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NMS II > Lumbar > Flashcards

Lumbar Flashcards

1
Q

lumbar flexion

A

80

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2
Q

lumbar extension

A

35

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3
Q

lumbar lateral flexion

A

25

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4
Q

doctor observes that patient maintains a certain posture to alleviate pain or the patient will tell doctor that standing in a certain way alleviates the pain

A

antalgia sign

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5
Q

antalgic lean away from the side of pain is consistent with

A

posterolateral herniated disc

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6
Q

antalgic lean toward the side of pain is consistent with what

A

posteromedial herniated disc

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7
Q

forward antalgic lean is consistent with what

A

posterocentral(rhizal) herniated disc

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8
Q

posterolateral herniated disc

A

posteromedial; meaning the antalgic lean would be toward the side of pain

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9
Q

with patient lying supine doctor raises the symptomatic leg, with the knee straight, off of the table until the pain is reproduced or pain increases. doctor then notes the angle at which the pain occurred/increased and the location of the pain

A

straight leg raiser (SLR)

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10
Q

purpose of the straight leg raiser test

A
  • testing for possible SOL or IVD lesion
  • SI problem
  • lumbosacral problem
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11
Q

pain at 0-30 degrees during SLR test most likely indicates what

A

SOL

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12
Q

pain at 30-60 degrees during the SLR test most likely indicates what

A

SI joint inflammation that is irritating the sciatic nerve

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13
Q

pain at >60 degrees during the SLR test most likely indicates what

A

lumbo-sacral problem

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14
Q

patient is seated on the table with back against wall and extends the leg at the knee while the doctor applies downward pressure just above the level of the knee

A

bechterew’s test

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15
Q

seated SLR

A

bechterew’s test

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16
Q

positive findings for bechterew’s test

A

same as SLR

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17
Q

if patient has +SLR, the doctor will lower the affected leg 5 degrees and then dorsiflex the foot.

A

braggards sign

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18
Q

which nerve is being tractioned when the foot is dorsiflexed during braggards sign

A

tibial nerve

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19
Q

patient is seated in a stooped over posture. head is flexed, knee is extended, and ankle is dorsiflexed

A

slump test

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20
Q

positive sign for slump test

A

radicular pain down leg (suspect disc bulge or herniation)

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21
Q

doctor performs SLR on the asymptomatic side in an attempt to reproduce pain on symptomatic side that was found on SLR

A

Crossed SLR (well leg raiser)

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22
Q

when performing crossed SLR test, symptoms occur at same level/angle as the SLR, what is indicated

A

potential posteromedial IVD bulge or herniation

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23
Q

when performing crossed SLR test, if symptoms occur at an increased angle compared to SLR test, what is indicated

A

potential posterolateral IVD buldge or herniation

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24
Q

crossed SLR test, then lower leg 5 degrees and dorsiflex foot

A

fajersztajn’s test

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25
Q

when performing fajersztajn’s test, pain at same angle as braggards indicates

A

posteromedial IVD bulge or herniation

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26
Q

when performing fajersztajn’s test, there is pain at a greater angle than braggards what is indicated

A

potential posterolateral IVD bulge or herniation

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27
Q

this will occur during the SLR, the patient will raise the ipsilateral hip to alleviate pain (roll away)

A

cox sign

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28
Q

if cox sign is present it may indicate

A
  • SOL
  • IVF encroachment
  • radiculopathy
  • nerve root
  • tension
  • sciatica
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29
Q

with patient lying prone the doctor attempts to touch the heel of one foot to the contralateral buttock

A

Ely’s Test

30
Q

positive sign for ely’s test

A

pain in the anterior thigh and/or groin area

31
Q

radiating pain found when performing ely’s test could indicate

A

femoral nerve or lumbar spine nerve root compression

32
Q

localized pain found when performing ely’s test could indicate

A

quadriceps muscle contracture

33
Q

with patient lying on their side (affected side up) with bottom leg straight and top leg bent at knee, the doctor will extend the thigh back on affected side

A

Femoral Nerve Traction Test

34
Q

purpose of the femoral nerve traction test

A

reproduce pain in the anterior thigh in the distribution of the femoral nerve

35
Q

radiating pain to the groin during femoral nerve traction test could indicate

A

L3 nerve root radiculopathy

36
Q

radiating pain to the anterior mid-thigh during femoral nerve traction test could indicate

A

L4 nerve root radiculopathy

37
Q

patient can’t walk on their heels (dorsiflex) indicates

A

may be an L5 problem (L4 IVD)

38
Q

patient can’t walk on their toes (plantar flex) indicates

A

may be an S1 problem (L5 IVD)

39
Q

patient not being able to walk on heels or on their toes

A

not being able to walk on their toes

40
Q

pt seated dr stabilizes lumbar spine with one hand and supports shoulder with other; pt is laterally flexed away, flexed forward and laterally toward dr and finally extended with compression of shoulder on side being tested; lumbar circumduction trying to elicit radiating leg pain or localized low back pain

A

kemps test

41
Q

pain with slight rotation or on convex side during kemps

A

capsulitis

42
Q

pain on extension or concave side during kemps test

A

facet problem

43
Q

geneal pain at the waist during kemps test

A

lumbar spine sprain/strain

44
Q

pain with flexion during kemps test

A

IVD lesion

45
Q

patient supine the doctor flexes the patient’s hip and knee to 90 degrees. doctor then tries to extend the leg

A

kernig’s sign

46
Q

positive kernig’s sign

A

elicit pain in spine or involuntary flexion of the opposite knee or hip

47
Q

patient supine the doctor flexes the head toward the xiphoid process

A

bradzinski sign

48
Q

positive bradzinski sign

A

elicit involuntary hip and knee flexion

49
Q

positive kernig’s or bradzinski sign and patient has a fever, what is indicated

A

meningitis

50
Q

patient supine the doctor flexes the hip and knee to 90 degrees. doctor tries to extend the leg and is trying to elicit pain in the hip, low back or thigh

A

lasegue test

51
Q

difference between lasegue test and kernig’s sign

A

what the doctor is observing:

  • kernig’s looking for flexion of opposite knee or hip (meningitis with fever)
  • lasegue looking for hip, low back, or thigh pain
52
Q

patient is either seated or supine and doctor passively flexes the patient’s chin to their chest. no brudzinski or lhermitte’s

A

linder’s sign

53
Q

difference between brudzinski’s sign, lhermitte’s, and linder’s sign

A

there is no difference in mechanics, the difference is what is being tested for

54
Q

positive linder’s sign

A

pain is elicited in the low back and sciatic nerve indicating nerve root irritation or inflammation

55
Q

patient lies supine with legs straight and lefts feet 6 inches off table and holds that position for 30 seconds

A

milgram’s test

56
Q

positive findings for milgram’s test

A

patient is unable to hold the position due to:

  • low back pain (herniation or lumbar strain/sprain)
  • no pain (may have weak core muscles)
57
Q

patient uses upper body strength to stand from seated position

A

minor’s sign

58
Q

patient lying prone the doctor attempts to touch the heel of one foot to the ipsilateral buttock

A

nachla’s test

59
Q

difference between ely’s and nachla’s

A

ely’s - heel to contralateral buttock

nachla’s - heel to ipsilateral buttock

60
Q

positive sign for nachla’s test

A

same as ely’s: pain in anterior thigh and/or groin area

61
Q

radiating pain found when performing nachla’s test could indicate

A

femoral nerve or lumbar spine nerve root compression

62
Q

localized pain found when performing nachla’s test could indicate what

A

quadriceps muscle contracture

63
Q

patient supports themself with their hand on the wall or table for balance and does 5 deep squats with a bounce at the bottom; do not perform on elderly or pregnant

A

quick test

64
Q

doctor performs SLR then lowers leg 5 degrees and dorsiflexes the big toe

A

sicard’s sign

65
Q

if positive sicard’s sign, which nerve root is most likely irritated

A

L5

66
Q

patient lies supine and the doctor flexes both hips to 90 degrees with the legs extended. patient then lowers legs to 45 degrees

A

bilateral leg lowering test (BLLT)

67
Q

positive findings for bilateral leg lowering test

A

pain in buttocks, SI or lower extremity, or the leg drops due to pain

68
Q

Looking for what in Bilateral Leg Lowering Test

A

lumbo-sacral sprain strain, facet syndrome or IVD lesion

69
Q

looking for what in quick test?

A

pain, locking/crepitus in LB, hips, knees or ankles

70
Q

minors sign can occur due to (6)

A
  1. SI jt lesion
  2. L5 strain/spring
  3. lumbo-pelvic fx
  4. IVD syndrome
  5. muscular dystrophy
  6. sciatica

NMS II (7 decks)

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