Lumbar Spine Examination

Question 1

Patellar deep tendon reflex primarily assess which nerve root (s)

Answer 1

L2-L4

Question 2

Achilles deep tendon reflex primarily assess which nerve root

Answer 2

S1

Question 3

Straight leg test positive sign indicates what

Answer 3

Lumbar/sacral radiculopathy

Question 4

Contralateral straight leg raise tests for what

Answer 4

Increases specificity of straight leg test

Spinal nerve radiculopathy?

Question 5

How to test if a patient is malingering during a leg raise test

Answer 5

Hold contralateral leg and monitor for extension

Involuntary extension will accompany voluntary hip flexion

Question 6

Thomas test examines what

Answer 6

Iliopsoas contracture

Question 7

What does Ferguson’s angle represent?

Answer 7

30-40 degrees

Represents angle of lumbosacral junction as measured by inclination of first sacral vertebra to the horizontal

Question 8

Spondylolysis fracture of pars inter articular is

Answer 8

Scottie dog fracture

Question 9

Intervertebral neural foramina of lumbar vertebra are located on which end

Answer 9

Inferior end

Contain spinal nerve roots, recurrent meningeal nerves and radical rise blood vessels

Question 10

Things that can decrease intervertebral neural foramina space

Answer 10

Extension (Pericles glade towards one another) arthritis, spurs, hypertrophy of posterior longitudinal ligament, herniation of nucleus pulposa, tissue congestion/edema, inflammation, perineural edema

Question 11

The IV discs are named for the vertebrae ______ them

Answer 11

Above them

Question 12

Vertebrae are more likely to herniate in what direction

Answer 12

Posteriorly

Question 13

Most common lumbar congenital abnormality: articular pillars on one side of vertebral unit are twisted so plane of joint does not match that of other side
Assessed with asymmetric muscle tensions and altered spinal motions

Answer 13

Zygapophyseal joint tropism

Question 14

Things that can make a patients posture appear slumped over

Answer 14

Psychiatric considerations, muscle spasms, reactive effort (relief of pressure form condition impinging lumbar nerves in intervertebral foramen)

Question 15

Things that can make a patients posture appear erect

Answer 15

Protection from herniated disk or effects of spinal stenosis

Question 16

Gait may appear as if ts listing to one side if what has occurred

Answer 16

Disc herniation

Muscle weakness of gluteus medius

Question 17

Lumbar vertebra pathologies

Answer 17

Spondylolisthesis
Fracture/dislocation
Underlying infection
Arthritis

Question 18

SI joint pathologies assessed with palpating

Answer 18

Sacroilitis

Ankylosis spondylitis.

Question 19

Paravertebral muscle etiologies assessed with palpating

Answer 19

Degenerative/inflammmatory MSK abnormalities, overuse injury, poor posture, anxiety, somatic dysfunction

Question 20

Lumbar ROM

Answer 20

Flexion 40-90
Extension 20-45
Rotation 3-18
Sidebending 15-30

Question 21

Positive straight leg test may indicate what between angles of 30-60

Answer 21

Lumbosacral radiculopathy (usually Fromm a herniated disc) or sciatic neuropathy

Question 22

A straight leg test may also produce positive findings above 70 degrees, but these are due to what

Answer 22

Muscle contracture, mechanical low back pain from joint or muscle strain

Question 23

Contralateral straight leg raise test indicates what

Answer 23

Used in conjunction with the straight leg raise test, can increase its specificity

+ pain in the contralateral leg indicates lumbosacral radiculopathy and/or sciatic neuropathhy

Question 24

Hoover’s sign

Answer 24

Test if a patient is malingering

+ test = no downforce detected in unaffected leg when they try to raise affected leg

Question 25

Thomas tests assesses what condition

Answer 25

Iliospoas tension/shortening/contracture

Question 26

Patient supine, flex one hip and knee to chest while extending opposite hip off table

Positive test is presence of posterior pelvic pain

What is this test and what does it indicate

Answer 26

Gaenslen test

Indicates SI joint dysfunction or pathology

Question 27

The valsalva test and indicate what pathology

Answer 27

Sciatica

+ test is sharp/burning pain radiating down the posterior or lateral aspect of leg when patient holds breath and bears down

Question 28

Patient standing, patient flexes hip and knee of one leg and hyperextends lower back

Answer 28

Stork test

Question 29

Positive stork test indicates

Answer 29

Possible pars defect/stress fracture

If bilateral, increased risk of spondylolisthesis

Question 30

What is a positive stork test

Answer 30

Pain in lower back as it stresses the posterior elements of spine on the ipsilateral side

Question 31

Features of cauda equine syndrome

Answer 31

Lower back pain
Bowel/bladder dysfunction
Saddle anesthesia (sensory loss of perineum and decreased anal sphincter tone)
Bilateral sciatica and leg weakness

Emergency