Textbook Reading spine

7/23/2019 Textbook Reading spine

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PHYSICAL EXAMINATIONTHE SPINE


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COLUMNAVERTEBRALIS

5 regions, 33 bones

Regions

Cervical (

ver!ebrae" T#oracic ( $%

ver!ebrae"

L&'bar ( 5 ver!ebrae"

Sacral bone (5 &se)* Sacr&'"

Cocc+geal bone (&se) * cocc+-"

ANATOM.


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T/E VERTEBRALCOLUMN

Ver!ebraese0ara!e) b+in!erver!ebral

)iscs

In!erver!ebral )iscs(an&l&s 1bros&s 2

n&cle&s 0&l0os&s"


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VERTEBRA

T+0ical ver!ebra #as Cor0&s ver!ebra

Arc&s ver!ebra (la'ina an) 0e)icle" 4ora'en ver!ebra

rocess&s s0inos&s ($"

rocess&s !ransvers&s (%"

rocess&s ar!ic&laris s&0erior (%"

rocess&s ar!ic&laris s&0erior(%"


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CERVICAL VERTEBRAE


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T/ORACIC AN6 LUMBARVERTEBRAE

Modifed rom Fig. 7.1


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SACRUM AN6COCC.7


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CERVICAL EXAMINATION


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SYMMETRY!ASYMMETRY"EFORMITY

TORTICOLIS

INSPE#SI


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Tenderness

Tumor mass

PALPATION

STEPS ONE

Palpate the lateral

aspects of the

vertebra

STEPS T$O


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STEPS THREE

Continue palpation into

the supraclavicular fossa

STEPS FO%R

Examine the anterior

aspect of the neck


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MOVEMENT

STEPS ONE

Flexion

Ask the patient to bend

the head forward

STEPS T$O

Extension

Ask the patient to till

the head backward


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STEPS THREE

Using a spatula in theclenched teeth as a

pointer. Then ask the

patient to flex the head

forward. Normal range

= 80

STEPS FO%R

Ask the patient toextend the head.

Normal range = 50

The total range in the flexion and extension

planes should be assessed. Normal range

= 130


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STEPS FIVE

Lateral flexionAsk the patient to tilt

his head on to his right

shoulder

STEPS SIX

Laterral flexion

or accuranc!" using a

spatula as a pointer.

Normal range = 45


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STEPS SEVEN

#f lateral flexion cannot

be carried out withoutforward flexion" this is

indicative of patholog!

involving the

atlantoaxial and

atlanto$occipital %oints.

STEPS EI&HT

Rotation

Ask to ptient to lookover the shoulder.


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STEPS NINE

Rotation

Again a spatula use apointer. Normal range

= 80


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THORACAL PHYSICALEXAMINATION


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INSPECTION


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PALPATION


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PERC%SSION


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MOVEMENT


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MOVEMENT FLEXION

S'(o)er*+ me,(od - 1/ 'm 0eg,( o02m)r +3ie i+ 2+ed+ )+e4 5(ere

16 'm 0eg,( o+3ie i+ em30oed.Begi ) 3o+i,ioig ,3e me+2re 5i,(,(e 1/ 'm mr8 0e9e0

5i,( ,(e dim30e+ oVe2+ :5(i'( mr8,(e 3o+,erior+23erior i0i' +3ie+;.


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MOVEMENT FLEXION

A'(or ,(e ,o3 o,(e ,3e 5i,( fger d +8 ,(e

3,ie, ,o


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MOVEMENT FLEXION

F0e=io i ,(e,(or'i' +3ie m)e me+2red 5i,(

,(e 233er 3oi, >/'m rom ,(e3re9io2+ ?eromr8.


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MOVEMENT EXTENTION

3,ie, r'(e+ (i+)'84 ++i+,ig (im) +,edig ,(e

3e09i+ d 3200ig)'8 o ,(e+(o20der


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MOVEMENT LATERAL FLEXION

me+2re ,(e g0eormed )e,5ee 0ie dr5 ,(ro2g(

T14 S1 d ,(e9er,i'0


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MOVEMENT ROTATION

T(e 3,ie, +(o20d)e +e,ed4 d +8ed,o ,5i+, ro2d ,o

e'( +ide. Ro,,io i+me+2red )e,5ee,(e 30e o ,(e+(o20der+ d ,(e3e09i+. T(e orm0m=im2m rge i+@/ d i+ 0mo+,e,ire0 ,(or'i'


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S%SPECTE" THORACIC COR"COMPRESSION

%+e )02, o)e',+2'( + ,(e (d0e o ,edo (mmer ,o+,ro8e ,(e +8i i e'(3r2m)i0i'0 +8i2dr,.

Fi02re o ,(e2m)i0i'2+ ,o ,5i,'( i,(e dire',io o ,(e+,im20,ed 2dr,

+2gge+,+ 'or'om3re++io o ,(,+ide , ,(e 33ro3ri,e0e9e0


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S%SPECTE" THORACIC MOTOR ROOT"YSF%NCTION

Beevors signThe patient places his

hands )e(id (i+(ed4


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S%SPECTE" AN#YLOSIN& SPON"YLITIS

C(e'8 ,(e 3,ie,*+'(e+, e=3+io ,,(e 0e9e0 o ,(e @,(1

i,er+3'e Le++ ,( D.6 'm i+

regrded + (ig(0+2gge+,i9e o

80o+ig+3od0i,i+


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L2m)0 E=mi,io


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PHYSICAL EXAMINATION

Ins0ec!ion

al0a!ion

erc&ssion

Move'en!s


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INSPECTION


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PALPATION


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PERC%SSION


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MOVEMENTS


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SACRAL SPARIN&

Documents

Textbook Reading spine