Sci Revised)

DIAGNOSTIC EXAMINATIONS & TOOLS

DIAGNOSTIC EXAMINATIONS & TOOLS

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History and Physical Examination

DIAGNOSTIC EXAMINATIONS & TOOLS  

“Red Flags” Pain -local pain, due to bone/soft tissue injury -radicular pain, due to nerve root compression

DIAGNOSTIC EXAMINATIONS & TOOLS 

Palpation -tenderness, bruising, or swelling due to local soft tissue damage -Palpable step-off due to malalignment -vertebral dislocation

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ROM Gait Assessment

DIAGNOSTIC EXAMINATIONS & TOOLS 

Rectal Examination -decreased or absent tone -loss of voluntary contraction -loss of bulbocavernosus reflex

DIAGNOSTIC EXAMINATIONS & TOOLS 

Motor Examination

The motor part of the examination tests 10 key muscles on each side of the body: MMT: 0 – total paralysis 1 – palpable or visible contractions 2 – full AROM, gravity-eliminated 3 – full AROM against gravity 4 – full AROM against moderate resistance 5 – full AROM against full resistance

DIAGNOSTIC EXAMINATIONS & TOOLS    

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C5 (biceps “elbow flexors”) C6 (wrist “wrist extensors”) C7 (triceps “elbow extensors”) C8 (end of middle finger “finger flexors”) T1 (little finger “finger abductors”)

DIAGNOSTIC EXAMINATIONS & TOOLS     

L2 (hip “hip flexors”) L3 (knee “knee extensors”) L4 (ankle “ankle dorsiflexors”) L5 (big toe “first toe extensors”) S1 (ankle (ankle plantar flexor”)

DIAGNOSTIC EXAMINATIONS & TOOLS 

Sensory Examinations Tests for 28 dermatomes, bilateral, using pin prick and light touch. 3- point scale: 0 – absent 1 – impaired 2 – normal

DIAGNOSTIC EXAMINATIONS & TOOLS C2- occipital protuberance C3- supraclavicular fossa C4- top of the acromioclavicular joint C5- lateral side of the antecubital fossa C6- thumb C7- middle finger C8- little finger

DIAGNOSTIC EXAMINATIONS & TOOLS T1- medial side of the antecubital fossa T2- apex of the axilla T3- 3rd intercostal space T4- 4th IS (nipple line) T5- 5th IS T6- 6th IS T7- 7th IS

DIAGNOSTIC EXAMINATIONS & TOOLS T8- 8th IS T9- 9th IS T10-10Th IS (umbilicus) T11- 11th IS T12- inguinal ligament at midpoint L1- half the distance between T12 and L2 L2- mid-anterior thigh

DIAGNOSTIC EXAMINATIONS & TOOLS L3- medial femoral condyle L4- medial malleolus L5- dorsum of the foot at the 3rd MTP S1- lateral heel S2- popliteal fossa in the midline S3- ischial tuberosity S4-S5- perianal area

DIAGNOSTIC EXAMINATIONS & TOOLS 

Neurological Assessment A - complete: no motor or sensory function is preserved in the sacral segments S4-S5 B - incomplete: sensory but not motor function is preserved below the neurological and includes the sacral segment S4-S5

DIAGNOSTIC EXAMINATIONS & TOOLS C – incomplete: motor fxn is preserved below the neurological level and more than half of key mm below the neurological level have a mm grade less than 3

D – incomplete: motor fxn is preserved below the neurological level, and atleast half of key mm below the neurological level have a mm grade of 3 or more

E – normal: motor or sensory fxn is normal

DIAGNOSTIC EXAMINATIONS & TOOLS DIAGNOSTIC TOOLS 

XRAY -An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. -exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body.

DIAGNOSTIC EXAMINATIONS & TOOLS

DIAGNOSTIC EXAMINATIONS & TOOLS 

MYELOGRAPHY -Myelography is an imaging examination that shows the passage of contrast material in the space around the spinal cord and nerve roots using a real-time form of x-ray called fluoroscopy. -By this means, myelography provides a very detailed picture (myelogram) of the spinal cord and

DIAGNOSTIC EXAMINATIONS & TOOLS

DIAGNOSTIC EXAMINATIONS & TOOLS 

CT SCAN -is also known as CAT scanning (Computed Axial Tomography). -CT has the unique ability to image soft tissues and renders more detail of bony structures than MRI. It is frequently performed immediately after myelography. -This combination of imaging studies is known as CT myelography.

DIAGNOSTIC EXAMINATIONS & TOOLS

DIAGNOSTIC EXAMINATIONS & TOOLS 

MRI -Magnetic resonance imaging (MRI) is used to visualize the body. -MRI is noninvasive -covers a large area of the spine and can show changes within the disc and vertebral body, it has become the imaging modality of choice in the diagnosing spinal cord injuries.

DIAGNOSTIC EXAMINATIONS & TOOLS

DIAGNOSTIC EXAMINATIONS & TOOLS PREPARED BY ROXANNE C. CARILLA