- Diagnosis
- History
- Examination
- Investigations
- History
- Management
- Interventions
Spinal Exam
Spinal Exam
Examination of the back is performed to identify and localise pathology affecting the vertebrae and soft tissues associated with the spine. Particular conditions of interest include radiculopathy, past spinal surgery and ankylosing spondylitis.
The Patient
Look
Feel
Move - Cervical
Move - Thoracic & Lumbar
Bones and Ligaments
Overview
Feel For
- Costochondral & sternochondral jointsBetween the sternum and the ribs anteriorly. Especially palpate for tenderness.
- Spinous processesPosterior processes of the vertebrae
- Interspinous & supraspinous ligamentsConnecting adjacent spinous processes posteriorly
- Facet jointsBetween vertebrae, lateral to the midline. Especially palpate the cervical facet joints.
- Costovertebral jointsOf the thoracic vertebrae
- Sacroiliac joint
Vertebral Landmarks
- C1 - feel for the transverse processes between the angle of the mandible and the mastoid, asking the patient to turn their head.
- C2 - palpate down from the occiput in the midline. The spinous process of C2 is the first palpable process.
- C7 - the most prominent spinous process posteriorly.
- T2 - palpate medially to the superior angle of the scapula.
- T6 - palpate medially from the inferior angle of the scapula.
Last updated on January 1st, 2017
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