◔

Lumbar Spine Examination: Difference between revisions

From WikiMSK

No edit summary
No edit summary
Line 1: Line 1:
{{stub}}
{{stub}}


==Inspection==
==Standing==
*Gait
*Gait
*Stature
*Stature
*Build
*Build
*Romberg
*Transitioning movements
*Transitioning movements
*Lumbar alignment coronal plane
*Posture and alignment
*Lumbar alignment sagittal plane
**Thoracolumbar alignment coronal and sagittal plane
**Lumbar alignment coronal and sagittal plane
**Pelvic alignment
**Foot alignment
*Movement
**Forward flexion
**Extension
**Side flexion
**Compound extension and rotation
*Trendelenburg
 
==Sitting==
*Breathing
*Pelvic alignment
*Pelvic alignment
*Thoracolumbar alignment coronal plane
*Thoracolumbar alignment sagittal plane
==Palpation==
*Skin drag
*Skin rolling
*Vertebral springing tenderness
*Rotation testing
*Iliac crest palpation
*PSIS palpation
*Long dorsal sacroiliac and sacrotuberous ligament palpation
*Iliopsoas palpation
*Gluteus medius, minimus, and piriformis palpation
==Movement==
*Forward flexion
*Extension
*Side flexion
*Rotation
*Extension/Rotation test
==Special Tests==
*Slump test
*Slump test
*Straight leg raise
*Femoral stretch test
*Sacroiliac joint provocation testing
*Iliopsoas length test
*Provocation test


==Neurological Exam==
==Lying==
*Tone
*Skin drag and rolling
*Power - hip flexion (L2), hip adduction (L3), ankle dorsiflexion (L4), great toe extension (L5), knee flexion (S1)
*Allodynia to cold and pin prick
*Reflexes - knee (L3, L4), [[:File:Medial hamstring reflex.PNG|medial hamstring]] (L5), achilles (S1) <ref>{{#pmid:23087820}}</ref>
*Palpation
*Sensation
**Vertebral springing tenderness
*Plantar reflexes
**Rotation testing
**Bony landmarks: Iliac crest, PSIS, LPSL, sacroiliac joint
**Soft tissue: sacrotuberous and sacrospinous ligaments, gluteus medius and gluteus minimus, piriformis, iliopsoas, quaratus lumborum, hamstring origin
*SIJ provocation testing: distraction, thigh thrust, sacral thrust, compression
*Hip joint range of motion
*Special tests
**Straight leg raise
**Femoral stretch test
**Iliopsoas length test and tenderness
**Direction preference
**Centralisation phenomenon
*Neurological examination
**Tone
**Power: hip flexion (L2), hip adduction (L3), ankle dorsiflexion (L4), great toe extension (L5), knee flexion (S1)
**Reflexes: knee (L3, L4), [[:File:Medial hamstring reflex.PNG|medial hamstring]] (L5), achilles (S1) <ref>{{#pmid:23087820}}</ref>
**Sensation: L2, L3, L4, L5, S1, S2, S3
**Plantar reflexes


==References==
==References==

Revision as of 19:29, 25 May 2021

This article is a stub.

Standing

  • Gait
  • Stature
  • Build
  • Romberg
  • Transitioning movements
  • Posture and alignment
    • Thoracolumbar alignment coronal and sagittal plane
    • Lumbar alignment coronal and sagittal plane
    • Pelvic alignment
    • Foot alignment
  • Movement
    • Forward flexion
    • Extension
    • Side flexion
    • Compound extension and rotation
  • Trendelenburg

Sitting

  • Breathing
  • Pelvic alignment
  • Slump test

Lying

  • Skin drag and rolling
  • Allodynia to cold and pin prick
  • Palpation
    • Vertebral springing tenderness
    • Rotation testing
    • Bony landmarks: Iliac crest, PSIS, LPSL, sacroiliac joint
    • Soft tissue: sacrotuberous and sacrospinous ligaments, gluteus medius and gluteus minimus, piriformis, iliopsoas, quaratus lumborum, hamstring origin
  • SIJ provocation testing: distraction, thigh thrust, sacral thrust, compression
  • Hip joint range of motion
  • Special tests
    • Straight leg raise
    • Femoral stretch test
    • Iliopsoas length test and tenderness
    • Direction preference
    • Centralisation phenomenon
  • Neurological examination
    • Tone
    • Power: hip flexion (L2), hip adduction (L3), ankle dorsiflexion (L4), great toe extension (L5), knee flexion (S1)
    • Reflexes: knee (L3, L4), medial hamstring (L5), achilles (S1) [1]
    • Sensation: L2, L3, L4, L5, S1, S2, S3
    • Plantar reflexes

References

  1. ↑ Esene et al.. Diagnostic performance of the medial hamstring reflex in L5 radiculopathy. Surgical neurology international 2012. 3:104. PMID: 23087820. DOI. Full Text.
Retrieved from ‘https://wikimsk.org/w/index.php?title=Lumbar_Spine_Examination&oldid=8937’