脊柱检查（Spinal examination）.docVIP

脊柱检查（Spinal examination） (I) spinal column Check whether the physiological curve exists, whether there is abnormal curvature, tenderness and percussion pain, and whether the motion is limited or not. 1. when the curvature of the spine is normal, the spine has four physiological bends from the side, that is, the cervical part is slightly inclined to the front, the chest is slightly backward, the lumbar spine is prominent forward, and the sacral vertebra is obviously backward convex. At the time of the examination, the patient was standing or sitting, exposing the body to the full, and observing the presence of 4 physiological bends of the spine from the lateral and posterior position, whether there was any scoliosis, lordosis, or kyphosis. Common causes include rickets, spinal tuberculosis, injuries, chronic pleural thickening, pleural adhesions, and deformities of the shoulder or thorax. 2. spinal activity requires the subjects to perform flexion, extension, and lateral bending movements to see if spinal activity is limited and if vertebral pain is present. The range of spinal movement in normal subjects varies greatly with age, exercise training and spinal structure. Limited activities are seen in muscle injury, ligament strain, proliferative arthritis, tuberculosis, tumor, intervertebral disc prolapse, spinal injury, etc.. 3. the tenderness of the spine and percussion pain should be taken to the sitting position by the examiner. The body is slightly tilted forward, and the spinous process of the spine and the paraspinal muscles are pressed from top to bottom with the right thumb, and the normal spinous process and paraspinal muscles are free of tenderness. The tenderness of spinous process is positive in spinal tuberculosis, prolapse of intervertebral disc, spinal trauma or fracture. Tenderness of paraspinal muscles is often found in low back muscle fiber or strain. Percussion hammer for knocking one by one each vertebral spinous process of thoracic and lumbar spi