EXAMINATION of BACK & SPINE

Week 2 – MSK – Clinical Skills 5701

Name of Student ______________________________ Date Completed: 9/20/2022
Setting the stage of the encounter
1. Greetings and introduction (introduces self with the name and as a medical student)
2. Disinfects hands prior to shaking hands with patient
3. Verifies identifying data & determines how the patient wishes to be addressed, asks about the preferred pronoun.
4. Ensures the patients’ privacy and comfort
5. Sets the agenda (explains what will happen during the encounter
6. Asks permission to proceed

Examination of the back & spine

1. Inspection:
Inspect the anterior, posterior, and sides of the patient. [Observe posture while standing – feet together and arms at sides. Note
symmetry or abnormal position of the head, neck, or shoulders. Identify sternocleidomastoid muscles. Identify spinous processes,
paravertebral muscles, iliac crests, and posterior superior iliac spines. Note, from the side, the cervical, thoracic, and lumbar curves.
Note the presence of muscle wasting or abnormal hair growth.]

2. Palpate the spinous processes of each vertebra of the spinal column including in the cervical spine.

3. Palpate the facet joints that lie between the vertebrate of the neck.

4. Palpate the trapezius muscles.

5. Palpate the muscles between the scapulae.

6. Palpate the paravertebral muscles.

7. Palpate the sacroiliac joint.

8. “Percuss” the spine by gently tapping with the ulnar surface of the fist.
9. Check neck range of motion. [Have patient touch chin to chest, tilt head back, turn chin to right and left shoulders, and bend head laterally to
right and left shoulders.]
10. Check spine range of motion. [Support and help the patient during these maneuvers as appropriate. Have patient flex forward and extend
backwards. Have the patient rotate the trunk with the feet planted firmly on the floor. Have the patient bend laterally to the right and left.]
11. Perform the straight leg raise test to assess for pain arising from the sciatic nerve (lumbar radiculopathy).
CLOSING THE ENCOUNTER

1. Asked the patient “Does he/she has any questions? Concerns?”

2. Informs about what happens next
2. Demonstrated attentiveness via non- verbal body language
3. Used appropriate language and avoided medical jargon
4. Demonstrated professional behavior
 EXAMINATION of BACK & SPINE
Week 2 – MSK – Clinical Skills 5701

Narrative Feedback (Comment on the overall performance – communication skills, examination skills, technique)

Name of Faculty _______________________