Torticollis - not to miss following points

Torticollis

Look
Anterior  - head position - centre or deviated to one side with rotation
                   decrease head and shoulder distance on one side 
                  facial aymmetry present or not ? 

                  eyes - nystagmus ?
        
                  taut sternocleidomastoid muscle
             
                   chest - muscles wasting present or not ? 


Side -          ear close or touching the shoulder

                   lordosis
        
                    comment on deltoid contour and elbow extended 

Back -
                    b/l shoulder symmetrical 
                    normal hairline 
                    scapula at same level 
                    occiput flat or nomal ? 

Gait / Squatting - Normal or not ? 

Feel - comment of taut sternocleidomastoid muscles, 
           palpate on sternum, clavicle , AC joint, Scapula and Proximal humerus 
           palpate on C-spine 

Movement 
         of Neck 
              Shoulder 
                

Neurology tests 
            Myotome 
            Dermatome 
            Reflexes 

cross adduction thigh
                                spine -humeral
                                reflex - radial
                                clonus
            Romber's Test - to quickly excluder any cord abnormality. 



  Vascular Examination of UE- Pulsation of Brachial , Radial and Ulnar Artery 

  

walking - normal squatting normal , romberg test negative

feel no tenderness

Sensory examination - normal UE




torticollis , hip disorder and club foot are considered a package disorder thatswhy when you find one try to exclude the presence of other during examination (that's the rational for checking squatting ).

C-spine affects all 4 extremities so also check reflexes on lower extremity. Gait and squatting  gives quick screening of motor power on lower extremity. Reflexes are tested separately.

Upper extremity requires a thorough test for sensory motor and reflexes in depth.






Comments

Popular posts from this blog

Outline of Treatment of Spinal Tuberculosis

COXA VARA

Paediatric Supracondylar Humerus Fracture

Hind Foot amputation

Timing and Outcome of Surgery in Hip Fractures