Physical Exam at Comprehensive Spine Center of Dallas

Video Transcription

So, this would be what we call the objective or physical exam portion of being treated. And so, every patient, we would have them stand on their toes and stand on their heels, and then do a tandem gate walk, which is a heel toe kind of walk, for balance, and then the patient I’d have stand normal. And so, from the general physical exam, I’d look in someone’s mouth, let me see inside your mouth. you’re looking for any abnormalities in the mouth. We check the chest area for any kind of abnormality. And the belly area for rigidity, softness, but also check your pulse, look at any swelling problems with the skin in your hands and fingers. And that would be a kind of general exam with a patient.

We also go through a range of motion. If we’re talking about the neck, which would be chin down, looking for any restriction. Chin up to the ceiling, right and left rotation, and then side bending. And so, in this, we’re looking for any kind of restriction that the patient may have. And then we do what we call palpation, we’re going to touch the area, touch the skin. We can feel changes in the soft tissue tightness, a pain response, so that’s going to feel a triggering response into the tissue in the area that’s been injured. We’ll do a muscle strength exam where we’ll check the different muscle groups of the upper extremities, with wrist extension and wrist flexion. All of this is in accordance to specific nerves. And then pull arms to the ceiling, push arms to the floor. Abduction or arms extended. We ask If there’s any sensation, any decrease in sensation in the dermatomes, which go to specific nerve groups. Long track sign is a specific exam looking for tightness in the spinal cord. And we’ll do reflexes, which would be looking at the different nerves. Typically, I’d have a hammer, but we check reflexes.

We’ll do similar for the lower lumbar area. We have specific exams for shoulders for knees for ankles and elbows, which we can go into later. So typically, you have a general exam looking at the head, the overall demeanor of a patient looking in their mouth, their chest, their belly, their pulse, their skin, and any kind of swelling and then we’ll focus in. In this case we focused in on the cervical neck area and the nerves that are affecting or are connected to the cervical area by checking, muscle strength, sensation, reflexes, and what we call long track signs, which help determine if there is any pathology to the central spinal cord. And that is what you would kind of expect from a physical exam. From there we would discuss again, imaging an MRI, which we would review, to connect what we are finding from the subjective, the history of a patient, the facts, the physical exam, and then talking about using imaging, such as x-rays, MRI, EMG which is a nerve study. Then we will try to devise a treatment plan based on all of that based upon what we synthesized or grouped together.