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Samenvatting Blok 8 - Praktijk - Lumbaal radiculair syndroomm

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Lumbaal radiculair syndroom
Screening
- aanmelden
- hulpvraag inventariseren
- pluis / niet- pluis (rode vlaggen)
- infomeren over bevindingen van de screening

Anamnese
-

Inspectie
Totaal
- deformiteiten
- anthalgische houding (naar één kant hangen)
- patienten met L4-L5 hangen in een lateral shift
- patienten met L5-S1 hangen vaak voorovergebogen

Lokaal
- atrofie

Functioneel
- lopen, tillen, hakken lopen, tenen, lopen, traplopen

Palpatie
- tonus

Bewegingsonderzoek
- LWK en heup
- Spierkracht MRC
  M. iliopsoas (L2).
  M. quadriceps (L3/L4).
  M. tibialis anterior (L4).
  M. extensor hallucis longus (L5).
  M. peroneus (L5/S1).
- sensibiliteit (pin-prik test / tweepunts-discriminatie test)
- peesreflexen
 Kniepeesreflex: L3/L4.
 Achillespeesreflex: L5/S1.

Specifieke testen
- Kemp
- SLR (60 graden heup anteflexie )
- vasalva
- hakval-test
- slump
- vinger top bodem afstand (> 25cm)
- gekruiste Laseque

Wanneer je niet aan een hernia denkt:

,  SI- gewricht testen: (gaat kijken of er nutatie en contra-nutatie plaats vindt)
o Distractie test (gapping test).
o Compressietest (approximation test).
o Pelvic torsie test (gaenslan test).
o Thigh Thrust test (Femoral shear test).
o Patrick sign (faber test).
Hiermee test je of de pijn uit het SI gewricht komt.
 Spierlengtetest m. piriformis:
o Flexie, adductie, endorotatie heup.
o Bij het piriformis syndroom is de spierlengte beperkt en pijnlijk.
 Isometrische weerstandstest piriformis:
o Therapeut geeft isometrische weerstand tegen de extensie, abductie en
exorotatie heup.

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Uploaded on
February 27, 2016
Number of pages
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Written in
2014/2015
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