Ortho III Midterm- Neurodynamics Flashcards
What test stresses only the dura?
Passive neck flexion
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?
SLR= Sciatic
SLR + DF + EV=Tibial nerve (TED)
SLR + DF + IV= Sural nerve (SID)
SLR + PF + IV= Fibularis/ Peroneal nerve (FIP/ PIP)
With the prone knee bend test which nerve is being stressed?
Femoral nerve
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?
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
Define mechanical interface?
Any soft tissue that can cause an entrapment of the nerve
What are the 3 types of vulnerable sites (peripheral sites)?
Tunnels
Branches
Hard surfaces/ bony prominences
The lateral femoral cutaneous nerve is 100% _. How do you tension the lateral femoral cutaneous nerve?(2)
Is 100% SENSORY
You can tension the lateral femoral cutaneous nerve with extension and adduction
The femoral nerve is _ and _, but typically symptoms that result from impingement are _. What movements stress the nerve or put it on stretch? (2)
Femoral nerve is MOTOR AND SENSORY, but typically symptoms that result from impingement are SENSORY.
Movements that stretch/ stress:
-extension and abducton
The Obturator nerve is tensioned or stressed with which movements? (2) The Obturator nerve is _ and _
Flexion and abduction
Obturator nerve is SENSORY AND MOTOR
The _ nerve is the largest of the sensory branches, and it most commonly causes _. What is it’s relationship to hip? Knee? And ankle?
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)
What is the alternate position for tensioning the femoral nerve, lateral femoral cutaneous nerve, and Obturator nerve?
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
With a HNP which level of the spine most commonly causes impingement of the femoral nerve/ femoral neuralgia? Next 2? Associated percentages?
L4- 80% occurs at this level
L3- 35%
L2- 8%
Due to the way the nerves exit in the lumbar spine it is possible that compression/ HNP at one level can?
Can affect multiple nerve roots, not just those that exit at that spinal level
What is a common entrapment site of the sciatic nerve in the hip? Can also occlude?
Often trapped in the piraformis muscle
Can also occlude the blood supply to the sciatic nerve
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?
The CLUNEAL NERVES supply the sensation . . .
Nerve roots: L1-L3
Often affected with bone graft donor sites
The CLUNEAL nerves will cause pain?
Cluneal nerves will cause pain superior to the iliac crest
Which percentage of people have the sciatic nerve pass inferior to the piraformis? Through the piraformis? Passes superior to the piraformis?
Pass inferior: 87%
Through: 12%
Superior: .5%
What is the percentage of those with LBP that is due to piriformis syndrome?
6-10% (as high as 12%) have piriformis syndrome
With double crush syndrome it is more likely that?
More likely that is being impinged in multiple entrapment sites
What test is used to look at piriformis syndrome? What are the 2 causes? And associated percentages?
The FAIR test
2 causes:
- overuse 43%
- Trauma 18%
What is the common entrapment site for the tibial nerve?
Soleus (soft tissue tunnel)
Where is the common entrapment site for the fibular nerve?
The point where it attaches to the fibular head
What are the 3 pretibial muscles that are important in gait?
TEE
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
The deep fibular nerve is often entrapped in? Due to?
Entrapped in the retinaculum of the dorsum of the foot.
Due to exertionm anterior compartment syndrome
During passive neck flexion test the spinal canal is lengthened between _ and _ _(in a hypermobile person).
Between 7 and 10 CENTIMETERS
Contraindications for neurodynamic tests: recent onset or worsening of _ _, _ _ tensions, or _ to the _ _.
Recent onset or worsening of NEUROLOGICAL SIGNS, CAUDA EQUINA tensions, or INJURY to the SPINAL CORD.
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.
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.
