Neuroprovocation Testing

Question 1

Neurodynamics

Answer 1

-Dynamic mechanical and physiological properties of NS
-inter and intra neural communication
-neural tissue responds to moving by: gliding, lengthening, compression

Question 2

Adverse Neural Tension

Answer 2

-abnormal physiological or mechanical response from NS
-limits range/stretch
-neuro s/s

Question 3

Mechanisms of Neural Adverse Tension

Answer 3

-dura tethered to bony canal and adhesions increase tension
-C6, T6, L4

Question 4

Site of Vulnurability: Tunnel

Answer 4

-tunnels increase probability of spatial compromise
-friction or trauma

ex: carpal tunnel

Question 5

Site of Vulnurability: Branches

Answer 5

-where a nerve branches
-harder to move from forces here

ex: radial n at elbow

Question 6

Site of Vulnurability: Hard Interfaces

Answer 6

-nerve lying on bone or passing throuhg fascia
-easier to compress

Question 7

Site of Vulnurability: Proximity to Surface

Answer 7

-superficial nerves are more vulnerable to compression

Question 8

Site of Vulnurability: Adherence to interfacing structures

Answer 8

-nerve more adherent in some places

ex: common fib at head of fibula

Question 9

Nerve Mechanisms of Injury

Answer 9

-Posture: adaptive shortening
-Trauma: fracture, dislocation
-Extremes of Motion: traction
-Electrical injury
-Compression

Question 10

Neurodynamic Mobility Exam

Answer 10

-Subjective (Pain, spasms, paresthesias)
-Observation
-Palpation
-ROM
-Resisted testing
-Nerve provocation test

Question 11

Nerve Provocation Testing

Answer 11

-asses contribution of nerve to pain
-sequential and progressive stretch on dura

Question 12

3 Signs of a Positive NTPT

Answer 12

1. Reproduces Pt s/s
2. Movement of distant body part causes responses
3. Test differences from L to R

Question 13

Straight Leg Raise

Answer 13

-test for sciatic n

1. actively raise leg
2. passively raise leg
3. DF
4. Pt lift head

Pain in 0-30: acute/severe MSK
Pain in 30-70: nerve issue
Pain >70: not positive
Crossed SLR sign: opposite s/s, disc protrusion

Sensitizers:
-Tibial: DF > Eversion > Toe Ext
-Sural: DF > Inversion
-Common fib: PF > Inversion

Question 14

Slump Test

Answer 14

-test neuromobility

1. Hands behind back
2. Head and neck flexed
3. Lumbar flx
4. Straighten knee
5. overpressure
6. DF of ankle
7. Pt moves head

Question 15

Upper Limb Tension Testing

Answer 15

1. Use elbow to depress scap
2. Abduct
3. Extend wrist and fingers
4. ER
5. Elbow extension
6. Lat sidebending

+ Findings: differences btw sides, different elbow ROM, reproduction of s/s

Question 16

Sensitizers

Answer 16

-maneuvers that increase neural tension
-bias toward nerves

Question 17

Indication for Neurodynamic Mobilizations

Answer 17

-Neurological s/s
-Antalgic Postures
-Active or passive mmt Dysfunction
-Tenderness to palpation over superficial neural tissues

Question 18

Contraindications for Neurodynamic Mobilizations

Answer 18

-Recent repair
-Malignancy
-Active Inflammatory Disorders
-Acute Inflammatory Demyelinating Disorders

Question 19

Precautions for Neurodynamic Mobilizations

Answer 19

-irritable conditions
-SC signs
-Nerve root signs
-Severe night pain w/ no Dx
-recent paresthesia or anesthesia
-Mechanical spine pain w/ peripheralization s/s

Question 20

Neurodynamic Mobilization Techniques: Gliding

Answer 20

-load one end of nerve while relieving stress on opposite end
- 1 “on” and 1 “off” then switch

ex: head flx and ankle PF, the head ext and ankle DF

Question 21

Neurodynamic Mobilization Techniques: Tension

Answer 21

-load opposite ends of nerve
-both “on” or “off”
-when glides no longer help

ex: head flx and ankle DF, the head ext and ankle PF

Question 22

Neurodynamic Mobilization Techniques: Stretching

Answer 22

-load opposite ends of nerve and hold
-7-30s
-both “on” or “off”
-most agressive

ex: head flx and ankle DF (hold), the head ext and ankle PF (hold)