Spine Exam

Question 1

What is the normal range of flexion of the cervical spine?

Answer 1

0 - 80 degrees

Question 2

How do you ask the patient to flex their cervical spine?

Answer 2

Ask the patient to touch their chin to their chest

Question 3

What is the normal range of extension of the cervical spine?

Answer 3

0 - 50 degrees

Question 4

How do you ask the patient to extend their cervical spine?

Answer 4

Ask the patient to look up to the ceiling

Question 5

What is the normal range of lateral flexion of the cervical spine?

Answer 5

0 - 45 degrees

Question 6

How do you ask the patient to laterally flex their cervical spine?

Answer 6

Ask the patient to touch their ear to their shoulder on each side

Question 7

What is the normal range of rotation of the cervical spine?

Answer 7

0 - 80 degrees

Question 8

How do you ask the patent to rotate their cervical spine?

Answer 8

Ask the patient to turn their head to the left and the right

Question 9

How do you ask the patient to flex their lumbar spine?

Answer 9

Ask the patient to touch their toes whilst keeping their legs straight

Question 10

What is the normal range of extension of the lumbar spine?

Answer 10

10 - 20 degrees

Question 11

How do you ask the patient to extend their lumbar spine?

Answer 11

Ask the patient to lean back as far as they are comfortably able

Question 12

How do you ask a patient to laterally flex their lumbar spine?

Answer 12

Ask the patient to slide their left hand down their outer aspect of their leg and vice versa

Question 13

How do you ask a patient to rotate their thoracic spine?

Answer 13

• Get the patient to cross their arms across their chest

- Ask them to rotate left and right

Question 14

What is Schober’s test used to identify?

Answer 14

Restricted flexion of the lumbar spine, which may occur in conditions like ankylosing spondylitis

Question 15

What is the interpretation of Schober’s test?

Answer 15

Normal lumbar flexion would give an increase in the distance of the markings from 15cm to more than 20cm

Question 16

What is the sciatic stretch test/straight leg raise used for?

Answer 16

To identify sciatic nerve irritation

Question 17

How does a positive sciatic stretch test/straight leg raise present and what could it be suggestive of?

Answer 17

• Positive if the patient experiences pain in the posterior thigh or buttock region
• Suggests sciatic nerve irritation (secondary to lumbar disc prolapse)

Question 18

What is the femoral nerve stretch test used for?

Answer 18

To identify femoral nerve irritation

Question 19

How does a positive femoral nerve stretch test present?

Answer 19

If the patient experiences pain in the thigh and/or inguinal region

Question 20

What further assessments and investigations should be done after a spine exam?

Answer 20

• Neurovascular exam of upper and lower limbs
• Examination of the hip and shoulder joints
• Further imaging