Flashcards in Lumbar Orthopedic Exams Deck (75)
What is Cox Sign?
An observation of the patient raising the Ipsilateral hip to alleviate the pain
Cox Sign may indicate?
Nerve root tension
How is Ely's Test performed?
With patient prone attempt to touch the heel of one foot to the Contralateral buttock
A classic positive of Ely's test is?
Pain in the anterior thigh and/or groin area
A positive Ely's Test indicates?
Radiating pain may be from the femoral nerve or an upper lumbar spinal nerve root compression (dermatomal)
Localized pain is due to quadriceps muscle contracture (myofascial)
How is the femoral nerve traction test performed?
With patient lying on their unaffected side, with the bottom leg straight and the top leg bent at the knee, dr extends the thigh back on the affected side to traction the femoral nerve
What is a classic positive for the femoral nerve traction test?
Reproduction of pain in the anterior thigh in the distribution of the femoral nerve
What would a positive femoral nerve traction test indicate?
Radiating pain to the groin may indicate L1 nerve root radiculopathy
Radiating pain to the anterior mid thigh may indicate L3 nerve root radiculopathy
If patient is unable to walk on their heels what would this indicate?
L5 problem (L4 IVD)
If patient is unable to walk on their toes what does this indicate?
S1 problem (L5 IVD)
How is Kemp's Test performed?
Circumduction of the lumbar spine towards the side of involvement - "foramina compression test" of the lumbar spine
*make sure to watch video
What is the positive sign for Kemp's Test?
Eliciting pain or localized low back pain
A positive Kemp's Test would indicate?
Nerve root irritation
Local pain with slight rotation or on convex side (capsulitis)
Local pain on extension or concave side (facet problem)
General pain at the waist (lumbar spine sprain/strain)
Radiating leg pain with flexion (IVD lesion)
Local pain with slight rotation or on convex side during Kemp's Test indicates?
Local pain on extension or on concave side during Kemp's Test indicates?
General pain at the waist during Kemp's Test indicates?
Lumbar spine sprain/strain
Radiating leg pain with flexion during Kemp's Test indicates?
How is Kernig's Sign performed?
With patient supine, dr flexes patient's hip and knee to 90 deg, then tries to extend the leg
What is a classic positive of Kernig's Sign?
**Elicits pain in the head
Pain in the spine
Involuntary flexion of Contralateral hip or knee
A positive Kernig's Sign in addition to fever indicates?
How is Brudzinski Sign performed?
With patient supine, dr flexes patient's head toward the xiphoid process
How is Brudzinski Sign different from Soto Hall?
Soto Hall is looking for cervical problems
Brudzinski Sign is looking for meningitis
The differentiating factor is fever and pain in the head versus the spine to indicate meningitis
What is a positive for Brudzinski Sign?
***Pain elicited in the head
Pain in the spine - nuchal rigidity
Involuntary flexion of the hip or knee
A positive Brudzinksi Sign with fever indicates?
How is Lasegue Test performed?
With patient supine, dr flexes hip and knee to 90 deg, then tries to extend the leg
Performed the same as Kernig's sign
What is the difference between Lasegue Test and. Kernig's sign?
Kernig's sign is looking for increase in headache for meningitis
Laseque Test is looking for increase in low back pain for nerve root compression/irritation
What is a classic positive of Lasegue Test?
Elicit pain in the hip, low back, or thigh
A positive finding for Lasegue test would indicate?
Pain in hip: hip pathology
Pain in thigh or leg: radiculopathy
Bilateral pain: tight hamstrings
How is Lindner's Sign performed?
Patient is either seated or supine, dr passively flexes patient's chin to their chest