Lumbar Spine Exam Flashcards
What is normal Ferguson’s angle?
30-40 degrees
What is Ferguson’s angle?
Represents angle of the lumbosacral junction as measured by inciniation of the first sacral vertebra to the horizontal
In spondylolysis as seen as the scottie dog collar, where exactly is the fracture?
Pars interarticularis
what is spondylolisthesis?
anterior slippage of one vertebra on another after a pars-interartularis fracture
what muscle can you use to check the motor function of L1?
Ilipsoas (hip flexion) - innervation form L1-L3
What muscle you can check to check for the motor function of L4?
Quadriceps (knee extension)
what muscle can you check to check for the motor function of s1?
Gastrocnemius (ankle planterflexion)
Hip adductors are innervated by what nerve root?
L2-L3
when you’re asking patient to walk on their heel, what nerve root are you checking?
L5 (dorsiflexors)
What nerve root is the most common radiculopathy affecting the lumbosacral spine?
L5
when pt is asked to walk on their toes to test for strength of plantarflexor (gastrocnemius/soleus complex) what nerve root is being checked?
S1
what is the straight leg test used for?
Used to test for lumbosacral radiculopathy and/or sciatic neuropathy.
where it the most common site of disc herniation in the lumbar region?
L5-S1
How do you perform a straight leg test?
Pt supine, raise pts relaxed and straightened leg, flexing at the hip.
what is a positive test for straight leg test?
Positive sign usually occurs at 30-60 degrees.
why do you have to raise at least to 30 degrees to to check for nerve root compression as seen in straight leg test?
Dura is not stretched until 30 degrees.
in straight leg test, pain in greater than 70 may still indicate nerve root compression, but increase likelihood that pain is due to _
mechanical low back pain due to muscle strain or joint disease.
Straight leg by itself is not so specific. what else can you perform to increase the specificity of the straight leg test finding?
Perform the contralateral (crossed) straight leg raise test)
what is Hoover’s sign?
It is a test for malingering or functional weakness (conversion disorder)
How is Hoover’s sign test performed? what is positive
Pt supine, hold hand under the heel of the unaffected leg and ask pt to flex the affected leg against slight resistance while maintaining extension at knee. + = no downward force on the unaffeted leg as they attempt to lift the affected leg.
What is the Thomas test, how do you perform it and what is a positive test?
psoas tension. Pt tested in supine position with buttocks towards ends of table. Flex both hips and knes to chest and drop the affected leg toward the table, keeping the other knee at chest. Positive test is that the lower extremity on the involved side will be unable to fully extend at hip. Indicates ilipsoas tension, shortening or contracture which is a common finding in acute and chronic low back pain.
What is Gaenslen test, how do you perform it and what is positive?
Tests for SI joint pain. Pt supine, flex on hip and knee to chest while simultaneously extending oppsoite hip (off side of the table). Maneuver stresses both SI joints. Positive pelvic pain indicates a positive test for SIJ dysfunction or pathology
What is the rationale behind valsalva as a way to test for sciatica/lumbar?
Sciatica due to disc herniation usually increase with coughing, sneezing or performance of valsalva maneuver.
What is Kerng’s sign, how do you perform it and what is positive test?
Kernig’s sign is testing for meningeal irritation. Pt supine, and flex hip and knee to 90. Attempt to passively extend the leg at knee. Positive = increased resistance to extension and pain behind knee.
