Station Progress:

[vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][ultimate_heading main_heading=”Candidate brief” main_heading_color=”#000000″ sub_heading_color=”#000000″ main_heading_style=”font-weight:bold;” main_heading_font_size=”desktop:36px;”]

“This patient has backache.  Please examine his spine and discuss your findings with the examiners.”

[/ultimate_heading][vc_empty_space image_repeat=”no-repeat”][vc_video link=”https://vimeo.com/149496587″][vc_empty_space image_repeat=”no-repeat”][vc_row_inner row_type=”row” type=”full_width” use_row_as_full_screen_section_slide=”no” text_align=”left” css_animation=””][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Station time” counter_value=”20″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Time for this encounter” counter_value=”10″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Maximum time to examine your patient” counter_value=”8″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Minimum time for discussion and questions” counter_value=”2″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][/vc_row_inner][vc_empty_space image_repeat=”no-repeat”][/vc_column][/vc_row][vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][vc_accordion style=”accordion”][vc_accordion_tab title=”Common examiner questions”][vc_column_text]Common examiner questions include the following:

  1. What do you think this patient has?
  2. How would you like to investigate this patient next?
  3. What do you think the underlying cause of this patient’s signs is?

[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Diagnosis and clinical signs”][vc_column_text]This patient has a normal spine.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Discussion”][vc_column_text]

Examination of the spine

 

  • Firstly introduce yourself to the patient and request permission to examine them;
  • Check if they are in any pain, and explain, if they do experience any pain during the examination, to inform you immediately;
  • Look at the spine, ideally in a standing position, or from the back with the patient sat at the side of the examination couch:
    • check the skin for any changes;
    • check for any evidence of swelling;
    • check for any spinal deformities such as kyphosis, lordosis or scoliosis;
    • check the spine from the side for the tell-tale ‘question-mark’ position associated with ankylosing spondylitis;
    • check for muscle wasting.
  • Feel down the spinous processes:
    • confirm the alignment that you observed;
    • check for tenderness.
  • The spine is divided into the cervical, thoracic, lumbar and sacral regions, and hence these have to be examined in turn:
    • the cervical spine is examined via movements of the head:
      • flexion and extension;
      • lateral flexion;
      • rotation
    • thoracic and lumbar spine:
      • flexion of the spine (touch your toes);
      • extension of the body (arch backwards);
      • lateral bending (run your arm down your leg, on both sides);
      • rotation by twisting, while keeping the hips fixed.
  • Nerve stretch tests can also be carried out:
    • sciatic nerve stretch (L4-S2):
      • lay the patient supine;
      • ask the patient to straight leg raise, which will cause pain and result in limited movement due to tension in the sciatic nerve roots;
    • femoral nerve stretch (L2-L4):
      • lay the patient prone;
      • flexing the knee causes pain to radiate up into the back;
      • extending the hip joint can also produce pain if there is nerve tension.
  • Thank the patient and ensure you maintain their dignity at all times.

[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Specimen case presentation”][vc_column_text]”This patient has a clinically normal spine.”[/vc_column_text][/vc_accordion_tab][/vc_accordion][/vc_column][/vc_row]