Topic 42 - Examination of the skull and the spine. Examination of pain sensation.

Question 1

Examination methods of the head:

Answer 1

Inspection

Question 2

What to inspect for head examination:

Answer 2

1. Posture of the head: normal or abnormal
2. Shape
3. Mobility
4. Ears: drooping or pointing
   (5. Sign of pain by palpation)
5. Facial expression

Question 3

Abnormal head positions:

Answer 3

lateral turn
tilted
stargazing: opisthotonus
Head rotation
Neck pain
Weakness of neck muscles

Question 4

Answer 4

Lateral head turning

Question 5

Answer 5

Right sided head tilt

Question 6

Other abnormalities concerning the head, not only the position:

Answer 6

1. Bulging scull: hydrocephalus
2. Drooping ears and lips: Facial paralysis

Question 7

Answer 7

Extended (opisthotonus)

Stargazing

Question 8

What do we observe to examine facial expression?

Answer 8

Eyelids
Nostrils
Ears
Facial muscles function
Examination of the eyes

Question 9

Examination methods of the spine:

Answer 9

Inspection: abnormal shape, position, muscle symmetry

Palpation: sensitivity, look for pain

Question 10

Abnormal findings of the spine:

Answer 10

1. Curved spine
2. pseudokyphosis
3. lordosis
4. scoliosis

Question 11

What is pseudokyphosis?

Answer 11

being humpbacked, dorsal deviation

Question 12

What is lordosis?

Answer 12

concave curvature of the spine, ventral deviation

Question 13

What is scoliosis?

Answer 13

lateral curvature of the spine

Question 14

Superficial pain examination:

Answer 14

Pinch with hemostat and prick with needle, pain provoking percussion

Question 15

Normal response upon superficial pain:

Answer 15

Skin twitch
Leg withdrawal upon reflexes

Behavoural:
Crying
Biting
Turning to direction of pain

Question 16

How to evaluate the superficial pain, name the different stages:

Answer 16

– normaesthesia = normal
– hyperaesthesia = excessive sensitivity
– anaesthesia= loss of sensation
– paraesthesia = An abnormal sensation, burning, tingling

Question 17

Examination of deep pain sensation:

Answer 17

• Only if superficial pain is absent
• Squeezing of digit or claw with a hemostat

Question 18

Examination of spinal pain, indications:

Answer 18

– Stiff neck, not leaning down to the bowl
– Not jumping on sofa
– not standing on hind leg
– not walking on stairs