Lumbar Spine Examination Flashcards
Patellar deep tendon reflex primarily assess which nerve root (s)
L2-L4
Achilles deep tendon reflex primarily assess which nerve root
S1
Straight leg test positive sign indicates what
Lumbar/sacral radiculopathy
Contralateral straight leg raise tests for what
Increases specificity of straight leg test
Spinal nerve radiculopathy?
How to test if a patient is malingering during a leg raise test
Hold contralateral leg and monitor for extension
Involuntary extension will accompany voluntary hip flexion
Thomas test examines what
Iliopsoas contracture
What does Ferguson’s angle represent?
30-40 degrees
Represents angle of lumbosacral junction as measured by inclination of first sacral vertebra to the horizontal
Spondylolysis fracture of pars inter articular is
Scottie dog fracture
Intervertebral neural foramina of lumbar vertebra are located on which end
Inferior end
Contain spinal nerve roots, recurrent meningeal nerves and radical rise blood vessels
Things that can decrease intervertebral neural foramina space
Extension (Pericles glade towards one another) arthritis, spurs, hypertrophy of posterior longitudinal ligament, herniation of nucleus pulposa, tissue congestion/edema, inflammation, perineural edema
The IV discs are named for the vertebrae ______ them
Above them
Vertebrae are more likely to herniate in what direction
Posteriorly
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
Zygapophyseal joint tropism
Things that can make a patients posture appear slumped over
Psychiatric considerations, muscle spasms, reactive effort (relief of pressure form condition impinging lumbar nerves in intervertebral foramen)
Things that can make a patients posture appear erect
Protection from herniated disk or effects of spinal stenosis
Gait may appear as if ts listing to one side if what has occurred
Disc herniation
Muscle weakness of gluteus medius
Lumbar vertebra pathologies
Spondylolisthesis
Fracture/dislocation
Underlying infection
Arthritis
SI joint pathologies assessed with palpating
Sacroilitis
Ankylosis spondylitis.
Paravertebral muscle etiologies assessed with palpating
Degenerative/inflammmatory MSK abnormalities, overuse injury, poor posture, anxiety, somatic dysfunction
Lumbar ROM
Flexion 40-90
Extension 20-45
Rotation 3-18
Sidebending 15-30
Positive straight leg test may indicate what between angles of 30-60
Lumbosacral radiculopathy (usually Fromm a herniated disc) or sciatic neuropathy
A straight leg test may also produce positive findings above 70 degrees, but these are due to what
Muscle contracture, mechanical low back pain from joint or muscle strain
Contralateral straight leg raise test indicates what
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
Hoover’s sign
Test if a patient is malingering
+ test = no downforce detected in unaffected leg when they try to raise affected leg
