Neurodynamics Lab

Question 1

Normal Response

Answer 1

Tingling sensation in leg, foot, toes

Deep stretch or ache

Question 2

Positive Test

Answer 2

Reproduces comparable sign
Test response can be altered by distant movement
Differences in ROM, resistance and symptoms involved vs. noninvolved side
Adverse response to nerve palpation

Question 3

Nerves and Levels - Femoral

Answer 3

L2-L4

Question 4

Nerves and Levels - Sciatic

Answer 4

L4-S3

Question 5

Nerves and Levels - Fibular

Answer 5

L4-S1

Question 6

Nerves and Levels - Tibial

Answer 6

S1-S2

Question 7

Nerve Palpation - Sciatic

Answer 7

Midway btw greater troch and ischial tub

Question 8

Nerve Palaption - Femoral

Answer 8

lateral to inguinal pulse

Question 9

Nerve palpation - FIbular

Answer 9

palpate neck of fibula

Question 10

Nerve Palpation - Tbial

Answer 10

posterior to medial malleolus

Question 11

PROM Testing

Answer 11

Slump Test
SLR
Crossed SLR
Prone Knee Bend

Question 12

Slump Test

Answer 12

Continual assessment of sx
Pt seated with hands behind back, full flexion is added to thoracolumbar region while head is maintained in neutral
Apply overpressure - assess
Cervical flexion - asses
Knee extension - assess
Ankle dorsiflexion - assess
Release LE components
Repeat and assess on other leg

Question 13

POsitive slump test if

Answer 13

Comparable sign is found and then with release of cervical felxion - sx are decreased or further ROM is gained

Question 14

What pt history would lead you to perform a slump test

Answer 14

ANSWER

Question 15

What tx based classifications are associated with positive neurodynamic tests?

Answer 15

ANSWER

Question 16

SLR - increases distance nerve travels

Answer 16

Btw 30 and 70 degrees of SLR the length increases 2-6 mm - other structures become involved after 70 degrees

Question 17

SLR

Answer 17

Patient in supine with NO pillow
Screen hip/knee ROM first!
SLR is done passively with knee extended until resistance or sx occur
Leg is lowered to the point just before resistance or sx and then ankle DF or passive cervical flexion is added
Hip IR and ADD can also be added

Question 18

Postitive SLR

Answer 18

Increase in sx with cervical flexion - problem in neuromeningeal system

Question 19

Crossed SLR

Answer 19

High Sp
Lifting of the asymptomatic leg produces pain in the symptomatic leg
Possibel cause of pos test = SIJ involvement, large or medially displaced disc herniation

Question 20

Prone Knee Bend

Answer 20

Patient prone
Stabilize pelvis
Flex knee fully
If no sx, extend hip while maintaining knee flexion
Dura is stretched at 80-100 deg knee flexion, beyond 100 deg introduces btoh rectus and lumbar spine motion
Can do n side lying to incorporate spinal flexion (with release of neck flexion, hip ext should inc)

Question 21

Normal response to Prone knee bend

Answer 21

Stretch.pull anterior thigh

Positive test if comparable sign is reproduced

Question 22

Interventions

Answer 22

Accessory Lumbar PA with SLR
Flexion PPIVM with SLR
Neural Slide (slump, SLR)
Slump stretching

Question 23

Neural slide intervention

Answer 23

Increase length of nerve bed at one joint and decrease length of nerve bed at adjacent to move relative to surrounding structures

Question 24

SLR slider

Answer 24

Patient side lying
Spinal flexion with knee flexion and hip extension
Move into spinal ext with knee ext and hip flex, May add ankle movements PF/DF

Question 25

Slump Slider

Answer 25

Patient seated with spinal flexion, ankle PF

Move into seated spinal extension with knee ext and ankle DF

Question 26

Slump Stretching

Answer 26

Pt in long sitting with feet against wall to maintain DF

Therapist or pt applies pressure into cervical felxion to point of sx reproduction, hold 30 sec 2-5 reps