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NMS 2 Exam One > Lumbar Orthopedics > Flashcards

Lumbar Orthopedics Flashcards

1
Q

procedure for Antalgia sign

A

Dr will observe patient while standing to see if they maintain a certain posture to help alleviate pain

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2
Q

findings of Antalgia sign when leaning away from the side of pain

A

means posterolateral herniated disc

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3
Q

findings of Antalgia sign when leaning toward the side of pain

A

means posteromedial herniated disc

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4
Q

findings of Antalgia sign when leaning forward away from the pain

A

means posterocentral herniated disc

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5
Q

procedure for Straight leg raiser

A

patient lies face up, doctor raises the symptomatic leg until the pain is reproduced

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6
Q

purpose for Straight leg raiser

A

testing for possible SOL, disc lesion, sacro-iliac or lumbosacral problem

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7
Q

findings of Straight leg raiser

A

pain may suggest sciatica from lumbosacral lesion or SOL

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8
Q

with straight leg raiser, if pain is in first 30 degrees it means

A

means something major

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9
Q

with straight leg raiser, if pain is between 30 and 45 degrees it means

A

means sciatic irritation

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10
Q

with straight leg raiser, if pain is after 60 degrees it means

A

means lumbosacral problem

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11
Q

procedure for Bragard’s sign

A

(done if the patient has positive straight leg raiser)

perform a straight leg raiser then lower the leg 5 degrees and dorsiflex the foot

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12
Q

purpose of Bragard’s sign

A

attempt to reproduce leg pain

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13
Q

findings of Bragard’s sign

A

will be positive if there is an increase in leg pain

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14
Q

procedure for Sicard’s sign

A

(done if the patient has positive Bragard’s sign)

perform straight leg raiser, lower leg 5 degrees, dorsiflex foot & relax, then dorsiflex big toe

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15
Q

purpose of Sicard’s sign

A

to reproduce leg pain

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16
Q

findings of Sicard’s sign

A

irritation of usually L5 nerve root, but can be L4 or S1 as well

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17
Q

procedure for Bechterew’s test

A

(is a seated straight leg raiser)
patient sits with back straight then extends the leg at the knee; if no pain then Dr applies downward pressure right above the knee while patient lifts leg

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18
Q

purpose of Bechterew’s test

A

pain should be the same as in straight leg raiser

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19
Q

findings of Bechterew’s test

A

will be positive if straight leg raiser is positive

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20
Q

procedure for Slump test

A

patient is seated with back maximally slumped, knee is at 90 degrees, foot is fully dorsiflexed, then patient extends the leg at the knee

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21
Q

purpose of Slump test

A

pain should be the same as in straight leg raiser

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22
Q

findings of Slump test

A

if positive then possible disc bulge or herniation

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23
Q

procedure for Crossed straight leg raiser

A

is the same as straight leg raiser but done on ASYMPTOMATIC side first

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24
Q

purpose of Crossed straight leg raiser

A

attempt to reproduce leg pain

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25
Q

findings of Crossed straight leg raiser

A

if symptoms are at same angle as straight leg raiser then possible posteromedial disc bulge or herniation
if symptoms are at increased angle of straight leg raiser then possible posterolateral disc bulge or herniation

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26
Q

procedure of Fajersztajn’s test

A

performs crossed straight leg raiser (on asymptomatic side!), then lowers leg 5 degrees and dorsiflex foot

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27
Q

purpose of Fajersztajn’s test

A

attempt to reproduce leg pain

28
Q

findings of Fajersztajn’s test

A

if pain is at the same angle as Braggard’s sign, then possible posteromedial disc bulge or herniation
if pain is at a greater angle than Braggard’s sign, then possible posterolateral disc bulge or herniation

29
Q

procedure for Cox sign

A

perform straight leg raiser and the patient will raise ipsilateral hip to alleviate pain

30
Q

findings of Cox sign

A

positive may indicate SOL, IVF enroachment, radiculopathy, nerve root tension, sciatica

31
Q

procedure for Ely’s test

A

patient lies prone and Dr touches heel of foot to opposite buttock

32
Q

purpose of Ely’s test

A

to produce pain in anterior thigh and/or groin

33
Q

findings of Ely’s test

A

radiating pain could be from femoral nerve or upper lumbar nerve root compression
localized pain could be from quad muscle

34
Q

procedure for Femoral nerve traction test

A

patient lies with unaffected side up, bottom leg straight, top leg bent at the knee then Dr extends the thigh back to traction nerve

35
Q

purpose of Femoral nerve traction test

A

to reproduce pain in anterior thigh (femoral nerve)

36
Q

findings of Femoral nerve traction test

A

radiating pain to the groin may mean L1 nerve root radiculopathy
radiating pain to the anterior mid thigh may mean L3 nerve root radiculopathy

37
Q

procedure for Heel/toe walking test

A

patient walks on their heels a few steps (tests dorsiflexion), then walks on toes a few steps (tests plantar flexion)

38
Q

findings of Heel/toe walking test

A

if patient can’t walk on heels then may be L5 problem (L4 disc)
if patient can’t walk on toes then may be S1 problem (L5 disc)

39
Q

procedure for Kemps test

A

patient is seated, Dr hand on lumbars on side of pain and on shoulders for support, then patient is flexed obliquely away from side of pain, then circled forward around to side of pain, then jut belly out to come into extension, then Dr compresses shoulder on side of pain

40
Q

purpose of Kemps test

A

to elicit pain in low back

41
Q

findings of Kemps test

A

local pain with rotation or pain on convex side means capsulitis
local pain with extension or pain on concave side means facet problem
pain (radiating) with flexion means disc lesion
could also be radiculopathy, sprain/strain, etc

42
Q

procedure for Kernig’s sign

A

patient lies supine, Dr flexes hip and knee to 90 degrees then Dr extends leg

43
Q

purpose of Kernig’s test

A

elicit pain in head or spine (increasing headache means positive sign); opposite knee and hip may also flex

44
Q

findings of Kernig’s test

A

pain with fever means meningitis

45
Q

procedure for Brudzinski sign

A

patient lies supine and Dr flexes patient’s head toward xiphoid process

46
Q

purpose of Brudzinski sign

A

trying to elicit pain in head or spine; opposite knee and hip may also flex

47
Q

findings of Brudzinski sign

A

pain with fever means meningitis

48
Q

procedure for Lasegue test

A

patient lies supine and Dr flexes hip and knee to 90 degrees, then try to extend the leg

49
Q

purpose of Lasegue test

A

trying to elicit pain in hip, low back, or thigh

50
Q

findings of Lasegue test

A

hip pain means hip pathology
thigh or leg pain means radiculopathy
bilateral pain means tight hamstrings

51
Q

procedure for Lindner’s sign

A

patient is seated or supine and Dr passively flexes patients chin to chest

52
Q

purpose of Lindner’s sign

A

puts traction on meninges and nerve roots

53
Q

findings of Lindner’s sign

A

pain in low back and sciatic nerve means nerve root irritation
supine version means meningitis
seated version means cervical myelopathy or meningitis

54
Q

procedure for Milgram’s test

A

patient lies supine and lifts feet 6 inches off table and holds for 30 seconds

55
Q

findings of Milgram’s test

A

if patient is unable to hold because of:
low back pain means herniation or sprain/strain
no pain then weak core muscles

56
Q

procedure for Minor’s sign

A

Dr has the patient stand from a seated position and sign is present if they have to use upper body strength to stand

57
Q

purpose of Minor’s sign

A

to see if there is recruitment of upper body strength to stand up

58
Q

findings of Minor’s sign

A

SI joint lesion, L5 strain/sprain, lumbo-pelvic fracture, disc syndrome, sciatica

59
Q

procedure for Nachla’s test

A

patient lies prone and Dr attempts to touch the heel of foot to ipsilateral buttock

60
Q

purpose of Nachla’s test

A

test attempts to produce pain in anterior thigh and/or groin area

61
Q

findings of Nachla’s test

A

radiating pain may be from femoral nerve or lumbar spine nerve root compression
localized pain may be from quad muscle contracture

62
Q

procedure for Quick test

A

patient supports themselves with hand against wall or table then they do 5 deep squats with a bounce at the bottom

63
Q

purpose of Quick test

A

looking for pain/locking/crepitus in low back, hips, knees, ankles
don’t perform on elderly or pregnant

64
Q

findings of Quick test

A

pain/locking/crepitus in low back, hips, ankles, knees

65
Q

procedure for Bilateral leg lowering test

A

patient lies supine and Dr flexes hips to 90 degrees with legs extended (take both straight legs to 90 degrees), then patient lowers legs until Dr tells them to stop at about 45 degrees

66
Q

purpose of Bilateral leg lowering test

A

looking for lumbo-sacral sprain/strain, facet syndrome, or disc lesion

67
Q

findings of Bilateral leg lowering test

A

pain in buttocks, SI joint, or lower extremity, or leg drops because of pain

NMS 2 Exam One (5 decks)

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