Spine

Question 1

1. General examination

Answer 1

Walking aids
Specialist shoes
Body habitus
Signs of pain
Systemically well

Question 2

2. Look

Answer 2

Comment on walking, willingness to weight bear
Gait
Alignment/Deformity
Skin changes
Wasting
Swelling

Question 3

3. Gait

Answer 3

Antalgic
Trendelenberg
Foot drop
Stiff hip

Question 4

4. Alignment/deformity

Answer 4

Normal khyphosis/lordosis
Scoliosis
Question mark posture ?ank spond

Question 5

5. Skin changes

Answer 5

Scars (discectomy), erythema, bruising

Question 6

6. Wasting

Answer 6

Para spinal and gluteal muscles

Question 7

7. Feel

Answer 7

Temperature
Spinous processes
Paraspinal muscles
Sacroiliac joints

Question 8

8. Move

Answer 8

C spine
Thoracic
Lumbar spine

Question 9

9. C spine (move)

Answer 9

Flexion - chin on chest
Extension - head back
Rotation - head to left/right shoulder
Lateral flexion - left/right ear to shoulder

Question 10

10. Thoracic (move)

Answer 10

Rotation - fix pelvis, twist to left and right

Question 11

11. Lumbar spine

Answer 11

Lateral flexion - run hand down side of leg
Extension - lean back as far as possible
Flexion - 2 fingers on lumbar spine, touch toes keeping legs straight

Question 12

12. Special Tests

Answer 12

Nerve Root Compression (fmst, slr)
Modified Schober’s Test
Wall Test

Question 13

13. Nerve Root Compression

Answer 13

Femoral Nerve Stretch Test (L2, L3, L4)
on front, knee 90°, passive hip extension
Pain in back, bum, or legs suggests herniation

Straight Leg raise (L4, L5, S1)
pain at 30°- 70° in back, bum or legs suggests herniation

Question 14

14. Modified Schobers Test

Answer 14

Lumbosacral junction (dimples of Venus)
10cm above, 5 cm below
Patient touches toes, measure, <5cm increase = reduced Rangel of flexion

Question 15

15. Wall test

Answer 15

Head can’t touch wall = increases khyphosis

Question 16

16. Joint above

Answer 16

Hip - internal rotation, flexion

Question 17

17. Neurovascular

Answer 17

Dorsalis pedis, tibialis anterior
Sensation - L1, L2, L3, L4, L5, S1
Reflexes - knee and ankle