Neurodynamics UE

Question 1

definition of clinical neurodynamics

Answer 1

the clinical application of mechanics and physiology of the nervous system as hey relate to each other and are integrated with musculoskeletal function

Question 2

Neurodynamic tests - examination of neural tissue

Answer 2

Mechanical and physiological features

Question 3

Neurodynamic tests assess peripheral afferent sensitization

Answer 3

hypersensitivity of neural tissue

Question 4

Neurodynamic tests - continuous tract

Answer 4

mechanically, chemically, electrically, connective tissue

Question 5

Causes of neurodynamic pathology

Answer 5

Mechanical

Physiological

Question 6

Mechanical cause

Answer 6

tension
sliding
compression

Question 7

Physiological cause

Answer 7

intraneural blood flow
inflammation
mechanosensitivity

Question 8

Mechanical - dural attachments

Answer 8

Cranium
Joint capsule
PLL
Ligamentum flavum

Question 9

Mechanical - tension points

Answer 9

points where dura is attached or can become adhered
C6 T6 1st rib
scalene mm
radial head
pronator teres
flexor carpi ulnaris
carpal tunnel

Question 10

Phsiological mechano-sensitivity

Answer 10

The ease with which the neural tissues become active when mechanical force is applied to them

Question 11

Subejctive complaints

Answer 11

Radiating pain in involved UE

UE paresthesias, numbness, and weakness may be present

Question 12

Additional subjective fidnings

Answer 12

Chronic symptoms
Co-existing pathology elsewhere
Impaired movement - pain first and then loss of movement

Question 13

Contraindications

Answer 13

Irritable conditions
Pathology of other structures involved
Neurological signs
Circulatory changes
Malignancy 
Cord signs

Question 14

Normal response

Answer 14

Muscle activity
Stretchign sensation
Tingling

Question 15

Positive objective findings

Answer 15

Comparable sign produced
Test response can be altered by movement distant from site of symptoms
Significant diff in ROM, resistance, and sx involved vs. non-involved side
Adverse response to nerve palpation

Question 16

Impairments of body function - clinical guidleines

Answer 16

Neck and neck related radiating pain reproduced with cervical extension, SB, and rot toward involved side (spurling)
Upper limb neurodynamic testing
Relieved with distraction
May have UE sensory, strength, or reflexive deficits associated with involved nerves

Question 17

Practical handling skills

Answer 17

Joint ROM must be assess for limitation prior to nerve testing 
Cervical lateral flexion
Shoulder depression, abduction
Elbow extension
Full spinal flexion

Question 18

Intervention - guidelines

Answer 18

Upper quarter and nerve mobilization procedures
Traction
Thoracic mobilization/manipulation

Question 19

Neurodynamic intervetion

Different intervention =

Answer 19

different effects
Tensioning exercises
Sliding exercises
Manual interventions

Question 20

Mechanical - tensioning techniques

Answer 20

Lengthening the distance the nerve travels
Nerve glide - movement of one or several joints to elongate the nerve bed and the nerve - inc nerve tension and intraneural pressue, reduces intraneural blood flow

Question 21

Mechanical - sliding technique

Answer 21

sliding relative to other structures - elongate nerve at one joint balanced by reduction in length of nerve bed at an adjacent site
Nerve slides relative to surrounding strucutres
Longitudinal excursion of the nerve

Question 22

Mechanical - tensioning techniques - abnormal impulse generation

Answer 22

Trigger ectopic discharges

Exacerbates symptoms

Question 23

mechanical - sliding technique - dynamic variation in intraneural pressure

Answer 23

facilitate evacuation of intraneural edema

Reduce symptoms

Question 24

Altered nerve physiology

Answer 24

Neural inflammation
Intraneural blood flow
Mechanosensitivity

Question 25

Direct intervention

Answer 25

sliding, gliding, traction…

Question 26

Indirect intervention

Answer 26

Manipulation to spine