OrthoTests

OrthoTests - Lumbo-Pelvic assessment Sitting Standing Squat...

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Lumbo-Pelvic assessment Standing Squat Test Pt. squats as far down as possible while holding on to wall or a chair bounce 2-3 times. Screen peripheral joints as ankle, knee, hip, as well as SI joints and lower back. Trendelenberg Test Dr. contact pt iliac crests pt asked to lift leg to 90 degrees. Hip hike hip pathology of g med of g min weakness on side of hip hike. Standing Kemp's Test Pt. asked to run hand down the back their leg whilst pr guide pt into ext-l flex- I/L rot of lumbar spine. Load facet joints and decrease IVF size on same side. Pain down the leg neurogenic claudication, pain locally facets. Sitting Flip Dr. extends the pt. knee and looks for symptoms pt. supine unilat. SLR. If both tests cause sciatic pain +ve. Only first test +ve lower lumbar spine problem. Supine SLR Stretch nerve root, 35-70 degrees L4, L5, S1, S2 & S3 nerve root. Pain after 70 degrees lumbar or SI pain. WSLR or cross over sign SLR on good leg. Pain in opposite leg space occupying lesion (large IVD protrusion, usually postero-medially). This test causes stretch of both I/L and C/L nerve root, as well as a lateral pull on the dura. Bilateral straight leg raise test SLR of both leg simultaneously. Pain before 70 degrees SI joints. Pain after 70 degrees lumbar spine. Brag gard ’s test SLR + dorsiflexion, lower to point where pain disappears dorsiflexion, differentiate between nerve root and muscle pain from gastrocs-hamstrings. Bonne t’s test (SLR and external rot) SLR + internal rotation/external rotation. Internal rotation stretch piriformis, external rotation contract or shorten piriformis. Pain sciatic nerve entrapped in the piriformis muscle. Bowstring test SLR + pressure in popliteal fossa with knee flexed with thigh remaining in the same position to re- establish symptoms, indicator for tension or pressure on the sciatic n. Kernig/brudzinski test Pt. asked to flex neck onto chest Dr. performs SLR until pain is felt knee & hip is flexed and pain will disappear. Pain may indicate meningeal irritation, nerve root involvement or dural irritation. Milgrams test Pt. asked to actively raise legs to 10 cm above table and hold it for 30 sec. Test raises intradiscal pressure and may indicate space occupying lesion. Be aware of lumbar spine pain. Sign of buttock Dr. takes pt. into SLR, if restricted knee flexed to see if hip flexion increases. If hip flexion increases problem is in lumbar spine -ve result. If hip flexion does not increase buttock pathology (bursitis, tumour, abscess or gluteal or piriformis muscle strain). Naff zig ner’ s test Supine, Dr. gently compresses jugular veins for approx 10 sec. Pt. face flushes, Pt. is asked to cough. If this causes low back pain: spinal theca is being compressed increased intrathecal pressure, which covers the spinal cord. Pelvic Rock
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This note was uploaded on 07/15/2011 for the course ECO 2023 taught by Professor Mr.raza during the Summer '10 term at FAU.

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OrthoTests - Lumbo-Pelvic assessment Sitting Standing Squat...

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