Final Ortho Tests

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Author:
Anonymous
ID:
47173
Filename:
Final Ortho Tests
Updated:
2010-11-03 20:10:32
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Orthopedic Tests
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Starting after Midterm & going until Final
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  1. Lumbar Flexion Degree & End Feel
    Tissue Stretch

    70-90 Degrees
  2. Lumbar Extension Degree & End Feel
    Tissue Stretch or Bone

    30-50 Degrees
  3. Lateral Flexion Degree & End Feel
    Tissue Stretch

    30 Degrees
  4. Rotation Degree & End Feel
    Tissue Stretch

    35 Degrees
  5. Neri's Bowing Sign
    Test: Pt bends forward [bow]

    + Pt flexes knee on affected side- traction on nerve root = radicular pain

    I:: Dural mobility compromise [disc herniation, lateral recess stenosis, tumor]
  6. Heel Walking
    Test: Pt walk 10 feet towards Dr on heels

    + Toes drop

    I:: L4-L5 lesion, common peroneal nerve, problem with Ant Tib or Extensors
  7. Toe Walking
    Test: Pt walks on toes away from Dr about 10 feet

    + Heels drop

    I:: S1 leson or tibial nerve, gastroc/soleus problem
  8. Bechterew's Test
    Test: Pt actively extends each leg separately, then both legs together

    + radicular pain, inability to perform b/c pain, pt leans back on both hands w/extension of one or both legs

    I:: L4-S3 radiculopathy [disc herniation, tumor, osteophytes, lateral canal stenosis]
  9. Tripod Sign
    Pt leans back with arms on the table creating a tripod like posture
  10. Sitting Root Test
    a.k.a Lasegue Sitting

    Test: Pt seated w/neck flexed to chest, Dr passively extends the leg

    + radicular pain in elevated leg

    I:: L4-S3 radiculopathy [disc herniation, tumor, osteophytes, lateral canal stenosis]
  11. Sciatic Tension Test
    Test: Dr. raise's pt leg to point of pain- then flex knee until pain in alleviated, Dr then places fingers in post. thigh & popliteal fossa & tries to recreate stretch on nerve ~ Bilateral

    + Radicular pain

    I:: intra or extra dural irritation of sciatic nerve
  12. Minor's Sign
    Test: Pt stand up & Dr watch's how it is performed

    + Pt supports self on unaffected side while standing & keeps affected leg flexed

    I:: L4-S3 radiculopathy
  13. Straight Leg Raise [SLR]
    Test: Elevate leg to point of pain or 90 degrees~ Bilateral

    + Radicular Pain

    I:: pain between 35-70 = L4-S3 nerve root irritation; Pain prior to 35 extra-dural sciatic involvement
  14. Bragard's Test
    Test: Perform SLR to point of pain & backs off the hip flex 5 degrees, or until pt is out of pain & dorsiflex the foot

    + Radicular Pain [Sicard's or Turyn's can confirm]

    I:: irritation of L4-S3 nerve roots w/pain 35-70; pain prior to 35 extra-dural sciatic irritation
  15. Sicard's Test
    Dr. performs a SLR to just short of pain & then extends the big toe

    Confirms Bragard's Test
  16. Turyn's Sign
    W/both legs straight on the table Dr. Dorsiflexes the big toe

    Confirm's Bragard's Test
  17. Well Leg Raise [WLR]
    Test: Dr. Raises unaffected leg until pain is produced or reaches 90 degrees

    + increase radicular pain on affected leg

    I:: Probably medial disc protrusion involving L4-S3 Nerve Roots
  18. Fajersztajn's test
    Test: Dr. Raises unaffected leg & then dorsiflexes the foot

    + increase in pain or production of radicular pain on affected leg

    I:: Probable medial disc protrusion involving L4-S3 nerve roots
  19. Bowstring Test
    a.k.a Cram Test or Popliteal Pressure Sign

    Test: SLR to point of pain, Dr. Flexes knee w/o flexing hip further; Dr asks pt if sx are relieved & Dr exerts pressure on hamstrings working down the popliteal fossa

    + Radicular pain

    I:: irritaton of sciatic nerve either intradurally or extradurally
  20. Femoral Nerve Traction
    Test: pt on side w/head flexed; extend hip 15 degrees while keeping knee straight, if no radicular pain is produced flex knee w/o further hip extension

    + radicular pain down anterior thigh {L2-L4}

    I:: Possible L2, L3, L4 radiculopathy
  21. Ely's Heel-to-Buttock Test
    Test: Pt on stomach, Dr passively flexes the Pt's heel to their opposite buttock, dr can then extend the hip

    + radicular {ant thigh} or non-radicular pain &/or inability to hyperextend hip

    I:: tight rectus femoris, iliopoas irritation or L2, L3, L4 radiculopathy
  22. Kemp's
    Test: Dr stabilize PSIS w/one hand & other hand grasps pt shoulders & passively bends the spine obliquely backwards

    + radicular or achy pain

    I:: radicular pain=irritation of spinal nerve roots, achy pain may indicate facetal problems, capsulitis, mm spasms
  23. Freiberg's Sign
    Test: Dr internally rotates affected leg & performs an SLR; if pain is produced dr externally rotates the leg and asks if there is a change in Sx

    + sx relieved by external rotation

    I:: probably piriformis syndrome
  24. Piriformis Test
    Test: pt on side, flex hip to 90 & positioned near edge of table, dr puts 1 hand on pelvis while other puts downward pressure on the knee

    + buttock pain or radicular pain

    I:: butt pain=piriformis spasm, radicular pain=piriformis syndrome
  25. Hibb's Test
    Test: pt on stomach, flex leg to buttock & internall rotates hip

    + pain in SI or hip joint

    I:: abcess/sprain of SI, hip joint capsulitis, arthritis
  26. Yeoman's
    Test: pt on stomach, grab knee, stabilize pt SI joint, passively extend hip & applies a P-A pressure on SI

    + SI joint pain

    I:: SI joint inflammation, infection, sprain
  27. Iliac Compression Test
    a.k.a approximation test

    Test: pt on side, contact iliac crests & press towards the floor

    + pain in the SI

    I:: SI joint inflammation, infection, sprain
  28. Dejerine's Triad
    Ask if Sx are provoked by coughing, sneezing, &/or bearing down

    + localized or radiating pain

    I:: increased intrathecal pressure from disc defect, mass, osteophyte
  29. Spinous Percussion
    Test: percuss each SP starting away from area of pain

    + localized pain or radicular

    I:: local pain= possible fx, radicular pain= possible disc defect

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