Lower Limb Neurodynamics “nerve Movement”

Question 1

What level is the femoral nerve and what actions does it do?

Answer 1

L2-3- it tests the Ilio- muscle- it does hip flexion

L3-4- femoral nerve- it tests the quadriceps muscles and does knee extension

Question 2

What level is the deep perineal nerve at?

Answer 2

L4-5- tibialis anterior and it’s action is dorsiflexion

L4-5-S- EHL and it’s action is big toe extension

Question 3

Where is the common perineal nerve located?

Answer 3

L5-S1 - the acting muscles are Peroneus Longus and brevis. It does eversion

Question 4

Where is the tibial nerve located?

Answer 4

L5-S1-2, it tests gastrocnemius, soleus and does plantarflexion

Question 5

Where is the sciatic nerve located?

Answer 5

L5-S1- it tests the hamstrings and it’s action is knee flexion

Question 6

What are some indications for doing a neurological examination in the lumbar spine?

Answer 6

Pain in dermatomal distribution
Pain in lumbar spine referred beyond the hip
Altered sensation in the lower limb
Pain in the lower limb related to a lumbar condition
Complaints of weakness in the lower limb

Question 7

What reflexes mean…

Answer 7

Hyper-reflexic= UMN lesion
Hypo- reflexic = LMN lesion or low tone
Absent= LMN lesion

Question 8

What happens during a straight leg raise test and what nerve does it test?

Answer 8

Supine lying, medially rotate the hip slightly, passively extend the knee and flex the hip
Add dorsiflexion inversion/eversion, PF inversion, CXR Flex to test different nerves such as perineal

Question 9

What nerve does the prone knee bend test test and how is it done?

Answer 9

Side lying, lower knee pulled up to chest with neck flex, the knee should be pulled into full flexion passively. The other hip should be pulled into hip extension. Until R1/P1 then ask patient to extend the neck, should be able to move the leg further.

Question 10

What is the slump test like?

Answer 10

The slump test tests the sciatic nerve. The patient should sit fully supported with their thighs on the bed. Their hands are held behind their back. The shoulders should be slumped down. This should be held or OP. Neck flexion is active and monitor/OP
dorsiflexion the ankle and extend the knee

Question 11

What are the 3 upper motor neurone tests?

Answer 11

Babinski
Clonus
Hoffman’s