the

LUMBAR SPINE PALPATION

okay so for a lumber spine and palpation

anteriorly we're just going to check

first of all for the symphysis pubis so

for this and we would come with a karate

chop hand and go for the hyper cleaner

eminence and basically palpate downwards

towards the and symphysis pubis

obviously with female patients you do

this really to ensure and comfort of the

patient and also dignity and making sure

you talk to the patient before you do

this about what you're going to do and

the reason why you're doing it and then

we also go across and palpate the ASIS

which is basically the anterior superior

iliac spine which is at the only point

that you complete at the front and then

we were going to palpate between the

symphysis pubis and the ASIS which is

your inquire area between which you're

going to check for hernias or the lymph

nodes being swollen in infection type

conditions then you can come up up and

across and actually from the ASIS follow

the EF crest so idiot criss cross and

looking for things like input hip

pointers or apophysitis so just

generally checking through the the idiot

crest and we'll set of soft tissues

surrounding that and then from there

we're going to come onto the front or

into a prone position and we're going to

look at the lumber spine palpation in

pro so posterior in the lumbar spine

we're going to orientate ourselves first

of all by coming to the iliac crest and

then if we come across to the spine and

the lung spine will be at the level of

l45 vertebra then what we can do is

palpate that vertebra and we can go down

to l5 s1 in a lot of patient or some

patients and if they're caught

instability or responded I thesis you

will feel a dip in this area rule or

step off science but just being people

to look after this and then we can

palpate upwards from the l4 five spinous

process and just check the spinous

process is up from l5 to our one

two to three centimeters laterally to

the lumbar spine so if we come back to

our four five again go two to three

centimeters lateral we will find the

facet joints and the muscles overlying

needs so again similarly to the spinous

processes we can go to the facets and

then we've superiorly from l4 5 and 12 3

4 L 3 2 and L 2 1 then if we come back

down again and when we take ourselves on

to L 4 5 and then we go on to the l5 s1

and then we go centrally we can go on to

the sacrum so we can pop a the sacrum

and if we move distal sense relief on

the sacrum we can come onto the sacral

hiatus which is essentially where the

sacrum drops off we come back up to the

sacrum again and if we go from cross

onto the PSIs so if we come across onto

the PSI so posterior superior iliac

spine and then we come across to the

sacrum that would be level with s 2 2 s

2 is level with that psi s then if we

come across again onto the iliac crests

we can come posteriorly or inferior

rather onto the wedge cancer so if we

come down we can reach that dread great

trochanter which is a bony point in the

lateral aspect of the hip and then if we

go to the PSIs on the same side we can

then palpate between the two points to

palpate glutes but also an sciatic nerve

is found midway between the issue of

curiosity and the British panther so we

can also from here if we go to our

greater but if we go to our ischial

tuberosity sorry which is the bony point

on the inferior aspect of the gluteal

line so it comes between ischial

tuberosity and the great granter is a

sighting nerve midway between those two

points

you