Ortho III Midterm- Neurodynamics

Question 1

What test stresses only the dura?

Answer 1

Passive neck flexion

Question 2

What nerve is stressed during SLR? SLR with Dorsiflexion and eversion? SLR with Dorsiflexion and Inversion? And SLR with plantar flexion and inversion? And associated acronyms?

Answer 2

SLR= Sciatic
SLR + DF + EV=Tibial nerve (TED)
SLR + DF + IV= Sural nerve (SID)
SLR + PF + IV= Fibularis/ Peroneal nerve (FIP/ PIP)

Question 3

With the prone knee bend test which nerve is being stressed?

Answer 3

Femoral nerve

Question 4

With the SLR test if the pain occurs in the mid calf or dorsum of first two toes which nerve is on stretch? If pain occurs in lateral ankle With dorsifexion? If pain occurs in lateral ankle/ foot with plantar flexion?

Answer 4

Mid calf/ dorsum of first 2 toes= tibial

Lateral ankle with Dorsiflexion= Sural (inversion) and Tibal (eversion)

Lateral ankle with plantar flexion= fibular/ Peroneal nerve

Question 5

Define mechanical interface?

Answer 5

Any soft tissue that can cause an entrapment of the nerve

Question 6

What are the 3 types of vulnerable sites (peripheral sites)?

Answer 6

Tunnels
Branches
Hard surfaces/ bony prominences

Question 7

The lateral femoral cutaneous nerve is 100% _. How do you tension the lateral femoral cutaneous nerve?(2)

Answer 7

Is 100% SENSORY

You can tension the lateral femoral cutaneous nerve with extension and adduction

Question 8

The femoral nerve is _ and _, but typically symptoms that result from impingement are _. What movements stress the nerve or put it on stretch? (2)

Answer 8

Femoral nerve is MOTOR AND SENSORY, but typically symptoms that result from impingement are SENSORY.

Movements that stretch/ stress:
-extension and abducton

Question 9

The Obturator nerve is tensioned or stressed with which movements? (2) The Obturator nerve is _ and _

Answer 9

Flexion and abduction

Obturator nerve is SENSORY AND MOTOR

Question 10

The _ nerve is the largest of the sensory branches, and it most commonly causes _. What is it’s relationship to hip? Knee? And ankle?

Answer 10

The SAPHENOUS nerve is the largest of the sensory branches of (L3-L4), and it most commonly causes NUMBNESS

Relationship to joint:
Hip- passes anterior (tensioned with extension)
Knee- passes posterior to the medial condyle (tensioned with extension)
Ankle- passes the ankle on the anterior surface of the foot (stressed with plantar flexion)

Question 11

What is the alternate position for tensioning the femoral nerve, lateral femoral cutaneous nerve, and Obturator nerve?

Answer 11

Side lying

• knee bend with extension: femoral nerve
• knee bend with extension and adduction: lateral femoral cutaneous nerve
• knee bend with extension and abduction: Obturator nerve

Question 12

With a HNP which level of the spine most commonly causes impingement of the femoral nerve/ femoral neuralgia? Next 2? Associated percentages?

Answer 12

L4- 80% occurs at this level

L3- 35%

L2- 8%

Question 13

Due to the way the nerves exit in the lumbar spine it is possible that compression/ HNP at one level can?

Answer 13

Can affect multiple nerve roots, not just those that exit at that spinal level

Question 14

What is a common entrapment site of the sciatic nerve in the hip? Can also occlude?

Answer 14

Often trapped in the piraformis muscle

Can also occlude the blood supply to the sciatic nerve

Question 15

The _ _ supply the sensation to the skin over the iliac crest between the PSIS and the tubercles. Nerve roots? Which procedure can often affect these nerves?

Answer 15

The CLUNEAL NERVES supply the sensation . . .

Nerve roots: L1-L3

Often affected with bone graft donor sites

Question 16

The CLUNEAL nerves will cause pain?

Answer 16

Cluneal nerves will cause pain superior to the iliac crest

Question 17

Which percentage of people have the sciatic nerve pass inferior to the piraformis? Through the piraformis? Passes superior to the piraformis?

Answer 17

Pass inferior: 87%

Through: 12%

Superior: .5%

Question 18

What is the percentage of those with LBP that is due to piriformis syndrome?

Answer 18

6-10% (as high as 12%) have piriformis syndrome

Question 19

With double crush syndrome it is more likely that?

Answer 19

More likely that is being impinged in multiple entrapment sites

Question 20

What test is used to look at piriformis syndrome? What are the 2 causes? And associated percentages?

Answer 20

The FAIR test

2 causes:

• overuse 43%
• Trauma 18%

Question 21

What is the common entrapment site for the tibial nerve?

Answer 21

Soleus (soft tissue tunnel)

Question 22

Where is the common entrapment site for the fibular nerve?

Answer 22

The point where it attaches to the fibular head

Question 23

What are the 3 pretibial muscles that are important in gait?

Answer 23

TEE

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus

Question 24

The deep fibular nerve is often entrapped in? Due to?

Answer 24

Entrapped in the retinaculum of the dorsum of the foot.

Due to exertionm anterior compartment syndrome

Question 25

During passive neck flexion test the spinal canal is lengthened between _ and _ _(in a hypermobile person).

Answer 25

Between 7 and 10 CENTIMETERS

Question 26

Contraindications for neurodynamic tests: recent onset or worsening of _ _, _ _ tensions, or _ to the _ _.

Answer 26

Recent onset or worsening of NEUROLOGICAL SIGNS, CAUDA EQUINA tensions, or INJURY to the SPINAL CORD.

Question 27

Contributing factors that consistently predict a poor outcome: presence of a belief that back pain is? _ _ behavior. Tendency toward _ _ and _. An expectancy that _ _ rather than _ _ will be the answer.

Answer 27

Belief that back pain is harmful or potentially disabling

FEAR AVOIDANCE behavior

Tendency toward LOW MOOD AND WITHDRAWAL

An expectancy that PASSIVE TREATMENT rather than ACTIVE PARTICIPATION will be the answer.