Flashcards in Lumbars Deck (19)
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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
