Topic 42 - Examination of the skull and the spine. Examination of pain sensation. Flashcards
Examination methods of the head:
Inspection
What to inspect for head examination:
- Posture of the head: normal or abnormal
- Shape
- Mobility
- Ears: drooping or pointing
(5. Sign of pain by palpation) - Facial expression
Abnormal head positions:
lateral turn
tilted
stargazing: opisthotonus
Head rotation
Neck pain
Weakness of neck muscles
Lateral head turning
Right sided head tilt
Other abnormalities concerning the head, not only the position:
- Bulging scull: hydrocephalus
- Drooping ears and lips: Facial paralysis
Extended (opisthotonus)
Stargazing
What do we observe to examine facial expression?
Eyelids
Nostrils
Ears
Facial muscles function
Examination of the eyes
Examination methods of the spine:
Inspection: abnormal shape, position, muscle symmetry
Palpation: sensitivity, look for pain
Abnormal findings of the spine:
- Curved spine
- pseudokyphosis
- lordosis
- scoliosis
What is pseudokyphosis?
being humpbacked, dorsal deviation
What is lordosis?
concave curvature of the spine, ventral deviation
What is scoliosis?
lateral curvature of the spine
Superficial pain examination:
Pinch with hemostat and prick with needle, pain provoking percussion
Normal response upon superficial pain:
Skin twitch
Leg withdrawal upon reflexes
Behavoural:
Crying
Biting
Turning to direction of pain
How to evaluate the superficial pain, name the different stages:
– normaesthesia = normal
– hyperaesthesia = excessive sensitivity
– anaesthesia= loss of sensation
– paraesthesia = An abnormal sensation, burning, tingling
Examination of deep pain sensation:
- Only if superficial pain is absent
- Squeezing of digit or claw with a hemostat
Examination of spinal pain, indications:
– Stiff neck, not leaning down to the bowl
– Not jumping on sofa
– not standing on hind leg
– not walking on stairs
