Test 3- PNS Injuries 2

Question 1

Cervical AROM screening

Answer 1

• Rotation right and left
• Lateral flexion right and left
• Flexion
• Extension (careful to watch for dizziness secondary to vertebral artery or vestibular issues

Question 2

Spurling Test

Answer 2

Cervical test for nerve dysfunction
-technique: extension and lateral flexion of neck and then compression of the neck to test for radiculopathy (pain radiating down the arm)

Question 3

Dermatome screen

Answer 3

Look for difference in sensation from one side to the other (alike or different?)

• C4: Neck and AC joint area
• C5: Top of shoulder and deltoid insertion region (rotator cuff)
• C6: Volar lateral forearm on thumb side
• C7: middle finger volar surface, posterior arm and forearm
• C8: Small finger and ulnar side of the hand
• T1: medial forearm
• T2: Apex of axilla

Question 4

Sensory screening for nerve damage

Answer 4

• Kleenex or cotton balls
• Both sides simultaneously
• Alike or different
• Document what client says

Question 5

Myotome screen

Answer 5

Look for one-sided weakness

• C4: shoulder shrug
• C5: shoulder abduction
• C5-C6: elbow flexion, wrist extension
• C7: elbow extension, wrist flexion
• C8: thumb abduction
• T1: small finger abduction

Question 6

Deep Tendon Reflex (DTR) grading

Answer 6

4+ = hyperactive clonus
3+ = hyperactive reflexes
2+ = normal
1+ = hypo reflexive 
0 = no response

Question 7

Reflex assessments for UE nerve damage

Answer 7

• Biceps = C5-C6
• Brachioradialis = C5-C6
• Triceps = C6-C7

Question 8

Neural Tension

Answer 8

Amount of strain on a nerve at rest and with movement.

• If a nerve becomes caught or restricted anyway along it’s path= abnormal increase in neural tendon
• Overstretching a nerve can result in neural tension

Question 9

New Neural Tension Test

Answer 9

Similar to MMT

• 5 positions
• Record when first symptom appears
• S1= onset or change of patient’s symptoms
• S2= define stop point in the test based on person’s discomfort level
• Motion available between S1-S2= the treatment zone

Question 10

Types of Nerve Gliding techniques

Answer 10

• Tensioning techniques: moving one or several joints to enlongate/stretch nerves at both ends
• Sliding techniques: Enlongating nerve by stretching one side and shorting the other side. This creates the largest amount of nerve excursion with the least amount of strain

Question 11

General treatment for nerve dysfunction

Answer 11

• Identify: identify what is causing the problem
• Improve: improve posture by stretching, strengthening and soft tissue mobilization
• Make: make room for nerve to move by decreasing tightness in muscles
• Strengthen: strengthen weak muscles and stretch tight muscles to restore balance

Question 12

Correcting posture

Answer 12

Gentle, progressive stretching (use caution)

• improve forward rounded posture
• improve pelvic alignment
• strengthen abdominal muscles

Question 13

Edema control

Answer 13

• Elevation
• Ice
• Overhead fisting
• Compression dressing

Question 14

Desensitization program for scar hypersensitivity

Answer 14

Uses graded series of modalities and procedures to decrease reactivity to external stimuli

• 3 to 4 times a day for 10 min each session
• Graded modalities: textures, particle immersion and vibration

Question 15

Pillar pain

Answer 15

Pain at the site of release after carpal tunnel release surgery

• different that scar sensitivity
• creates difficulty gripping and weight-bearing
• usually relieved with wrist brace

Question 16

Axillary nerve

Answer 16

High risk for traction injuries

• heavy loads on shoulder produce traction and stretch of nerve
• Damage leads to shoulder pain and weakness of deltoid and teres minor