Lab: Lumbar Spine

Question 1

Hoover Sign:

Answer 1

pos. = lack of counter-pressure on the healthy side
ind. = lack of organic basis for paralysis (malingering/hysteria). with organic hemiplegia, the patient will still exert downward pressure when attempting to raise paralyzed leg

Question 2

Straight Leg Raiser (SLR):

Answer 2

pos.= radiating pain and/or dull posterior thigh pain
ind.= sciatic radiculopathy or tight hamstrings.
positive b/w 35-70 degrees= possible discogenic sciatic radiculopathy.
>70 degrees= tight hamstrings

Question 3

Goldthwait Sign:

Answer 3

pos.=localized pain, low back or radiating pain down the leg
ind.= lumbo-sacral or sacroiliac pathology.
pain occurring after the lumbar spinouses move= possible lumbo-sacral problem,
pain occurring before the lumbars move= possible sacroiliac problem

Question 4

Bragard Sign:

Answer 4

pos. = radiating pain in posterior thigh

ind. = sciatic radiculopathy

Question 5

Buckling Sign:

Answer 5

pos. = pain in the posterior thigh with sudden knee flexion (buckle)
ind. = sciatic radiculopathy

Question 6

Bowstring Sign:

Answer 6

pos. = pain in the lumbar region or radiculopathy

ind. = sciatic nerve root compression, helps rule out tight hamstrings

Question 7

Lasegue Test:

Answer 7

pos. = reproduction of sciatic pain before 60 degrees

ind. = sciatica

Question 8

Milgram Test:

Answer 8

pos. = inability to perform test and/or low back pain

ind. = weak abdominal muscles or space occupying lesion

Question 9

Valsalva Maneuver:

Answer 9

pos. = radiating pain from the site of lesion (usually recreating the complaint in the cervical or lumbar are of the spine)
ind. = space occupying lesion (e.g. disc pathology)

Question 10

Bechterew Test:

Answer 10

pos. = reproduction of radicular pain or inability to perform correctly due to tripod sign.
ind. = sciatic radiculopathy

Question 11

Neri Bowing Sign (Neri Sign):

Answer 11

pos. = pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
ind. = positive with a variety of low back pathologies. hamstring tension on the pelvis may trigger the response.

Question 12

Anterior Innominate Test (Mazion Pelvic Maneuver or Advancement Sign):

Answer 12

pos. = the inability to bend at the waist more than 45 degrees, bc of either/or
(1) radiating pain along the sciatic nerve, either unilateral or bilateral
(2) low back pain (lumbar or pelvic regions)
ind. = (1) sciatic neuralgia or radiculopathy, etc. possibly due to lumbar disc pathology
(2) anterior (rotational) displacement of the ilium relative to the sacrum

Question 13

Lewin Standing Test:

Answer 13

pos. = radiating pain down the leg causing flexion of the patient’s knee or knees
ind. = gluteal, lumbosacral or sacroiliac pathologies

Question 14

Heel Walk:

Answer 14

pos. = inability to perform test

ind. = L4-L5 disc lesion (L5 nerve root)

Question 15

Toe Walk:

Answer 15

pos. = inability to perform test

ind. = L5-S1 disc lesion (S1 nerve root)

Question 16

Ely Heel to Buttock Test:

Answer 16

(1) pos.= inability to raise the thigh
(1) ind.= iliopsoas spasm
(2) pos.= pain in the anterior thigh
(2) ind.= inflammation of lumbar nerve roots
(3) pos.= pain in the lumbar region
(3) ind.= lumbar nerve root adhesions