End Lab Flashcards
(21 cards)
L’Hermitte sign
Electric shock like the sensations down the spine and/or through the extremities indicates dural irritation severe spinal cord injury or degeneration
Brudzinski sign
Involuntary knee flexion indicating meningeal irritation or nerve root lesion classic test for meningitis
Jackson compression
One exacerbation of localized cervical pain indicating foraminal encroachment without nerve root pressure or facet pathology or two exacerbation of cervical pain with a radicular component indicating foraminal encroachment with nerve root compression one would then want to evaluate the myotome reflex and dermatome of the nerve root involved
Maximal cervical compression
Pain on the concave side indicating foraminal encroachment with or without nerve root compression based on presence or absence of a radicular component
bakody sign
Decrease or absence of radiating pain indicating cervical foraminal compression nerve root entrapment usually C-5 C6 level because of this motion elevates the suprascapular nerve and relieves traction on the upper brachial plexus
Adam sign
Patient presents with a C or S shaped scoliosis we observe the patient bending forward to touch the toes looking for any change in the scoliosis if the scoliosis goes away then it is a functional scoliosis caused by trauma or subluxation if the scoliosis remains it is evidence of a pathological or structural scoliosis
Schepelmann sign
Pain on the concave side indicates intercostal neuritis we would then evaluate the thoracic dermatomes to the corresponding intercostal spaces well pain on the convex side indicates fibrous inflammation of the pleura with possible intercostal myofasciitis
Beevor sign
Superior movement of the umbilicus is indicative of either a spinal cord lesion at the level of T10 or a nerve root lesion at the level of t 11 - 12 which results in abdominal weakness or there’s going to be inferior movement of the umbilicus which is indicative of nerve root involvement T7 -t10
Roo’s elevated arm stress test. (EAST)
TOS
Ischemic pain heaviness of the arms or numbness and tingling of the hand indicating thoracic outlet syndrome on side involved Evans considers this test to be the most accurate for thoracic outlet syndrome
Adson test
scalenus anticus or cervical rib
Pain and/or paresthesia decreased or absent pulse or pallor indicating compression of the nerovascular bundle by scalenus anticus or cervical rib
Halstead maneuver
scalenus anticus or cervical rib
Pain and/or paresthesia decreased or absent pulse or pallor indicating compression of the nerovascular bundle by scalenus anticus or cervical rib
Costoclavicular maneuver aka Edens
Clavicle and 1st rib
Pain and/or paresthesia decreased or absent pulse or pallor indicating compression of the nerovascular bundle between the clavicle and 1st rib
Hyper abduction maneuver a.k.a. right test
Pectoralis minor and coracoid process
Pain and/or paresthesia decreased or absent pulse or pallor indicating compression of the axillary artery by pectoralis minor or coracoid process thoracic outlet syndrome
Fromet paper sign
The patient is seen to flex the thumb thereby recruiting the median nerve to compensate for apparent weakness indicates ulnar nerve paralysis weakness or palsy of the adductor pollicis muscle
Belt test
There will either be pain during both forward bending motions indicating lumbar involvement or pain during the non-stabilized bending and no pain while the sacrum is stabilized indicating pelvic involvement
Kemp test
Two possible outcomes either there will be pain with a radicular component re-creating existing sciatic pain which indicates a disc protrusion. medial disc protrusion will be positive as the patient is leaning away from the side of pain and a lateral disc protrusion will be positive as the patient is leaning into the side of pain or there will be localized pain indicating lumbar spasm or facet capsulitis
Linder sign (same as brudzinski’s and Soto hall)
Pain along sciatic distribution or sharp diffuse pain in the leg indicating sciatic radiculopathy
Turyn sign (medial plantar nerve)
Pain in the gluteal region or radiating sciatic pain indicating sciatic radiculopathy
Bonnet sign
Pain in the posterior thigh, immediate pain is sciatic neuropathy from piriformis syndrome
Fajersztajn test
Cross over
Well leg
Two possible outcomes either there will be pain down the affected leg which is crossover sign which indicates a medial disc protrusion or there will be decrease in pain down affected leg indicating lateral disc protrusion
Femoral stretch test a.k.a. Femoral nerve traction test
Pain on the anterior portion of the thigh indicating traction of the femoral nerve which is involvement of the second third and fourth lumbar nerve roots femoral nerve entrapment
