REMS Spine

Question 1

What do you inspect for?

Answer 1

• Scars
• Muscle wasting
• Rashes
• Asymmetry
• Scoliosis
  From the side
• Cervical and lumbar lordosis
• Thoracic kyphosis

Question 2

What do you feel?

Answer 2

• Palpate spinous processes and sacroiliac joints

- Palpate spinal muscles for tenderness

Question 3

What are the movements in the cervical spine?

Answer 3

• Tilt head to each side (ear to shoulder) for lateral flexion
• Turn head to look over each shoulder for rotation
• Chin to chest and tilt head back for flexion and extension

Question 4

What are the movements in the lumbar spine?

Answer 4

• Flexion and extension
• Place two fingers on spinal processes and ask patient to bend over and watch fingers move apart and together when patient stands up again
• Lateral flexion; ask patient to run hand down side of the leg to the knee to assess lateral flexion

Question 5

What are the movements in the thoracic spine?

Answer 5

• Ask pt to sit on the bed with their arms crossed

- Ask the patient to move their chest from side to side

Question 6

What other movements in spinal exam?

Answer 6

• Ask pt to lie down
• Straight leg raising test; stretches the sciatic nerve and is abnormal with lumbar disc disease
• Dorsiflex the patient’s foot and raise pt’s leg straight
• Watch for pain and assess the degree of hip flexion

Question 7

What would you recommend be done at the end of a spinal exam?

Answer 7

Full neurological and vascular exam if indicated by history