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Ortho Dx > Lumbar > Flashcards

Flashcards in Lumbar Deck (19):
1

Lumbar Bony Palpation

Spinous Processes (count them out)
Sacral Tubercles (count them out)
Iliac Crests
PSIS

2

Soft tissue Lumbar

Paraspinals (palpate as a unit & individual) = Spinalis, Longissimus, Iliocostalis
Sciatic Nerve
Gluteus Maximus
Gluteus Medius
Hamstrings = biceps femoris, semitendinosus, semimembranosus
Anterior abd muscles

3

ROM lumbar

Flexion = 25
Extension = 30
Lateral bending = 25
Rotation = 30

4

Hoover Sign

*used to differentiate organic versus hysterical leg paralysis.

+ : Lack of counter-pressure on the healthy side
Indicates: Lack of organic basis for paralysis (malingering/hysteria). With organic hemiplegia, the patient will still exert downward pressure when attempting to raise paralyzed leg.

5

Straight leg raiser SLR

Positive: radiating pain and or dull posterior thigh pain
Indicates: sciatic radiculopathy or tight hamstrings. Positive between 35–70° = possible discogenic sciatic radiculopathy greater than 70° = tight hamstrings.

6

Goldthwait Sign

Positive: localized pain in the low back or radiating pain down the leg

Indicates: lumbosacral or sacral iliac pathology. Pain occurring after the lumbar spine has moved indicates possible lumbo-sacral problem. Pain occurring before the lumbar has moved indicates possible sacral iliac problem.

7

Bragard Sign

Positive: radiating pain in the posterior thigh.

Indicates: sciatic radiculopathy.

8

Buckling sign

Positive: pain in the posterior thigh with sudden knee flexion (buckle).

Indicates: sciatic radiculopathy

9

Bowstring sign

Positive: pain in the lumbar region or radiculopathy

Indicates: sciatic nerve root compression, helps rule out tight hamstring.

10

Lasegue Test

Positive: reproduction of sciatic pain before 60°.

Indicates: sciatica

11

Milgram Test

Positive: inability to perform test and/or low back pain.

Indicates: weak abdominal muscles or space occupying lesion.

12

Valsalva Maneuver

Positive: radiating pain from site of lesion [usually re-creating the complaint and cervical or lumbar area of the spine].

Indicates: space occupying lesion e.g. disc pathology

13

Bechterew Test

Positive: reproduction of radicular pain or inability to perform correctly due to tripod sign.

Indicates: sciatic radiculopathy.

14

Neri Bowing Test

Positive: pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side.

Indicates: positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response.

15

Anterior Inominate Test aka Mazion Pelvic Maneuver (advancement sign)

Positive: the inability to bend at the waist more than 45°, because of either/or
1. Radiating pain along the sciatic nerve, either unilateral or bilateral.
2. Low back pain [lumbar or pelvic regions]

Indicates:
1. Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology.
2. Anterior [rotational] displacement of the ilium relative to the sacrum.

16

Lewin Standing Sign

Positive: radiating pain down the leg causing flexion of the patient's knee or knees.

Indicates: gluteal, lumbosacral or sacroiliac pathology

17

Heel Walk

Positive: inability to perform test.

Indicates: L4 – L5 disc lesion [L5 nerve root].

18

Toe walk

Positive: inability to perform test

Indicates: L5 – S1 disc lesion [S1 nerve root]

19

Ely Heel to Buttock Test

Positive: 1. Inability to raise the thigh.
2. Pain in the anterior thigh.
3. Pain in the lumbar region.

Indicates: 1. Iliopsoas spasm.
2. Inflammation of lumbar nerve roots.
3. Lumbar nerve root adhesions.