NMS 2 Flashcards
Trendelenburg test
patient stands and raises one foot and then the other while the doctor observes the butt
positive: butt on foot that is elevated drops
indicates: hip abductor weakness on stance leg side
ely’s sign
patient side lying, involved side up. doctor places one hand on plevis. thigh is abducted and extended. the doctor then alows the leg to drop into adduction
positive: knee stays elevated
indicates: TFL contracture
barlow’s
bone with baby’s hip in adduction, in which gentle posterior pressure is placed on each hip, one at a time
positive: deep sounding “thunk” as ball subluxates out of socket
ortolani’s
infant supine. legs are abducted and externally rotated
positive: palpable or audible click
indicates: congenital hip dislocation
allis
patient supine. patient flexes both knees to 90 degrees with feet placed flat on table and both maleoli are approximated. doctor compares height of knees
positive: significant difference
indicates; posterior displaced femoral head or femur shortening
thomas test
while the patient is supine the thigh is flexed with knee bent upon the abdomen
positive: oppostive thigh/knee rises off table
indicates hip flexion contracture (psoas)
laguerre’s test (patrick fabre in air)
patient supine, doctor flexes, abducts and laterally rotates hip. doctor then aplies pressure over oppositve ASIS with one hand and with other hand presses down knee
positive: pain inhip
indicates: hip joint lesion, SI lesion
patrick’s test (fabre’s)
patient supine. thigh is flexed, abducted, externally rotated and extended while downward pressure is placed on opposite ASIS and same knee
positive: pain inhip
indicates: hip lesion
yeoman’s
doctor stabilizes SI joint esting with other hand. doctor flexes leg of affected side and hyperextends the thigh by lifting knee off table
nachlas test
leg flexed to 90. heel approxiated to same butt. doctor stabilzes side they are testing
positive: pain in SIjoint
indicates: SI lesion or if pain is on anterior thigh: femoral nerve stretch
hibb’s
doctor stabilizes pelvis on side they are standing. with other and, doctor grasps the ankle of the opposite leg and flexes kee to 90 degrees. doctor slowly pushes leg laterally away producing internal rotation of the hip
pain in femur- hip pathology
iliac compression
patient is in side-lying position with involved side up. doctor’s hands are placed over the upper part of the iliac crest. doctor exerts donward pressure
lewin-gaenslen’s
patient lies on unafffected side and pulls lower knee to chest. doctor stands behind patient stabilizes pelvis and hyperextends the top thigh
hip abduction stress test
patient is lying on non affected side. patient actively abducts leg, then doctor exerts downward pressure proximal to knee
positive: pain at PSIS
indicates: SI joint problems, glute medius weaknesss
minor’s sign
ask patient to rise from seated position
positive: patient will support body with uninvolved side balancing on good side
indicates: sciatica
becterew’s sitting test
patient seated. patient attempts to extend each leg one at a time. doctor places one hand on the side being tested to resist hip flexion by the patient. patient then attempts to extend both legs together with both thighs stabilized by the doctor
positive: pain or leaning back
indicates: disc, posteromedial disc if pain when good leg raised
neri’s bowing
when bending forward from waist the knee flexes on side of involvement
positive: knee bucking
indicates: tight hamstring (disc problem, SI sprain/strain, lumbosacral lesions)
kemp’s
patient seated/standing and supported by doc. doctor rotates patient’s trunk from the original position and circumducts the trunk otward the affected side and then away from the affected side
positive: sciatic pain down involved side
indicates: posteromedial disc(kemp’s away from pain), posterolateral disc(kemp’s into pain, localized pain(facet)
belt test AKA supported adam’s test
patient bends forward and the examiner notes when the pain occurs. then while doctor is behind the patient the doctor grasps the ASIS and braces their hip into the sacrum. the patient then flexes again and ROM is noted.
if lesion is in pelvis, patient will have no pain while pelvis is stabilized
lesion is in the spine, pain will present in both situations
bonnet’s sign
when the patient supine the doctor stands on side being tested. doctor internally rotates leg, adducts leg, then performs SLR
positive: radicular pain into limb
indicates: piriformis syndrome
bowstring sign
doctor performs an SLR to the point of pain. knee is flexed slightly and placed on doctor’s shoulder. digital pressure is placed above the popliteal fossa and then in the popliteal fossa
positive: apin in lumbar region or radiculopathy
indicates: sciatica
lindner’s sign
patient’s head is pasivley flexed to chest
positive: pain in lumbar region radiating to sciatic nerve
indicates: root sciatica
goldthwait’s
patient supine with affected leg raised slowly while hand is under lumbosacral portion of spine. repeat on other side
positive: pain
indicates: 0-30:SI, 30-60:lumbosacral, 60-90: lumbar spine or contralateral SI
milgram’s
patient is supine with limbs extended. patient is aske dto elevate legs until 6 inches off table and hold for as long as possible
positive: pain
indicates SOL
WLR (fajerstazn’s)
SLR with dorsiflexion of foot is performed on asymptomatic side of sciatic patient
positive: pain down symptomatic side
indicates: medial disc lesion