Bowstring test. By Philans Cosmos Ankrah

Thorough

1. BOWSTRING
TEST
BY
PHILANS COSMOS ANKRAH

3. OBJECTIVES
By the end of this presentation, students should be able to;
Describe the sciatic nerve and its course of supply
Identify lesions of the sciatic nerve
Identify the bowstring test as one of the tests of sciatic nerve
pathology
Outline the steps in conducting the bowstring test
Give the implications of the results obtained

4. THE SCIATIC NERVE
(LUMBOSACRAL PLEXUS)
also known as the ischiadicnerve and the ischiatic
nerve
It begins in the lower back and runs through the
buttock and down the lower limb.
The sciatic nerve supplies nearly the whole of the skin
of the leg, the muscles of the back of the thigh, and
those of the leg and foot.
It is derived from spinal nerves L4 through S3.

5. COURSE
Exits the sciatic notch and runs anterior (deep) to piriformis.
It then lies posterior (superficial) to the short external rotators
(superior gemellus, inferior gemellusand obturatorinternus).
It then runs down the posterior leg where it breaks into its three
main divisions at the level of the mid thigh.
The terminal branches are the common peroneal and tibial
nerve.

6. SUPPLY
Articular branches supply the hip-joint
Muscular branches supply posterior thigh muscles and
muscles of the leg.
Sensor supply; innervates the skin on the posterior aspect of
the thigh and gluteal regions, as well as the entire lower leg
(except for its medial aspect).

7. PATHOLOGY
Pain caused by a compression or irritation of the sciatic nerve by
a problem in the lower back is called sciatica.
Common causes of sciatica include the following lower back and
hip conditions: spinal disc herniation, degenerative disc disease,
lumbar spinal stenosis, spondylolisthesis, and piriformis
syndrome
Sciatic nerve palsy is a complication of total hip arthroplasty
Sciatic nerve palsy can also result from severe spinal stenosis

8. SCIATICA

10. THE BOWSTRING TEST
Steps
Subject begins supine with legs extended With a little
abduction of the hip and internal rotation
Examiner performs a passive straight leg raise on the
involved side
If radiating pain is reported, the examiner then flexes
the subjects knee until symptoms are reduced
The examiner then applies pressure to the popliteal
area in attempt to reproduce the radicular pain

11. BOWSTRING TEST (RESULTS)
Positive Test
Reproduction of radicular pain with popliteal
compression
Positive Test Implications
Sciatic nerve pathology

12. STEPS AGAIN

14. THANK YOU…