Thoracic/Lumbar/Pelvic Flashcards
Amoss Sign
Observe patient rise from side lying position to sitting. Looking if pm uses upper body strength to assist and signs of pain.
Note location of pain
Beevors Sign
Observe umbilicus while pm lying supine, does slight crunch and leg lift.
Umbilicus will deviate in opposite direction of weakness.
Chest expansion test
Use tape to measure, wrap around level of 4th intercostal space. Ask pm to inhale and exhale maximally.
Less than 1.25”: may have spinal ankylosis, rib fracture, sprain/strain…
Forestier Bowstring Sign
Observe ROM while pm laterally bends side to side.
+: muscle spasm, AS, pain inhibiting motion, stacking
Note location of pain
Rib motion test
Place both hands on pm chest At sternocostal angle while pm lying supine. Observe movement of ribs as pm inhales/exhales.
Rib fixed expiration: elevated rib
Rib fixed inspiration: depressed rib
Indicates rib sublux, muscle strain, pleuritis, fracture, arthritides
Adams Position
Observe any changes is scoliosis as the patient flexes forward at waist. Keep hands in prayer position to touch the floor.
Scoliosis disappears: functional
Scoliosis remains: structural
Bragards Sign
If pm has +SLR lower leg 5* and dorsiflex foot. Causes traction of Tibial nerve.
+: reproduction or increase of leg pain
Note location of pain
Sicards sign
If + SLR and Bragards then: dorsiflex big toe.
Irritation of the L5 nerve root MC, sometimes L4/S1.
Note location of pain
Bechterews test (seated SLR)
Seated with back straight (as if against a wall), extend leg at knee. If no pain doc applies downward pressure above knee while pm lefts leg against resistance.
Used to confirm SLR
Note location of pain
Slump test
Seated with back maximally slumped(?). Start with knee at 90* and max ankle dorsiflexion. Extend the leg
If +: suspect disc bulge or herniation.
Note location of pain
Crossed SLR
Perform CSLR on asymptomatic side.
*Post.medial disc bulge: + same level/angle as SLR or herniation
Post.lateral disc bulge: + increased angle comp. to SLR
Fajerztajns Test
CSLR then lowers leg 5* and dorsiflex foot.
Post.medial disc bulge or herniation if +
Post.lateral disc bulge if pain at greater angle
Cox Sign
Happens during SLR.
Pm will raise ipsilateral hip to alleviate pain.
+: SOL, IVF encroachment, radiculopathy, nerve root, tension, sciatica
Ely’s Test
Prone. Attempt to touch heel to contralateral butt. Pain in ant thigh or groin area.
Radiating pain: Femoral nerve root or upper L nerve root compression
Localized pain: quad muscle contracture
Note location of pain
Femoral nerve Traction Test
Affected side up, bottom leg straight, top leg bent at knee. Doc extends thigh back to traction Femoral nerve.
Radiating pain to groin: L1 nerve root radiculopathy
Radiating pain to ant mid thigh: L3 nerve root radiculopathy
Note location of pain
Heel/toe Walking Test
Test dorsiflexion and plantar flexion.
Can’t walk on heels: L5 problem (L4 IVD)
Can’t walk on toes: S1 problem (L5 IVD)
Kemps Test
Seated, leans to opp side of pain, doc supports lumbars and hand on pain side shoulder. Circumduct pm forward to pain side knee, jet out belly, lean back to pain side.
See notes page 136.
Kernigs Sign
Supine, doc flex hip and knee to 90*. Then doc tries to extend the leg at the knee.
Pain with fever: meningitis
Elicit pain in head/spine or involuntary flexion of opp knee/hip
Brudzinski Sign
Supine, doc flex head to xiphoid process.
Elicit pain in head/spine or involuntary hip/knee flexion.
Pain with fever: meningitis
Lasegue Test
Supine, doc flex hip and knee to 90*. Then tries to extend leg at knee. Elicit pain in hip/low back/thigh. Hip pain: hip pathology Thigh/leg pain: radiculopathy Bilateral pain: tight Hams
Lindners Sign
Seated or supine, doc passively flex chin to chest.
Traction the meninges/nerve roots.
Low back/sciatica: nerve root irritation or inflammation
Supine: same as Brudzinski’s Sign
Seated: same as Lhermittes procudure
Milgrams Test
Supine, lift FEET 6” off table and hold 30 sec.
Unable due to pain: herniation or lumbar sprain/strain
Unable not due to weakness: weak core muscles
Note location of pain
Minors Sign
Uses upper body to stand from seated.
+: SI joint lesion, L5 strain/sprain, lumbo pelvic fracture, IVD syndrome, MD, sciatica
Nachlas Test
Prone, doc tries to touch heel to ipsilateral butt.
Elicit pain in ant thigh and/or groin area.
Radiating pain: femoral nerve root or lumbar nerve root compression
Localized pain: tight quads
Quick Test
Do 5 deep squats by wall with bounce at the bottom.
Looking for pAin.
Note location of pain
Bilateral Leg Lowering Test
Supine, doc flex hips to 90* legs extended. Pm lowers legs to 45*.
Look for lumbo sacral sprain/strain, facet syndrome, IVD lesion.
Anterior Innominate Test
Standing, unaffected foot 2-3 feet forward. Flex forward at waist, attempts to touch toes. If foot rear foot remains flat they should take a farther step forward to torque pelvis.
Local pain over SI joint
Looking for: unilateral forward displacement of ilium, sacrum, or SI joint sprain
Belt Test
Standing bent at waist, note pain. Doc stands behind patient stabilize sacrum with doc’s hip, tells pm to bend forward again.
SI Problem: pain in first part, no pain in second
Lumbar Problem: pain in first & second parts
Erichsens Test
Prone, doc compress SI joints. Creates double IN Ilium.
Stresses SI joint ligaments
Gaenslens Test
Supine, doc brings unaffected knee to chest, doc SLOWLY hyper extends affected leg into table.
SI joint pain on side being tested or radiating pain to thigh/groin
Note pain location
Goldthwaits Sign
Supine,doc palates L5&S1, use other hand to elevate affected leg.
SI joint problem: pain b4 L5/S1 separation
Lumbar problem: pain after L5/S1 separation
Note location of pain
Hibbs Test
Prone, doc flexes knee 90* and internally rotates femur by pushing foot laterally.
Looking for sacroiliac lesion
Note location of pain
Iliac Compression Test
Lie on unaffected side, doc compresses iliac crest on affected side toward table.
Creates a double “EX” ilium.
Looking for sprain of post. SI ligament, SI joint inflammation, or subluxation
Lewin Gaenslen Test
Lies on unaffected side, bring unaffected knee to chest, doc SLOWLY hyper extends affected thigh.
Looking for SI joint sprain or arthritis.
+: SI joint pain on affected pain or muscle tightness
Yeomans Test
Prone, doc puts pressure on sacrum, place other hand under affected knee, lifts knee off table (extending thigh).
Looking for SI joint lesion (specifically the ant. SI ligaments), femoral nerve irritation, iliopsoas or rectus femoris muscle contracture.
