We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published bySalvatore Allis
Modified about 1 year ago
Spine Examination Himanshu Sharma Himanshu Sharma
Axial pain Radiculopathy Myelopathy Deformity
History Site Start + duration + course Exacerbating / Relieving (stenotic) Associated symptoms Weakness Coughing / P&Ns % back : leg (arm) Disability Bladder/bowel dysfunction Myelopathic symptoms Management so far Analgesia Physio Previous surgery
RED FLAGS OF SERIOUS SPINAL PATHOLOGY Presentation 55 (65) Non-mechanical pain, thoracic pain ? Widespread neurology Unwell, weight loss Past history carcinoma, steroids, HIV Structural deformity
Waddell’s 5 classes Tenderness superficial non-anatomical Simulation axial loading pseudo-rotation Distraction >40 o SLR difference sitting v supine At least 3 needed to be +ve Regional disturbance motor eg cogwheel sensory - non anatomical Overreaction disproportionate pain response
Examination Standing Walking Couch
Standing Look Back Deformity Swellings Birth marks Scars Legs Lower limb wasting Cavus feet / claw toes Feel Site of tenderness Move Pain worse on flexion / extension ? Heel and tiptoe stance
Ankylosing spondylitis Chest expansion Modified Schober test Hip fixed flexion
Neurofibromatosis Café-au-lait Axillary freckling Neurofibromas Spinal deformity
Couch Abdominal (AAA) Hips +/- knees Pulses SLR + tension signs (Femoral stretch) Sensation Motor Long tract signs
Straight leg raise Record angle on both sides Record site of pain Lasegues reduce angle slightly + dorsiflex ankle Bowstring test
Maps Dermatome Myotome Sclerotome
Upper limbs Sclerotome map
Lower limbs Sclerotome map
Long tract signs Romberg’s Hoffman’s sign Lhermitte’s sign Increased muscle tone Brisk reflexes Clonus Extensor plantars Cavus feet (long standing)
History When first noticed Any progression Menarche / growth potential Any pain & its nature Neurological symptoms Birth marks / PMH Family history Siblings
Examination Trunk shoulder height symmetry rib hump - forward bending waist asymmetry hip asymmetry side of curve and flexibility on suspension leg length inequality Neurological upper and lower limbs Subtle signs - abdo reflexes, Hoffman’s, clonus Ligamentous laxity
Waleed Awwad, MD, FRCSC. Anatomy Spinal Column Anatomy Spinal Column.
รศ. นพ. สุรชัย แซ่จึง ภาควิชาออร์โธปิดิกส์ คณะแพทยศาสตร์ มหาวิทยาลัยขอนแก่น.
Assessment of LBP and Hip pain GP Registrar Training 24 th November 2009 Sue Hammersley and Julie James.
Examination of the Adult Spine Mark Galloway, PA.
NeuroSurgery Case: Low Back Pain. Salient Features A 45 year old office secretary Sudden snap and pain in the left lumbar area while trying to lift a.
Back Pain Back pain is second to the common cold as a cause of lost days at work. About 80% of people have at least one episode of low back pain during.
AHS Sports Medicine Prentice. Bones (p ) Lumbar vertebrae 1-5 Sacrum Coccyx Joints Intervertebral Joints Facet Joints.
Low Back Pain. What is low back pain? Pain in the low back.
Back & Neurological Examination Dr Munir Saadeddin FRCSed.
Anatomy and Physical Examination of the Lower Back Sports Medicine Fellowship Uniformed Services University of the Health Sciences.
For the Primary Care clinician Low Back Pain: Focused Exam.
An orthopaedic overview. Review anatomy General exam reminder Four conditions to illustrate the exam including overview of provocative testing.
LUMBAR SPINE. Bony Anatomy Made of two parts - vertebral body and vertebral arch Pedicles – attach body to arch.
4 patients falling over. Mrs April Aged 62 Complains of tripping up when she walks on uneven surfaces Falls over and comes to hospital PMH COPD Vegan.
Back Pain Mr. Ash Mukherjee Specialist Registrar Emergency Medicine.
THE SPINE Chris A. Gillespie, MEd, ATC, LAT Director, Athletic Training Education Samford University.
Common Orthopaedic Conditions Associated with Complex Neurodisability Lindsey Hopkinson and Victoria Healey Heads of Paediatric Physiotherapy Physiocomestoyou.
University of Delaware Special Tests in The Spine Tara Jo Manal PT,OCS, SCS.
© 2005 The McGraw-Hill Companies, Inc. All rights reserved. The Spine PE 236 Juan Cuevas, ATC.
Prof. M.ABD ELAZIZ, MD, Ph D- Clinical Pharmacology Department of Clinical Pharmacy College of Pharmacy Salman Bin Abdulaziz University Mohammad Ruhal.
Lumbar Spine Orthopedic Tests. Lumbar Anatomy Erector Spinae Group.
BACKACHE BLOCK BACKPAIN Prof. Mthunzi Ngcelwane HoD: Orthopaedics.
Back pain – a comprehensive guide Lawrence Pike James Street Family Practice.
Cervical Spine. Movements of the vertebral column –Flexion –Extension –Rotation –Lateral flexion.
Hip and Pelvis Muscle Tests. Gaenslen’s Sign Used to assess if pathology exists in sacroiliac joint Patient lies supine on table with both knees bend.
The Spine and Posture II Mazyad Alotaibi. Clinical Evaluation of Posture Where to Start – Draw a line down vertical axis – History – Inspection/observation.
LOW BACK PAIN The GPs Problem. The GPs Problems Lots of patients Precise diagnosis is difficult Changing guidelines - triage - what helps and what doesn’t?
Back Pain. Background 30 million adults in UK /yr experience back pain 1/3 experience pain> 12 months and 1/5 of above will be off work >3/12 Costs NHS.
Neural mobilization Tests Neural mobilization Tests Passive neck flexion (PNF). Straight leg raise (SLR). Prone knee bends (PKB). Upper limb tension tests.
Chapter 10: Flexibility Lesson 10.1: Flexibility Facts Self-Assessment 10: Arm, Leg, and Trunk Flexibility.
Skeletal Muscle Movements Health History Inspection Palpation.
Posture means position Posture is the body’s alignment and positioning with respect to COG. Attitude of the body, the relative alignment of body/limb.
Musculoskeletal HDR Mark Brooke Samar Shefta Why Is MSK So Important? 1 in 5 patients consulting their GP is for a MSK condition MSK conditions are often.
Sports Medicine: Physical Fitness. 1. Discuss FITT formula guidelines for stretching 2. Review basic stretching guidelines 3. Learn basic stretches for.
TYPE OF MUSCLE CONTRACTION Dr. Walaa S. Mohammad.
Thoracic Spine. Thoracic Cage Anterior Thoracic Cage Posterior.
Cervical Radiculopathy. Normal Anatomy Cervical spinal nerves exit via the intervertebral foramen Intervertebral foramen is the gap between the facet.
CERVICAL SPONDYLOSIS DR T.P MOJA STEVE BIKO ACADEMIC HOSPITAL.
Muscles & Muscle Groups Where They Are What They Do Joint Action.
4 patients with pains in their legs………………. Mr H 65 years of age Type II Diabetes Developed shortness of breath when walking the dog Worse when he is climbing.
Cervical Spine Ove Indergaard MSc MCSP HPC. Anatomy.
Preventing Back Injuries. Reduce Your Risk of Back Injuries Most Americans experience back pain at some point in their lives. Back injuries account for.
EXAMINATION OF THE FOOT AND ANKLE Dr. Mohammed Zaheer Dalati Senior Registrar Department of Orthopaedics College of Medicine King Khalid University Hospital.
Back Pain Neck and Back Pain Study Day January 2013.
Evaluation of back pain and other disorders of the Spine.
15 Minute Workout while at your desk …a healthy workplace initiative.
Shoulder Examination Prof. Mamoun Kremli AlMaarefa College.
Gait development in children. The prerequisite for Gait development Adequate motor control. C.N.S. maturation. Adequate R.O.M. Muscle strength. Appropriate.
Kinesiology Laboratory 8 Posture and Gait Analysis.
Musculoskeletal Lecture NUR 216 Professor Shugart.
© 2017 SlidePlayer.com Inc. All rights reserved.