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Flashcards in Lumbar Spine Deck (18):

Bony Palpation

Lumbar spinous processes, sacral tubercles, iliac crest, PSIS


Soft Tissue Palpation

Paraspinal muscles(palpate as a unit) superficial layer: Spinalis, Longissimus, Iliocostalis, Sciatic Nerve, Gluteus Maximus, Gluteus Medius, Hamstrings: Biceps femoris, semitendinosus, semimembranosus, and anterior abdominal muscles.


Hoover Sign

Positive: 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 the paralyzed leg.


Straight Leg Raiser

Positive: Radiating pain and/or dull posterior thigh pain.
Indicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70 degrees indicates possible discogenic sciatic radiculopathy. Greater than 70 degrees indicates tight hamstrings.


Goldwait Sign

Positive: Localized pain, low back or radiating pain down the leg.
Indicates: Lumbo-sacral or sacroiliac pathology. Pain occuring before the lumbar spinouses move indicates possible sacroiliac problem. Pain occurring after the lumbar spinouses move indicates possible lumbo-sacral problem.


Bragard Sign

SLR on patient. Examiner lowers the raised leg (5 degrees) from the point of pain and sharply dorsiflexes patient's foot.
Positive: Radiating pain in posterior thigh.
Indicates: Sciatic radiculopathy


Buckling Sign

Positive: Pain in the posterior thigh with sudden knee flexion (buckle).
Indicates: Sciatic radiculopathy.


Bowstring Sign

Positive: Pain in the lumbar region or radiculopathy.
Indicates: Sciatic nerve root compression, helps rule out tight hamstrings.


Lasegue Test

Positive: Reproduction of sciatic pain before 60 degrees
Indicates: Sciatica


Milgram Test

Positive: Inability to perform test and/or low back pain.
Indicates: Weak abdominal muscles or a space occupying lesion.


Valsalva Maneuver

Positive: Radiating pain from the site of lesion (usually recreating the complaint in the cervical or lumbar area of the spine).
Indicates: Space occupying lesion (e.g. disc pathology)


Bechterew Test

Positive: Reproduction of radicular pain or inability to perform the test due to tripod sign.
Indicates: Sciatic Radiculopathy


Neri Bowing Test(Neri Sign)

Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side.
Indicates: Positive for a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response..


Anterior Innominate Test a.k.a Mazion Pelvic Maneuver a.k.a Advancement Sign

Positive: Radiating pain along the sciatic nerve, either unilateral or bilateral.
Indicates: Sciatic neuralgia, or radiculopathy, etc. possibly due to lumbar disc pathology.
Positive: low back pain (lumbar or pelvic regions)
Indicates: anterior (rotational) displacement of the ilium relative to the sacrum.


Lewin Standing Test

Positive: Radiating pain down the leg causing flexion of the patient's knee or knees.
Indicates: Gluteal, lumbosacral or sacroiliac pathologies


Heel Walk

Positive: Inability to perform test
Indicates: L4-L5 disc lesion (L5 nerve root)


Toe Walk

Positive: Inability to perform test
Indicates: L5-S1 disc lesion (S1 nerve root)


Ely Heel to Buttock Test

Positive: Inability to raise thigh
Indicates: Iliopsoas spasm
Positive: pain in the anterior thigh
Indicates: inflammation of lumbar nerve roots.
Positive: pain in the lumbar region
Indicates: Lumber nerve root adhesions