Spinal palpation

Spinal palpation is a preliminary examination of the spine in a palpation manner for the diagnosis of spinal lesions. Single-thumb palpation method: use one thumb to point the ventral side of the affected area with the fiber (muscle, ligament, etc.) in the same direction, or perpendicular to the longitudinal axis of the spine, in order, dial, press, touch, check for soft tissue Abnormalities in injury and anatomical location. Basic Information Specialist classification: growth and development check classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: No pain zones were found during the examination. Positive: The people in the examination had abnormal pain in the waist and abdomen. Tips: Pregnant women should not do this check. Patients with lumbar fractures are not suitable for this examination. Normal value No pain zones were found during the examination. Clinical significance 1. Check the spine for side bends - the middle and index fingers are placed on both sides of the thoracic spinous process, from top to bottom, from light to heavy to the lumbosacral. 2. Check the spinous process for side bends - the thumb is placed on the upper thoracic vertebra, sliding down slowly against the spinous process, and then contralateral. 3. Virtual fist sniper to find the pain zone. a. Spinous process line - L5/S1 segment, L5/L4 segment, L4/L3 segment, see if there is pain in the spinous process, interspinous, and spine, clinically more common in L5/S1 segment. b. Transverse processes on both sides - L5/S1 transverse process, L5/L4 transverse process, L4/L3 transverse process, whether it is local pain or radioactivity. 4. Thumb press to find pain points. a. Press the top of the spinous process and up, down, left and right. b. Press the 2 cm joint capsule next to the spinous process. c. Press the transverse tip of L3, L4, L5, S1. d. Press the lumbosacral and ankle joints. e. Press the piriformis and the outlet, the starting and ending points of the gluteus medius, the distribution area of ​​the gluteal epithelium, the iliac crest, the ischial tuberosity, and the outlet of the hip transverse stripes. See if there is deep tenderness and radiation pain, and curl up. If the thumb is not found in the abdomen, use your fingertips to find it. 5 See the density of the muscles. a. Dense - indicates that there is a problem in the middle and shallow layers, and the fanning is loosened in the middle layer during operation. b. Relaxation - prohibits large-area operation and disables the setting of the needle. People who need to be examined have abnormal pain in the waist and abdomen. Positive results may be diseases: young kyphosis, interspinous ligament injury, spinous process fracture, spinous process tenderness, traumatic anterior spondylolisthesis, palsy, and odontoid fracture Taboo before inspection: no special contraindications. Requirements for examination: Check for relaxation, check for possible pain, and respond to pain. Inspection process 1. Single-thumb palpation method: use one thumb to refer to the abdomen sacral side in the affected area and the fiber (muscle, ligament, etc.) in the same direction, or perpendicular to the longitudinal axis of the spine, in order, according to the order, dial, press, touch, check No soft tissue damage and abnormalities in anatomical location. 2. Double-thumb palpation method (also called “eight” word palpation method): the four fingers are slightly flexed, the thumb is slightly stretched and abducted, and the external “eight” style is used. And the direction of the fiber (muscle, ligament, etc.), or perpendicular to the longitudinal axis of the spine, in order, in order, to check whether there is fiber break, blunt, hard, contracture, elastic deterioration, etc., while examining the spinous process Changes in position and spine gap size, etc. 3. Three fingers (food, middle, unknown three fingers) palpation spine method: the middle finger is driven on the top of the spinous process, the food and the unnamed two fingers are placed next to the spinous process, and quickly slide along the spine to detect the existence of the physiological curve. Or disappear, reverse, angulated, kyphosis, concave, deformed, etc. Then check the upper thoracic ligament with no change, spinous process with or without hemiplegia. Not suitable for the crowd Patients with lumbar fractures are not suitable for this examination. Pregnant women should not do this check. Adverse reactions and risks Nothing.

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