With careful manual stabilization of the head and neck, the patient is logrolled onto a side to allow Palpation of the thoracic and lumbar spine Inspection of the back Rectal examination if indicated to check tone (decreased tone indicates possible spinal cord injury), the prostate (a high-riding prostate suggests urethral or pelvic injury), and presence of blood In the US, most patients arriving by ambulance are immobilized on a long, rigid board for ease of transport and to stabilize possible spinal fractures.