Spine and Hip

Question 1

Neck (planes and angles)

Answer 1

Flexion - 30
Extension - 0
Hyperextension - 30
Lateral flexion - 40
Rotation - 30

Question 2

Back (planes and angles)

Answer 2

Forward flexion - 90
Hyperextension - 30
Rotation - 30
Lateral flexion - 30

Question 3

Hip (planes and angles)

Answer 3

Flexion - 115
Extension - 0
Hyperextension - 30
ABduction - 50
ADduction - 30
Internal rotation - 30
External rotation - 50

Question 4

Thoracic kyphosis

Answer 4

Exaggerated forward rounding of the back

humpback

Question 5

Gibbus deformity

Answer 5

A form of kyphosis
Collapsed vertebra causes a sharp angular deformity
Less of a curvature and more of a sharp angular protrusion particularly visible from the side

Question 6

Lumbar lordosis

Answer 6

Excessive inward curvature of lumbar spine

swayback

Question 7

Scoliosis

Answer 7

lateral curvature of the spine

When bent forward, back will not be flat (tilted)

Question 8

Kyphoscoliosis

Answer 8

Combination of outward curvature (kyphosis) and lateral curvature (scoliosis) of the spine

Question 9

Distraction test

Answer 9

Test cervical spine pain/nerve impingement
Place one hand under chin and one under occiput (back of head); Lift up gently
Pain goes away=cervical nerve compression

Question 10

Valsalva test

Answer 10

Tests for space-occupying lesions (herniated disc, tumor)
Have pt hold breath and bear down
Pain may radiate to dermatome corresponding with neurologic level of c-spine pathology

Question 11

Adson test

Answer 11

Test subclavian artery
Feel radial pulse and abduct, extend, and externally rotate arm while palpating pulse
Have pt turn head toward arm being tested
Compression of subclavian artery=diminished/loss of pulse

Question 12

Compression test

Answer 12

Press down on top of pts head while sitting or supine

Increased pain= note distribution and dermatome

Question 13

Straight leg raise test

Answer 13

Test sciatic nerve
Pt supine and provider passively lifts straight leg
Dorsiflex foot
Pain=sciatic nerve pain

Question 14

Hoover test

Answer 14

Test pt effort
Place hands under heels during active straight leg raise
As pt lifts one leg, the opposite heel should press down

Question 15

Pelvic rock test

Answer 15

Pt supine
Place hands on iliac crests with thumbs on anterior sup. iliac spine, palms on iliac tubercles
Compress pelvis toward midline
Pain at sacroiliac joint= pathology of joint (infection/trauma)

Question 16

Fabere or Patrick test

Answer 16

Test pathology in hip and sacroiliac joint
Pt supine, foot of involved side on opposite knee
Extend ROM by pressing one hand on flexed knee and other on ant. sup. iliac spine of opposite side
Pain(w/ or w/o pressing)= pathology in hip joint or sacroiliac joint(w/pressure)

Question 17

Trendelenburg test

Answer 17

Test strength of gluteus medius
Stand behind pt and observe dimples overlaying post. sup. iliac spines
Have pt stand on one leg and watch for elevation of pelvis on unsupported side
Elevation=normal muscle function
Remains/drops=weak/nonfunctioning-positive test

Question 18

Thomas test

Answer 18

Test flexion deformity
Pt supine - place hand under lumbar spine
Flex hip to bring to trunk - notice at what point back touches hand
Have pt hold one leg to chest and other flat on table
-if hip doesn’t extend fully, pt rocks forward, or arches back = fixed flexion contracture

Question 19

Pelvic obliquity

Answer 19

Tilted pelvis
Observe/palpate ant. sup. iliac spines not in same horizontal plane
Difference in leg length can also indicate