Spine and Hip Flashcards
Distraction test
Test used to determine if traction relieves neck pain (narrowing of neural foramen). Lift under pts chin and occiput
Valsalva test
Increases intrathecal pressure to determine if there is a herniated disc or tumor. Have pt bear down and hold breath and determine if there is an increase in pain
Adson test
Determine state of subclavian artery (may be compressed by rib or clavicle). Take pts radial pulse, then abduct, extend, and externally rotate the arm. Then have pt turn head toward arm being tested. Radial pulse will decrease if there is a compression
Compression test
Press down on the top of pts head. If increase in pain at c-spine or extremity. Indicates a narrowing of neural foramen, pressure on facet joint, or muscle spasm
Straight leg raising test
Designed to reproduce back and leg pain so cause can be determined. Pt supine, lift leg from heel (knee straight). If pain with dorsiflexion of foot = lumbar pain. If pain with no dorsiflexion=hamstring
Hoover test
Determines effort in pt. Cup one hand under heel of opposite foot then have pt raise affected leg. Should feel pressure in hand under heel, indicates pt effort
Pelvic rock test
Tests sacroiliac joints. Pt supine, hands on iliac crests with thumbs on ASIS, palms on tubercles. Forcible compress pelvis towards midline. May be pain around SI joint
Fabere Patrick test
Supine, place foot of involved side on opposite knee. hip should be flexed, abducted and externally rotated. If inguinal pain, hip joint. If back pain, SI joint. (don’t forget it may be an abdominal issue)
Trendelenburg test
Used to evaluate strength of the gluteus medius muscle. Stand behind pt, look at dimples, have pt stand on one leg. There should be a slight elevation of dimple on unsupported side. If there is a drop in dimple the muscle is not engaging properly
Thomas test
Used to detect flexion contractures of the hip. Supine, place hand under pelvis to stabilize, flex hips, thigh to trunk. Notice when back touches hand as this is happening. Then bring on leg up to abd while other leg extended, if hip does not fully extend it may be a flexion contracture
Pelvic obliquity
Tests for scoliosis. Place hands on iliac crest while patient is standing, note whether one side is higher than another. May suggest leg length discrepancy or scoliosis
What is the sequence of the exam during evaluation of the spinal column
- Inspection
- Palpation
- Blunt percussion over spine for lesions
- ROM
- Special tests
What are facet joints
Joints that attach one vertebral body to the next.
What is the angle of the cervical facet joints
45 degrees
What is the angle of the thoracic facet joints
60
