Week 6: Neurodynamics Flashcards
How can we assess peripheral nerves?
Neurodynamic tests
What is a dermatome
Area of skin that is mainly supplied by a single spinal nerve
Number of dermatomes in each section of vertebrae
8 cervical nerves
12 thoracic nerves
5 lumbar nerves
5 sacral nerves
What is a myotome
A group of muscles served by a spinal nerve root
What is a neurodynamic test
assessment and treatment of the physical nervous system
Series of movements that place consecutive load on the nervous system
Neurodynamic tests used
Straight leg raise (+ biases)
Slump
Prone knee bend
ULTT1 median
ULTT2a median
ULTT 2b radial
ULTT3 ulnar
Nerve trunk innervated in straight leg raise
L4-S3
Steps of SLR
Hip flexion (maintain knee ext)
DF ankle
Hip adduction
Hip internal rotation
Cervical flexion
Trunk lateral flexion
Tibial nerve modified SLR
dorsiflexion + eversion + pronation
Sural nerve modified SLR
dorsiflexion + inversion
Peroneal nerve modified SLR
Plantarflexion + inversion
Slump test nerve trunk innervated
L4-S3
Nerve trunk innervated in prone knee bend
L2-L4
Slump knee bend nerve trunk innervated
L2-L4
ULTT1 - Median nerve nerve trunk innervated
C6-T1
ULTT2b - Radial nerve nerve trunk innervated
C5-T1
ULTT3 - Ulnar nerve nerve trunk innervated
C8-T1
What is structural differentiation
Allows us to differentiate between neural and non-neural structures
If a change in symptoms is based on a differentiating maneuvre - symptoms are ___
neurogenic
What is a positive neurodynamic test
reproduction of patients symptoms
structural differentiation gives a neural result
range of motion may be reduced
What is not a positive neurodynamic test
contralateral testing: symmetrical response. e.g. bilateral tightness
Does not reproduce patients symptoms
Which ULNT helps determine whether a patient has cervical radiculopathy
Median
Does Median Nerve ULNT help diagnose carpal tunnel syndrome
No
What is a slider
Sliders aim to induce sliding of the peripheral nerves in relation to their surrounding structures with a minimal increase in nerve strain
Achieved by simultaneous lengthening of the nerve bed at one joint while shortening the nerve bed over another joint
What is a tensioner
Aim to increase nerve strain by simultaneously elongating the nerve bed at multiple joints
how many pairs of spinal nerves
31
Brachial plexus
C5-T1
Median, Ulnar, Radial, Musculocutaneous, axillary
Median nerve
C5-T1
Flexors of wrist
Radial nerve
C5-T1
Posterior arm (extensors)
Ulnar nerve
C8-T1
Hand muscles
Axillary nerve
C5-C6
Deltoid and Teres minor
Musculocutaneous nerve
C5-C7
Biceps brachii, brachialis, coracobrachialis
L2
Lift your shoe
Hip flexion
L3
Extend the knee
Knee extension
L4
Stop the door
Dorsiflexion
L5
The toes divide
Toe extension
S1
Lift a tonne
plantarflexion
S2
Heel to bum
Knee flexion
C2
look at your shoe
neck flexion
C3
fallen tree
Lateral neck flexion
C4
I’m not sure
Shoulder elevation
C5
Arms out wide
Shoulder abduction
C6
smell your wrist
elbow flexion and wrist extension
C7
no zombies in heaven
elbow extension and wrist flexion
C8
Youre doing great
thumb extension and ulnar deviation
Lumbar plexus
L1-L4
Lumbosacral trunk
L4-L5
Sacral plexus
S1-S4
What do Neurodynamics do
detect if movement is a contribution to nerve pain
Tensioner
Tension at both ends
Slider
Tension on one side
