low back check

The low back examination is a comprehensive examination of the lower back and back for the diagnosis and timely treatment of lumbar disease. Basic Information Specialist classification: growth and development check classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Tips: Lumbar vertebrae flexion movement can reach 80 ~ 90 °. Normal value First, look at the diagnosis Observe the skin color of the back and back without abscess and sinus. From the side, the lumbar vertebral curvature is normal. From the back, the lumbar spinous process is located in the midline. Second, exercise check: waist movement has flexion, extension, side bend, and rotation. 1. Flexion exercise: The patient takes a standing position and bends forward, and the lumbar spine flexion movement can reach 80-90°. 2, extension movement: does not affect the waist extension movement. 3, side bending exercise: does not affect the lumbar motion. 4, rotational movement: two sides for comparison without lumbar soft tissue injury or lumbar transverse process fractures and other injuries without lumbar dyskinesia. Third, palpation 1. Bone palpation: The patient stands during the examination, and the lumbar spine processes are palpated one by one without tenderness, deformity and mass. 2, soft tissue palpation: Palpation on the lumbar spine line is not tender. When palpating the sacral spine, pay attention to the shape of the muscle during palpation, without tenderness, cramps or atrophy. Symmetrical muscles on both sides, no local mass. When examining the muscles of the anterior abdominal wall, the paralyzed patient was supine, the knees were flexed, and the muscle tension of the palpation was changed. There was no lumbar abscess when examining the inguinal region. Fourth, special inspection: 1. Straight leg raising test. No radiation pain and elevation of the lower extremities were limited during the elevation of either leg. 2. The lumbosacral region is not in a passive flexion state. 3, picking test: This test is mainly used to check the pediatric spine flexion function is barrier-free. First take an object on the ground, let the child pick up, pay attention to observe the posture of its pickup. Such as erect bending and picking up things as normal. 4, prone back extension test: This test is used to check infantile spinal lesions. If the feet are raised, the spine is not straight and the thighs, pelvis and abdominal wall do not leave the bed. Clinical significance Abnormal result First, look at the diagnosis Observe the color of the skin on the lower back and pay attention to the presence or absence of abscess and sinus. From the side, whether the lumbar vertebral curvature is normal, from the back, whether the lumbar spinous process is located in the midline. Second, exercise check The waist movement has four types: flexion, extension, side bending and rotation. 1. Flexion exercise: The patient takes a standing position and bends forward, and the lumbar spine flexion movement can reach 80-90°. 2, extension exercise: common diseases affecting the extension of the waist are lumbar spondylolisthesis, lumbar tuberculosis, ankylosing spondylitis. 3, lateral bending exercise: common diseases affecting lumbar scoliosis are lumbar transverse process fractures, soft tissue injury of the lower back. 4, rotary motion: two sides for comparison. If there is injury to the soft tissue of the waist or the fracture of the lumbar vertebrae, there may be a rotational dyskinesia of the waist. Third, palpation 1. Bone palpation: When the patient is standing during the examination, the palpation of the lumbar spine is palpated one by one for tenderness and deformity. When the front of the vertebrae is examined, the patient is supine, the knees are flexed, and the abdominal muscles are loosened. The doctor puts the hand under the umbilicus and gently presses down, palpating the front of the 5th lumbar vertebrae and the 1st vertebral body. No tenderness and lumps. 2, soft tissue palpation: treatment of lumbar spine line palpation, such as spine ligament or interspinous ligament laceration, tenderness when palpation. When palpating the sacral spine, pay attention to the shape of the muscle during palpation, and whether it is tender, sputum or atrophy. Whether the muscles on both sides are symmetrical, whether there is a mass in the area. When examining the muscles of the anterior abdominal wall, the paralyzed patient is supine, the knees are flexed, and the abdominal muscle tension is palpated. Check for lumbosacral abscess when examining the groin area. Fourth, special inspection 1. Straight leg raising test: When the lower extremity radiation pain and the elevation range are limited during the raising of any side leg, the straight leg raising test is positive, suggesting lumbar disc herniation, piriformis syndrome, Lesions in the spinal canal and other diseases. 2, the lumbosacral part of the passive flexion state: such as lumbosacral pain, this test is positive. It indicates that the lumbosacral ligament is damaged or the lumbosacral joint has lesion 3, picking test: This test is mainly used to check the pediatric spine flexion function is barrier-free. First take an object on the ground, let the child pick up, pay attention to observe the posture of its pickup. Such as erect bending and picking up things as normal. When the spine has lesions and the waist cannot be flexed, the child bends his hips, bends his knees, straightens his waist, holds the knees in one hand, and picks up the other hand. This is positive for the pickup test. 4, prone back extension test: This test is used to check infantile spinal lesions. When the feet are lifted, the spine is in a straight state, and the thigh, pelvis and abdominal wall leave the bed at the same time, which is positive for the prone extension test. People who need to be examined: young children, people with abnormal pain in the waist and abdomen. Precautions No abscess and sinus. The lumbar spine flexion movement can reach 80-90°, the lumbar spine can reach 30° normally, the lumbar scoliosis can reach 20-30°, and the range of motion can reach 30°. The palpation of the lumbar spine is not tender, deformed, no tenderness and lumps. The straight leg raising test was negative. The supine knee flexion and hip flexion test was negative. The pickup test was negative. The prone back extension test was negative. Inspection process The patient takes the standing position, bends it forward, stretches the waist, tries to bend sideways to one side, rotates the torso to one side and then returns to the original position, then rotates the torso to the other side. The patient is lying on his back and flexing his knees to relax the abdominal muscles. The doctor puts his hand under the navel and gently presses down and palpates. 1. Straight leg raising test patient supine position, double lower limbs straight and close together. The paralyzed patient first straightens one side of the lower limb to the maximum, then puts it back to the examination bed surface, and then checks the other side of the lower limb, and compares the two sides. 2, supine knee flexion and hip test patients supine position, legs close together, squatting as far as possible to bend the hips, knees. The doctor presses the patient's knees with both hands, so that the thighs are as close as possible to the abdominal wall, and the lumbosacral region is in a passively flexed state. 3, picking test This test is mainly used to check the pediatric spine flexion function is barrier-free. First take an object on the ground, let the child pick up, pay attention to observe the posture of its pickup. Such as erect bending and picking up things as normal. 4, prone back extension test This test is used to check infantile spinal lesions. The child was in a prone position and the doctor lifted his feet. Not suitable for the crowd Generally no taboos. Adverse reactions and risks Generally not.