Lumbar Spine Flashcards
What are the steps for the lumbar spine that you’re going to need to do with the presentation
8 steps to get all points
1) sanitize hands
2) inspection of lumbar spine and verbalize your findings (anatomical landmarks, posture, whatever… scars, structural exam)
3) palpation of lumbar spine on skin (skin, spinous and transverse, SI joint and paravertebral)
4) ROM of lumbar spine (F/E, SB,R)
5) LE extremity strength testing and verbalize finding (bilaterally) –> hip flexors, knee flexors/extensors, ankle flexors/extensors
6) sensory testing on LE.. make sure they’re the same on each sideprobably should do pulse as well
7) LE DTR (at least one)
8) specialty testing
Perform a lower spine exam
have them lay on their stomach, look at L1-L5
note the dysfunction
then TV watching and child’s pose
**can do it seated!!
ROM of the lumbar spine?
F - 40-90
E - 20-45
Rotation - 3-18
sidebending - 15-30
What artery are you going to palpate?
dorsalis pedis (removing sock)
popliteal fossa pulse
posterior tibialis
Patellar tendon tests what?
Achilles Tendon?
L4
S1
LE strength testing:
what are you testing
what is the strength testing #?
they’re sitting off the edge of the table, you put your hands on their thigh above the knee and have them push up –> hip flexors
on the anterior portion of the leg, then posterior
then on the top of the foot and bottom of the foot
+5/5
Straight Leg Test?
straight leg raise,
at 45 degrees, complaint of radiating pain.. lumbosacral radiculopathy or sciatic neuropathy
15 or less –> IT band
75+ –> mechanical low back pain due to muscle strain
Sensation testing
bilateral touching, single touching.
know your dermatomes
make sure they close their eyes
What is the contralateral straight leg test?
raise the leg up and the opposite leg has radiating pain between 30 and 60 degrees –> lumbar radiculopathy and/or sciatic neuropathy
What is Hoover’s sign?
You hold your hand under the heel of the unaffected leg
ask the patient to try and flex the affected leg against slight resistance
if an honest effort is made, you should feel unaffected leg’s heel pushing down as they attempt to raise the affected leg
+ test –> no downward force –> malingering
Thomas Test?
Patient supine with buttocks towards the end of the table
flex both hips and knees to the chest, have the patient extend the AFFECTED leg towards the table
+ test would be if the LE on the involved side is not able to fully extend at the hip (i.e. thigh/popliteal region not flat on the table)
this indicates Iliopsoas tension, shortening or contracture
**iliopsoas hypertonicity
Gaenslen Test?
flex one hip and knee to chest while simultaneously extending the OPPOSITE hip (off side of table)
+ test is posterior pelvic pain
indicates sacroiliac joint dysfunction or pathology
