Phisical Assessment of Lumbar Spine

7/25/2019 Phisical Assessment of Lumbar Spine

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Physical assessment

of Lumbar Spine

By : PuspitaPrihatini

(20070310028)

Dokter Pembimbing : Dr. RenoRanuh p. !"


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Lumbar Anatomy


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#

$

5 vertebrae L1-L5

5 intervertebraldiscs 5 pair of exiting

nerve roots Lumbar lordosis

L1-S1 ranges from

30 !"0 #he apex oflumbar lordosisL3-L$


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#ypical lumbar vertebra%L&'

1( )ody&( *ertebral

foramen+canal3( ,ntervertebral

foramen$( Pedicle5( #ransverse process

( Lamina.( Spinous process"( /acet oints

uperior

%nterior(ob&i'ue)

% atera& P

Posterior(ob&i'ue)

1

&

3

$

5

.

"


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Ligaments1( Anterior longitudinal

ligament&( Posterior longitudinal

ligament3( Ligamentum avum$( ,nterspinous

ligaments5( Supraspinous

ligament( ,ntertransverse

ligaments

$


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#he aorta and venacava bifurcatearound the level ofthe L3+L$ disc space

Aorta *ena cava ,liac arteries

,liac veins 2idsacral vessels


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Pysical assessment


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i4ayat

Location of pain Locali6ed or

radiating7

8nset of pain Acute9 chronic9insidious7

:onsistency of pain :onstant+intermittent

7 ,mproves+;orsens

4ith activity7 2echanism

/lex9 ext9 rotation9 lat(


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P2= ofin uries+surgery7

)o4el+bladdersymptoms7

,ncontinence or

fre>uency eferral history

#ime in themedical system7

? of physiciansseen7


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Sagittal curvature Scoliosis

/rontal curvature @ormal curves Standing posture Shoulders

=ead ;al ing posture %gait'

,nspection+8bservation


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Posture Shoulders and pelvis should be level )ony and soft-tissue structures

should appear symmetrical @ormal lumbar lordosis

Bxaggerated lumbar lordosis iscommon characteristic of 4ea enedabdominal 4all


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Palpation #ransverse processes Spinous processes Paravertebral musculature

Symmetry Spasm

Absence of any sacral and+orlumbar processes suggestsspina biCda

*isible or palpable step-oDindicative of spondylolisthesis


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Flexion - 80

Extension - 35

Side bending - 40 each side

Twisting - 3-18


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Special test


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Straight leg raise test %SL '+Lasegue test

2embaring an pasien Satu tung ai lurus diatas me a peri sa dan satu

tung ai diang at eatas Pasien a an merasa esa itan saat tung ai

diang at hingga $5 E tes lasegue positif #es lasegue positif E =@P positif #es lasegue ana positif E lesi =@P di anan

%sebali nya'


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)raggard #est Posisi sama seperti lasegue test @amun eti a tung ai diang at ma a

telapa a i pasien didorong uat eatas %dorso e si ma simal'

Positif E terasa nyeri sepan angtung ai


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*alsalva maneuver

#est yang bertu uan untumening at an te anan intrate aldan menimbul an ge ala

Pasien diminta menahan nafas

)ila terasa nyeri dipinggang danmen alar e tung ai E tes valsavapositif


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@aD6iger #est


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GernigHs #est

Pasien dalam eadaan berbaring di me a peri sa /le si an paha pada persendian panggul sampai

membuat sudut I0 Setelah itu tung ai ba4ah di e stensi an pada

persendian lutut sampai membentu sudut 135dera at terhadap paha(

)ila terdapat nyeri E ernigHs sign positif


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)rud6ins i test Pasien berbaring Gepala pasien di e si an sehingga

dagu menyentuh dada Positif E gera an e si epala dii uti

gera an e si di sendi lutut danpanggul secara re e tori


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=oover test

Jntu membeda an elumpuhanriil atau elumpuhan buatanKmalingering

Prosedur Pasien dalam eadaan

berbaring 2enginstru si an pasien untu

menggera an a i yangnormal

Pantau gera ta ter endalidari a i yg lumpuh

%M'E@o pressureElo4 eDort


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#erima asih NOOON

Phisical Assessment of Lumbar Spine

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