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femoral traction test : لاخر التيستات
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femoral traction test : لاخر التيستات

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Questions and Answers

Which test is used to assess upper motor neuron lesions?

  • Slump Test
  • Oppenheim Test (correct)
  • Sitting Root Test
  • Nachlas Test
  • What does a positive Babinski sign indicate?

  • Upper motor neuron lesion (correct)
  • Sciatic nerve tension
  • Lower motor neuron lesion
  • Tight quadriceps muscles
  • What nerve is stretched during the Prone Knee Bending (Nachlas) Test?

  • Femoral nerve (correct)
  • L2 nerve root
  • Sciatic nerve
  • L3 nerve root
  • What does pain in the anterior thigh during the Prone Knee Bending (Nachlas) Test indicate?

    <p>Tight quadriceps muscles</p> Signup and view all the answers

    What is the purpose of the Sitting Root Test?

    <p>Assess tension on the sciatic nerve</p> Signup and view all the answers

    Which test is considered the most common neurological test for the lower limb?

    <p>Slump Test</p> Signup and view all the answers

    Which test is done with the patient in the supine position and involves flexing the hip until the patient complains of pain or tightness in the back or back of the leg?

    <p>Straight Leg Raising Test</p> Signup and view all the answers

    What is the purpose of the slump test?

    <p>To stress individual nerves</p> Signup and view all the answers

    Which movement has also been called the Hyndman's sign, Brudzinski's sign, Lindner's sign, and Soto-Hall test?

    <p>Neck flexion</p> Signup and view all the answers

    What does a positive slump test indicate?

    <p>The same lesion</p> Signup and view all the answers

    What should be noted when doing bilateral knee extension in the slump position?

    <p>Any asymmetry in the amount of knee extension</p> Signup and view all the answers

    What is the purpose of the provocative maneuvers in the slump test?

    <p>To reproduce the patient's pathological symptoms</p> Signup and view all the answers

    Which test is typically used to indicate a large intervertebral disc protrusion and a poor prognosis for conservative treatment?

    <p>Lhermitt's test</p> Signup and view all the answers

    What does a positive Lasègue's test and crossover sign indicate?

    <p>Sequestration of the disc</p> Signup and view all the answers

    What symptoms should be carefully questioned if the Lasègue's test is positive?

    <p>Bowel and bladder symptoms</p> Signup and view all the answers

    What does the Valsalva Maneuver test for?

    <p>Increased intrathecal pressure</p> Signup and view all the answers

    What is lumbar instability characterized by?

    <p>Loss of control in the neutral spine</p> Signup and view all the answers

    What does the Farfan Torsion Test primarily test for?

    <p>Structural instability</p> Signup and view all the answers

    Which nerve roots are primarily stretched during unilateral straight leg raising?

    <p>L4, L5, and S1</p> Signup and view all the answers

    What is the normal range of hip flexion during unilateral straight leg raising?

    <p>80° to 90°</p> Signup and view all the answers

    What may result from adhesions within the areas where tension develops during unilateral straight leg raising?

    <p>All of the above</p> Signup and view all the answers

    Which test involves extension of the big toe instead of foot dorsiflexion?

    <p>Sicard’s test</p> Signup and view all the answers

    What does pain in the sciatic nerve distribution during straight leg raising indicate?

    <p>Nerve root pathology</p> Signup and view all the answers

    In which position is the patient for the modified straight leg raising test?

    <p>Side-lying</p> Signup and view all the answers

    Which test is a combination of the classic Lasègue test and the sitting root test?

    <p>Flip Sign</p> Signup and view all the answers

    What does a positive Flip Sign test indicate?

    <p>Problems in the lower lumbar spine</p> Signup and view all the answers

    What muscle appears flat as a result of atrophy in the Gluteal Skyline Test?

    <p>Gluteus maximus</p> Signup and view all the answers

    What may a positive Gluteal Skyline Test indicate?

    <p>Damage to the inferior gluteal nerve</p> Signup and view all the answers

    What action during the Knee Flexion Test indicates sciatic nerve root compression?

    <p>Bending the knee on the affected side while forward flexing the spine</p> Signup and view all the answers

    What does a positive Naffziger Test indicate?

    <p>Compression of the spinal theca</p> Signup and view all the answers

    Which test involves passive extension of the hip while the knee is flexed as much as possible?

    <p>Prone Knee Bending (Nachlas) Test</p> Signup and view all the answers

    What does a negative Oppenheim test indicate?

    <p>No reaction or no pain</p> Signup and view all the answers

    What does unilateral neurological pain in the lumbar area, buttock, or posterior thigh indicate during the Prone Knee Bending (Nachlas) Test?

    <p>L2 or L3 nerve root lesion</p> Signup and view all the answers

    Which test is a modification of the slump test and is used to catch the patient unaware?

    <p>Sitting Root Test</p> Signup and view all the answers

    What does pain in the back or leg during the Bechterewis test indicate?

    <p>Sciatic nerve tension</p> Signup and view all the answers

    Which test is considered the most common neurological test for the lower limb?

    <p>Slump Test</p> Signup and view all the answers

    Which test is used to assess upper motor neuron lesions?

    <p>Flip Sign</p> Signup and view all the answers

    What does a positive Babinski sign indicate?

    <p>Upper motor neuron lesion</p> Signup and view all the answers

    What does a positive Naffziger Test indicate?

    <p>Increase in intrathecal pressure</p> Signup and view all the answers

    Which test is typically used to indicate a large intervertebral disc protrusion and a poor prognosis for conservative treatment?

    <p>Slump Test</p> Signup and view all the answers

    What does the Farfan Torsion Test primarily test for?

    <p>Lumbar instability</p> Signup and view all the answers

    What may result from adhesions within the areas where tension develops during unilateral straight leg raising?

    <p>Sciatic nerve root compression</p> Signup and view all the answers

    Which test is used to test for lumbar instability and aberrant movement patterns?

    <p>Farfan Torsion Test</p> Signup and view all the answers

    Which test involves the patient flexing the hip until they complain of pain or tightness in the back or back of the leg?

    <p>Lasègue's test</p> Signup and view all the answers

    What does a positive Lasègue's test and crossover sign indicate?

    <p>Large intervertebral disc protrusion</p> Signup and view all the answers

    What does the Valsalva Maneuver test for?

    <p>Increased intrathecal pressure</p> Signup and view all the answers

    What does a positive slump test indicate?

    <p>Sciatic nerve root compression</p> Signup and view all the answers

    What does the Slump test primarily test for?

    <p>Increased intrathecal pressure</p> Signup and view all the answers

    During the slump test, the examiner is primarily looking for

    <p>Reproduction of the patient's pathological symptoms</p> Signup and view all the answers

    What is a nonpathological response during the slump test?

    <p>Symmetric increased range of knee extension and ankle dorsiflexion on release of neck flexion</p> Signup and view all the answers

    What is the purpose of the straight leg raising test?

    <p>To test the neurological tissues of the lower limb</p> Signup and view all the answers

    Which movement during the straight leg raising test indicates stretching of the dura mater of the spinal cord or a lesion within the spinal cord?

    <p>Neck flexion</p> Signup and view all the answers

    What is the purpose of the provocative maneuvers in the slump test?

    <p>To stress individual nerves</p> Signup and view all the answers

    What may a positive Bragard's test indicate?

    <p>A lesion in the hamstring area</p> Signup and view all the answers

    What is the primary nerve root stretched during unilateral straight leg raising test?

    <p>L3, L4, L5</p> Signup and view all the answers

    At what degree of hip flexion are the nerve roots normally completely stretched during unilateral straight leg raising test?

    <p>70°</p> Signup and view all the answers

    What is the most common cause of pain after 70° of hip flexion during unilateral straight leg raising test?

    <p>Joint pain from the lumbar area</p> Signup and view all the answers

    In patients who are very hypermobile, when may a positive straight leg raising test be observed even in the presence of nerve root pathology?

    <p>At 110° to 120° of hip flexion</p> Signup and view all the answers

    When should the examiner compare the left and right sides for symptoms during straight leg raising test?

    <p>Before deciding whether a lesion is caused by stretching of the neurological tissue or arises from the joints or other soft tissues</p> Signup and view all the answers

    During bilateral straight leg raising test, when does pain indicate a lesion in the lumbar spine area?

    <p>After 70° of hip flexion</p> Signup and view all the answers

    What is the purpose of the Oppenheim test?

    <p>To assess upper motor neuron lesions</p> Signup and view all the answers

    What does a positive Prone Knee Bending (Nachlas) test indicate?

    <p>A lumbar nerve root lesion</p> Signup and view all the answers

    What does pain in the anterior thigh during the Prone Knee Bending (Nachlas) test indicate?

    <p>Stretching of the femoral nerve</p> Signup and view all the answers

    What is the purpose of the Sitting Root Test?

    <p>To assess tension on the sciatic nerve</p> Signup and view all the answers

    What does a positive Slump Test indicate?

    <p>Increased tension in the neuromeningeal tract</p> Signup and view all the answers

    What is the purpose of the Bechterewis test?

    <p>To assess upper motor neuron lesions</p> Signup and view all the answers

    Which test is used to assess damage to the inferior gluteal nerve or pressure on the L5, S1, or S2 nerve roots?

    <p>Gluteal Skyline Test</p> Signup and view all the answers

    What does a positive Knee Flexion Test indicate?

    <p>Sciatic nerve root compression</p> Signup and view all the answers

    What does a positive Naffziger Test indicate?

    <p>Compression of the spinal theca</p> Signup and view all the answers

    What does a positive Flip Sign indicate?

    <p>Problems in the lower lumbar spine</p> Signup and view all the answers

    What does a positive Gluteal Skyline Test indicate?

    <p>Atrophy of gluteus maximus muscle</p> Signup and view all the answers

    What does pain in the sciatic nerve distribution during bilateral straight leg raising test indicate?

    <p>Sciatic nerve root compression</p> Signup and view all the answers

    During the slump test, the examiner is primarily looking for

    <p>Reproduction of the patient's pathological symptoms</p> Signup and view all the answers

    What is the purpose of the straight leg raising test?

    <p>To stress individual nerves</p> Signup and view all the answers

    Which movement during the straight leg raising test indicates stretching of the dura mater of the spinal cord or a lesion within the spinal cord?

    <p>Flexion of the neck</p> Signup and view all the answers

    What is the most likely cause of back pain during the straight leg raising test?

    <p>Disc herniation from pressure on the anterior theca of the spinal cord</p> Signup and view all the answers

    What does a positive slump test indicate?

    <p>Pathology causing pressure on neurological tissues</p> Signup and view all the answers

    What should be noted when doing bilateral knee extension in the slump position?

    <p>Symmetric restriction of knee extension and ankle dorsiflexion</p> Signup and view all the answers

    Which test is primarily used to test for structural instability and aberrant movement patterns?

    <p>Farfan Torsion Test</p> Signup and view all the answers

    What is the purpose of the Valsalva Maneuver test?

    <p>To test for increased intrathecal pressure</p> Signup and view all the answers

    Which test is typically used to indicate a large intervertebral disc protrusion and a poor prognosis for conservative treatment?

    <p>Lasègue's test</p> Signup and view all the answers

    What does a positive Lasègue's test and crossover sign indicate?

    <p>Large intervertebral disc protrusion</p> Signup and view all the answers

    What does the Slump test primarily assess?

    <p>Lumbar instability</p> Signup and view all the answers

    What should the examiner inquire about if the Lasègue's test is positive?

    <p>Bowel and bladder symptoms</p> Signup and view all the answers

    During the straight leg raising test, the nerve roots primarily stretched are the L5, S1, and S2 nerve roots of the sciatic nerve. What is the normal range of hip flexion at which these nerve roots are completely stretched?

    <p>80° to 90°</p> Signup and view all the answers

    What is the purpose of comparing the left and right legs during the straight leg raising test?

    <p>To assess for joint pain from the lumbar area or sacroiliac joints</p> Signup and view all the answers

    What may result in pain during the straight leg raising test if it extends from the back down into the leg in the sciatic nerve distribution?

    <p>Herniation of the intervertebral disc</p> Signup and view all the answers

    What does pain during the modified straight leg raising test indicate if it occurs when the examiner passively extends the patient's knee?

    <p>Herniated disc affecting nerve roots from L4 down to S3</p> Signup and view all the answers

    What does pain during the bilateral straight leg raising test before 70° of hip flexion indicate?

    <p>Space-occupying lesion in the sacroiliac joints</p> Signup and view all the answers

    What may a positive well leg raising test indicate during the straight leg raising test?

    <p>Herniated disc affecting nerve roots from L4 down to S3</p> Signup and view all the answers

    Which movement is limited in a patient with spondylolisthesis instability in anterior shear when the 'I' movement is attempted?

    <p>Forward flexion</p> Signup and view all the answers

    What does a positive lateral lumbar spine stability test indicate?

    <p>Structural instability</p> Signup and view all the answers

    What does a positive passive lumbar extension test indicate?

    <p>Lumbar instability</p> Signup and view all the answers

    What does a positive pheasant test indicate?

    <p>Spinal segment instability</p> Signup and view all the answers

    What does a positive posterior shear test indicate?

    <p>Spinal segment instability</p> Signup and view all the answers

    What does a positive prone hip extension test indicate?

    <p>Lumbar instability</p> Signup and view all the answers

    Which movements are tested in the H and I Stability Tests?

    <p>Flexion and extension</p> Signup and view all the answers

    What is the first part of the H and I Stability Tests called?

    <p>H movement</p> Signup and view all the answers

    What is the second part of the H and I Stability Tests called?

    <p>I movement</p> Signup and view all the answers

    Which movements are performed during the 'H' movement of the H and I Stability Tests?

    <p>Side flexion, flexion, and extension</p> Signup and view all the answers

    Which movements are performed during the 'I' movement of the H and I Stability Tests?

    <p>Flexion, side bending, and extension</p> Signup and view all the answers

    How many movements would be limited if a hypomobile segment is present during the H and I Stability Tests?

    <p>At least two</p> Signup and view all the answers

    During the plank test, the patient should be able to hold the position for at least how many seconds?

    <p>90 seconds</p> Signup and view all the answers

    What is the most common cause of vascular intermittent claudication?

    <p>Arteriosclerosis</p> Signup and view all the answers

    What is the name of the test where the patient pedals against resistance on an exercise bicycle?

    <p>Bicycle Test of van Gelderen</p> Signup and view all the answers

    What is the purpose of the stoop test?

    <p>To assess neurogenic intermittent claudication</p> Signup and view all the answers

    What is the purpose of Gower's sign?

    <p>To assess muscle weakness of the pelvic girdle</p> Signup and view all the answers

    What does a positive sign of the buttock test indicate?

    <p>Abscess</p> Signup and view all the answers

    Which position is the patient placed in for testing the integrity of left rotation on L5-S1?

    <p>Right side-lying position</p> Signup and view all the answers

    What is the purpose of the Test of Anterior Lumbar Spine Instability?

    <p>To test for posterior lumbar spine instability</p> Signup and view all the answers

    Which of the following is an indicator of facet joint pain according to the Clinical Prediction Rule for Facet Joint Involvement?

    <p>Localized unilateral back pain</p> Signup and view all the answers

    What is the purpose of McKenzie's Side Glide Test?

    <p>To test for lumbar instability and aberrant movement patterns</p> Signup and view all the answers

    What is the purpose of Milgram's Test?

    <p>To test for nerve root symptoms</p> Signup and view all the answers

    What is the purpose of the One-Leg Standing (Stork Standing) Lumbar Extension Test?

    <p>To assess lumbar instability and aberrant movement patterns</p> Signup and view all the answers

    Which test is used to measure the amount of flexion occurring in the lumbar spine?

    <p>Schober Test</p> Signup and view all the answers

    What is indicated by pain in the back during the patient standing on one leg and extending the spine while balancing on the leg?

    <p>Pars interarticularis stress fracture</p> Signup and view all the answers

    Which test is used to measure the endurance of the abdominal and back extensor muscles and the ability to maintain core stability?

    <p>Prone Bridge Test</p> Signup and view all the answers

    What is indicated by pain in the lumbar spine during both parts of the Yeoman's Test?

    <p>Facet joint pathology</p> Signup and view all the answers

    Which test is used to measure core trunk stability and strength of the hip and spine extensors and the contralateral external oblique and ipsilateral internal oblique muscles?

    <p>Supine Bridge Test</p> Signup and view all the answers

    What is indicated by pain in the back and associated symptoms during the Quadrant (Lumbar Quadrant, Extension Quadrant, Kemp's Test) Test?

    <p>Facet joint pathology</p> Signup and view all the answers

    Which movements are tested in the H and I Stability Tests?

    <p>Flexion and extension of the lumbar spine</p> Signup and view all the answers

    What is the first part of the H and I Stability Tests called?

    <p>The H movement</p> Signup and view all the answers

    In the H movement of the H and I Stability Tests, which movement is performed first?

    <p>Side flexion</p> Signup and view all the answers

    In the I movement of the H and I Stability Tests, which movement is performed first?

    <p>Forward flexion</p> Signup and view all the answers

    How many movements are performed in the H and I Stability Tests?

    <p>3</p> Signup and view all the answers

    If flexion is more painful than extension in the H movement, what should be done?

    <p>Extension should be done before flexion</p> Signup and view all the answers

    During the Lateral Lumbar Spine Stability Test, which direction does the examiner apply a downward pressure to the transverse process of L3?

    <p>Posterior</p> Signup and view all the answers

    What is the purpose of the Passive Lumbar Extension Test?

    <p>To assess for lumbar hyperextension</p> Signup and view all the answers

    During the Pheasant Test, what action does the examiner perform while the patient lies prone?

    <p>Applies pressure to the posterior aspect of the lumbar spine</p> Signup and view all the answers

    What is the purpose of the Prone Hip Extension Test?

    <p>To assess for abnormal lumbopelvic motion</p> Signup and view all the answers

    During the Prone Segmental Instability (PIT) Test, what action does the examiner perform while the patient lies prone with the body on the examining table?

    <p>Applies pressure to the posterior aspect of the lumbar spine</p> Signup and view all the answers

    What is the purpose of the Specific Lumbar Spine Torsion Test?

    <p>To assess for specific levels of the lumbar spine</p> Signup and view all the answers

    Which position is the patient placed in for testing the integrity of left rotation on L5-S1?

    <p>Right side-lying position</p> Signup and view all the answers

    What movement is performed to achieve rotation and side bending during the test of left rotation on L5-S1?

    <p>Pulling the right arm upward and forward</p> Signup and view all the answers

    What is the purpose of the Anterior Lumbar Spine Instability test?

    <p>To evaluate the movement of the L5 spinous process on L4</p> Signup and view all the answers

    What is the test position for the Posterior Lumbar Spine Instability test?

    <p>Sitting position</p> Signup and view all the answers

    What is the primary indicator of facet joint pain according to the Clinical Prediction Rule for Facet Joint Involvement?

    <p>Localized unilateral back pain</p> Signup and view all the answers

    What is the purpose of McKenzie's Side Glide Test?

    <p>To assess for facet joint involvement</p> Signup and view all the answers

    Which type of intermittent claudication is commonly associated with spinal stenosis?

    <p>Neurogenic</p> Signup and view all the answers

    What is the purpose of the Bicycle Test of van Gelderen?

    <p>To assess neurogenic intermittent claudication</p> Signup and view all the answers

    What does the stoop test assess?

    <p>Relation between neurogenic symptoms, posture, and walking</p> Signup and view all the answers

    What is the purpose of the Treadmill Test?

    <p>To determine if the patient has vascular intermittent claudication</p> Signup and view all the answers

    What is Gower's Sign a sign of?

    <p>Muscular dystrophy</p> Signup and view all the answers

    What does a positive sign of the buttock test indicate?

    <p>Pathology in the lumbar spine or hamstrings</p> Signup and view all the answers

    Which test is used to measure the amount of flexion occurring in the lumbar spine?

    <p>Schober Test</p> Signup and view all the answers

    What is a positive Beevor Sign indicative of?

    <p>Weakness or paralysis in the abdominal muscles</p> Signup and view all the answers

    Which test is used to measure the endurance of the abdominal and back extensor muscles and the ability to maintain core stability?

    <p>Prone Bridge Test</p> Signup and view all the answers

    What does a positive Schober Test indicate?

    <p>Muscle tightness in the lumbar spine</p> Signup and view all the answers

    Which test is used to measure core trunk stability and strength of the hip and spine extensors and the contralateral external oblique and ipsilateral internal oblique muscles?

    <p>Supine Bridge Test</p> Signup and view all the answers

    What does a positive Yeoman's Test indicate?

    <p>Spondylolisthesis</p> Signup and view all the answers

    Which part of the H and I Stability Tests is performed first?

    <p>The H movement</p> Signup and view all the answers

    Which position is commonly used to manipulate the spine during assessment?

    <p>Side-lying position</p> Signup and view all the answers

    What is the purpose of the H and I Stability Tests?

    <p>To assess lumbar stability</p> Signup and view all the answers

    Which movement is performed first during the 'I' movement of the H and I Stability Tests?

    <p>Forward flexion</p> Signup and view all the answers

    What is the purpose of the Test of Anterior Lumbar Spine Instability?

    <p>To assess the integrity of left rotation on L5-S1</p> Signup and view all the answers

    If flexion is more painful than extension in the H movement, what should be done?

    <p>Extension should be done before flexion</p> Signup and view all the answers

    What are the indicators of facet joint pain according to the Clinical Prediction Rule for Facet Joint Involvement?

    <p>Localized unilateral back pain</p> Signup and view all the answers

    What is the purpose of McKenzie's Side Glide Test?

    <p>To test for posterior lumbar spine instability</p> Signup and view all the answers

    How many movements are performed during the 'I' movement of the H and I Stability Tests?

    <p>4 movements</p> Signup and view all the answers

    What does it indicate if at least two of the movements into the same quadrant are limited during the H and I Stability Tests?

    <p>Presence of a hypomobile segment</p> Signup and view all the answers

    What is the purpose of Milgram's Test?

    <p>To assess lumbar instability</p> Signup and view all the answers

    What is the purpose of the One-Leg Standing (Stork Standing) Lumbar Extension Test?

    <p>To assess core trunk stability</p> Signup and view all the answers

    What is the purpose of the Schober test?

    <p>To measure the amount of flexion occurring in the lumbar spine</p> Signup and view all the answers

    What is the purpose of the Quadrant (Lumbar Quadrant, Extension Quadrant, Kemp's Test) Test?

    <p>To assess possible facet joint pathology</p> Signup and view all the answers

    What is the purpose of the Thomas Test?

    <p>To test for tight iliopsoas</p> Signup and view all the answers

    What is the purpose of the Prone Bridge Test (Plank Test, 4-Point Hold Test, Hover Test)?

    <p>To measure the endurance of the abdominal and back extensor muscles</p> Signup and view all the answers

    What is the purpose of the Supine Bridge Test?

    <p>To measure core trunk stability and strength</p> Signup and view all the answers

    What does a positive Beevor Sign indicate?

    <p>Pathology in the abdominal muscles</p> Signup and view all the answers

    Which movement is limited in the presence of spondylolisthesis instability in anterior shear during the 'I' movement of the H and I Stability Tests?

    <p>Forward flexion</p> Signup and view all the answers

    What action does the examiner perform during the Prone Hip Extension Test?

    <p>Observes or palpates for abnormal lumbo-pelvic motion patterns</p> Signup and view all the answers

    What is the purpose of the Pheasant Test?

    <p>To assess unstable spinal segment</p> Signup and view all the answers

    What is the purpose of the Posterior Shear Test?

    <p>To assess posterior shear</p> Signup and view all the answers

    What is the purpose of the Prone Segmental Instability (PIT) Test?

    <p>To assess microinstability in the lumbar spine</p> Signup and view all the answers

    Which level of the lumbar spine does the Specific Lumbar Spine Torsion Test stress?

    <p>L3-L4</p> Signup and view all the answers

    Which of the following tests is used to assess neurogenic intermittent claudication by determining whether a relation exists between neurogenic symptoms, posture, and walking?

    <p>Stoop test</p> Signup and view all the answers

    Which test involves the patient pedaling against resistance on an exercise bicycle and assessing for pain and tingling in the buttock and posterior thigh?

    <p>Bicycle test</p> Signup and view all the answers

    Which test is used to determine if the patient has neurogenic intermittent claudication by assessing for pain in the buttock and lower limb during brisk walking?

    <p>Stoop test</p> Signup and view all the answers

    Which test is used to determine if the patient has intermittent claudication by recording time to first symptoms, total ambulatory time, and precipitating symptoms?

    <p>Treadmill test</p> Signup and view all the answers

    Which test is positive when the patient uses their hands and arms to 'walk up' their body due to weakness of the pelvic girdle muscles?

    <p>Gower's sign</p> Signup and view all the answers

    Which test is used to assess for pathology in the buttock behind the hip joint, such as a bursitis, tumor, or abscess?

    <p>Sign of the buttock</p> Signup and view all the answers

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