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NYCC Patient Assessment 1 > LE Neural tests part 2 (standing, prone, SI) > Flashcards

LE Neural tests part 2 (standing, prone, SI) Flashcards

1
Q

What are the other names for a belt test?

A

Supported Adam’s test
Supported forward bending test

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2
Q

If a patient feels great in the tub and worse getting out of the tub what condition may be suspected?

A

SI joint lesion

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3
Q

Which orthopedic test/sign is used to differentiate a lumbo-sacral issue vs an SI problem?

A. Lewin’s standing
B. Neri’s Bowing sign
C. Belt test
D. Advancement Test
E. Braggard’s test

A

C. Belt test

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4
Q

How is an Adam’s test performed?

A

Observe patient with structural scoliosis standing
Then ask patient to file forward at the waist while the doctor observes the patients back for signs of structural change

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5
Q

What is a doctor looking for when a patient bends forward for an Adam’s test?

A

Scapular winging, rib humping, iliac crest height

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6
Q

What are the positive findings for an Adam’s test?

A

Resolution of structural findings

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7
Q

What are the indications for the positive findings for an Adam’s test?

A

Resolution indicates functional scoliosis
No resolution indicates structural scoliosis

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8
Q

A patient performs an Adam’s and their scapular winging and rib humping goes away. How is this recorded and what is indicated?

A

Positive Adam’s test indicating functional scoliosis

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9
Q

A patient performs an Adam’s test and their rib humping and iliac crest height differential does not go away. How is this recorded and what is indicated?

A

Positive Adam’s test indicating structural scoliosis

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10
Q

How is a Belt/Supported Forward Bend/Supported Adam’s test performed?

A
  • Instruct pt to bend fully forward toward their toes and note when pain begins
  • have pt contact both ASIS
  • Repeat while dr stands behind pt and blocks SI joint motion by supporting sacrum with their thigh/hip and pulling backward on ASIS bilaterally over pt’s hands (prevents flexion below level of LS junction)
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11
Q

What are the positive findings for a Belt/Supported Forward Bend/Supported Adam’s test?

A

Decrease in pain upon supported flexion
Increase in pain at an earlier angle

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12
Q

What is indicated by a positive finding for a Belt/Supported Forward Bend/Supported Adam’s test?

A

Source of pain in the unsupported Adam’s test was of SI origin if pain decreases
(SOF: If pain increases at an earlier angle may indicate a LS problem)

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13
Q

What test is performed standing to determine if the source of a patients low back pain is of SI origin?

A

Belt test/Supported Adam’s test/Supported Forward bending test

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14
Q

A Belt test is performed and the patient has increased pain at an early angle before completing forward flexion, how is this recorded and what does it indicate?

A

Positive indicating LS involvement

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15
Q

A Belt test is performed and the patient has a decrease in pain in forward flexion, how is this recorded and what does it indicate?

A

Positive indicating SI involvement

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16
Q

What is Neri’s sign also called?

A

Bowing sign or Knee flexion test

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17
Q

How is a Neri’s sign performed?

A

Patient stands and bends forward from the waist

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18
Q

What is a present finding for Neri’s/Bowing sign?

A

Patient’s affected leg flexes at the knee and the patient reports reproduction of the LE complaint in this position

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19
Q

What is indicated by a present Neri’s/Bowing sign?

A

Sciatic radiculopathy, hamstring spasm, SI lesion, or LS strain

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20
Q

A present Neri’s/Bowing sign will be present with knee flexion on the (Asymptomatic/Symptomatic) side?

A

Symptomatic

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21
Q

What test is performed after a Neri’s/Bowing sign if present?

A

Lewin’s Standing test

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22
Q

How is a Lewin’s Standing test performed?

A

If the patient’s knee is flexed when standing normally, or with performance of Neri’s test, the examiner stabilizes the patient’s pelvis then attempts to pull the flexed knee back into extension

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23
Q

What is a positive result for a Lewin’s Standing test?

A

Increase in posterior leg pain or inability to keep the leg straight

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24
Q

What is indicated by a positive result for a Lewin’s Standing test?

A

Sciatic radiculopathy or hamstring spasm

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25
Q

What standing LE orthopedic tests can indicate sciatic radiculopathy or a hamstring spasm?

A

Neri’s sign
Lewin’s standing test
Advancement test

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26
Q

How is an advancement test performed?

A

The patient bends forward to elicit pain into the leg
The patient is then asked to advance the SYMPTOMATIC leg one step and bend forward again

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27
Q

What is a positive result for an advancement test?

A

Reproduction of the radiating pain with less trunk flexion than before

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28
Q

What is indicated by a positive result for an advancement test?

A

Sciatic radiculopathy, sciatic neuritis, hamstring spasm

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29
Q

What two prone LE tests can be positive for facet syndrome?

A

Nachlas test
Ely’s Heel to Buttock Test

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30
Q

If a Nachlas test is performed and a patient points to the anterior thigh as their site of pain. How is this recorded?

A

Positive femoral nerve traction test with a negative Nachlas test

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31
Q

How is Nachlas test performed?

A

Approximate the patient’s heel to the IPSILATERAL buttock and ask the patient to localize the site of pain

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32
Q

For a Nachlas test the examiner approximates the patient’s heel to the (Ipsilateral/Contralateral) buttock?

A

Ipsilateral

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33
Q

What is a positive finding for a Nachlas test?

A

Pain localized by a patient

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34
Q

What is indicated by a positive finding for a Nachlas test?

A

Non-specific LS, SI, or facet pain (if in lower back)
Femoral nerve root irritation

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35
Q

A Nachlas test is performed and the heel is approximated to the ipsilateral buttocks, how many findings are recorded and what are they?

A

Three: Nachlas, Ely’s sign, femoral nerve traction test

36
Q

If a Nachlas test is performed and the patient reports pain in the lower back how is this recorded what does it indicate?

A

Positive indicating facet syndrome

37
Q

How is Ely’s sign performed?

A

Upon performance of Nachlas test, observe for hunching of the pelvis

38
Q

What is a present Ely’s sign?

A

Hunching of the pelvis during Nachlas test

39
Q

What prone orthopedic test can elicit an Ely’s sign?

A

Nachlas test

40
Q

What is indicated by a present Ely’s sign during Nachlas test?

A

Tightness of the 2 joint hip flexors (Rectus femoris and tensor fascia lata)

41
Q

What muscles are two joint hip flexors?

A

Rectus femoris and tensor fascia lata

42
Q

What muscles are likely tight in a patient with a present Ely’s sign during Nachlas test?

A

Rectus femoris and tensor fascia lata

43
Q

What test confirms an Ely’s sign?

A

Thomas’ test

44
Q

How is an Ely’s Heel to Buttock test performed?

A

The examiner approximates the patient’s heel to the OPPOSITE buttock

45
Q

When an examiner performed an Ely’s Heel to Buttock test they approximate the patient’s heel to the (Ipsilateral/Opposite) buttock?

46
Q

What is a positive result for an Ely’s Heel to Buttock Test?

A

Inability to perform the movement or pain upon approximation

47
Q

What is indicated by a positive result for an Ely’s Heel to Buttock Test?

A

Hip joint lesion, facet, SI, lumbar, iliopsoas (If Ely’s present), femoral nerve root irritation

48
Q

A positive result for Ely’s Heel to Buttock Test is the same as Nachlas test but may also include what joint?

A

Femoracetabular joint

49
Q

What are examples of SI orthopedic tests?

A

Fortin Finger test
Gaenslen’s test
Lewin’s-Gaenslen test
Erichsen’s sign
Hibb’s test
Yeoman’s test
Mennel’s test

50
Q

How is a Fortin Finger test perfomed?

A

Have patient point to the site of pain

51
Q

What are positive results for a Fortin Finger test?

A

Localization with one finger
Localization inferomedial to the PSIS within one centimeter
Localization is consistent as the patient points to the same area over at least TWO trials

52
Q

What is indicated by a positive Fortin Finger test?

A

SI joint lesion

53
Q

All ligaments of the hip restrict what motion?

54
Q

How is a Gaenslen’s test performed?

A

With the patient’s side close to the edge of the examining table, instruct the patient to grasp the opposite knee and approximate it to their chest
Examiner then gently lowers the affected side OFF THE EDGE OF THE TABLE

55
Q

What is a positive finding for a Gaenslen’s test?

A

SI joint pain

56
Q

What is indicated by a positive finding for a Gaenslen’s test?

A

SI joint lesion

57
Q

How is a Lewin-Gaenslen test performed?

A

Identical to Gaenslen’s test except the patient is side-lying while the doctor stabilizes the pelvis

58
Q

What is the patient position for a Gaenslen’s test?

59
Q

What is the patient position for a Lewin-Gaenslen test?

A

Side-lying (lateral recumbent)

60
Q

What is the patient position for Erichsen’s sign, Hibb’s test, Yeoman’s test, and Mennell’s test?

61
Q

Why may a Lewin-Gaenslen test be used over a Gaenslen test?

A

A Lewin-Gaenslen test has the additional advantage of allowing the examiner to palpate the SI joints

62
Q

What is a positive finding for a Lewin-Gaenslen test?

A

SI joint pain

63
Q

What is indicated by a positive finding for a Lewin-Gaenslen test?

A

SI joint lesion

64
Q

For a Lewin-Gaenslen test you must be skin on skin at the SI joint (TRUE/FALSE)?

65
Q

How is Erichsen’s Sign performed?

A

Patient prone, firm pressure is applied toward the midline using a soft contact lateral to the PSIS

66
Q

What is a present finding for Erichsen’s Sign?

A

SI joint pain

67
Q

What is indicated by a present finding for Erichsen’s sign?

A

SI joint lesion

68
Q

How is Hibb’s test performed?

A

Patient prone, flex the knee and use the lower leg as a lever to internally rotate the hip with NO STABILIZATION

69
Q

What is a positive finding for a Hibb’s test?

A

SI joint pain or hip pain

70
Q

What is indicated by a positive finding for a Hibb’s test?

A

SI joint or hip lesion

71
Q

How is a Hibb’s test different from a piriformis stretch test in its procedure?

A

A Hibb’s test has NO STABILIZATION of the hip while the piriformis stretch test does

72
Q

What SI test can be used to differentiate between femoracetabular and SI problems?

A

Hibb’s test

73
Q

How is Yeoman’s test performed?

A

Patient prone, flex the knee and lift the distal femur to create hip extension
Add downward pressure on the IPSILATERAL SI

74
Q

What is a positive finding for Yeoman’s test?

A

SI joint pain

75
Q

What is indicated by a positive finding for Yeoman’s test?

76
Q

What SI orthopedic test can be used as an SI extension adjustment?

A

Yeoman’s test

77
Q

What SI test is the most sensitive or SI lesions?

A

Yeoman’s test

78
Q

A femoral nerve traction test can be positive when what two tests are performed?

A

Nachlas Test and Yeoman’s test

79
Q

What position is the patient in for a Mennel’s test?

80
Q

What orthopedic sign is indicative of an SI issue?

A

Erichsen’s sign

81
Q

How is a Mennell’s test performed?

A

Patient prone, examiner applies pressure with thumbs from the PSIS’s outward into the soft tissue noting and pain at the SI
Doctor then slides the thumbs toward the midline (Erichsen’s sign) and notes any pain at the SI
If the second maneuver elicits pain, rock the ilium forward with the superior hand on the SI joint, inferior hand on the femur, and then pull posteriorly noting any exacerbation of pain

82
Q

What is a positive finding for a Mennell’s test?

A

Exacerbation of SI pain

83
Q

What is indicated by a positive finding for a Mennell’s test?

A

Myofascial involvement of gluteal muscles if pain in step 1
SI subluxation or sprain if pain in steps 2-4

84
Q

If a patient has pain in step one of Mennell’s test when the examiner pushes with their thumbs from the PSIS laterally what is indicated?

A

Myofascial involvement of gluteal muscles

85
Q

If a patient has pain in step two, three, or four of Mennell’s test what is indicated?

A

SI subluxation or sprain

86
Q

What is the only SI orthopedic test than brings the hip into flexion?

A

Mennell’s test

87
Q

What sign is performed in the second step of Mennell’s test?

A

Erichsen’s sign

NYCC Patient Assessment 1 (15 decks)

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