Lower Quadrant Flashcards
(29 cards)
Initial Observation
observe in waiting room, sitting position, sit > stand, facial expression, ADL, Gait
Postural Exam
head position, shoulder height, spinal alignment, iliac crests, leg length, foot posture, lateral shift?
Quick Tests
full squat (w/ feet flat), heel raise (B/L and U/L, PF + S1), stand on heels (DF= L4-5), gait, balance, SLS (neutral? glut med? lateral shift?), Romberg (Stand feet together, eyes closed, + is swaying)
AROM of L/S
Check for: willingness to move, excursion, quality of motion in forward bending, backward bending, side bending, rotation… if AROM is painfree, apply overpressure
Gour’s Sign: uses hands to return to upright from forward bending, (+) for instability
More AROM if cardinal movements painfree
- Ext, SB, Rot (ipsilateral hand to back of thigh, would irritate ipsilateral facet)
- Flexion, SB, Rot (contralateral hand to front of thigh, would irritate contralateral facet)
Outcome Measures
McGill Pain Scale (very long), FABQ (lower score associated with increased return to work), Owestry (0-10)
Special Questions
type of mattress, sleep position, effect of prolonged sitting, effect of coughing, sneezing, valsalva, effect of sit > stand, strength, motor control
General Q’s re: health
general health, bladder retention/ incontinence, groin numbness, unexpected weight loss, night sweats, unrelenting night pain, PMH of CA, if fluct w/ meals, refer to GI, Meds, Imaging, fatigue
Deep Tendon Reflexes
Paella Tendon (L4), Achilles(S1), 0- albsent, 4+ hyperreflexive
UMN Testing
Babinski and clonus
Hip, knee, ankle Screen
A/PROM, Resistance, Palpate piriformis, FADDIR, FABER, ASLR with compression
Slump Test
Long sitting: Flex spine, flex neck, extend knee, DF ankle; if shooting pain (+), if neural tension releases with cervical extension (+),
pSLR, Lasegues’ test
passive SLR up to 70 (+) pain for disc herniation, inc with C/S flexion
Femoral nerve stretch, prone knee bend
same test, fem nerve can also be done S/Ling, (+) for upper lumbar herniation or neural adhesions
compression of trunk
supine, knees to chest, apply superior force to ITs with forearm
distraction of trunk
hook-lying, wrap arms around distal femur & WS back
Tests to increase intrathecal pressure
Milgram (B/L SLR), Nafziger (palpate jugular and compress), Valsalva
SIJ Tests for CPR: Anterior gapping
heel of palms on medial aspect ofC/L ASISs, apply lateral force pushing ASISs away
SIJ Tests for CPR: Posterior distraction
press ASISs in towards one another with medial force, or S/Ling, apply inferior force
SIJ Tests for CPR: Gaenslen’s Test
Pt is supine, bring one knee to chest, other knee and SI off the table, press bottom LE inferiornly and innominate bone should rotate
SIJ Tests for CPR: Compression/ SPring Test
Pt prone, hand on sacru, arm perpendicular, give it an inferior force
SIJ Tests for CPR: Thrust Test
Thomas position, hold distal femur and give inferior force, other hand on SI feel for movement
Correlation of nerves on ant thigh
Anterior femoral cutaneous nerve with L2
Correlation of nerves on lateral superior thigh
L1 and lateral cutaneous femoral nerve
