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Lumbar orthopedic tests
Terms in this set (25)
The patient is prone. Flex the knee and bring the foot to the same buttock.
pain is produced in the SI or LS area or if pain radiates down the thigh or leg. Remember to note where the pain is produced when performing orthopedic tests as this directs you to the irritated or injured structure. What would the above findings indicates as the cause of the positive test?
SI or LS lesion or inflammation of the upper lumbar nerve roots with radiation
The supine patient flexes and holds their unaffected leg toward their abdomen. The lumbar spine should flatten and the opposite leg should remain flat on the table.
shortened iliopsoas muscle
The patient is supine. The doctor flexes the knee and thigh of the unaffected leg to the patient's abdomen while hyperextending the affected thigh off the edge of the table.
SI pathology or upper lumbar nerve root compression
Approximate the heel to the opposite buttock in the prone patient.
With a hip lesion or psoas irritation the prone patient will be unable to do this test normally. This test aggravates inflammation of the lumbar nerve roots and will cause femoral radicular pain to the anterior thigh. It will also stretch lumbar nerve root adhesions causing upper lumbar discomfort.
Femoral Nerve or radicular inflamation
support pelvis with hip and ask pt to flex. Release and ask patient to flex again.
If pain is present in both instances the pain is spinal in origin, if pain is only present unsupported it is pelvic in origin.
The patient is prone. The doctor flexes the knee fully and pushes the leg laterally causing internal rotation of the femoral head.
The patient is prone. The affected SI joint is stabilized and this knee is flexed to 90 degrees. The thigh is then hyperextended.
SI lesion; anterior SI ligaments
Patrick's Test FABERE Sign
The patient is supine. The doctor flexes the hip, abucts the thigh, crosses the ankle over the contralateral knee and externally rotates the hip. The hip is then extended by applying downward pressure on the knee.
coxa pathologic condition
Smith Peterson Test
The doctor palpates the L5-S1 spinous processes while performing a SLR on the affected leg.
Determination of Sacral or Lumbar origin
Well Leg Raise Test/ Fajersztahn's test
A SLR and then Bragard's test are performed on the unaffected leg.
If this causes pain on the symptomatic side then the test is positive.
Herniated disc is medial to the nerve root and is now compressing the nerve on the symptomatic leg
Otherwise known as "Patrick FABERE in the air". Patient is supine. The doctor flexes and abducts the affected hip and the patient's foot lies on the examiners forearm. Dr. laterally rotates hip applying overpressure at end of ROM while stabilizing contralateral pelvis at the ASIS.
Coxa Pathologic Condition
Done in combination with another test. The patient is supine. One knee and hip are flexed 90 degrees and then an attempt is made to completely extend the leg. Positive test if pain prevents extension. May also be accompanied by involuntary flexion of the opposite knee and hip.
The seated patient first extends one leg at a time and then both legs together. The test is positive when this causes low back pain or sciatica or the patient is unable to perform without leaning backward.
sciatica, disc lesion, exostoses, adhesions, spasm or subluxation
The doctor places the supine patient's leg on their inside shoulder and presses near the hamstring insertion and then in the popliteal fossa.
lower disc problems as well as LS and SI strain subluxations
lumbar nerve root compression
If a SLR is positive, lower the leg just below the angle of pain production and sharply dorsiflex the foot.
sciatic neuritis, spinal cord tumors, IVD lesions, spinal nerve irritation
Double Leg Raise Test
First do SLR on each leg and note angle at which pain is produced. Then raise both legs together.
Femoral Nerve Traction
Yeoman's on the patient's side
ant thigh Px: Upper lumbar radiculopathy
Groin Px: L3 nerve root radiculopathy
Seated and standing
Flex forward and away then roll into concavity while creating pressure.
Degenerative Joint disease, exostosis, inflammatory or fibrotic residues, narrowing from disc degeneration tumor
This test can be performed seated or supine. It should be combined with a SLR whenever SLR produces a questionable result. Passively flex the head to the chest.
Pain: lumbar spine; sciatic nerve distribution
Means: nerve root irritation or inflammation
The patient is supine with the legs extended. They are instructed to raise their legs 6" above the table.
pain prevents raising the legs. The ability to hold this position for any time rules out Thecal Involvement
The standing patient is asked to bend forward. This sign is present when the patient flexes the knee on affected side and if trunk flexion causes increased pain in the affected leg.
lower disc problem as well as lumbosacral and sacroiliac strain subluxation
A SLR is performed to the point at which symptoms are reproduced. The leg is then lowered to below that point and the examiner sharply dorsiflexes the big toe of the affected foot.
SLR (lesague) Test
both legs from supine brought to 90'
limit because of pain: sciatica, lumbosacral orSI lesion, subluxation, disc lesion, spondylolisthesis, adhesions, IVF occlusion.
Worse pain: traction of nerve
Sciatica type pain: SOL
Iliac Compression Test
The patient is side lying with the knees bent. The doctor presses down on the upper part of the superior iliac crest.
SI sprain, inflammation, subluxation or fracture
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