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OF
THE TRUNK
PAIN
• What caused the pain? (acute or chronic)
• Where is the pain?
• Radiation? (to & from)
• Character
• Abnormal sensation
• Exacerbation and relief?
• Course (progressive, regressive , stationary)
IMPORTANT POINTS
• Patients occupation
• Faulty postural habits?
• Abnormal gait?
• Medications?
• Sphincter & sex abnormalities
PAST HISTORY
- SYSTEMIC DISEASE
- MEDICATION
- SURGERY
FAMILY HISTORY
Examination
of the Dorso lumbar Spine
Patient examined standing
LOSS OF LUMBAR LORDOSIS
LIST
SCOLIOSIS
Attitude:
• + PAIN
• Sciatic list.
• Decreased lumbar lordosis.
• Scoliosis.
Prone position
Hip extension S1
Knee flexion S1 & S2
ABRASIONS,CONTUSIONS
KYPHUS
Dermatomes (L1 (L4
• L1 back of trochanter
and groin
• L2 front of thigh
knee, back of iliac crest
• L3 upper buttock, front
of thigh, & knee &
medial lower leg
• L4 inner buttock, outer
thigh, inside of leg,
dorsum of foot
& great toe
Dermatomes (L5 (S4
• L5 buttock, lat. Aspect of leg
& dorsum of foot, inner
sole & first three toes
• S1 buttock, back of thigh and
leg
• S2 same as S1
• S3 groin, inner thigh,
perinium
• S4 & S5
perineum genitals &
lower sacrum
AUTONOMOUS SENSORY ZONES
nipple line (T4),
xiphoid process
(T7)
Umbilicus
(T10)
• Knee L3
• Ankle S1
• Medial hamstrings L5
• Lateral hamstring S1
PRIMITIVE (spinal) REFLEXES
Anus
Glans
Babiniski test
Bulbo-cavernosus test
Lumber Root Syndromes
Root pain
Dermatome
Muscle weakness
Reflexes abn.
Sensory examination.
Special tests
Malingerer patient
PLAIN X-RAY
CT
D CT 3
MRI
BONE SCAN