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By H. S Hall

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How firm? The ligaments in other portions of the body are similar when palpated. 9) We now return to the elbow with our palpating hand, placing the middle finger into a small groove on the dorsal side of the elbow. The thumb comes to rest on the opposite side on the volar side and palpates the radial head. " Again we ask, how hard is it? What does the surface feel like? How does it react to pressure? 10) The index finger and thumb are now moved more proximally until they drop into the joint space.

C2-C7: The palpating finger rests postero-Iaterally above the facets of the two adjoining vertebrae, with the fingertip placed over the joint space. The examiner's opposite hand guides the patient's head and cervical spine, specifically the portion superior to the spinal segment in question, into the direction that is being tested, i. e. rota- 40 Diagnosis in Manual Medicine tion, sidebending, flexion or extension. One palpatorily evaluates the quality of joint movement and the presence of restriction along the various planes of joint movement.

After Bischoff 1988) Fig. 47. Testing of the segmental irritation point by introducing extension to the spine. (After Bischoff 1988) 50 Diagnosis in Manual Medicine L2-L4 Patient and examiner positioning are the same as for L1. The segmental irritation point associated with the lumbar spine can be found directly below the transverse process, approximately one fingerbreadth from the spinous process in the space formed by the row of the spinous processes and the trunk extensor muscles. L5 Patient positioning: prone or astride the examination table.

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