Special Maneuvers for Advanced Health
Assessment Final
Nerve root irritation or lumbar disk herniation at the L4, L5, and S1 levels - correct answer Straight leg
raise
o Pt lies supine with the neck slightly flexed
o Ask pt to raise the leg keeping the knee extended
o No pain should be elicited below the know with leg straight
Sciatic nerve tenderness - correct answer Sitting knee extension
o Pt is in sitting position with legs dangling
o Ask pt to extend the leg at the knee
o Pain with extension or attempts to lean back to reduce tension on nerve is a positive sign of sciatic
nerve tenderness
Inflammation of the nerve root at the L1, L2, L3, and sometimes L4 level - correct answer Femoral stretch
test or hip extension test
o Pt lying in prone position and extend the hip
o No pain is expected
o Presence of pain on extension is a positive sign of nerve root irritation
Fluid or an effusion in the knee - correct answer Ballottement
o Knee is extended (leg straight)
o Apply downward pressure on the suprapatellar pouch (hand pushing just above the knee) with the
web or the thumb & forefinger of one hand
o Then push the patella downward against the femur
o Release pressure against the patella (push on the knee cap) but keep your finger lightly touching it
o If an effusion is present the patella will float out as if a fluid wave were pushing it
