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7 - CLET Lab > Orthopedic Diagnosis: Lumbar Spine > Flashcards

Orthopedic Diagnosis: Lumbar Spine Flashcards

1
Q

Hoover Sign

A
  • Positive: Lack of counter-pressure on the healthy side
    • Indicates: Lack of organic basis for paralysis (malingering/hysteria). With organic hemiplegia, the patient will still exert downward pressure when attempting to raise the paralyzed leg
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2
Q

Straight Leg Raiser

A
  • Positive: Radiating pain and/or dull posterior thigh pain
    • Indicates: Sciatic radiculopathy or tight hamstrings
      1. Positive between 35-70º = possible discogenic sciatic radiculopathy
      2. Positive > 70º = tight hamstrings
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3
Q

SLR

A
  • Positive: Radiating pain and/or dull posterior thigh pain
    • Indicates: Sciatic radiculopathy or tight hamstrings
      1. Positive between 35-70º = possible discogenic sciatic radiculopathy
      2. Positive > 70º = tight hamstrings
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4
Q

Goldthwait Sign

A
  • Positive: Localized pain, low back or radiating pain down the leg
    • Indicates: Lumbosacral or sacroiliac pathology
      1. Pain occuring after the lumbar spinouses move = possible lumbosacral problem
      2. Pain occuring before the lumbars move = possible scroiliac problem
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5
Q

Bragard Sign

A
  • Positive: Radiating pain in posterior thigh
    • Indicates: Sciatic radiculopathy
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6
Q

Buckling Sign

A
  • Positive: Pain in the posterior thigh with sudden knee flexion (buckle)
    • Indicates: Sciatic radiculopathy
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7
Q

Bowstring Sign

A
  • Positive: Pain in the lumbar region or radiculopathy
    • Indicates: Sciatic nerve root compression, helps rule out tight hamstrings
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8
Q

Lasegue Test

A
  • Positive: Reproduction of sciatic pain before 60º
    • Indicates: Sciatica
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9
Q

Milgram Test

A
  • Positive: Inability to perform the test and/or low back pain
    • Indicates: Weak abdominal muscles or space occupying lesion
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10
Q

Valsalva Maneuver

A
  • Positive: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)
    • Indicates: Space occupying lesion (e.g. disc pathology)
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11
Q

Bechterew Test

A
  • Positive: Reproduction of radicular pain or inability to perform correctly due to tripod sign
    • Indicates: Sciatic radiculopathy
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12
Q

Neri Bowing Test

A
  • Positive: Pain accompanied by flexion of the knee on th affected side and body rotation away from the affected side
    • Indicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response
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13
Q

Neri Sign

A
  • Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
    • Indicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response
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14
Q

Anterior Innominate Test

A
  • Positive: The inability to bend at the waist more than 45º becuase of either/or
    1. Radiating pain along the sciatic nerve, either unilateral or bilateral
      • Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
    2. Low back pain (lumbar or pelvic regions)
      • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
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15
Q

Mazion Pelvic Maneuver

A
  • Positive: The inability to bend at the waist more than 45º, because of either/or
    1. Radiating pain along the sciatic nerve, either unilateral or bilateral
      • Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
    2. Low back pain (lumbar or pelvic regions)
      • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
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16
Q

Advancement Sign

A
  • Positive: The inability to bend at the waist more than 45º because of either/or
    1. Radiating pain along the sciatic nerve, either unilateral or bilateral
      • Indicates: Sciatic neuralgia or radiculopahty, etc., possibly due to lumbar disc pathology
    2. Low back pain (lumbar or pelvic regions)
      • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
17
Q

Lewin Standing Test

A
  • Positive: Radiating pain down the leg causing flexion of the patient’s knee or knees
    • Indicates: Gluteal, lumbosacral or sacroiliac pathologies
18
Q

Heel Walk

A
  • Positive: Inability to perform the test
    • Indicates: L4-L5 disc lesion (L5 nerve root)
19
Q

Toe Walk

A
  • Positive: Inability to perform the test
    • Indicates: L5-S1 disc lesion (S1 nerve root)
20
Q

Ely Heel to Buttock Test

A
  1. Positive: Inability to raise the thigh
    • Indicates: Iliopsoas spasm
  2. Positive: Pain in the anterior thigh
    • Indicates: Inflammation of the lumbar nerve roots
  3. Positive: Pain in the lumbar region
    • Indicates: Lumbar nerve root adhesions
21
Q

Minor Sign

A
  • Positive: Knee flexion of affected leg which supporting upper body weight (hand on back or thigh) on unaffected side
    • Indicates: Sciatica, lumbosacral or sacroiliac joint lesion
22
Q

Belt Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum non-stabilized bending and no pain during sacrum stabilized bending
    • Indicates: Pelvic involvement
23
Q

Supported Adam Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum non-stabilized bending and no pain during sacrum stabilized bending
    • Indicates: Pelvic involvement
24
Q

Supported Forward Bending Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum stabilized bending and no pain during sacrum stabilized bending
    • Indicates: Pelvic involvement
25
Q

Kemp Test

A
  1. Positive: Pain usually radicular, recreating existing sciatic pain
    • Indicates: Disc protrusion
      1. In medial disc protrusion Kemps will be positive as the patient is leaning away from the side of pain
      2. In lateral disc protrusion Kemps will be positive as the patient is leaning into the side of pain
  2. Positive: Local pain
    • Indicates: Lumbar spasm or facet capsulitis
26
Q

Lindner Sign

A
  • Positive: Pain along sciatic distribution or sharp diffuse leg pain
    • Indicates: Sciatic radiculopathy
27
Q

Turyn Sign

A
  • Positive: Pain in the gluteal region or radiating sciatic pain
    • Indicates: Sciatic radiculopathy
28
Q

Sicard Sign

A
  • Positive: Posterior thigh and leg pain
    • Indicates: Sciatic radiculopathy (usually from a disc lesion)
29
Q

Bonnet Sign

A
  • Positive: Pain in posterior thigh or leg
    • Indicates: Immediate pain is sciatic neuropathy from piriformis syndrome
30
Q

Fajersztajn Test

A
  1. Positive: Pain down affected leg (cross-over sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
31
Q

Well-Leg-Raising Test of Fajersztajn

A
  1. Positive: Pain down affected leg (cross-over sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
32
Q

Cross-Over Sign

A
  1. Positive: Pain down affected leg (cross-over sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
33
Q

Femoral Stretch Test

A
  • Positive: Pain on the anterior portion of the thigh
    • Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
34
Q

Femoral Nerve Traction Test

A
  • Positive: Pain on the anterior portion of the thigh
    • Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
35
Q

Naffziger Test

A
  • Positive: Radicular pain (typically in lumbars, possibly cervical or thoracic)
    • Indicates: Space occupying lesion

7 - CLET Lab (28 decks)

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