ORTHOS - LE Flashcards
Lasague’s Test
PT: supine
doc: raises the leg, bends it, and then extends it again
= Lumbar N root compression / irritation, lumbar radic
Bechterew’s Test
pt: sit with legs off the table.
doc: instructs the pt to extend one leg at a time and then both
(+) can’t preform because of radic pn, or pt leans back
= compression of the sciatic N roots
Sicard’s test
SLR–> back off 5 degrees–> flex big toe
0=35: SI join disorder, M dysfunction, piriformis sx
35-70: Sciatic N root tension (L5,S1,S2)
70-90: Lumbar disorder
Minors sign
pt: sit to stand
(+) : lumbar radic will stand on healthy side and keep affected leg flexed
= lumbar radic
Antalgic Lean Sign
lateral disc: lean away from side of pn
medial disc: lean toward the side of pn
central disc: flexed position
Neri sign:
instruct pt to stand and bend over
(+): flexes knee on affected side
= lower lumbar N root irritation, disc, SI sublux
Fajersztan’s test
doc raises pt’s unaffected leg –> lowers –> DF foot
(+) incr radic leg pn
= medial disc: incr pn on affected side
= lateral disc: decr pn on affected side
Kemps
radicular pn= irritation of spinal N root
lateral disc herniation= radicular pn with ipsi bending
medial disc herniation= radicular pn with contra bending
local achy: facet problem, capsulitis, SI jt prob, M spasm
what levels are the femoral N root
L2,L3,L4
Femoral N traction
pt: lays with affected side up
doc: extend affected leg 15 degrees –> then flex the knee to stretch femoral N further
(+): pn radiating into anterior medial thigh (L3), Pain extending to mid tub (L4),
pn on contra side: N root compression
Brudzinski’s sign
pt supine–> flex head to chest –> knees bend
= meningeal irritation/ meningitis or N root
= radic pn
= bac. meningitis= head pn, neck stiffness, nuchal rigidity, temp
Kerning’s test
pt’s lower legs are // with table. instruct pt to extend leg upwards
(+) inability to straighten the leg or pn
= meningeal irritation, meningitis, N root, disc, tumor, lumbar radic
Goldwaiths test
fingers in interspinous space –> SLR
(+) radicular pn
before sp fan: SI jt disorder, piriformis M dysfunction
during SP fan: intrathecal SOL- disc, osteophyte, mass
After SP fan: lumbar M, lig disorder
Sign of the Buttock test
SLR–> restriction found–> flex pt’s knee to see if hip flexion occurs
(+) hip flexion doesnt increase when knee is flexed = SI jt dysfunction
= SI jt patho, inflam process, bursitis, mass or abscess
Hibb’s test
pt is prone –> flex leg to opposite butt
(+) pn in SI or hip jt
= abcess/ sp of SI; hip jt lesion
Pelvic Rock
(+) pn on either side of SI
= SI jt lesion such as inflammaotyr process in the jts
Gaenslen’s test
pt supine and slides over to one side of the table–> hang leg off table
unaffected leg is flexed to chest
doc: applies pressure to ea leg to shear SI jt -
(+) pn in the SI on the extended leg side
= SI jt inflam, infection, anterior SI lig sp
Lewin Gaenslen’s test
= general SI lesion of the iliofemoral, ischiofemoral ligaments
or inflammatory process
Piriformis test
pt is side-lying with knee up
doc: puts downward pressure on leg
(+) butt pn or sciatic radiating pn
= buttock pn for piriformis, radiating pn= impingement of sciatic N by piriformis
Patricks test (FABRE)
1st: press flexed leg into acetabulum
2nd: flex leg, externally rotate and abduct leg (figure 4)
(+) pn in groin/ hip or glut fold
= capsulitis, arthritis, fx, AVN inflam
Laguerre’s = FABRE in the air
indications of trendelenburg
g. med weakness on stance side or hip path on stance side- superior glut N lesion
also (+) with: dislocation of hip, fx, sublux, legg calve perthes dz
indications of Ely’s test
tight rectus femoris M or hip flexion contracture: tight psoas
Thomas test
pt: hold knee to chest
doc: palpate opp. leg
(+): tightness, or involuntary leg flex
= hip flexion contracture–> if tightness isnt palpated it can be restriction at the hip joint
Ober’s test indication
tight iliotibial band or TFL contracture
Modified Helfet’s test
(+) tibial tub remains at midline with patella with knee extension –> normal would move inline with LATERAL border of patella with extension
= rotation is blocked due to torn meniscus
Bounce home
(+) unable to extend the knee fully or rubbery end feel on full extension
= meniscus
McMurray’s test
IR and ER listening to jt line for clicking or popping
= meniscus
Steinman’s tenderness displacement test
doc: place hands on jt line -> flex and extend knee
(+) pn moves anterior during knee extension or posteiror during knee flexion
= meniscus dysfunction
structures effected during anterior drawer
ACL
MCL if more than 1 cm of movement
Posterolateral capsule, posteromedial capsule, Iliotibial band, posterior oblique lig, arcuate popliteus complex
structures effected during posterior drawer
PCL, posterior oblique lit, ACL
Slochum test
pts leg is flexed 45 degrees and IR
doc: pulls P-A
(+) 5 mm of tibial movement
= ACL, posterolateral capsule, LCL or ITB
Hughston’s drawer test
Pt has leg flexed
Doc pushes AP in IR and ER
IR: PCL and MCL
ER: PCL and LCL
Lachman’s test
doc stabilized the femur with 1 hand and grabs the prox tib –> pulls PA
= ACL
Reverse lachman’s test
pt is prone
doc: stabilize posterior thigh with one hand–> grasp tib and press AP
(+) pn with AP pressure , soft end feel
= PCL
Lateral Pivot Shift (Test of MacIntosh)
doc: raise leg to 30 degrees, IR tibia–> apply valgus stress
(+) tibi reduced, pt will experience “giving away” –> ITB pulls back
= ACL, posterior capsules or LCL
structures indicated in adduction stress test of the knee
when in ext: fibular collateral lig, posterior lateral capsule, ACL, PCL, ITB
when in flexion: fibular collateral lig (LCL) posterolateral capsule, ITB
nobles compression
doc: pressure on the lateral condyle–> extend the knee
(+) pn under the thumb at the lateral condyle in 30 degrees of flexion (w/ cc of pn with activity)
= ITB friction sx
what is the difference btw fairbanks apprehension test and patellar apprehension test
fairbanks: knee is flexed to 30 degrees
patellar apprehension: no flexion
Indication of patellar grinding test:
chondromalacia patella, retropatellar arthrits, chondral fx, prepatellar bursitis
Clarke’s sign
at 30, 60, and 90 degrees: doc uses a web contact at superior pole of the patella–> asks pt to contract quads
(+): retropatellar pn, cant hold contraction
= chondromalacia
Dreyers test:
pt cant raise leg actively–> stabilize the quad tendon –> pt can raise the leg with stabilization
= fx of the patella
Mediopatellar Plica test
knee flexed to 30 degrees–> push patella medially with thumb
(+) pn or clicking
Hughston’s PLICA
doc flexes the knee and medially rotates the tibia –> press patella medially with the heel of the other hand –> doc is flex/ ext the knee
(+) popping
= suprapatellar plica
Buerger’s test
raise one leg and PF/DF for 2 min –> then hang leg off the table –> venous return in less than 1 min
= arterial compromise
Homan’s sign
raise leg and DF foot (stretches the calf/ tension on deep veins) –> doc squeezes the calf
(+): deep pn at posterior leg or calf
= thrombophlebitis/ DVT
Moses
prone pt–> doc flexes knee 90 degrees –> doc squeezes the pt’s calf
(+): pn in calf
= phlebitis or vascular occulsion/ DVT
Thompson’s test
prone pt–> flex leg –> doc squeezes calf–> no PF
= ruptured achilles
tinel’s tap foot sign
prone pt–> leg flexed–> tap behind medial malleolus
(+) paresthesia radiating to the foot
= posterior tibial N
