As we work on palpation of the lumbar spine to detect any misalignments, the patient is lying in the front position and lying face down and again in order to assess where the lumbar vertebrae are at again we need to work by way of landmarks. Typically we are going to feel out to the sides to feel the iliac crest or the top of that hip bone and then going towards the middle and that should be the fourth lumbar vertebrae. Then we go down from there, there is number five so five, four, three, two, and one and we also confirm by the ribs here. Then we are basically going to put a little pressure on top of them just to see how that flexibility is. Then we go side to side to see if we have equal motion from the left to the right. Then we are also going to feel the paraspinal muscles to see if they are more tense one side to the other, equally tender, and tender to the touch and then the above and we are just reassessing again how this all feels and that would be the basis for palpitation to assess for misalignment of the lumbar spine.