VERBALS LUMBAR Flashcards

1
Q

BONY PALPATION: LUMBAR SPINE

A
  1. Lumbar Spinous Processes
  2. Sacral Tubercles
  3. Iliac Crest
  4. PSIS
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2
Q

SOFT TISSUE PALPATION: LUMBAR SPINE

A
  1. Paraspinal Muscles (palpate as a unit and individually) superficial layer
    • Spinalis
    • Longissimus
    • Iliocostalis
  2. Sciatic Nerve
  3. Gluteus Maximus
  4. Gluteus Medius
  5. Hamstrings
    • Biceps Femoris
    • Semitendinosus
    • Semimembranosus
  6. Anterior Abdominal Muscles
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3
Q

RANGE OF MOTION: LUMBAR SPINE

A
  • FLEXION: 25
  • EXTENSION: 30
  • LEFT LATERAL BENDING: 25
  • RIGHT LATERAL BENDING: 25
  • LEFT ROTATION: 30
  • RIGHT ROTATION: 30
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4
Q

HOOVER SIGN

A
  • 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
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5
Q

STRAIGHT LEG RAISER (SLR)

A
  • 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
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6
Q

GOLDTHWAIT SIGN

A
  • 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
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7
Q

BRAGARD SIGN

A
  • POSITIVE: Radiating pain in posterior thigh
  • INDICATES: Sciatic Radiculopathy
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8
Q

BUCKLING SING (CIPRIANO)

A
  • POSITIVE: Pain in the posterior thigh with sudden knee flexion (buckle)
  • INDICATES: Sciatic Radiculopathy
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9
Q

BOWSTRING SIGN

A
  • POSITIVE: Pain in the lumbar region or radiculopathy
  • INDICATES: Sciatic nerve root compression, helps rule out tight hamstrings
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10
Q

LASEGUE TEST

A
  • POSITIVE: Reproduction of sciatic pain before 60 degrees
  • INDICATES: Sciatica
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11
Q

MILGRAM TEST

A
  • POSITIVE: Inability to perform test and/or low back pain
  • INDICATES: Weak abdominal muscles or space occupying lesion
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12
Q

VALSALVA MANEUVER

A
  • 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)
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13
Q

BECHTEREW TEST

A
  • POSITIVE: Reproduction of radicular pain or inability to perform correctly due to tripod sign
  • INDICATES: Sciatic radiculopathy
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14
Q

NERI BOWING TEST (Neri Sign)

A
  • 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
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15
Q

ANTERIOR INNOMINATE aka MAZION PELVIC MANEUVER (ADVANCEMENT SIGN)

A
  • POSITIVE:

The inability to bend at the waist more than 45 degrees, because of either/or

  1. Radiating pain along the sciatic nerve, either unilateral or bilateral
  2. Low back pain (lumbar or pelvic regions)
  • INDICATES:
    1. Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
    2. Anterior (rotational) displacement of the ilium relative to the sacrum
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16
Q

LEWIN STANDING TEST

A
  • POSITIVE:

Radiating pain down the leg causing flexion of the patient’s knee or knees

  • INDICATES:

Gluteal, lumbosacral or sacroiliac pathologies

17
Q

HEEL WALK

A
  • POSITIVE:

Inability to perform the test

  • INDICATES:

L4-L5 disc lesion (L5 nerve root)

18
Q

TOE WALK

A
  • POSITIVE:

Inability to perform test

  • INDICATES:

L5-S1 disc lesion (S1 nerve root)

19
Q

ELY HEEL TO BUTTOCK TEST (Evans calls this Ely sign as an a.k.a.)

A

POSITIVE:

  1. Inability to raise the thigh
  2. Pain in the anterior thigh
  3. Pain in the lumbar region

INDICATES:

  1. Iliopsoas spasm
  2. Inflammation of lumbar nerve roots
  3. Lumbar nerve root adhesions