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MSK > 3.3 Thoracolumbar Special Tests > Flashcards

3.3 Thoracolumbar Special Tests Flashcards

1
Q

Pt sits on the exam table and is asked to “slump” so the spine flexes and shoulders sag forward while PT holds the chin and head erect

A

Slump Test or Sitting Dural Stretch Test

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2
Q

Procedure of Slump Test (4 parts)

A

Part 1: Pt slumps then PT holds chin & head erect

Part 2: PT flexes Pt’s neck & holds head down & shoulder slumped

Part 3: Extend Pt’s knees

Part 4: Dorsiflex the foot of the same leg

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3
Q

ULNT 1 nerve bias

A

Median, Anterior Interosseous, C5, C6,
C7

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4
Q

ULNT 2 nerve bias

A

Median, Axillary, Musculocutaneous

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5
Q

ULNT 3 nerve bias

A

Radial Nerve

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6
Q

ULNT 4 nerve bias

A

Ulnar, C8, T1

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7
Q

PT palpates for the radial pulse > pt’s head rotates to the side that is tested > pt then extends the head & PT puts the shoulder into extension and ER > pt is asked to take a deep breath

A

Adson’s Test

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8
Q

Pt’s arm is hyperabducted so that the hand is brought over the head c elbow and arm in the coronal plane c shoulder in ER

A

Wright’s Test

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9
Q

Modification of Wright’s test with shoulder 90 degrees abducted and ER > head rotated away from the test side

A

Allen’s Test

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10
Q

PT palpates the radial pulse then draws the pt’s shoulder down and back

A

Military brace test / Costoclavicular Syndrome

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11
Q

Pt is in supine c hands cupped behind the head > instructed to flex the head onto the chest > Pt actively raises the extended leg by flexing the hip until pain is felt > Pt then flexes the knee

A

Brudzinski-Kernig Test

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12
Q

(+) Brudzinski-Kernig Test

A

If pain disappears upon knee flexion

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13
Q

T OR F: Brudzinski-Kernig Test are similar to SLR test except it is passively done

A

FALSE

ACTIVELY done

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14
Q

(+) Brudzinski-Kernig Test may mean? (3)

A

indicate meningeal irritation,
nerve root involvement,
or dural irritation

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15
Q

Pt lies in prone while PT passively flexes the knee as far as possible so that pt’s heel rests at the buttocks

A

Nachlas Test (PKB1-2, PKE)

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16
Q

If the examiner is unable to flex the patient’s knee past 90° because of a pathological condition in the knee, the test may be performed by ____ of the hip while the ____ is flexed as much as possible.

A

passive extension of hip while knee is flexed

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17
Q

How many seconds does Nachlas Test (PKB1-2, PKE) need to be held for?

A

45-60 seconds

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18
Q

Unilateral neurological pain in the lumbar area, buttock, posterior thigh, or sometimes the anterior thigh in the Nachlas Test (PKB1-2, PKE) means?

A

L2 or L3 nerve root lesion

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19
Q

Pain in the anterior thigh in the Nachlas Test (PKB1-2, PKE) means?

A

tight quads or stretching of the femoral nerve

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20
Q

(+) Slump test

A

Sx decrease in neck extension

positive for increased tension in the neuromeningeal tract

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21
Q

Nerve bias for Slump test 1

A

spinal cord,
cervical and lumbar nerve roots,
sciatic nerve

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22
Q

Nerve bias for Slump test 2

A

obturator nerve

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23
Q

Nerve bias for Slump test 3

A

femoral nerve

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24
Q

Nerve bias for Slump test 4

A

spinal cord,
cervical and lumbar nerve roots,
sciatic nerve

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25
Q

What should be the hip and knee position in SLR test

A

hip IR & ADDUCTED
knee extended

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26
Q

If pain is primarily back pain in SLR testing?

A

disc herniation
or
pressure is more CENTRAL

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27
Q

If pain is primarily leg pain in SLR testing?

A

pressure is more LATERAL

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28
Q

T OR F: In SLR test, disc herniations or pathology causing the pressure between the two extremes are more likely to cause pain in both areas

A

TRUE

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29
Q

neck flexion movement in Lasegue’s
Test

A

Brudzinski Sign,
Linder Sign,
Soto-Hall test
Hyndman’s Sign,

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30
Q

ankle dorsiflexion movement in Lasegue’s Test

A

Bragard’s Test

31
Q

SLR c neck flexion and extension of the big toe instead of dorsiflexion

A

Sicard’s Test

32
Q

involves only extension of the big toe

A

Turyn’s Test

33
Q

In SLR test, tension in the ____ is normal

A

cervicothoracic junction

34
Q

In SLR test, pain increasing c neck flexion, ankle dorsiflexion, or both indicate?

A

stretching of the dura mater of the SC
OR
lesion of the spinal cord

35
Q

In SLR test, pain that does not increase with neck flexion indicate?

A

hamstring area lesion
OR
lesion in the lumbrosacral/SI joints

36
Q

Pt is relaxed in prone c head straight and arms by the sides > PT stands at pt’s feet and observes the buttocks from the level of the buttocks > Pt is asked to contract the gluteal muscles

A

Gluteal Skyline Test

37
Q

(+) Gluteal Skyline Test

A

Affected gluteus maximus may show less contraction or may be atonic and remain flat

38
Q

(+) Gluteal Skyline Test may indicate?

A

inferior gluteal nerve damage
OR
pressure on L5, S1, S2 nerve roots

39
Q

Tests for joint dysfunction in lumbar spine (3)

A

Stork standing test
Quadrant test
Schober test

40
Q

Pt stands on one leg and extends the spine while balancing on the leg

A

Stork Standing Test/ One-leg standing Lumbar extension test

41
Q

(+) stork standing test

A

pain the back

42
Q

what fx is associated with stork standing test?

A

pars interarticularis stress fx

43
Q

If stress fx is unilateral – standing on the ____ leg causes more pain

A

unilateral: IPSILATERAL leg more pain

44
Q

What is the indication if rotation is combined with extension in stork standing test and pain results with it?

A

joint facet pathology

45
Q

Causes maximum narrowing of the intervertebral foramen & stress on the facet joint to the side on which rotation occurs

A

Quadrant Test/ Extension Quadrant Test

46
Q

How many cm/inches above S2 in schober test

A

10 cm / 4 inches

47
Q

In quadrant test, overpressure is applied in _____ while pt ____ and ____ to the side of pain

A

overpressure on EXTENSION
SIDE FLEXED & ROTATES to the side of pain

48
Q

How many cm/inches below S2 in schober test

A

5 cm / 2 inches

49
Q

Special tests for muscle tightness in lumbar spine (4)

A
  • 90-90 Straight Leg Raising Test
  • Ober’s Test
  • Ely’s Test
  • Thomas Test
50
Q

Other name for 90-90 Straight Leg Raising Test

A

Hamstrings Contracture, Method 1

51
Q

What test is this?

Pt in supine > flexes both hips to 90 degrees with knees bent

Pt may grasp behind the knees c both hands to stabilize hips at 90 degrees of flexion

Pt actively extends each knee in turn as much as possible

A

90-90 Straight Leg Raising Test

52
Q

For normal hamstring flexibility in 90-90 Straight Leg Raising Test, knee extension should be within _____ degrees of full extension

A

20 degrees

53
Q

In 90-90 Straight Leg Raising Test, if the hamstrings are tight, what is the end feel?

A

muscle stretch

54
Q

Tests TFL for contracture

A

Ober’s Test

55
Q

What test is this?

Pt is in side-lying c lower leg flexed at the hip and knee for stability > PT passively abducts and extends pt’s upper leg c knees straight or flexed to 90 degrees > PT slowly lowers the upper limb

A

Ober’s Test

56
Q

(+) Ober’s Test

A

If (+) contracture, leg remains abducted and does not fall to the table

57
Q

Other name for Ely’s Test

A

Tight rectus femoris, method 2

58
Q

In Ely’s Test, if pt’s hip on the same side of the flexing knee spontaneously flexes, what does this indicate?

A

tight rectus femoris

59
Q

Used to assess a hip flexion contracture (most common hip contracture)

A

Thomas Test

60
Q

If the leg does not lift off the table but abducts as the other leg is flexed to the chest

A

J sign/stroke

61
Q

J sign/stroke is indicative of what?

A

Indicative of a tight ITB on the extended side

62
Q

(+) Thomas test

A
  • Pt’s straight leg raises off the table
  • Muscle stretch end feel will be felt
  • If lower limb is pushed down onto the table, Pt may exhibit an increased lordosis (another positive sign)
63
Q

Tests for lumbar instability (2)

A
  • H and I Stability Test
  • Passive Lumbar Extension Test
64
Q

Tests for muscle spasm

A

H and I Stability Test

65
Q

(+) hypomobile segment present in H and I Stability Test

A

at least 2 of the movements (into the same quadrant) would be limited

66
Q

In Passive Lumbar Extension Test, how many cm/ft the PT lifts the legs of the Pt off from the bed?

A

30 cm / 1 ft

66
Q

(+) instability present in H and I Stability Test

A

one quadrant will be affected but only by ONE of the moves

67
Q

T OR F: Numbness/Pricking sensation are positive signs for Passive Lumbar Extension Test

A

FALSE

NOT positive signs

POSITIVE SIGNS:
If in the extended position, pt complains of:
- Very strong pain in the lumbar region
- Very heavy feeling in the low back
- Feels like low back is “coming off” and pain disappears when the legs are lowered to the start position

68
Q

Lumbar special tests for malingering (2)

A
  • Burns Test
  • Hoover Test
69
Q

Pt is asked to kneel on a chair then bend forward to touch the floor with the fingers

A

Burns Test

70
Q

(+) Burns Test

A

pt is unable to perform the test or the pt overbalances

71
Q

What test is this?

Pt lies in supine > PT places one hand under each calcaneus while pt’s legs remain relaxed on the exam table > PT is then asked to actively lift one leg off the table, keeping knees straight (straight leg testing)

A

Hoover Test

72
Q

(+) Hoover Test

A

pt does not lift the leg or PT does not feel pressure under the opposite heel

MSK (7 decks)

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