Ankylosing Spondylitis & Meningeal Irritation Orthos

Question 1

Tape measure placed around the 4th intercostal space. Pt exhales completely, measurement taken, then pt inhales deeply, measurement taken.
Normal 1.5 - 3 inches chest expansion.

Answer 1

Chest Expansion Test
(+) = less than 1.5” women and less than 2” men
Dx: AS

Question 2

While standing the pt performs side bending to both sides. (+) = Muscle tightening on concave side

Answer 2

Forrestier’s Bowstring Sign

Indicates: AS

Question 3

Pt supine. Doctor supports the legs on the table. Pt is then asked to sit up without using hands. (+) = unable to perform.

Answer 3

Lewin Supine Test

Indicates: AS

Question 4

Pt is asked to go from a side lying position to a seated position. (+) = Localized T/L pain and/or lack of ROM

1. Test?
2. Indications?

Answer 4

1. Amoss Sign

2. AS, IVD syndrome, or Severe Sprain/Strain

Question 5

PPW fever, headache, photophobia, and nuchal rigidity.

Answer 5

Meningeal Irritation

Question 6

Evaluation for Meningeal Irritation:

1. Increase in protein indicates…
2. Decrease in glucose indicates…

Answer 6

1. Viral (protein up)

2. Bacterial (glucose down)

Question 7

Pt supine. Doctor passively flexes the pts head approximating the chin to chest. (+) = Buckling of the pts knees.

Answer 7

Brudzinski Sign

Indication: meningeal irritation

Question 8

Pt supine. Doctor flexes the hip and knee to 90/90 position and then attempts to extend knee. (+) = pt resists extension; resistance causes Kicking motion (K)

Answer 8

Kernig’s Sign

Indication: meningeal irritation

Question 9

Tests for AS?

Answer 9

Forrestiers, Lewin, Amoss, and Chest Expansion

Question 10

Tests for meningeal irritation ?

Answer 10

Brudzinski, Kernigs, Urine test for High Protein/Low Glucose, and s/s of HA with photophobia and nuchal rigidity