Lumbars Flashcards Preview

Ortho Lab > Lumbars > Flashcards

Flashcards in Lumbars Deck (19)
Loading flashcards...
1

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 paralyzed leg

2

Straight Leg Raiser (SLR)

Positive:
Radiating pain and/or dull posterior thigh pain.
Indicates:
Sciatic radiculopathy or tight hamstrings.
Positive between 35 ~ 70 degrees = possible discogenic sciatic radiculopathy and positive >70 degrees = tight hamstrings

3

Bragard’s Sign

Positive:
Radiating pain in posterior thigh.
Indicates:
Sciatic radiculopathy

4

Buckling Sign (Cipriano)

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

5

Bowstring Sign

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

6

Goldthwait’s Sign

Positive:
Localized pain, low back or radiating pain down the leg.
Indicates:
Lumbo-sacral or sacroiliac pathology.

Pain occurring after the lumbar spinouses move indicates possible lumbo-sacral problem.

Pain occurring before the lumbars move indicates possible sacroiliac problem.

7

Lasegue’s Test

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

8

Milgram’s Test

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

9

Valsalva maneuver

Positive:
Radiating pain from site of lesion, usually recreating the complaint in the cervical or lumbar area of the spine.
Indicates:
Space occupying lesion

10

Bechterew's Test

Positive:
Reproduction of radicular pain or inability to perform test correctly due to Tripod Sign.
Indicates:
Sciatic radiculopathy

11

Anterior Innominate Test a.k.a. Mazion’s Pelvic Maneuver, Advancement Sign

Positive:
The inability to bend at the waist for more than 45 degrees, because of either/or
(1) Radiating pain along sciatic nerve, either unilateral or bilateral.
(2) Low back pain in the lumbar or pelvic regions.
Indicates:
(1) Sciatic neuralgia or radiculopathy, possibly due to lumbar disc pathology.
(2) Anterior rotational displacement of the ilium in relation to the sacrum.

12

Heel Walk

Positive:
Inability to perform test.
Indicates:
L4-L5 disc lesion, L5 nerve root

13

Toe Walk

Positive:
Inability to perform test.
Indicates:
L5-S1 disc lesion, S1 nerve root.

14

Ely Heel to Butock Test
a.k.a
Ely Sign

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 adhesion

15

Neri Bowing Test

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

Indicates:
Variety of low back pathologies. Hamstring tension on the pelvis may trigger the response.

16

Lewin Standing Test

Positive:
Radiating pain down the leg causing flexion of the patient’s knee or knees.

Indicates:
Gluteal, lumbosacral or sacroiliac pathologies

17

Lumbar Spine
Bony Palpation

1) Lumbar spinous processes
2) Sacral tubercles – “Skin on skin 2nd tubercle and below on top of shorts”
3) Iliac crest
4) PSIS

18

Lumbar Spine
Soft Palpation

1) Paraspinaal muscles (palpate as a unit) superfical layer
• Spinalis
• Longissimus
• Iliocostalis
2) Sciatic Nerve
3) Gluteus Maximus
4) Gluteus Medius
5) Hamstrings
• Biceps femoris
• Semitendinosus
• Semimembranosus
6) Anterior abdominal muscles – “Do Abb’s first”

19

Lumbar Spine
Ranges of Motion

Active and Passive
1) Flexion 25°
2) Extension 30°
3) Left lateral bending 25°
4) Right lateral bending 25°
5) Left rotation 30°
6) Right rotation 30°