1 / 26

Clinical examination of the spine by Jwalant Mehta

Dr Jwalant Mehta, one of the top spine surgeons in UK, qualified in 1989 and a gold medalist for his brilliant academic performance. Also, shares his knowledge through publications, editorials, research papers

JwalantMehta
Download Presentation

Clinical examination of the spine by Jwalant Mehta

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clinical examination of the Spine Jw alant S.Mehta MBBS, MS (Orth), D Orth, MCh (Orth), FRCS (Tr & Orth) Consultant SpineSurgeon The Royal Orthopaedic Hospital Spire ParkwayHospital BMI The Priory andEdgbaston Bromsgrove PrivateClinic

  2. Generalaspects • Introduction • Consent to examination • Non-verbal communication (eyecontact) • ‘Firstimpressions’ • Exposure; comfort (warm hands androom) • Inflictingpain

  3. Standingun-supported • Shoulders, Pelvis • Musclecontours • Sp inalcontours • Limblengths

  4. Standing: sideprofile • Forwardstoop • Hips andknees • Forwardgaze • Sp inalcontours

  5. Range ofmotion • Range • Rhythm • Extremesof range • Pain

  6. Flexion of thetrunk • Generalflexibility • Getting up toneutral • Discogenic:painful

  7. Extension of thetrunk • Facetloading • Discprolapse/ stenosis • Spondylolysis • 1 leghyper-extension

  8. Cervical spine range examination

  9. Pain • Sym ptom reported by thepatient • Tenderness • Midline • Gentle thump • Segm entalrotation • Muscle spasm, tenderpoints

  10. Neurology • Motor (grades, through the full range of thejoint) • Sensations (allmodalities) • Reflexes (deep, superficial andpathologic) • ASIAcharts • Document withdate

  11. Upper limb neurologicalexam

  12. Lower limbneurologic examination

  13. Deep tendonreflex • Grading: • 0 absent • 1+ hypoactive • 2+ normal • 3+ hyperactive • 4+ hyperactive with clonus 5+ sustainedclonus • Compare with oppositeside

  14. Deep tendonreflex Stretch reflex: Contraction in response to stretch of muscle spindles (receptors in parallel to muscle fibres. 2 neutronarc.

  15. Superficial abdominalreflex Motor response to skin stimulation. Poly-synaptic response. Peripheral sensory nerve; ascending sensory tract;brain; descending motor tract and muscle. Present; absent orasymmetric.

  16. Babinskireflex

  17. Hoffmansreflex

  18. Inverted radialreflex

  19. Sacro-iliacjoints • Stablejoint • Referredpain • Tenderness • Stressingjoint • Inflammation, injury

  20. Waddell’s ‘non-organic’signs • Tenderness: superficial;non-anatomic • Simulationofpain:axialload;rotation • Distraction: straight legraise • Regional: motor;sensory • Over-reaction

  21. Ancillaryexamination • Shou lderexamination • Hipexamination • Peripheral nerves and Brachialplexus • Distalpulses

  22. Peripheralnerves • Tinels sign over the course of thenerve • Phalens test for Carpal tunnelsyndrome • Neurological examination (sensations,motor) • Median nerve; Ulnar nerve in upperlimb

  23. Thoracicoutlet

  24. Contact us • Royal Orthopaedic Hospital • BMI The Priory Hospital • Spire Parkway Hospital • Bromsgrove Private Clinic

  25. Contact and Connect • Clinical secretary: SamanthaLeavy +44 785 021 1939 • Medico-legal secretary: JanClarke +44 121 4508928 • Spire Parkway Hospital:0121 704 5500 • BMI NEC (National Enquiry Centre): 0808 101 0337 • Email: info@mehtaspine.co.uk • The appointments are booked through the clinic

More Related