Spine examination - questions from quiz Flashcards

1
Q

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

A

a gibbus

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2
Q

how does the angular deformity arise in a gibbus ?

A

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.

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3
Q

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

A

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

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4
Q

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

A

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

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5
Q

defien lordosis and kyphosis

A

lordosis = the curve is convex (inwards)

kyphosis - the curve is concave (outwards)

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6
Q

describe the curves of the spine

A

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

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7
Q

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

A

the spinous processes

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8
Q

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

A

a significant spinal injury

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9
Q

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

A

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

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10
Q

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

A

The paraspinal muscles

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11
Q

what are the sacroiliac joints ?

A

The joints between the spine and pelvis.

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

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12
Q

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 ?

A

cervical and lumbar

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

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13
Q

what are the movements assessed in the cervical spine ?

A

flexion/extension

lateral flexion left and right

rotation left and right

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14
Q

which type of movements are assessed in the lumbar spine ?

A

flexion/extension

lateral flexion left and right

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15
Q

how is range of flexion in the lumbar spine measured?

A

using schobers test

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16
Q

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

A

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

17
Q

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

A

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.