Sci Revised)

8/14/2019 Sci Revised)

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DIAGNOSTIC EXAMINATIONS

& TOOLS


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DIAGNOSTIC EXAMINATIONS &

TOOLS

History and Physical Examination


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DIAGNOSTIC

EXAMINATIONS & TOOLS

Red Flags

Pain-local pain, due to bone/soft tissue

injury

-radicular pain, due to nerve rootcompression


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DIAGNOSTIC


Palpation

-tenderness, bruising, or swelling

due to local soft tissue damage

-Palpable step-off due tomalalignment

-vertebral dislocation ROM Gait Assessment


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DIAGNOSTIC


Rectal Examination

-decreased or absent tone

-loss of voluntary contraction

-loss of bulbocavernosus reflex


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DIAGNOSTIC


Motor ExaminationThe motor part of the examination tests 10key muscles on each side of the body:

MMT: 0 total paralysis1 palpable or visible contractions

2 full AROM, gravity-eliminated

3 full AROM against gravity

4 full AROM against moderateresistance

5 full AROM against full resistance


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DIAGNOSTIC


C5 (biceps elbow flexors)

C6 (wrist wrist extensors) C7 (triceps elbow extensors)

C8 (end of middle finger finger

flexors) T1 (little finger finger abductors)


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DIAGNOSTIC


L2 (hip hip flexors)

L3 (knee knee extensors) L4 (ankle ankle dorsiflexors)

L5 (big toe first toe extensors)

S1 (ankle (ankle plantar flexor)


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DIAGNOSTIC


Sensory Examinations

Tests for 28 dermatomes, bilateral,

using pin prick and light touch.

3- point scale:

0 absent1 impaired

2 normal


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DIAGNOSTIC


C2- occipital protuberance

C3- supraclavicular fossa

C4- top of the acromioclavicular joint

C5- lateral side of the antecubital fossa

C6- thumbC7- middle finger

C8- little finger


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DIAGNOSTIC


T1- medial side of the antecubital fossa

T2- apex of the axilla

T3- 3rd intercostal space

T4- 4th IS (nipple line)

T5- 5th IST6- 6th IS

T7- 7th IS


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DIAGNOSTIC


T8- 8th IS

T9- 9th IS

T10-10Th IS (umbilicus)

T11- 11th IS

T12- inguinal ligament at midpointL1- half the distance between T12 and

L2

L2- mid-anterior thigh


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DIAGNOSTIC


L3- medial femoral condyle

L4- medial malleolus

L5- dorsum of the foot at the 3rd MTP

S1- lateral heel

S2- popliteal fossa in the midlineS3- ischial tuberosity

S4-S5- perianal area


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DIAGNOSTIC


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


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DIAGNOSTIC


C incomplete: motor fxn is preserved belowthe neurological level and more than half of

key mm below the neurological level have a

mm grade less than 3D incomplete: motor fxn is preserved below

the neurological level, and atleast half of key

mm below the neurological level have a mmgrade of 3 or more

E normal: motor or sensory fxn is normal


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DIAGNOSTIC


DIAGNOSTIC TOOLS

XRAY

-An x-ray (radiograph) is a noninvasivemedical test that helps physiciansdiagnose and treat medical conditions.

-exposing a part of the body to a smalldose of ionizing radiation to producepictures of the inside of the body.


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DIAGNOSTIC



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DIAGNOSTIC


MYELOGRAPHY

-Myelography is an imaging

examination that shows the passageof 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


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DIAGNOSTIC



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DIAGNOSTIC


CT SCAN

-is also known as CAT scanning(Computed Axial Tomography).

-CT has the unique ability to imagesoft tissues and renders more detail ofbony structures than MRI. It is

frequently performed immediately aftermyelography.

-This combination of imaging studies is

known as CT myelography.


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DIAGNOSTIC



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DIAGNOSTIC


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 andvertebral body, it has become the

imaging modality of choice in the

diagnosing spinal cord injuries.


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DIAGNOSTIC



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DIAGNOSTIC


PREPARED BY ROXANNE C. CARILLA

Sci Revised)

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