Upper Quarter Neurodynamics

Question 1

What key components are in the Neurodynamic Paradigm (4)?

Answer 1

• nerves move with surrounding tissues
• when entrapped or impinged normally symptoms are distal to area
• entrapment or impingement can physically shorten length of nerve available to move
• when stretched nerves also compress causing abnormal function

Question 2

Contraindication for neurodynamic testing (4)?

Answer 2

• recently repaired peripheral nerve
• malignancy
• active inflammatory conditions
• neurologic: acute demyelinating diseases

Question 3

Precautions for neurodynamic testing (6)?

Answer 3

• irritable condition
• spinal cord signs
• nerve root signs
• severe night pain (no dx)
• recent paresthesia/anesthesia
• mechanical spine pain with peripheralization of symptoms

Question 4

What is the general neurodynamic treatment sequence?

Answer 4

1st - joint mobilization along path of nerve (causes neurophys relaxation)
2nd - myofascial/neuromuscular release along pathway of nerve (reduce adhesions)
3rd - neurodynamic flossing (facilitate movement of nerve)

Question 5

What is the difference between flossing and tensioning?

Answer 5

Flossing - used early, less irritating, release tension in one area and take it up in another.
Tensioning - used at end of treatment (if at all), more irritating, takes up slack at both ends

Question 6

List the steps of ULNT - median nerve technique (7)?

Answer 6

1 - block shoulder
2 - wrist extension
3 - wrist supination
4 - laterally rotate shoulder
5 - shoulder abduction
6 - extend elbow
7 - lateral cervical flexion (sensitization)

Question 7

List the steps of ULNT - radial nerve technique (6)?

Answer 7

1 - block shoulder
2 - wrist pronation/flexion
3 - elbow extension
4 - shoulder medial rotation
5 - shoulder abduction
6 - lateral cervical flexion (sensitization)

Question 8

List the steps of ULNT - ulnar nerve technique (6)?

Answer 8

1 - block shoulder
2 - finger/wrist extension
3 - lateral shoulder rotation (down to table)
4 - elbow flexion
5 - shoulder abduction
6 - lateral cervical flexion (sensitization)

Question 9

How can you differentiate if your patient has a peripheral nerve problem or a nerve root problem?

Answer 9

• if symptoms increase with ipsilateral side bend = nerve root problem
• if symptoms increase with contralateral side bend = peripheral nerve tension problem