Upper Limb Neurodynamics

Question 1

Upper Limb Neural Test 1 - Structure, Movement, Differentiating and Sensitizing Manoeuvres

Answer 1

Gain of function, median nerve.
Supine. 90° abduction, 90° elbow flexion. shoulder and arm stabilized.
Wrist and thumb extension.
Supination.
Shoulder external rotation.
Elbow extension.
Differentiation manoeuvre: cervical contralateral side bending.
Sensitizing manoeuvre: shoulder depression.

Question 2

Upper Limb Neural Test 2A -Structure, Movement, Differentiating and Sensitizing Manoeuvres

Answer 2

Gain of function. Modified median nerve.
Supine, diagonal position. Shoulder just off the bench, stabilized with your hip.
Elbow extension.
Supination.
Wrist and finger extension.
Abduction, if necessary.
Differentiation manoeuvre: contralateral head side bending.
Sensitizing manoeuvre: shoulder depression.

Question 3

Upper Limb Neural Test 2B - Structure, Movement, Differentiating and Sensitizing Manoeuvres

Answer 3

Radial Nerve. Gain of function.
Supine, diagonal position. Hip supporting shoulder.
Make a fist, with thumb inside.
Elbow extension.
Full pronation.
Full flexion of the wrist.
Abduction.
Differentiation manoeuvre: shoulder depression.

Question 4

Upper Limb Neural Test 3 - Structure, Movement, Differentiating and Sensitizing Manoeuvres

Answer 4

Ulnar nerve. Gain of function.
Supine. High 5, pistol grip.
Pronation.
Wrist and finger extension.
Full elbow flexion.
External rotation of shoulder.
Abduction.
Sensitizing manoeuvre: shoulder depression.
Differentiating manoeuvre: contralateral head flexion.

Question 5

ULNTs - Sensitivity/Specificity

Answer 5

Combined: .97 sensitivity (rule out).
ULNT3 highest specificity: .88.
ULNT1 highest sensitivity: .83