Back And Spine Exam

Question 1

B&S exam - Introduction

Answer 1

PPE/Hand Hygiene
Hi I’m James…
Patient identifiers
Seek consent and explain examination
Appropriate exposure of patient

Question 2

B&S exam -Look - General inspection

Answer 2

Mobility aids
Gait and posture
Body habitus
Visible distress or pain
Scars, pigmentation, erythema, rashes, bruises
Extra-articular manifestations of rheumatalgocial disease

Question 3

B&S exam - Look (after general inspection)

Answer 3

Lateral:
Normal curvature cervical lordosis, thoracic kyphosis and lumbar lordosis
Normal pelvic tilt
Posterior:
No scolosis,
No abnormal hair indicating Spina bifita occulata
Normal muscle bulk

Question 4

B&S Exam Feel

Answer 4

Feel along spine, start at C7 and count up then back to C7 and go down
No warmth or tenderness present
Parapsinal muscle tenderness and muscle spasm —> locate the sacroiliac joint/popsterior superior iliac spine,, just under these dimples ig

Question 5

B&S exam - Move

Answer 5

Get the to sit down.
Cervical: flexion/extension/lateral flexion/ rotation
Thoracic: rotation
Stand Up:
Lumbar: Flexion, extension, lateral flexion

Question 6

B&S exam special test

Answer 6

Schober’s test:
1. Identify PSIS (dimples of Venus)
2. Draw a mark here
3. Measure 5cm below and 10 above
4. Ask patient to bend foward and touch toes
5. Distance should increase from 15cm —> at east 20cm
Straight leg raise test:
- indicates lumbosacral nerve root irritation
-patient lies in bed supine with legs straight
-slowly lift leg up at foot and ankle straight up aka passive flexion of hip with knee extended
Flex hip up tp 80-90 degrees
Positive is pain in ca;f buttock thigh