Professional Documents
Culture Documents
Columna Vertebralis
5 regions, 33 bones
Regions
Cervical ( 7 vertebrae)
Thoracic ( 12 vertebrae)
Lumbar ( 5 vertebrae)
Sacral bone (5 fused =
Sacrum)
Coccygeal bone (4 fused =
coccyx)
The Vertebral Column
Vertebrae separated by
intervertebral discs
Intervertebral discs (anulus
fibrosus + nucleus pulposus)
The Vertebral Column
- Spinal Curvatures
concave and convex curves
Curvatures :
Kyphosis (cervical and
lumbar)
Lordosis (thoracic and
sacrum)
Scoliosis (abnormal)
Vertebra
Typical vertebra has :
Corpus vertebra
Arcus vertebra (lamina and pedicle)
Foramen vertebra
Processus spinosus (1)
Processus transversus (2)
Processus articularis superior (2)
Processus articularis superior(2)
Cervical Vertebrae
Thoracic and Lumbar Vertebrae
Symmetry/ asymmetry
Deformity
Torticolis
Hematoma
PALPATION
Flexion Extension
Ask the patient to bend Ask the patient to till
the head forward the head backward
STEPS THREE STEPS FOUR
Rotation
Again a spatula use a
pointer. Normal range
= 80
Thoracal Physical Examination
Inspection
Position :
Patient stand
Examination :
Assess the thoracic curvature
from side
Examination :
Access the flow of movement in the
spine, and whether the curvature
increases
Examination :
Assess the curvature of the
thoracic spine
Examination :
Check if there is a regular but fixed
kyphosis is found
Examination :
Check for an angular kyphosis, with a
gibbus or prominent vertebral spine
Position :
Patient sitting and bend forward
Examination :
Palpate and look for tenderness
higher in the spine at the thoracal
spine
Position :
Patient bend forward
Examination :
Lightly percuss the spine in an orderly
progression from the root of the neck to
the sacrum
Results :
Note that significant pain is a feature of
tuberculous and other infections, trauma
(especially fractures) and neoplasms
Movement
Position :
Patient attempt to touch his toes
Examination :
Watch the spine closely for
smoothness of movement and any
areas of restriction
Examination :
Note the distance between the finger
and the ground
Examination :
See the angle of range flexion. The
majority of normal patients can reach
the floor or within 7 cm from it
Examination :
Flexion in the thoracic spine may be
measured with the upper point 30 cm
from the previous zero mark
Physical Examination
History taking
1. Note the patients age and occupation: both
may be relevant.
2. Ask about the onset of the pain
3. Ask about any directly relevant previous
history
4. Ask about the site and nature of the pain
5. Ask about radiation of the pain
6. Ask about motor involvement
7. Make enquiries in the following areas
Inspection
Palpation
Percussion
Movements
Physical Examination
Inspection
Palpation
Percussion
Movements