Lumbar Tests Flashcards Preview

Spinal Tx 600 > Lumbar Tests > Flashcards

Flashcards in Lumbar Tests Deck (22):
1

Segmental Instability Test

Check for spondylolisthesis, segmental instability in joint

Prone on table, feet on floor
Pressure applied to lumbar spine

Positive if pain reproduced while relaxes, but disappears when legs lifted of floor.

2

Valsalva testi

Tests for intrathecal pressure (usually due to space-occupying lesion. -- tumour, herniated disc, osteophyte).

Possible sciatic nerve involvement.

Sit down. Bear down.

Positive if pain reproduced.

3

Quadrant Test

Standing

Patient extends spine, laterally flexes, and rotates toward pain. Apply over pressure into shoulders.

Positive: reproduces pain

[narrowing foramen, stress facet joint]

4

Dural Slump Test

Tests for tension in neuromeningeal tract.

Sit up, hands behind back
Slump with chin in neutral
Apply over pressure to shoulders
Flex neck
over pressure to cervical, thoracic and lumbar spine
Knee extension (possibly passive)
Dorsiflexion (passive)
Hold with max knee extension
Overpressure to c-spine


Positive if symptoms REproduced (not just produced), if knee extension increases or symptoms decrease with neck extension.

5

Neural tissue tends to adhere more at what points?

C6 T6 L4 Knee

6

Straight Leg Raising Test

AKA Lasegue's test

Tests for disc herniation, PN involvement, disc

Passive test
Unilateral. Unaffected side first.

Supine. Hip medially rotated, adducted, knee extended.
Passive flexion of hip until patient complains of back or hamstring
Lower leg until symptoms disappear.
Passive dorsiflexion
Can flex neck to make more provocative

7

SLR: at what point in hip flexion is the sciatic nerve tensioned

35°

8

SLR: 35-70°

Sciatic nerve tense over IVD

Range of deformation decreases as angle increases

9

SLR 70°+

No further deformation of nerve root. Pain is probably joint pain.

10

Unilateral SLR: sequence of tension

Greater sciatic foramen
Ala of sacrum
Where nerve crosses pedicle
Intervertebral foramen

11

SLR: nerves tractioned

Sciatic
Lumbosacral nerve roots
Dura mater

L5-S2 nerve roots

12

SLR: pain in back

Disc herniation
Likely smaller and more central if back pain only

13

SLR: pain in posterior leg

Periphery nerve involvement

14

SLR: pain in back and posterior leg

Disc herniation and peripheral nerve

15

SLR: increase in pain

Dura mater or spinal cord involvement

16

Lasegue's sign

Pain when unaffected leg tested.
Large disc protrusion medial to nerve root
Bladder/bowel symptoms

17

SLR: tibial nerve bias

Foot eversion
Toe extension

18

SLR: sural nerve bias

Foot inversion

19

SLR: common fibularis bias

Plantarflexion
Foot inversion

20

Bilateral SLR

Pelvis not stabilized, rotates more on flexion,decreasing stress

Pain before 70°: SI joint

Pain after 70°: lumbar spine lesion

21

Bowstring sign

After positive SLR
Tests for pressure on sciatic nerve

Knee slightly flexed (20°)
Ankle resting on shoulder

Apply pressure to popliteal area

Positive if radicular symptoms reproduced.

22

Prone knee bending

Passive

Prone. Heel to buttocks

Pain in quad: rectus femoris

Pain in lumbar spine (especially radicular symptoms): lumbar spine issue -- likely L3

IL ASIS rotates forward before 90° flexion: SI joint hypomobility