L-4 Motor

Name of test

REVERSE STRAIGHT LEG RAISING SIGN (FEMORAL STRETCH TEST)

What it tests

FEMORAL NERVE FUNCTION, IN SPECIFIC, RELATED TO RADICULITIS OR INFLAMMATION OF THE NERVE ROOT

How to do it

PATIENT SHOULD LIE PRONE AND THE CLINICIAN SHOULD THEN FLEX THE KNEE TO 90 DEGREES AND THEN EXTEND THE LEG AT THE HIP. AN ALTERNATIVE MRTHOD IS DONE WITH THE PATIENT SUPINE AND THE EXTENDED LEG IS LIFT IN EXTENSION AT THE HIP (HIP HYPEREXTENSION)

The normal response

NO PAIN RADIATING DOWN THE ANTERIOR THIGH WITH ANY OF THE VARIETY OF REVERSE STRAIGHT LEG RAISING TESTS

What it means if not normal

IRRITATION OR INFLAMMATION OF THE L4 NERVE ROOT PRODUCING A RADICULITIS MOST COMMONLY DUE TO A HERNIATED NUCLEUS PULPOSUS (L3-L4) OR POSSIBLY DUE TO DISC TEARING AND RELEASE OF LOCAL INFLAMMATORY COMPONENTS (SUBSTANCE P)

Comments

L4 PREDOMINANTLY PROVIDES STRENGTH FOR KNEE EXTENSION VIA INNERVATION OF THE FOUR MUSCLES OF THE QUADRICEPS

Citations

Hoppenfeld, Stanley. Orthopaedic Neurology. Philadelphia: J.B. Lippincott Co., 1997.


K. Anderson, J. Hall. Sports Injury and Management: Philadelphia: Williams & Wilkins, 1995


Reider, Bruce. The Orthopaedic Physical Examination, 2nd Ed.: Philadelpiha: Elsevier Saunders, 2005.

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