Cervical and Lumbar Exam Flashcards
(26 cards)
Common CCs of cervical region?
- posterior neck pain
- upper trap/shoulder pain
- pain b/t shoulder blades
- weakness
- alt in fine motor control
- numbness: very specific or very generalized
What should you observe with your pt presenting w/ cervical complaint?
always pay attention to pt’s movements and actions:
- general appearance
- abnormal pain behaviors
- mood and affect
- gait
Inspection part of exam for cervical complaint?
- skin
- posture
Palpation part of exam for cervical complaint?
- cervical pt tenderness
- muscle spasms
- lymphadenopathy
ROM testing for cervical complaint?
- flexion: 80-90
- extension: 70
- lateral bending: 20-45
- rotation: 70-90
Sensory testing in cervical region (dermatomes)?
- C5: lateral upper arm
- C6: lateral forearm
- C7: middle finger
- C8: ulnar border of hand
- T1: medial upper arm
Testing muscle strength in cervical dermatome?
- deltoids (C5): abduction of shoulder
- biceps (C5, C6): elbow extension
- wrist extension (C6, C7)
- wrist flexors (C7)
- triceps (C7): elbow etension
- finger extension (C7)
- finger flexion (C8)
- intrinsics (T1)
Special tests for Cervical region?
axial loading
foraminal compression test (spurlings):
- + if pain radiates to arm toward which head is side flexed, sig: cervical root compression
What does a + hoffman’s reflex mean?
- presence of upper motor neuron lesion from spinal cord compression
Cervical reflexes tested?
- biceps: C5
- triceps: C7
- brachioradialis: C6
Common CCs of lumbar region?
- back pain (gen horseshoe pattern)
- buttock pain
- leg pain
- weakness
- numbness/tingling
Observation part of lumbar exam?
- always pay attention to pt’s movements and actions
- general appearance
- abnormal pain behaviors
- mood and affect
Inspection part of lumbar exam?
- skin
- muscle spasms
- posture
- look for lordosis, scoliosis
Palpation part of lumbar exam?
- pt tenderness
- trochanteric tenderness
- SI jt pain
ROM testing part of lumbar exam?
- flexion: 40-60
- extension: 20-35
- lateral bending: 15-20
- rotation
Gait testing for lumbar exam?
- tip toe walking
- heel walking
- tandem gait
Sensory testing - lumbar exam?
- L1: groin
- L2: midanterolateral thigh
- L3: distal anteromedial thigh
- L4: medial ankle
- L5: dorsum of foot
- S1: lateral border of foot
Dermatomes for muscle strength of lumbar spine?
- hip flexors: L1, 2, 3
- hip adductors: L2, 3, 4
- quads: 2, 3, 4
- ankle inversion: L4, 5
- EHL, toe extensors L5
- ankle eversion L5, S1, 2
- ankle plantar flexion L5, S1, 2
L4 MRS?
- M: tibialis anterior-ankle dorsiflexion
- R: patella tendon
- S: medial aspect of foot
L5 MRS?
- M: extensor hallucis longus: great toe extension
- S: dorsum of foot
S1 MRS?
- M: peroneus longus and brevis ankle eversion
- R: achilles tendon
- S: lateral aspect of foot
Special tests for lumbar spine?
- babinski
- ankle clonus
- positive reflects presence of upper motor neuron lesion from spinal cord compression
What is supine SLR testing?
- if pain is reproduced around 40 degrees of hip flexion or less, the test is +, pain exacerbated by adding ankle dorsiflexion while leg is raised
What is the femoral nerve stretch test?
- pt lies prone w/ knee passively flexed to the thigh
- positive test = anterior thigh pain
