special test for lumbar spine – Flashcards

Pt position: supine Eval: pt attempts an active straight leg raise on the involved side + test: Pt does not attempt to lift the leg and the examiner does not sense pressure from the uninvolved leg pressing down on the hand implications: pt is not attempting to perform the test

pt position: prone eval: examiner carefully pushes the spinous process anteriorly, feeling for the springing of the vertebrae + test: The vertebra does not move, moves excessively, or pain is elicited implications: hypomobility or hypermobility of the vertebral segment

pt position: sitting eval: pt takes and holds a deep breath while bearing down similar to performing a bowl movement. + test: increased spinal or radicular pain implications: increase in intrathecal pressure causes pain, 2ndary to a space occupying lesion. (herniated disk, tumor, or osteophyte)

pt position: supine eval: pt performs a bilateral straight leg raise to the height of 2-6 inches and is asked to hol the position for 30 sec. + test: a pt is unable to hold the position, cannot lift the leg, or experiences pain with the test. imp: intrathecal or extrathecal pressure causing an intervertebral disk to place pressure on a lumbar nerve root

pt position: supine eval: A: pt performs a unilateral active straight leg raise with the knee extended until pain occurs. B: After pain occurs the pt flexes the knee +test: pain is experienced in the spine and possibly raidiating into lower extremity. Pain relieved when knee flexes. Implications: nerve root impingement, 2ndary to bulging of intervertebral disk or bony extrapment.

+ test: pt complains of pain before the end of the normal ROM. Pain described radiating distally along the tested leg, usually in post thigh, radiating into the calf and perhaps the foot. Highly significant if findings at 30 degrees or less implications: sciatic nerver irritation/compression, pain before hip reaches 70 degrees of hip flexion may indicate disk involvement.

+ test: pain is experienced on the side opposite that being raised. implications: a large space occupying lesion such as a herniated intervertebral disk.

+ test: sciatic pain or reproduction of other neurologic symptoms. implications: impingement of the dural lining, spinal cord, or nerve roots.

+ test: pain is elicited in the anterior and lateral thigh implications: nerve root impingement at the L2, L3, or L4.

(tension) + test: exquisite tenderness with possible duplication of sciatic symptoms, as compared with the opposite side. implications:sciatic nerve irritation. (Bowstring) + test: radiating symptoms are experienced with knee extension, and symptoms are relieved with knee flexion at approx. 20 degrees.

+ test: pain is noted in the lumbar spine or SI area implications: Shear forces are placed on the pars interarticularis by iliopsoas pulling the vertebra ant. resulting in pain. SPONDY!

+ test: compression:pain arising from the SI Joint distraction: pain relieved implications: Sacroiliac pathology

+ test: reproduction of symptoms in the SC joint or hip implications: pain in inguinal area ant. to the hip may indicate hip pathology. pain in the SI area during the application of overpressure may indicate SI joint pathology.

+test: Pain in SI region Implications: SI joint dysfunction

+ test: movement of the medial mall. is observed. If the involved leg (painful side) goes from a longer to a shorter position, there is an ant. rot. of the ilium on that side. If the involved side goes from a shorter to a longer position, posterior rotation of the iliuim on the sacrum is indicated. implication: rotated ilium.