Ortho 2 (special tests/glides): TMJ, neck, VAT, cranial nerves and dizziness, ULNT's/SLR Flashcards
(28 cards)
Dental occlusion assessment
slides 1-32
Cx spine ROM flex, ext, SF, ROT
last semester
ms flexibility/palpation of upper traps, scalene, SCM
last semester
TMJ ROM opening, closing, protraction, retraction, lateral deviation
slides 34-51
TMJ RISOM opening, closing, protraction, retraction, lateral deviation
slide 52
TMJ palpation - lateral pole, condyle
TMJ passive accessory glides (inf/ant)
slides 65-67
Outside technique: Pht place thumb on body of mandible
tectorial membrane ligament stress test
TMJ palpation - temporalis
TMJ palpation - masseter
TMJ palpation - Posterior & sub-mandibular muscles
TMJ palpation - lateral pterygoid
TMJ palpation - medial pterygoid
transverse ligament stress test
alar ligament stress test
Anterior & Posterior atlanto-axial membranes stress test
vertebral artery testing
Contraindication to testing VA:
- VBI &/or SC S&S on S/A or first part of dizziness protocol
- Trauma < than 6 weeks
- Cr-Vx lig stress test = (+)ve
- Fracture or risk of fracture
Need 45° of rotation to cause blood flow disturbance & at least another 10-15° to have complete obstruction.
Pht must recognize the potential for obtaining false (-)ve
Neuro exam for cranial nerves
see slides 20-32
dizziness differentiation tests
ULNT1
Move almost all the nerves btw neck & hand – median, radial & ulnar n, brachial plexus, spinal ns & Cx n roots
Indications:
- Should be performed when a neural component to U/Q pain/sy is present or when pht want to exclude a neural component
- This test is particularly relevant in cases where symptoms are localized to the median nerve
Good inter & intra reliability
Normal Responses:
- Similar areas of response in both ULNTs
- Sensory response was more frequent in ULNT2m than ULNT1
- The nature of the response was more neurogenic (tingling, burning, P&N) in ULNT2m than ULNT1
ULNT2m
It Ax the median n, brachial plexus, related spinal ns & low Cx n roots
Indications:
- When pt’s symptoms are provoked by scap depression
- Symptoms are localized to the median nerve
- Can be used in preference to the ULNT1 when shoulder problem & want to avoid abd
Distal Manoeuvre:
- Cx spine ipsilat side flex or
- Releasing scapula depression or
- Wrist flexion
Normal Responses:
- Similar areas of response in both ULNTs
- Sensory response was more frequent in ULNT2m than ULNT1
- The nature of the response was more neurogenic (tingling, burning, P&N) in ULNT2m than ULNT1
ULNT2r
Indications:
- This test is particularly relevant in cases where symptoms are localized to the radial nerve
- Posterior shoulder pain
- Lateral elbow pain
- Dorsal F/A pain (radial tunnel syndrome, de Quervain’s disease)
Distal Manoeuvre:
- Cx spine ipsilat side flex or
- Release a small amount of pressure from scapula depression or
- Wrist extension
Normal Responses:
- Posterior/lateral FA & wrist deep pain/stretch
- Painful stretch post aspect of hand, lat arm & biceps
ULNT3
Indications:
- This test is particularly relevant in cases where symptoms are localized to the ulnar nerve
- Anterior shoulder
- Axilla
- Along the medial aspect of the arm & elbow to the hypothenar eminence & 4-5th fingers
- C8 radiculopathy
- TOS
- CuTS
- Guyon’s canal syndrom
Distal Manoeuvre:
- Cx spine ipsilat side flex or
- Release a small amount of pressure from scap depression or
- Wrist flexion
Normal Responses:
- Stretch sensation in almost any region of the upper limbs
- But more common in ulnar distribution
- P & N and burning sensation can also occur
sciatic nerve neuromeningeal testing
