spine examination

Question 1

subsections of the spine examination and essentially any ortho examination

Answer 1

introduction
inspection
palpation 
movement 
special tests

Question 2

introduction

Answer 2

wash hands, full intro, check pt name, full explanation and consent
2. Asks patient to undress down to underwear
pain and paraphinelia, ask if they are able to walk.

Question 3

inspection

Answer 3

gait - ask the PT to walk and comment.

from behind:
DWARFS
deformity - scoliosis 
Wasting 
asymmetry
rashes and other skin issues
fasciculations - unlikely
scars

from the side:check alignment, normal lumbar lordosis and thoracic kyphosis

Question 4

palpation

Answer 4

palpate each spinous process for prominence, step or tenderness.

• paraspinal muscles for tenderness.
• palpate sacroiliac joints.

Question 5

movements

Answer 5

cervical flexion and extension
cervical lateral flexion
cervical rotation
thoracic and lumbar flexion and extension - guided
thoracic and lumbar lateral flexion - guided
thoracic and lumbar rotation whilst fixing the hips.

Question 6

special tests

Answer 6

-schober’s test - find dimples of venus in iliac crest line, 5cm below (just above but crack…) and 10cm above, hold those points and ask PT to bend forward to touch toes and then back up. should increase to about 20cm. comment.

• ask PT to lie prone on bed.
• femoral nerve stretch test, for both lower limbs individually. knee flex, plantar flex, hip extension. pain suggests. anterior thigh pain if L2-5 disc protrusion.
• offer to check perianal sensation and anal sphincter tone.
• ask PT to lie supine
• straight leg test (passive test with knee straight to elicit sciatica). comment on any limitation with approx degrees.
• perform sciatic stretch test - dorsiflex foot at this point of discomfort - test is positive if additional pain results

thank PT and present