis
What is the interpretation of Schober’s test?
Normal lumbar flexion would give an increase in the distance of the markings from 15cm to more than 20cm
What is the sciatic stretch test/straight leg raise used for?
To identify sciatic nerve irritation
How does a positive sciatic stretch test/straight leg raise present and what could it be suggestive of?
- Positive if the patient experiences pain in the posterior thigh or buttock region
- Suggests sciatic nerve irritation (secondary to lumbar disc prolapse)
What is the femoral nerve stretch test used for?
To identify femoral nerve irritation
How does a positive femoral nerve stretch test present?
If the patient experiences pain in the thigh and/or inguinal region
What further assessments and investigations should be done after a spine exam?
- Neurovascular exam of upper and lower limbs
- Examination of the hip and shoulder joints
- Further imaging
