Lumbar Spine and Trunk

Question 1

Test myotome of L2

Answer 1

hip flexion

Question 2

Test myotome of L3

Answer 2

knee extension

Question 3

Test myotome of L4

Answer 3

dorsiflexion and inverion

Question 4

Test myotome of L5

Answer 4

big toe extension

Question 5

Test myotome of S1

Answer 5

eversion

Question 6

Test myotome of S2

Answer 6

plantarflexion

Question 7

Test dermatome of L2

Answer 7

to half way down thigh - centrally and laterally

Question 8

Test dermatome of L3

Answer 8

knee and medial lower thigh

Question 9

Test dermatome of L4

Answer 9

medial lower leg and big toe

Question 10

Test dermatome of L5

Answer 10

lateral lower leg and middle 3 toes

Question 11

Test dermatome of S1

Answer 11

sole of foot from 5th toe, and heel/achilles

Question 12

Test dermatome of S2

Answer 12

posterior middle thigh and posterior middle upper calf

Question 13

Three things suggesting positive reflex test?

Answer 13

total absence
reduced reflex
increased reflex

Question 14

positive clonus test sign and meaning

Answer 14

tests for UMN legion

jerking movement as return to neutral

Question 15

positive babinski reflex sign and meaning

Answer 15

1st toe extends and toes fan out - normally toes flex to protect sole of foot

tests for UMN legion

Question 16

Attachments of Rectus Abdominus

Answer 16

• Origin: Anterior surface of symphysis pubis & pubic crest.
• Insertion: Xiphoid process & Costal cartilage of ribs 5, 6 & 7.

Question 17

Attachments of extenal oblique

Answer 17

• Origin: Outer borders of lower 8 ribs & their costal cartilages
• Insertion: Outer lip of anterior 2/3 of iliac crest, linea Alba via aponeurosis & pubic tubercle.

Question 18

Attachments of internal oblique

Answer 18

• Origin: Lateral 2/3 inguinal ligament, anterior 2/3 iliac crest & thoracolumbar fascia.
• Insertion: Inferior border lower 4 ribs, linea Alba via aponeurosis & pubic crest via conjoint tendon with transversus abdominus.

Question 19

Attachment of Erector Spinae - Illiocostalis lumborum

Answer 19

Spinous processes & supraspinous ligaments T11-5, posterior sacral crests, sacrotuberous ligament & posterior iliac crest.

Inserts by slips into the inferior borders of lower 6 ribs.

Question 20

What is the compression test?

Answer 20

Patient side lying - push downwards over iliac crest - compresses both SIJ

positive test - pain

Question 21

What is the Distraction Test?

Answer 21

Heels on ASIS - push down and inwards

positive test - pain

Question 22

What is the Thigh Thrust Test?

Answer 22

ASK CONSENT

patient close to edge of bed
flex far leg - support in axilla
palm down under far leg buttock
downwards pressure on the femur

test both sides

positive - pain on SIJ on flexed side

Question 23

What is the Gaenslens test?

Answer 23

Ask them to hold their knee flexed on opposite side to you

lower other leg off plinth
apply down pressure to knee off the plinth

Positive test - pain

Question 24

what forces are placed on the SIJ on the Gaeslens test?

Answer 24

posterior rotation force of the (R) ilium at the (R) SIJ and an anterior
rotation force of the (L) ilium at the (L) SIJ.

(if L leg is lowered off plinth)

Question 25

Nerve supply to: External oblique

Answer 25

Lower 6 Thoracic & 1st Lumbar Nerves

Question 26

Nerve supply to: internal oblique

Answer 26

Lower 6 Thoracic & 1st Lumbar Nerves

Question 27

Nerve supply to: rectus femoris

Answer 27

Lower 6 Thoracic Nerves

Question 28

Nerve supply to: erector spinae

Answer 28

Dorsal rami of thoracic and lumbar spinal nerves (T7 to L3)