Spine examination - questions from quiz

Question 1

what is the term used to describe a visible angular deformity in the thoracic region ?

Answer 1

a gibbus

Question 2

how does the angular deformity arise in a gibbus ?

Answer 2

Is created by vertebral wedging, where one (or more) of the thoracic vertebrae lose their anterior height and become triangular rather than square in sagittal cross section. This produces a focal angular deformity of the thoracic spine.

Question 3

what is a possible cause of a gibbus in an elderly patient ?

Answer 3

May relate to an insufficiency fracture of the vertebrae due to osteoporosis

Question 4

if a gibbus occurs in a young patient should you be worried ?

Answer 4

Yes! this is abnormal and could be due to things such as malignancy or infection

Question 5

defien lordosis and kyphosis

Answer 5

lordosis = the curve is convex (inwards)

kyphosis - the curve is concave (outwards)

Question 6

describe the curves of the spine

Answer 6

Cervical spine – Lordosis, Thoracic – Kyphosis, Lumbar – Lordosis

Question 7

when palpating the spine from crainally to caudally what structures are you palpating ?

Answer 7

the spinous processes

Question 8

when palpating the midline of the spine - if there is some tenderness what might this suggest ?

Answer 8

a significant spinal injury

Question 9

when palpating the midline of an arthritic spine what might you notice ?

Answer 9

that there is tenderness and that there is some facet joint movement

Question 10

what structures are you palpating when palpating from crainally to caudally at each side of the midline of the spine ?

Answer 10

The paraspinal muscles

Question 11

what are the sacroiliac joints ?

Answer 11

The joints between the spine and pelvis.

More specifically between the sacrum of the spine and the ilium of the pelvis.

Question 12

what are the 2 regions of the spine where the majority of movement takes place and hence are the 2 areas of the spine where movement is assessed ?

Answer 12

cervical and lumbar

Note - not the thorax as its main role is to provide an axial attachment for the thorax

Question 13

what are the movements assessed in the cervical spine ?

Answer 13

flexion/extension

lateral flexion left and right

rotation left and right

Question 14

which type of movements are assessed in the lumbar spine ?

Answer 14

flexion/extension

lateral flexion left and right

Question 15

how is range of flexion in the lumbar spine measured?

Answer 15

using schobers test

Question 16

where are the different marks on the back made in schobers test ?

Answer 16

Identify the level of the sacroiliac joints; make a mark 10cms above this level and 5cms below.

Question 17

describe schobers test and what should the distance between the marks be ?

Answer 17

With the patient standing, perform Schober’s test to assess flexion. Identify the level of the sacroiliac joints; make a mark 10cms above this level and 5cms below. These two marks are 15cms apart. Ask the patient to bend forward to far as possible. In a normally flexible lumbar spine, the distance between the marks will increase to at least 20cms as the space between the spinous processes increases.