Lumbar Exam Flow

Question 1

What are the signs of disc herniation?

Answer 1

Positive SLR, SMR deficits, positive quadrant (especially in flexion), valsalva, dejerine’s triad, prone extension (relieving)

Question 2

What are the signs of a disc derangement?

Answer 2

SLR, lack of SMR deficits, positive valsava, quadrant, dejerine’s, a directional preference (typically into extension and avoiding flexion)

Question 3

What are the SMRs for S1?

Answer 3

Achilles, foot eversion (peroneals), and small toe/ sole of the foot

Question 4

What are the SMRs for L5?

Answer 4

big toe extension, lateral lower leg, and hamstring

Question 5

What are the SMRs for L4?

Answer 5

Patella, medial leg, inverters (tib anterior)

Question 6

What is the neuropathic tool kit?

Answer 6

Pain, paresthesia, Nerve tension tests, loading tests, SMRs

Question 7

How do you determine a sprain?

Answer 7

Mainly history, muscle testing will be full, pROM will be painful at end range, palpation will be painful, AROM potentionally painful

Question 8

How do you determine a strain?

Answer 8

rROM will be painful, AROM will be painful, PROM will be painless, palpation will be painful, active prone extension, farfan torsion may be provocative

Question 9

What determines lumbar segmental dysfunction?

Answer 9

AROM, joint play, palpation

Question 10

What determines SI joint dysfunction?

Answer 10

Thigh thrust, SI compression, SI distraction, sacral thrust, Gaenslens, FABERs, Thomas, SI provocation

Question 11

What determines Facet Syndrome?

Answer 11

Kemps (local pain ONLY), negative SLR, palpation (tender facets), farfans, AROM (rotation esp), pone extension (provocative),
sitting is relieving, walking is aggravating,

Question 12

What are the leg length inequality tests?

Answer 12

All is, derfield, sit up test, Iliac crest measurement, PSIS comparison, trochanter height, tape measure