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DPT 672: Assessment Skills > Lumbar Assessment > Flashcards

Lumbar Assessment Flashcards

1
Q

Assessment Skills: Lumbar Assessment

Thoracolumbar
* ROM = ?
* End Feel = ?
* Loose pack = ?
* Close pack = ?
* Capsular pattern = ?

A

Thoracolumbar Snapshot

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2
Q

Assessment Skills: Lumbar Assessment

Pelvic Surface Anatomy

A
  • Iliac Crest: Standing, supine or prone; corresponds to L4-L5 interspace.
  • Posterior Superior Iliac Spine (PSIS): From iliac crest medially to inderiorly. [Helper Line: S2 locasted between PSIS].
  • Ischial Tubersity: Side lying; start gluteal fold until you feel a bony prominence.
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3
Q

Assessment Skills: Lumbar Assessment

Lumbar Surface Anatomy (Prone)

A
  • Sacral Sulcus: From PSIS, move superiorly and medially.
  • Inferior Lateral Angle (ILA): Inferior to PSIS.
  • Coccyx: Top of gluteal cleft.
  • Sacrotuberous Ligaments: From ILA to ischial tubersoty.
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4
Q

Assessment Skills: Lumbar Assessment

Lumbar Surface Anatomy (Prone / Processes)

A
  • Spinous Processes: L5: Start at PSIS, move medially and superiorly at a 30-45 degree angle L1-L4: Count superiorly from L5.
  • Transverse Processes: Move laterally from spinous process. Most easily felt in the trough between spinalis and longissimus. Note the orientation of transverse processes relative to spinous processes
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5
Q

Assessment Skills: Lumbar Assessment

Lumbar Surface Anatomy (Prone / T12)

A
  • T12 Spinous Process: Locate L5 spinous process and count superiorly; will be smaller than L1.
  • 12 Ribs: Move laterally from T12 spinous process.
  • Quadratus Lumborum: In the quadrant (yellow lines) created by the lumbar spinous processes, 12th rib and iliac crests.
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6
Q

Assessment Skills: Lumbar Assessment

Pelvic Surface Anatomy (Supine)

A
  • Anterior Superior Iliac Spine (ASIS): From iliac crests move distally and medially.
  • Psoas: From midpoint between ASIS and umbilicus, apply direct pressure toward the spine.
  • Iliacus: From ASIS move medially, and apply pressure downward to ilium.
  • Pubic Tubercles: Patient places thumbs on abdomen and slides down to pelvis. Examiner places thumbs on top of patient’s thumbs.
  • Greater Trochanter: Supine; have patient ER/IR hip to assist in locating.
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7
Q

Assessment Skills: Lumbar Assessment

Lumbar Surface Anatomy (Prone - Glute)

A
  • Helper line for Piriformis: PSIS to greater trochanter; divide lines into thirds.
  • Piriformis: Piriformis will be 1 – 2 cm inferior to middle 1/3 of helper line.
  • Helper line for Sciatic Nerve: Ischial tuberosity to greater trochanter.
  • Sciatic Nerve: Medial 1/3 to halfway between ischial tuberosity and greater trochanter.
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8
Q

Assessment Skills: Lumbar Assessment

Lumbar Surface Anatomy (Prone - Erectors)

A
  • Spinalis: Most medial
  • Longissimus: Middle
  • Iliocostalis: Most lateral
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9
Q

Assessment Skills: Lumbar Assessment

Thoracolumbar Flexion and Extension: Goniometer

A
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10
Q

Assessment Skills: Lumbar Assessment

Thoracolumbar Lateral Flexion: Goniometer

A
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11
Q

Assessment Skills: Lumbar Assessment

Thoracolumbar Rotation

A
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12
Q

Assessment Skills: Lumbar Assessment

Thoracolumbar Flexion and Extension: Inclinometer

Assessing ROM

A
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13
Q

Assessment Skills: Lumbar Assessment

Lumbar Lateral Flexion: Inclinometers

Assessing ROM

A
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14
Q

Assessment Skills: Lumbar Assessment

Assessing Strength

A
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15
Q

Assessment Skills: Lumbar Assessment

Assessing Strength

A
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16
Q

Assessment Skills: Lumbar Assessment

Assessing Strength

A
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17
Q

Assessment Skills: Lumbar Assessment

Trunk Flexion (0 – 5)

Assessing Strength

A
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18
Q

Assessment Skills: Lumbar Assessment

Trunk Extension (0 – 5)

Assessing Strength

19
Q

Assessment Skills: Lumbar Assessment

Trunk Rotation (0 – 5)

Assessing Strength

20
Q

Assessment Skills: Lumbar Assessment

Lower Abdominals

Assessing Strength

21
Q

Assessment Skills: Lumbar Assessment

Sensation protocal

Assessing M.R.S.

A
  • Use cotton ball or brush
  • Show patient what it feels like in an area that is not compromised.
  • Have the patient close his/her eyes
  • Using equal pressure L and R, gently touch the area one side at a time.
  • Use consistent cues and questions (“Does this feel the same on both sides?”).

“testing nervous systems ability to communicate w/other parts of the bod

“symmetry, quality, provocation”

22
Q

Assessment Skills: Lumbar Assessment

L2 Myotome

Assessing M.R.S.

A

L2 = hip flexion

“symmetry, quality, provocation”

23
Q

Assessment Skills: Lumbar Assessment

L3 Myotome

Assessing M.R.S.

A

L3 = Knee extension

“symmetry, quality, provocation”

24
Q

Assessment Skills: Lumbar Assessment

L4 Myotome

Assessing M.R.S.

A

L4 = Ankle dorsi flexion

“symmetry, quality, provocation”

25
Q

Assessment Skills: Lumbar Assessment

L5 Myotome

Assessing M.R.S.

A

L5 = Great toe extension

“symmetry, quality, provocation”

26
Q

Assessment Skills: Lumbar Assessment

S1 Myotome

Assessing M.R.S.

A

S1 = plantar flexion

“symmetry, quality, provocation”

27
Q

Assessment Skills: Lumbar Assessment

S2 Myotome

Assessing M.R.S.

A

S2 = knee flexion

“symmetry, quality, provocation”

28
Q

Assessment Skills: Lumbar Assessment

L4 Reflex

Grading Scale?

Assessing M.R.S.

A

L4 Reflex = Pateller

29
Q

Assessment Skills: Lumbar Assessment

S1 Reflex

Grading Scale?

Assessing M.R.S.

A

S1 Reflex = Achilles

30
Q

Assessment Skills: Lumbar Assessment

L1 Dermatome

Assessing M.R.S.

A

L1 Dermatome = Upper anterior thigh

31
Q

Assessment Skills: Lumbar Assessment

L2 Dermatome

Assessing M.R.S.

A

L2 Dermatome = Mid anterior thigh

32
Q

Assessment Skills: Lumbar Assessment

L3 Dermatome

Assessing M.R.S.

A

L3 Dermatome = Medial anterior thigh

33
Q

Assessment Skills: Lumbar Assessment

L4 Dermatome

Assessing M.R.S.

A

L4 Dermatome = Medial malleolus

34
Q

Assessment Skills: Lumbar Assessment

L5 Dermatome

Assessing M.R.S.

A

L5 Dermatome = Dorsum of great toe

35
Q

Assessment Skills: Lumbar Assessment

S1 Dermatome

Assessing M.R.S.

A

S1 Dermatome = Lateral malleolus or heel

36
Q

Assessment Skills: Lumbar Assessment

S2 Dermatome

Assessing M.R.S.

A

S2 Dermatome = Popliteal fossa

37
Q

Assessment Skills: Lumbar Assessment

Central Posterior to Anterior Glides (Spring Test)

Grading?

Assessing Joint Play

38
Q

Assessment Skills: Lumbar Assessment

Unilateral Posterior to Anterior Glides

Assessing Joint Play

39
Q

Assessment Skills: Lumbar Assessment

Special Tests

40
Q

Assessment Skills: Lumbar Assessment

Straight Leg Raise – Tension

Special Tests

41
Q

Assessment Skills: Lumbar Assessment

Slump Test

Assessing Joint Play

A

sciatic neural tension

42
Q

Assessment Skills: Lumbar Assessment

Prone Instability Test

Assessing Joint Play

43
Q

Assessment Skills: Lumbar Assessment

Assessing Joint Play

DPT 672: Assessment Skills (17 decks)

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