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Ortho > Cervical and Lumbar Exam > Flashcards

Cervical and Lumbar Exam Flashcards

1
Q

Common CCs of cervical region?

A
  • posterior neck pain
  • upper trap/shoulder pain
  • pain b/t shoulder blades
  • weakness
  • alt in fine motor control
  • numbness: very specific or very generalized
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2
Q

What should you observe with your pt presenting w/ cervical complaint?

A

always pay attention to pt’s movements and actions:

  • general appearance
  • abnormal pain behaviors
  • mood and affect
  • gait
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3
Q

Inspection part of exam for cervical complaint?

A
  • skin

- posture

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4
Q

Palpation part of exam for cervical complaint?

A
  • cervical pt tenderness
  • muscle spasms
  • lymphadenopathy
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5
Q

ROM testing for cervical complaint?

A
  • flexion: 80-90
  • extension: 70
  • lateral bending: 20-45
  • rotation: 70-90
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6
Q

Sensory testing in cervical region (dermatomes)?

A
  • C5: lateral upper arm
  • C6: lateral forearm
  • C7: middle finger
  • C8: ulnar border of hand
  • T1: medial upper arm
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7
Q

Testing muscle strength in cervical dermatome?

A
  • deltoids (C5): abduction of shoulder
  • biceps (C5, C6): elbow extension
  • wrist extension (C6, C7)
  • wrist flexors (C7)
  • triceps (C7): elbow etension
  • finger extension (C7)
  • finger flexion (C8)
  • intrinsics (T1)
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8
Q

Special tests for Cervical region?

A

axial loading
foraminal compression test (spurlings):
- + if pain radiates to arm toward which head is side flexed, sig: cervical root compression

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9
Q

What does a + hoffman’s reflex mean?

A
  • presence of upper motor neuron lesion from spinal cord compression
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10
Q

Cervical reflexes tested?

A
  • biceps: C5
  • triceps: C7
  • brachioradialis: C6
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11
Q

Common CCs of lumbar region?

A
  • back pain (gen horseshoe pattern)
  • buttock pain
  • leg pain
  • weakness
  • numbness/tingling
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12
Q

Observation part of lumbar exam?

A
  • always pay attention to pt’s movements and actions
  • general appearance
  • abnormal pain behaviors
  • mood and affect
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13
Q

Inspection part of lumbar exam?

A
  • skin
  • muscle spasms
  • posture
  • look for lordosis, scoliosis
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14
Q

Palpation part of lumbar exam?

A
  • pt tenderness
  • trochanteric tenderness
  • SI jt pain
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15
Q

ROM testing part of lumbar exam?

A
  • flexion: 40-60
  • extension: 20-35
  • lateral bending: 15-20
  • rotation
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16
Q

Gait testing for lumbar exam?

A
  • tip toe walking
  • heel walking
  • tandem gait
17
Q

Sensory testing - lumbar exam?

A
  • L1: groin
  • L2: midanterolateral thigh
  • L3: distal anteromedial thigh
  • L4: medial ankle
  • L5: dorsum of foot
  • S1: lateral border of foot
18
Q

Dermatomes for muscle strength of lumbar spine?

A
  • hip flexors: L1, 2, 3
  • hip adductors: L2, 3, 4
  • quads: 2, 3, 4
  • ankle inversion: L4, 5
  • EHL, toe extensors L5
  • ankle eversion L5, S1, 2
  • ankle plantar flexion L5, S1, 2
19
Q

L4 MRS?

A
  • M: tibialis anterior-ankle dorsiflexion
  • R: patella tendon
  • S: medial aspect of foot
20
Q

L5 MRS?

A
  • M: extensor hallucis longus: great toe extension

- S: dorsum of foot

21
Q

S1 MRS?

A
  • M: peroneus longus and brevis ankle eversion
  • R: achilles tendon
  • S: lateral aspect of foot
22
Q

Special tests for lumbar spine?

A
  • babinski
  • ankle clonus
  • positive reflects presence of upper motor neuron lesion from spinal cord compression
23
Q

What is supine SLR testing?

A
  • if pain is reproduced around 40 degrees of hip flexion or less, the test is +, pain exacerbated by adding ankle dorsiflexion while leg is raised
24
Q

What is the femoral nerve stretch test?

A
  • pt lies prone w/ knee passively flexed to the thigh

- positive test = anterior thigh pain

25
Q

What are you testing for w/ hip exam?

A
  • trochanteric tenderness

- ROM

26
Q

Special tests for SI jt irritation?

A
  • compression: pt lying w/ affected side up. Hips flexed at 45 and knees flexed at 90. Both hands on iliac crest and exerts downward pressure
  • distraction: pt supine and examiner stands on affected side, places hands on ASIS w/ arms crossed and applies pressure downward and laterally
  • fabers: pt supine w/ examiner at side, leg of afffected side is bent at hip and knee and foot positioned on opposite knee, downward and lateral pressure is applied to knee and the affected side

Ortho (24 decks)

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