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Ortho Tests

Methods 4 - ortho, MSR

TermDefinition
Neri Bowing Sign: The standing patient is asked to bend forward (Bow), the sign is present if the patient flexes the knee on affected side to ease leg and low back pain produced with trunk flexion. may indicate radicular pain from disc involvement, lumbosacral or SI strain
Belt Test (Adam’s Positions): patient asked to flex forward; if identified scoliosis remains it is structural, if straightens it is functional (Adam’s); px with flexion, doctor stabilizes pelvis & has patient bend again, if px remains = Lumbar origin, if it lessens = pelvic origin
Kemp's Test: patient leans forward to 1 side & then around to an obliquely extended position producing radicular pain. local pain produced = sprain/strain. test performed standing places more stress on facet joints, test performed sitting puts more stress on disc
Shober's Test: Find S2 on patient & mark dots .5 cm below & 10 cm above. patient bends forward & distance is measured = amount of L-spine flexion. do 2-3 times & average amounts. Evaluated for significant differences in a case of poor effort on the patint's part
Minor's Sign: arising from seated/FWD flex, Pt supports on hlthy leg, Flex knee & hip affected limb, place 1 hand on back, may walk up thigh w/ other hand. = patho condition w/ L/S origin, often w/ SI lesion, L/S strain/sprain, FX, disc syndromes, sciatica, dystrophy
Valsalva Maneuver: patient takes a deep breath & holds while bearing down as in blowing up a balloon creating an increase in intrathecal pressure. when space occupying lesion is present, pain will be produced.
Dejerine's Triad: Cough, sneeze & strain at stool cause increased intrathecal pressure. When space occupying lesion is present, pain produced. However, physical mvmnts of cough, sneeze & sitting posture of strain at stool can cause pain in L/S & SI sprain/strain syndromes
Bechterew's Test : Sitting straight leg raise; Patient is seated and straightens each leg actively, one at a time, hip flexion is then resisted. Radiating leg pain is characteristic of sciatica due to lumbar disc herniation. Back pain may also be produced.
Deyerle”s Sign: Patient is seated, the affected leg is passively extended at the knee until pain is produced. The knee is slightly flexed and pressure is applied in the popliteal fossa to reproduce leg pain.
Lesague Sitting Test: The patient is seated, the examiner passively raises a leg to extend the knee. Radiating leg pain is characteristic of sciatica due to lumbar disc herniation. Back pain may also be produced.
Lindner's Test: Passive flexion of the patient's neck is performed in either the seated or supine position. Pain in the lumbar region or along the sciatic nerve distribution indicates nerve root irritation or a space occupying lesion.
Piedallu's Sign: W/ patient sitting, height & position of iliac crests & PSISs are noted. If 1 PSIS is lower than other, patient is asked to bend forward. If the lower PSIS becomes the higher 1 the test is positive, indicating abnormality in torsion movement of SI joint
Gapping Test: Patient is supine, the examiner crosses arms placing both hands on each ASIS applying pressure M-L and slightly A-P. Unilateral gluteal or posterior crural pain indicates involvement of the anterior sacroiliac ligament.
SLR: Pt supine, examiner raise leg. (+) test = radicular pain down leg. Measurements use inclinometer. 35-70 degrees stretch sciatic N. Positive test below 30 degrees = peripheral sciatic entrapment. May produce back pain, note & localize, not = positive test.
Cox's Sign: When performing the SLR maneuver, the patient will antalgically elevate the hip on the involved side rather than allow the leg to be elevated through hip flexion. A positive test suggests a disc herniation which is likely to be medial to the nerve root.
Braggard's Sign: When straight leg raising test (SLR) is positive, leg is lower slightly & ankle is dorsiflexed. Radicular pain down leg is reproduced w/ positive test indicating possible sciatic neuritis, nerve root irritation, and space occupying lesions (disc, tumor).
Sicard's Sign: When straight leg raising test (SLR) is positive, leg is lower slightly & big toe is dorsiflexed. Radicular pain down leg is reproduced w/ a positive test indicating possible sciatic neuritis, nerve root irritation, & space occupying lesions (disc, tumor)
Well Leg Raise: A straight leg raise performed on the non painful leg side. Pain is produced in the painful leg when the disc herniation is medial to the nerve root.
Double Leg Raise: supine patient's legs both elevated simultaneously. positive test = pain produced earlier than w/ a single leg raise, typically caused by disc disease w/ instability. Pain may also be produced in the low back with a sprain/strain, L/S joint involvement.
Bowstring Sign: With the patient supine, the patient's leg is raised with the ankle on the doctor's shoulder. Firm pressure is exerted in the popliteal fossa producing lumbar pain and/or radiculopathy. It is therefore a test for nerve root compression.
Milgram's Test: supine patient asked to raise legs about 6 inch off table. positive test = low back pain, may indicate disc herniation tho lumbar M strain may also cause pain. test also increase intrathecal pressure & will be positive w/ space occupying lesion.
Patrick's fabere Test: Pt supine, examiner flex knee & hip, abduct thigh, place heel on opposite knee. apply pressure to bent knee, hold opposite ASIS. positive=hip joint lesion. traction thru psoas may irritate disc lesion & produce separating stress in SI joint,causing LBP.
Laguerre’s Test: The patient is supine, examiner flexes and abducts the hip, then laterally rotates (external rotation) the hip applying overpressure while stabilizing the opposite ASIS. Pain can be produced in the sacroiliac or hip.
Gaenslen's Test: patient supine w/ affected side close to edge of table. unaffected hip & knee brought up toward patient's chest. affected leg held on table or hung off edge of table so SI joint in stressed ext. pain on straight leg side = SI joint problem.
Lewin-Gaenslen’s Test: Done in side posture
Thomas Test: The patient lies supine and pulls the unaffected hip and knee into flexion bringing the knee up toward the chest. A raising of the straight leg or beding of the knee indicates shortened hip flexors.
Smith-Peterson Test (Goldthwait’s Test): The patient is supine, examiner palpates the lumbosacral region (SPs) and performs a straight leg raise. Pain produced befor the L5 SP moves indicates a sacroiliac problem, pain produced after the L5 SP moves indicates a lumbar spine problem.
Kernig/Brudzinski Test: patient supine, 1st flex neck to chest. if either/both knee flex = +. Then flex either leg at hip & knee to 90-90 position. As knee extends other knee will flex in + test. Knee flex in either test = meningeal irritation/inflamm. must rule out meningitis.
Iliac Spring Test (Erichsen’s Sign): Patient is prone, examiner places thenars over both PSISs and applies 1 or 2 sharp, quick compressions P-A and L-M. Pain and loss of springing indicates sacroiliac joint involvement.
Hibb’s Test: The patient is prone, examiner flexes the knee and internally rotates the hip. Pain will be produced with sacroiliac or hip problems.
Yeoman's Test: Patient is prone and examiner flexes the knee and extends the hip while stabilizing the pelvis. Pain in the sacroiliac joint indicates dysfunction.
Nachlas' Test: Patient prone, examiner flexes knee to approximate heel to ipsilateral buttock. Pain occurring in the sacroiliac joint or lumbosacral area indicates dysfunction. Pain in the anterior thigh comes from stretching the femoral nerve and lumbar nerve roots.
Hyperextension Test: The patient is prone, examiner stabilizes the lumbar spine and extends the hip using the straight leg. Anterior thigh pain indicates inflammation of the L3 and L4 nerve roots.
Ely's Sign: Patient prone, examiner flexes knee to approximate heel to opposite buttock. Pain produced with irritation to psoas or it sheath. Pain in anterior thigh comes from stretching femoral nerve and lumbar nerve roots. Pain may also occur in hip and SI joint.
Femoral Nerve Traction Test: The patient is side-lying, examiner behind stabilizing the pelvis and flexes the knee while extending the hip. Radiating anterior thigh pain indicates femoral nerve irritation.
Iliac Compression Test: The patient is side-lying, the examiner places both hands over the upper portion of the iliac crest and exerts pressure L-M. Pain in the sacroiliac joint indicates dysfunction.
Burns Bench Test: patient kneels on table & instructed to flex trunk forward reaching toward floor. maneuver does not negatively affect tissues of L-spine. If patient fails to perform or has increased back pain suspect psychological overlay and/or symptom amplification.
Flip Test: The patient is sitting. On the pretext of examining the knee, the examiner extends the knee producing a seated straight raise. It should cause leg pain if it did before, if not suspect psychological overlay and/or symptom amplification.
Libman’s Sign: Pressure is applied to the mastoid processes to provide an indication of the patient’s pain threshold. If pain occurs with relatively light pressure suspect symptom amplification.
Hoover's Test : The patient is supine, the examiner places one hand under the heel of a foot and the patient is asked to raise the other leg. Pressure should be felt on the heel if the patient is giving good effort.
Iliopsoas L1-L3
Sartorius L2-L3
Quadraceps L2-L4
Adductor longus L2-L4
Gracilis L2-S4
Gluteus medius L4-S1
Tensor fascia lata L4-L5
Piriformis L5-S1
Gluteus maximus L4-S2
Hamstrings L4-S2
Tibialis anterior L4-L5
Extensor hallicus longus L4-S1
Peronei L5-S1
Gastroc-Soleus L5-S2
L4 MSR (L3 Disc) Motor: Tibialis Anterior Reflex: Patellar Sensory: Medial foot
L5 MSR (L4 disc) Motor: EHL Reflex: Medial Hamstring Sensory: Dorsum of foot
S1 MSR (L5 disc) Motor: Peronei Reflex: Achilles Sensory: Lateral Foot
Created by: pharvey