Physical Examination in Occupational Medicine Dr. Majid Golabadi Occupational Medicine Specialist

Apley Scratch Test

Phalen Test

Tinnel sign

Upper Extremity Tendon Reflex Reflex Abnormality - Biceps, Triceps, Brachioradialis

Kyphosis is excessive curvature of the spine in the sagittal (A-P) plane. The normal back has 20° to 45° of curvature in the upper back, and anything in excess of 45° is called kyphosis. Scoliosis is abnormal curvature of the spine in the coronal (lateral) plane. Scoliosis of between 10° and 20° is called mild. Less than 10° is postural variation. Lordosis or hyperlordosis is excessive curving of the lower spine and is often associated with scoliosis or kyphosis. It can be exaggerated by poor posture.

Straight Leg Raise SLR Sensitivity 91% Specificity 26 % Examiner raises straight leg (30 to 60 degrees) eliciting radicular pain on same side (Lasegue Sign). Then lowers leg until pain goes away, the foot is then dorsiflexed causing return of pain Sensitivity 91% Specificity 26 % Consider Trendelenberg for Hip abductor weakness (L5) Hip extension for S1; short squat/getting out of chair (L4)

Crossed Straight Leg Raise (Crossed SLR) Examiner raises straight leg (30 to 60 degrees) eliciting radicular pain on opposite side. Sensitivity 25% Specificity 90-97% Consider Trendelenberg for Hip abductor weakness (L5) Hip extension for S1; short squat/getting out of chair (L4)

Reverse Straight Leg Raise (Reverse SLR) Patient is prone, examiner raises straight leg (30 to 60 degrees) –pain radiating to anterior thigh indicative of L3-L4 root irritation Sensitivity ? Specificity ? Consider Trendelenberg for Hip abductor weakness (L5) Hip extension for S1; short squat/getting out of chair (L4)

Duck Walk Test

Knee Deformities