Lumbars Flashcards
(19 cards)
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
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
Bragard’s Sign
Positive:
Radiating pain in posterior thigh.
Indicates:
Sciatic radiculopathy
Buckling Sign (Cipriano)
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.
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.
Lasegue’s Test
Positive:
Reproduction of sciatic pain before 60 degrees.
Indicates:
Sciatica
Milgram’s Test
Positive:
Inability to perform test and/or low back pain.
Indicates:
Weak abdominal muscles / Space occupying lesion.
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
Bechterew’s Test
Positive:
Reproduction of radicular pain or inability to perform test correctly due to Tripod Sign.
Indicates:
Sciatic radiculopathy
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.
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 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
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.
Lewin Standing Test
Positive:
Radiating pain down the leg causing flexion of the patient’s knee or knees.
Indicates:
Gluteal, lumbosacral or sacroiliac pathologies
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
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”
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°
