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Musculoskeletal 1 > Neural tension testing > Flashcards

Neural tension testing Flashcards

1
Q

Describe the sensory neurons and where they are found

A
  • dorsal root ganglia
  • afferent
  • joints
  • blood vessels
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2
Q

Describe the sympathetic neurons and where they are found/innervate

A
  • in sympathetic ganglia
  • afferent
  • viscera
  • blood vessels
  • glands
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3
Q

Describe the CT of neurons

A
  • Epineurium: whole nerve
  • Perineurium: fascicles/bundles of nerves
  • Endoneurium: axons or individual nerves
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4
Q

What is degree of viscoelasticity

A
  • passive movement in connective tissue of the nerve
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5
Q

Mobility of a nerve
- forces that are placed on it and how it moves

A
  • traction forces are distributed over the length of the nerve
  • ability to deform 5-10 mm
  • Tolerate limited tension, compression stress
  • adapt to positions of limbs and trunk
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6
Q

LMN peripheral nerve injury to nerve root

A
  • occurs in spine at VI foramen
  • myotomal, dermatomal and reflex changes
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7
Q

LMN peripheral sites along nerve path injury

A
  • motor, sensory changes in peripheral nerve distribution
  • Signs and symptoms: muscle weakness, pain/abnormal sensation where nerve innervated (not dermatome)
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8
Q

how can trauma, injury or surgery cause nerve injury?

A

Healing, nerve entrapment in scar tissue and adhesions (lose mobility)

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9
Q

Nerve tension and compression forces

A
  • Tensile force/traction - extremes of motion
  • Compression from:
    Posture: adaptive shortening, muscle fascia, liga, capsules
    Muscle hypertrophy, contraction, overuse
    Space occupying lesion: disc, tumor, one, swelling etc
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10
Q

When do you use neural tension tests?

A

when peripheral nerves appear to be involved

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11
Q

What is a positive test of a neural tension test?

A
  • Reproduction of pt’s symptoms
  • pain/paresthesia peripheral nerve pattern
  • Difference from uninvolved
  • Differentiate from stretching discomfort
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12
Q

What is the sensory distribution of Median nerve

A

Palm of hand on the thumb to half the ring finger

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13
Q

Motor component of median nerve

A
  • Wrist finger flexors (excluding FCU and ulnar side of FDP)
  • Pronators
  • Hand median muscles
  • thenars
  • 1-2 lumbricals
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14
Q

What is the course of the median nerve

A
  • Lateral and medial cords
  • Medial arm
  • Anterior elbow
  • Anterior forearm
  • Pronator teres (through)
  • Carpal tunnel (through)
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15
Q

What can occur with damage to the median nerve

A
  • ape thumb deformity
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16
Q

What are the steps to the median ULTT

A
  1. Depress and retract scapula
  2. Abduction, ER of GH joint
  3. Extend wrist
  4. Extend elbow
  5. CS SB away
17
Q

Ulnar nerve sensory component

A

½ ring and little finger
Palm and dorsal sides

18
Q

Ulnar nerve motor component

A

Motor:
FCU
Ulnar FDP
Ulnar intrinsics:
Lumbricals 4,5
Interossei
Adductor pollicis
Hypothenar muscles

19
Q

What is the course of the ulnar nerve

A

Course:
Median branch
Medial arm
Cubital tunnel (through on posterior elbow)
Medial forearm
Anterior wrist
Tunnel of guyan (through)

20
Q

what is the deformity that can occur with the ulnar nerve

A

Deformity: Benediction hand

21
Q

ULTT: ulnar nerve

A

elbow is extended to begin
1. Depress and retract scapula
2. Abduct and ER GH
3. Extend, RD wrist
4. Flex elbow
5. CS SB away

22
Q

Radial nerve sensory

A

Sensory: Posterior arm
Posterior forearm
Hand dorsal radial side (not including tips of index and middle finger)

23
Q

motor of the radial nerve

A

Motor:
Triceps
Anconeus
Brachioradialis
Supinator
Wrist, finger, and thumb extensors

24
Q

Course of the radial nerve

A

Course:
Posterior cord
Posterior arm
Triangular interval
Anterior to lateral epicondyle
Branches into
Deep: thru supinator to posterior forearm (becomes posterior interosseous)
Superficial branch: sensory to the dorsal wrist and hand

25
Q

Deformity that can occur with the radial nerve

A

Deformity: drop wrist

26
Q

ULTT: Radial nerve

A
  1. Depress scapula with hip
  2. Abduct, extend, IR shoulder
  3. Flex wrist and UD
  4. CS SB away
27
Q

Treatment for positive neural tension tests - and how are they carried out?

A
  • Controlled, component motions to glide nerve
  • Monitoring irritability of neural tissue with increased/lasting symptoms
  • Move to the point of slight symptoms/onset of altered sensibility
  • Done frequently 5-10 reps per hour with monitoring symptoms
28
Q

Sensory femoral nerve

A

Sensory:
Anterior femoral cutaneous: anterior medial thigh
Saphenous: medial lower leg

29
Q

Motor: femoral nerve

A

Motor:
Quadriceps
Iliacus
Sartorius

30
Q

course of femoral nerve

A

Course
anterior
Under inguinal ligament
Anterior hip and thigh

31
Q

LLTT femoral nerve

A

LLT:
Hip extension
Knee flexion

32
Q

sensory sciatic nerve

A

Sensory:
- Posterior thigh, leg and foot
- sural : posterior lateral calf
- Posterior tibial: heel
- Medial and lateral plantar: medial and lateral foot
- Superficial peroneal: dorsum of foot
- Deep peroneal: great two web space

33
Q

motor: sciatic

A

Motor:
Hamstrings and all lower leg

34
Q

courses: sciatic

A

Courses:
Under piriformis
Posterior buttock
Posterior thigh
posterior leg
Branches:
Tibial
Peroneal

35
Q

LLTT: sciatic

A

LLTT
Hip flexion
Knee extension
Hip adduction
Hip IR
Dorsiflexion
CS flexion

36
Q

What do nerve glides do for the nerve

A
  • promotes circulation to nerve and aids with healing
    promotes nerve mobility, limits scar tissue adherence
37
Q

How to tease out the peroneal

A

Musculoskeletal 1 (42 decks)

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