VERBALS LUMBAR Flashcards
BONY PALPATION: LUMBAR SPINE
- Lumbar Spinous Processes
- Sacral Tubercles
- Iliac Crest
- PSIS
SOFT TISSUE PALPATION: LUMBAR SPINE
- Paraspinal Muscles (palpate as a unit and individually) superficial layer
- Spinalis
- Longissimus
- Iliocostalis
- Sciatic Nerve
- Gluteus Maximus
- Gluteus Medius
- Hamstrings
- Biceps Femoris
- Semitendinosus
- Semimembranosus
- Anterior Abdominal Muscles
RANGE OF MOTION: LUMBAR SPINE
- FLEXION: 25
- EXTENSION: 30
- LEFT LATERAL BENDING: 25
- RIGHT LATERAL BENDING: 25
- LEFT ROTATION: 30
- RIGHT ROTATION: 30
HOOVER SIGN
- POSITIVE: Lack of counter-pressure to opposite side
- INDICATES: Lack of organic basis for paralysis (Malingering/hysteria). With organic hemiplegia, the patient will still exert downward pressure when attempting to raise paralyzed leg
STRAIGHT LEG RAISER (SLR)
- POSITIVE: Radiating pain and/or dull posterior thigh pain
-
INDICATES: Sciatic radiculopathy or tight hamstrings.
- Positive between 35-70 degrees equals possible discogenic sciatic radiculopathy
- > 70 equals tight hamstrings
GOLDTHWAIT SIGN
- POSITIVE: Localized pain, low back or radiating pain down the leg
-
INDICATES: Lumbo-sacral or sacroiliac pathology
- Pain occuring after the lumbar spinouses move equals possible lumbo-sacral problem
- Pain occuring before the lumbars move equals possible sacroiliac problem
BRAGARD SIGN
- POSITIVE: Radiating pain in posterior thigh
- INDICATES: Sciatic Radiculopathy
BUCKLING SING (CIPRIANO)
- POSITIVE: Pain in the posterior thigh with sudden knee flexion (buckle)
- INDICATES: Sciatic Radiculopathy
BOWSTRING SIGN
- POSITIVE: Pain in the lumbar region or radiculopathy
- INDICATES: Sciatic nerve root compression, helps rule out tight hamstrings
LASEGUE TEST
- POSITIVE: Reproduction of sciatic pain before 60 degrees
- INDICATES: Sciatica
MILGRAM TEST
- POSITIVE: Inability to perform test and/or low back pain
- INDICATES: Weak abdominal muscles or space occupying lesion
VALSALVA MANEUVER
- POSITIVE: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)
- INDICATES: Space occupying lesion (e.g. disc pathology)
BECHTEREW TEST
- POSITIVE: Reproduction of radicular pain or inability to perform correctly due to tripod sign
- INDICATES: Sciatic radiculopathy
NERI BOWING TEST (Neri Sign)
- POSITIVE: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
- INDICATES: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response
ANTERIOR INNOMINATE aka MAZION PELVIC MANEUVER (ADVANCEMENT SIGN)
- POSITIVE:
The inability to bend at the waist more than 45 degrees, because of either/or
- Radiating pain along the sciatic nerve, either unilateral or bilateral
- Low back pain (lumbar or pelvic regions)
-
INDICATES:
- Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
- Anterior (rotational) displacement of the ilium relative to the sacrum
LEWIN STANDING TEST
- POSITIVE:
Radiating pain down the leg causing flexion of the patient’s knee or knees
- INDICATES:
Gluteal, lumbosacral or sacroiliac pathologies
HEEL WALK
- POSITIVE:
Inability to perform the test
- INDICATES:
L4-L5 disc lesion (L5 nerve root)
TOE WALK
- POSITIVE:
Inability to perform test
- INDICATES:
L5-S1 disc lesion (S1 nerve root)
ELY HEEL TO BUTTOCK TEST (Evans calls this Ely sign as an a.k.a.)
POSITIVE:
- Inability to raise the thigh
- Pain in the anterior thigh
- Pain in the lumbar region
INDICATES:
- Iliopsoas spasm
- Inflammation of lumbar nerve roots
- Lumbar nerve root adhesions
