M4 Lumbar Orthos

Question 1

Pt supine. Doctor at end of table by feet. Slowly lift extended leg up. Normal = no pain in first 15-30 degrees

Answer 1

Straight Leg Raise (SLR)

Question 2

Test follows pain with SLR. Lift leg up until it hurts, just like in SLR, drop down 10-15 degrees and dorsiflex patient’s foot. Positive is reproduction of pain.

Answer 2

Bragard Sign

Question 3

What are the SLR and Bragard’s testing for?

Answer 3

Sciatica, Space Occupying Lesion (SOL)

Question 4

Test is follow up to Bragard’s. Release patient’s foot, extend great toe. Positive is reproduction of symptoms.

Answer 4

Sicard’s Test

Question 5

Follow up to SLR. Doctor raises UNAFFECTED leg straight up. Positive is pain reproduced on affected side.

Answer 5

Well leg raise

Question 6

What is being tested for in the well leg raise?

Answer 6

Space occupying lesion (SOL)

Question 7

Follow up test to well leg raise. Drop unaffected leg down 10-15 degrees, dorsiflex foot. Positive is reproduction of pain on affected side.

Answer 7

Fajersztajn’s sign

Question 8

Pt. Supine. Hand under back at lumbopelvic junction. Lift up each leg individually (legs are straight). Legs to same height = lumbosacral problem. Unaffected leg raises higher = SI Joint problem

Answer 8

Smith-Peterson Test

Question 9

Pt. Seated. Have pt extend one leg, then the other. Then one at a time, press down on their leg slightly above the knee (pt attempts to keep it up). Finally, have patient extend both legs and press down on them at the same time. Positive is unable to perform due to pain, pt leaning back to assist, or reproduction of sciatic type pain.

Answer 9

Bechterew’s test

Question 10

Pt supine. Doctor raises both legs to 90 degrees, patient lowers them to 45 and holds. Positive for SOL if patient cannot do it.

Answer 10

Double leg raise

Question 11

Pt supine. Patient raises both legs up about 6 inches and holds. Positive would be pain - SOL

Answer 11

Milgram’s test

Question 12

Pt supine. Doctor brings knee to almost 90 degrees, rest foot on shoulder and put pressure on hamstring. If no pain put pressure on popliteal fossa. Positive is reproduction of radiating pain/pain in low back.

Answer 12

Bowstring test

Question 13

Pt on side. Doctor extends hip 15 degrees and flexes knee (stretches femoral nerve). Positive is radiating pain in anterior thigh

Answer 13

Femoral traction test

Question 14

Pt standing. Have them bend forward to touch toes. Positive is knee flexing on affected side. Could be lumbar disc, lumbosacral or SI joint problem

Answer 14

Neri’s test

Question 15

Pt supine. Doctor lifts head (flexes). Positive is pain in low back/down leg.

Answer 15

Lindner’s test

Question 16

Pt supine. Doctor flexes head to chest. Patient’s knees flex. Positive for meningitis.

Answer 16

Brudzinski’s test

Question 17

Pt seated or standing. Doctor starts by turning patient away from side being tested and circumducts to the test side, then presses P-A, L-M on low back to maximize stress on facets/discs.

Answer 17

Kemp’s test

Question 18

Pt supine. Doctor flexes knee to 90 degrees while externally rotating hip and places that ankle on top of opposite leg’s knee (just proximal). Doctor applies pressure to straight leg’s ASIS while pressuring crossed leg’s medial knee area. Positive is pain in hip.

Answer 18

Patrick’s test (Faber)

Question 19

This test is similar to Patrick’s, but crossed leg is elevated instead of pressured. Positive is pain in hip or SI joint.

Answer 19

Laguerre’s test