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Spine examination Spine examination

Spine Examination

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Page 1: Spine Examination

Spine examinationSpine examination

Page 2: Spine Examination

1. The general principal is 1. The general principal is Look, Look, Feel, MoveFeel, Move..

2. Start by asking the patient to 2. Start by asking the patient to remove their top, if you are remove their top, if you are worried about this in anyway, worried about this in anyway, ask a chaperone to join you first.ask a chaperone to join you first.

3. Next you need to examine the 3. Next you need to examine the patient from patient from behindbehind, looking for , looking for any obvious abnormalities such any obvious abnormalities such as scarsas scars. You should also note . You should also note the muscle bulk and any the muscle bulk and any wastingwasting. Note the symmetry of . Note the symmetry of each side and also look for each side and also look for any any scoliosisscoliosis. You should also look . You should also look from the side to check for the from the side to check for the normal curvatures of the spinenormal curvatures of the spine. . This is cervical lordosis, thoracic This is cervical lordosis, thoracic kyphosis and lumbar lordosis.kyphosis and lumbar lordosis.

Page 3: Spine Examination

4. Next you should feel the 4. Next you should feel the areas around the spine. areas around the spine. Feel along the entire Feel along the entire length of the spine, length of the spine, palpating each spinous palpating each spinous process and checking with process and checking with the patient the patient for any for any tendernesstenderness. Furthermore . Furthermore you should palpate the you should palpate the sacroiliac joints and finally sacroiliac joints and finally the paraspinal muscles. As the paraspinal muscles. As it is difficult to observe the it is difficult to observe the patient's face for signs of patient's face for signs of discomfort, you should discomfort, you should regularly ask them if what regularly ask them if what you are doing is painful.you are doing is painful.

Page 4: Spine Examination

5. Movements of the spine 5. Movements of the spine are all performed are all performed activelyactively. . The first movements which The first movements which are examined are lumbar are examined are lumbar flexion, extension and lateral flexion, extension and lateral flexion. flexion. Flexion and extensionFlexion and extension are checked by asking the are checked by asking the patient to try and touch their patient to try and touch their toes (flexion) and then lean toes (flexion) and then lean backwards (extension). These backwards (extension). These movements may be assessed movements may be assessed quantitatively by placing the quantitatively by placing the index and middle fingers 5 index and middle fingers 5 centimeters apart and noting centimeters apart and noting how close and far apart they how close and far apart they move on the movements. move on the movements. Lateral flexionLateral flexion is examined is examined by asking the patient to run by asking the patient to run their hand down the outside their hand down the outside of their leg. of their leg.

Page 5: Spine Examination

6. Cervical spine movements 6. Cervical spine movements which are assessed are which are assessed are lateral flexion, rotation, lateral flexion, rotation, flexion and extensionflexion and extension. . There are some easy There are some easy commands for checking commands for checking these. these. Lateral flexionLateral flexion: : place your ear on your place your ear on your shoulder, shoulder, rotationrotation: look : look over your shoulder, over your shoulder, flexionflexion: : put your chin on your chest put your chin on your chest and and extensionextension: put your : put your head back to look at the head back to look at the ceiling. ceiling.

Page 6: Spine Examination

7. The other movement which 7. The other movement which is assessed is is assessed is thoracic thoracic rotationrotation. For this the . For this the patient should be sat on patient should be sat on the edge of the bed to fix the edge of the bed to fix the pelvis then ask the the pelvis then ask the patient to turn to each patient to turn to each

side.side.

Page 7: Spine Examination

8. The final check you should 8. The final check you should perform is laying the perform is laying the patient straight and patient straight and getting them to perform a getting them to perform a straight leg raise. This will straight leg raise. This will exacerbate exacerbate any pain due to any pain due to nerve entrapment or disc nerve entrapment or disc prolapse. prolapse.