Spine OSCE

Question 1

what is being assessed when looking at the spine?

Answer 1

front, side and back
skin: spots, nodules, dimples, naevus, scars
deformity: kyphosis, lordosis, scoliosis

Question 2

what are you assessing when you feel the spine

Answer 2

spinous processes (top to bottom) and sacroilliac joints
paraspinal muscles
thyroid and cervical lymph nodes

Question 3

what is being assessed when moving

Answer 3

active ROM (cervical, thoracic, lumbar)
flex, extend, lateral flexion, rotation (seated)
assess lumbar flexion by measuring
assess lateral flexion by measuring
percuss spine during slight flexion for pain

Question 4

what are the extras that can be offered?

Answer 4

examine gait
examine shoulders and hips
full body neuro and vasc exam
offer rectal exam

Question 5

what would be offered if there was a suspected prolapsed disc?

Answer 5

pain, paraesthesia on SLR, lower back down, then dorsifelx foot

Question 6

what is a positive bowstring test indicative of?

Answer 6

suspected lumbar disc herniation

Question 7

how is bowstring test carried out?

Answer 7

SLR, then flex knee, thumb in popliteal, stretch tibial nerve

Question 8

what is the femoral stretch

Answer 8

prone, flat thigh, flex knee

Question 9

what is indicative of ankylosing spondylitis

Answer 9

chest expansion at 4th ICS <1inch