Lecture 9 - Neural tension

Question 1

Define radicular pain

Answer 1

Pain radiated along spinal n.root

Question 2

Define neural indications

Answer 2

Suspicion of C7 in lateral epicondylitis, carpal tunnel syndrome, neck/back pain associated with extremity pains

Question 3

What is the principle of position?

Answer 3

Maintenance of first position
- note joint position
- symptoms changes at each step
- normal response

Question 4

Name the positive findings (3)

Answer 4

• Reproduction of sx
• Sensitizing test on ipsilateral alters sx
• Bilateral difference

Question 5

Explain the prone knee bend test

Answer 5

Examiner passively brings heel of patient to buttock (prone position) with making sure that hips are not rotated

Question 6

Limb position for PKB1 (Fem, L2-4 root)

Answer 6

Cervical = rotated to test side
Thor/lum = neutral
hip = neutral
knee = flexion

Question 7

Limb position for PKB2 (lat fem cutaneous)

Answer 7

Cervi = rotated to test side
Thor/lumb = neutral
Hip = EXT,ADD
Knee = flexion

Question 8

Limb position for prone knee bend ext (saphenous)

Answer 8

Thor/lum = neutral
Hip = EXT, ABD, lat rot
knee = ext
ankle = DF
foot = EVER

Question 9

What does slump test tests for? (5)

Answer 9

Spinal cord
Cervical, lumbar roots
Sciatic
*with hip ABD = obturator n.
Side lying = femoral n.

Question 10

Limb position for SLR1

Answer 10

Hip = flexion
Knee = extension
Ankle = DF

Question 11

What nerves are tested for SLR1

Answer 11

Sciatic and tibial nerves

Question 12

Limb positions for SLR2

Answer 12

Hip- flex
Knee- ext
Ankle – DF
Ankle – eversion
Toes – ext.

Question 13

Nerve tested for SLR2

Answer 13

Tibial n.

Question 14

Limb position for SLR3

Answer 14

Hip = flexion
Knee = extension
Ankle = DF
Ankle = Inversion

Question 15

Nerve tested for SLR3

Answer 15

Sural n.

Question 16

Limb position for SLR4

Answer 16

Hip = flexion + medial rotation
Knee = extension
ANkle = PF
ANkle = inversion

Question 17

Nerve tested for SLR4

Answer 17

Common peroneal n.

Question 18

See slide 21 for femoral n. (L2-L4)

Answer 18

Side lying on unaffected
Ober’s test for ITB (slight flex knee and hip)
Straight back
Head slight flexion
Extend hip, then flex knee

Question 19

Positive sign for femoral n

Answer 19

Pain radiating anterior thigh

Question 20

Positive sign for L3

Answer 20

Groin and hip pain, radiates to medial thigh

Question 21

Positive sign for L4

Answer 21

Pain radiates to mid tibia

Question 22

Characteristic of upper limb (neural)

Answer 22

Easy to aggravate

Question 23

Contraindications for ULNTs (4)

Answer 23

Worsening neurological signs
Acute phase
Cauda equina
Spinal cord lesion

Question 24

Nerves tested with ULNT1

Answer 24

Median n. and anterior interosseous n. C5-C6-C7

Question 25

Position of ULNT1

Answer 25

Shd- depression, Ab (110) Forearm- Sup Wr- Ext Fin/Thb- Ext *Shd- Neut Elb- Ext Cerv- Contra SB

Question 26

Nerves tested with ULNT2

Answer 26

Median n. Musculocutaneous n. Axillary n.

Question 27

Position of ULNT2

Answer 27

Shd- depression, *Ab (10) Forearm- Sup Wr- Ext Fin/Thb- Ext *Shd- LR Elb- Ext Cerv- Contra SB

Question 28

Nerve tested for ULNT3

Answer 28

Radial n.

Question 29

Position of ULNT3

Answer 29

Shd- depression, Ab (10) Forearm- Pron Wr- Flex, Ul Dev Fin/Thb- Flex *Shd- MR Elb- Ext Cerv- Contra SB

Question 30

Nerves tested for ULNT4

Answer 30

Ulnar n. C8 T1

Question 31

Position for ULNT 4

Answer 31

Shd- depression, Ab (10-90) Forearm- Sup Wr- Ext, Rad Dev Fin/Thb- Ext *Shd- LR Elb- Flex Cerv- Contra SB