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Spine Exam - Coggle Diagram
Spine Exam
Neurological Exam/
Special tests
FUNCTION
Sacroiliac Joint pain
Direct pressure over SIJs with both thumbs whilst patient leands forward and supports self on exam couch
Pressure over scarum with patient lying prone
Modified Schober's test
Mark line between dimples of venus
Take point 10 cm above and 5 cm below this line
Patient flexes forwards, measure distraction of points
Normal : >7 cm
Chest Expansion
Measure expiration/ inspiration change at 4th ICS
Normal >5cm
Relexes
Knee jerk
L4 root
Ankle jerk S1 root
Plantar response
Sensation
Sensory level
Straight leg raise test
Supine
elevation of limb 30-70 degrees produces pain radiating down the leg below the knee
Pain <30 innapropriate
Pain>60-70 usually hamstring tension
Pain 30-60 possible radiculopathy
Sciatic stretch - lower limb slightly then dorsiflex ankle
Femoral Stretch Test
Patient standing on one leg holding onto table
or
Lie prne, flex xknee 90 and extend hip
FLex knee and hyperextend hip
Pain in anterior thigh indicates positive test
Waddell Signs
Excessive tenderness on minimal pressure
Palpation
FEEL
Lying and standing
Spinous procsses
SI joints
Paraspinal muscles
MOVE
Active Movements
Cervical Spine
Extention
Lost first in sponyloarthopathies
Lateral flexion
Rotation
Flexion
Thoracic / Lumbar Spine
Flexion
Schober's test
Extention
Lateral flexion
Lost in early inflammatory disease
Ipsilateral pain : Facet joint
Contralateral pain : Ligamentous
Lateral rotaion with fixed pelvis
Straight leg raising
Tone / Power
Measurements
Inspect
LOOK
Patient Standing
Muscle Bulk
Wasting
SPasm
Cervical lordosis
Thoracic kyphoscoliosis
Structural worsens with flexion
Functional improves with flexion
Lumbar lordosis
Pelvic tillt
Midleine dimples
Hariy tufts
Spina bifida occulta
Pilonidal cysts
Pathology Notes
Sacroiliac Joint
Infection / Inflammation causes low back pain radiating into buttock or thigh
Assesment
Direct pressure over
https://www.youtube.com/watch?v=zIn8sXAB7N4&pp=ygUWdmVyc3VzIGFydGhyaXRpcyBzcGluZQ%3D%3D