Trunk and Abdomen Orthopedic Tests

Trunk and Abdomen Orthopedic Tests:


 

Orthopedic / Special Test: Functional or Structural Scoliosis Test

Purpose: To find out whether the spinal curvature is functional or structural.

Procedure:

• Client is standing

• Observe the location and movement of the client’s spine and curvature

• Ask client to laterally bend their trunk on both sides slowly, then flex their trunk slowly

Positive Sign:

Functional Scoliosis: if the curvature fixes itself ( reverses) as the client laterally bends towards the convex side

Functional Scoliosis: if the curvature and rib humping reverse as the client bends forward

Structural Scoliosis: the curvature does not correct itself as the client laterally bends towards the convex side, and the curvature remains

Structural Scoliosis: if the curvature and rib humping remains the same as the client bends forward

 

Orthopedic / Special Test: Kemp’s Test

Testing for: Nerve root compression, due to disc herniation or facet joint irritation in the lumbar spine

Procedure:

• Client is standing

• Client actively and slowly extends, sidebends and rotates their thorax and lumbar spine to the affected side.

• Therapist may apply an inferiorly directed pressure to the shoulder on the affected side (Quadrant’s Test)

Positive Sign:

Nerve root compression: Radiating pain or other neurological signs in the affected leg.

Lumbar Facet Joint irritation: Pain local to the back

 

Orthopedic / Special Test: Kernig’s Test

Purpose: to stretch the spinal cord and the dural tube to reproduce the pain caused by nerve root involvement or meningeal irritation.

Procedure:

• Client is supine, with their hands behind their head.

• Client actively flexes their head into their chest.

• Then, with their knees in extension, client flexes their hip.

Positive Sign:

Meningeal irritation: Pain along the spine in the level of lesion

Nerve root involvement: Pain in a referral pattern to a limb

• Client may flex their knee or remove their head from flexion to reduce the stretch on the dural tube to reduce the pain

 

Orthopedic / Special Test: Quadratus Lumborum Length Test

Testing for: the length of the Quadratus Lumborum muscles

Procedure:

• Client is seated

• Therapist stands behind the client and landmarks both iliac crests

• Client slowly bends their torso laterally away from the tested side, then toward the tested side

• Therapists notes the Range of Motion on both lateral bending

Positive Sign: reduced range of motion or restriction when bending away from the tested side.

 

Orthopedic / Special Test: Rebound Tenderness

Testing for: possible presence of appendicitis or peritoneal inflammation

Procedure:

• Client is supine, their hips and knees are flexed

• Slowly apply pressure over Mc Burney’s point and the quickly release the pressure

Mc Burney’s point: two-thirds distance inferiorly along an imaginary line drawn from the umbilicus and the right ASIS.

Positive Sign: Severe pain when pressure is released. ( may be accompanied by nausea and low grade fever). This is a medical emergency. Massage is contraindicated with a Positive test result.

 

 

Orthopedic / Special Test: Scoliosis Short Leg

Purpose: to see if client has an uneven leg length that is causing functional scoliosis

Procedure:

• Client is standing

• Observe the client’s Bilateral Iliac Crests and Acromioclavicular joints levels, and see if there is tilting and scoliosis.

• Place a thin book under the shorter leg.

Positive Sign: the scoliosis curve reverses and neutralizes after the book was placed under the side with the shorter leg.

 

Orthopedic / Special Test: Scoliosis Small Hemipelvis

Testing for: Functional scoliosis due to the presence of a small hemipelvis . Hemipelvis* – one side of the pelvis.

Procedure:

• Client is seated

• Observe the client’s Bilateral Iliac Crests and Acromioclavicular joints levels, and see if there is tilting and scoliosis.

• Place a thin book under the lower ( smaller) pelvis side.

Positive Sign: the scoliosis curve reverses and neutralizes after the book was placed under the side with the lower pelvis.

 

Orthopedic / Special Test: Slump Test

Purpose: to stretch the spinal cord and the dural tube to reproduce the pain caused by nerve root involvement or meningeal irritation

Procedure:

• Client is seated and slumped into flexion

• Client actively flexes their head to their chest

• Client actively extends right knee then dorsiflexes the right foot. Do the left side after.

Positive Sign:

Meningeal irritation: Pain along the spine in the level of lesion

Nerve root involvement: Pain in a referral pattern to a limb

 

 

Orthopedic / Special Test: Valsalva’s Test

Testing for: the presence of a space-occupying lesion ( may be tumor, herniated disc, osteophytes) that is increasing the pressure within the spinal canal.

Procedure:

• Client is seated and curled forward.

• Client takes a breath while bearing down, as if moving the bowels

Positive Sign: pain local to the lesion site or radiating pain in a dermatomal pattern.

 

Orthopedic / Special Test: Vocal Fremitus Test ( fremitus = palpable vibration on the human body)

Purpose: to assess for areas of bronchial congestion ( usually with mucus, serum or lymph) due to Chronic Bronchitis or Emphysema

Procedure:

• Client is prone

• Instruct client to repeat the words “ blue balloons” or “ ninety nine” ( low frequency vocalizations).

• At the same time, therapist places both hands symmetrically over the client’s thorax, moving them over the lungs and bronchi assessing for the presence of vocal fremitus or palpable vibrations in the lungs.

Positive Sign: decreased vibration in areas of the lungs that has congestion.

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