Transverse Palpation with Patient Sitting
Palpation of Cervical transverses in position A has been described and is frequently done. Palpation of Dorsal or Lumbar transverses in the same position may sometimes be desirable. It can be done with the same movement as spinous process palpation, and may serve to detect a bent spinous process.
If it is necessary to palpate both transverses at the same time, stand in front of the patient and lean over his shoulder, letting his shoulders rest against your body. Use palmar surface of fingers of both hands and note which transverse is posterior to its fellow, if either, or whether both are posterior to the line of the others above and below them.
It is rarely possible to find if a transverse process be superior or inferior to its normal position, except the Atlas transverses, although this may occasionally be detected. Fortunately this is a rare form of subluxation, or appears rare, although it must be said that this apparent rarity may be due to our comparative inability to detect it in the living subject.
For convenience, _curve_ is used to denote the normal curvilinear deviation from a straight line naturally present in the normal spine or naturally assumed in response to the need for equilibrium during the erect position of the body: _Curvature_ means either the abnormal increase of any normal curve or the appearance of any abnormal curvilinear deviation of vertebrae from their normal position. Deviations from normal must contain at least three vertebrae to be considered curvatures.
The general inspection of the spine which precedes the count should bring to light, in addition to prominent subluxations, and general symptoms observable by inspection of the back, any _marked curvatures_. Their general locality and direction will be noted by this observation and their details left to be discovered by closer examination.
During palpation with a long and rapid glide one may also note these general points with respect to any curvature.
Do not mistake the four normal curves, the anterior Cervical and Lumbar and the posterior Dorsal and Sacral, for curvatures. The normal Lumbar curve is so unusual in practice that a novice has been known to name it a lordosis.