LUMBAR SPINE

Question 1

SLUMP TEST

Answer 1

Pt seated on edge of couch
Pt slumps (shoulders sag, spine flexed)
Examiner holds pt head and chin up
If no symptoms - flex pt head and apply pressure
If no symptoms - extend pt leg
If no symptoms - dorsiflex pt foot
Repeat on other side

Question 2

SLUMP TEST - WHAT DOES IT TEST?

Answer 2

Acute inflammatory lesion
Local sprain/strain
Facet irritation
Fracture
Increased pressure on nerve root
DJD
Osteophytes
Disc
Radiculopathy

Question 3

SLUMP TEST - POSITIVE TEST

Answer 3

Reproduction of symptoms - shooting or electrical leg pain (increased pressure on nerve root)
Local lumbar sacral pain (acute inflammatory lesion, local sprain/strain, facet irritation, spinal fracture)

Question 4

KEMPS TEST (SEATED)

Answer 4

Pt seated on edge of couch
Rest forearms on shoulders
Apply force down
If no pain
Extension + compress
Extension + rotation + compress (asymptomatic side first)

Question 5

KEMPS TEST (STANDING)

Answer 5

Pt standing
Pt wraps arm around and touch back of their leg (leg that’s same side as arm first)
Repeat on other side

Question 6

KEMPS TEST - WHAT DOES IT TEST?

Answer 6

Acute inflammatory lesion
Local sprain/strain
Facet irritation
Spinal fracture
Increased pressure on nerve root
DJD
Osteophyte
Disc
Radiculopathy

Question 7

KEMPS TEST - POSITIVE TEST

Answer 7

Localised pain (acute inflammatory lesion, local sprain/strain, facet irritation, spinal fracture)
Increased peripheral pain or numbness (increased pressure on nerve root)

Question 8

STRAIGHT LEG RAISE

Answer 8

Supine
Flex pt leg from hip, leg fully extended
Raise leg until pain/discomfort and lower leg so its out of the painful range
Dorsiflex foot - Bragards
Flex big toe - Cicards

Question 9

STRAIGHT LEG RAISE - WHAT DOES IT TEST?

Answer 9

Increased pressure on nerve root
DJD
Osteophytes
Piriformis nerve entrapment
SI/lumbar sprain or strain

Question 10

STRAIGHT LEG RAISE - POSITIVE TEST

Answer 10

Radicular pain (shooting) (increased pressure on nerve root)
Localised lumbarsacral pain (piriformis entrapment SI/lumbar sprain/strain)

Question 11

FEMORAL NERVE TRACTION TEST

Answer 11

Pt lay on asymptomatic side
Flex lower leg
Neutral spine
Head slightly flexed
Extend top leg to 15
Flex knee to stretch femoral nerve more

Question 12

FEMORAL NERVE TRACTION TEST - WHAT DOES IT TEST?

Answer 12

Femoral nerve or root compression

Question 13

FEMORAL NERVE TRACTION TEST - POSITIVE TEST

Answer 13

Radiation down anterior thigh (shooting or electrical pain)
Pain in groin and hip that radiates along anterior/medial thigh = L3 nerve root problem
Pain extending to mid tibia indicates L4 nerve root problem