Spine Physical Exam

  • WIPE, blah blah 🙂
  • “Take vital signs”
  • Proper exposure: both legs
  • General inspection of the patient + surroundings (walking aids)
  • Assess the pt’s gait

[green = upper spine, blue = lower spine]

1. Look: (from all sides, while the pt is standing)

  • Skin changes (rash, redness, discoloration)
  • Scars
  • Swelling
  • Muscle wasting
  • Deformity (curvatures, torticollis)

2. Feel: (first ask if they have pain?)

  • Temperature
  • Paraspinal muscles, LN
  • Spinous processes, sacroiliac joint

3. Move: active movements while holding the pt’s pelvis

  • Flexion + extension
  • Lateral flexion
  • Rotation

4. Special tests:

  • Straight leg raising
  • Femoral stretch test
  • Clonus
  • Babinski sign

 5. Dermatomes:

6. Myotomes:

  • C5: shoulder abduction
  • C6: elbow flexion
  • C7: elbow and wrist extension
  • C8: wrist and finger flexion
  • T1: finger abduction
  • L2: hip flexion
  • L3: knee extension
  • L4: ankle dorsiflexion
  • L5: big toe dorsiflexion
  • S1: ankle plater flexion 

7. Reflexes:

  • C5: biceps
  • C6: brachioradialis
  • C7: triceps
  • L4: patellar
  • S1: ankle jerk

8. Pulses:

  • Brachial, radial, ulnar
  • Popliteal, dorsalis pedis, post tibial

9. Joint above + joint below


Download the PDF version: here

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