lsp

Question 1

kemps test

Answer 1

a)compress down with forearms to induce neutral compression
b)if no symptoms, sidebend and compress with forearm
c)if no symptoms sidebend and rotate and compress
d)if no symptoms, sidebend, rotate and extend then compress
can reinforce forearms and cross arms to use hands
testing= Intervertebral nerve root
-acute inflammatory lesion
-local sprain/ strain
-facet irritation
-spinal fracture
Increased pressure on nerve root
positive test=Symptoms produced as intervertebral foramen narrows and facet joints are stressed on the side of rotation

Question 2

slump test

Answer 2

a)patient sits on plinth and is asked to slump (spine flexes and shoulders sag forward)
-examiner holds chin and head
b)if no symptoms are produced, examiner flexes patient’s neck and holds head down with slump
c)if no symptoms are produced, examiner passively extends patient’s knee
d)if no symptoms are produced, examiner also passively dorsiflexes patient’s foot of same leg
-repeat with other leg
testing= Increased pressure on nerve root
Acute inflammatory lesion
Local sprain/ strain
Facet irritation
Spinal fracture
Osteophytes
positive test= Reproduction of pathological symptoms
Local lumbosacral pain
Pain isn’t always positive

Question 3

SLR

Answer 3

Start on asymptomatic side first
a)-patient in supine position with hip medially rotated and adducted with knee extended
-examiner flexes hip until patient experiences pain or tightness in back of leg
b)if no symptoms, perform bragards–> add dorsiflexion of foot (adds more tension on sciatic nerve)
c)if no symptoms, perform sicards–> add toe flexion (maximum stretch on nerve)
testing= Increased pressure on nerve root (osteophytes, disc, radiculopathy)
Piriformis entrapment
Si/ lumbar sprain/ strain
positive test= Radicular pain in leg
Pain in back–> disc herniation due to pressure on anterior theca of spinal cord
Thecal sac= membranous sheath or tube of dura mater that surrounds the spinal cord and the cauda equina
Pain in leg–> pathology causing pressure is more lateral. Sciatic nerve distribution

Question 4

femoral nerve traction test

Answer 4

-patient lies on unaffected side with unaffected limb flexed slightly at hip and knee. Back should be straight
-examiner grasps affected limb and extends knee while extending hip 15 degrees. Then flex affected sides knee
testing= Femoral nerve/ root compression (osteophyte, disc, radiculopathy)
positive test= Radiating neurological pain down anterior thigh