Special Tests Flashcards
Dermatomes
Sensory nerve distribution, anesthesia, paresthesia
T12 D
Superior to inguinal ligament
L1 D
Mid lumbar region, superior/lateral buttock and thigh below inguinal ligament
L2 D
Lower lumbar region, posterolateral superior buttock, and anterior medial 1/3 of thigh
L3 D
Lower lumbar region, posterior/lateral superior buttock, anterior thigh to medial knee
L4 D
Posterior sacrum, posterior/lateral buttock, posterior/lateral thigh, anterior/medial lower leg, dorsum/medial foot/great toe
L5 D
Posterior sacrum, posterior/lateral inferior buttock, posterior/lateral thigh, anterior and posterior/lateral lower leg, dorsum of foot and toes
S1-S2 D
Posterior inferior buttock, posterior thigh and lower leg, plantar and lateral aspect of foot and toes
S3-S4 D
Saddle area and inner thigh
Myotome
muscles innervated by a specific nerve root level
T12 - L1 M
Quadratus lumborum
L1-L4 M
Hip flexion
L1 - L3 M
Iliacus
L2 - L3 M
Hip adduction - Adductor Longus, brevis, magnus, gracilis, pectineus, sartorius
L2-S1 M
Hip internal rotation
L3 - L4 M
Knee extension - Rectus femoris, vastus lateralis, medialis, intermedius
L4 M
Tibilias Anterior
L4-L5 M
Hip adbuction, ankle dorsiflexion - gluteus medius, maximus, TFL
L5 M
Toe extension - extensor hallicus longus, extensor digitorum longus
L5-S1 M
Hip extension, knee flexion, ankle eversion - fibularies longus and brevis, semitendinosus, extensor digitorum brevis, bceps femoris, gluteus max
L4-S2 M
Ankle Inversion
S1-S2 M
Hip ER, Ankle plantarflexion, flexor digitorum longus, flexor hallicus longus, gastroc, soleus, foor intrinsics, piriformis
Reflexes (grading)
0/2+ = arereflexia 1+ = hypo 2+ = normal 3+ = hyper 4+ = markedly hyper
Reflexes to do
L2/L3 = adductor Magnus L3/L4 = Quadriceps L4 = Glut min L5/S1 = Semimembranosus/tendinosus S1 = Gastroc
Upper motor neuron reflexes
Babinski
Clonus
Babinski
Stroke lateral border from calcaneum to head of 5th metatarsal to head of 1st metatarsal
Upward movement of great toe and splaying of others = positive
Clonus
Quick stretch into ankle dorsiflexion - repetitive tremor indicates positive test
Tests for directional Preference to determine cent/periph - For who and what are they
LBP with radiating pain
Repeated Lumbar Flexion
Repeated Lumbar Extension
Repeated Lumbar Flexion
Cent/Periph
Standing or Supine - bring knees (or one) to chest
Repeated Lumbar Extension
Cent/Periph
Prone- on elbows and then to hands
Tests of Lumbar Stability - for who, what are they
LBP with movement coordination impairment
Farfans Torsion Test
Test of Anterior Lumbar Spinal Stability
Prone Instability Test
Posterior Pelvic Pain Provocation Test (POSH)
Farfans Torsion Test
Stability
A test of passive structures - facet joint, capsule, interspinous ligament, neural arch, longitudinal ligaments, and IV disc
Patient is prone -examiner stabilizes ribe and lower thoracic/upper lumbar spine with one hand and places other hand under ant aspect of ilium
Examiner pulls ilium backward causing the spine to rotate
Positive if excessive motion is detected ans sx are reproduced
Repeat on both sides
Test of Anterior Lumbar Spinal Stability
Stability
Patient is side lying with hips flexed to 70 degrees and knees flexed, Examiner palpates spinous processes at the level to be tested, examiner pushes patient’s knees in line of the femur
Palpate for excessive morvement of spinous processes relative to SP below and inquire about sx reproduction
Prone Instability Test
Stability
Patient prone, trunk resting on plinth with feet on floor
Apply PA to painful segment
Ask patient to lift feet off floor
Re-apply PA at same segment
If sx dec - test is positive and patient will benefit from stabilization exercises
Posterior Pelvic Pain Provocation Test (POSH) Posterior Shear Test
Stability
Patient is supine, passively flex hip to 90 degrees, apply force through longitudinal axis of femur
Test is positive for patient who experiences deep pain in gluteal area - indicitive that they could benefit from stablization exercises
