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Flashcards in Lumbar Orthopedic Exams Deck (75)
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30

What is Cox Sign?

An observation of the patient raising the Ipsilateral hip to alleviate the pain

31

Cox Sign may indicate?

SOL
IVF encroachment
Radiculopathy
Nerve root tension
Sciatica

32

How is Ely's Test performed?

With patient prone attempt to touch the heel of one foot to the Contralateral buttock

33

A classic positive of Ely's test is?

Pain in the anterior thigh and/or groin area

34

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)

35

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

36

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

37

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

38

If patient is unable to walk on their heels what would this indicate?

L5 problem (L4 IVD)

39

If patient is unable to walk on their toes what does this indicate?

S1 problem (L5 IVD)

40

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

41

What is the positive sign for Kemp's Test?

Eliciting pain or localized low back pain

42

A positive Kemp's Test would indicate?

Nerve root irritation
Radiculopathy
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)

43

Local pain with slight rotation or on convex side during Kemp's Test indicates?

Capsulitis

44

Local pain on extension or on concave side during Kemp's Test indicates?

Facet problem

45

General pain at the waist during Kemp's Test indicates?

Lumbar spine sprain/strain

46

Radiating leg pain with flexion during Kemp's Test indicates?

IVD lesion

47

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

48

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

49

A positive Kernig's Sign in addition to fever indicates?

Meningitis

50

How is Brudzinski Sign performed?

With patient supine, dr flexes patient's head toward the xiphoid process

51

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

52

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

53

A positive Brudzinksi Sign with fever indicates?

Meningitis

54

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

55

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

56

What is a classic positive of Lasegue Test?

Elicit pain in the hip, low back, or thigh

57

A positive finding for Lasegue test would indicate?

Pain in hip: hip pathology
Pain in thigh or leg: radiculopathy
Bilateral pain: tight hamstrings
(Sciatica)

58

How is Lindner's Sign performed?

Patient is either seated or supine, dr passively flexes patient's chin to their chest

59

What is the purpose of Lindner's Sign?

To put traction on the meninges and nerve roots