Term
| The two guys who started Neurodynamics, Name and Time frame |
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Definition
Robert Elvey: Late 1970's, Brachial plexus tension testing
David Butler: Early 1990's, expanded on elvey's work, upper limb tension tests |
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Term
| Definition of Neurodynamics |
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Definition
Study fo the mechanics and physiology of the nervous system and how they relate to each other
Assumes the nervous system is a continuous tissue tract
AKA Neutral Tension |
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Term
Neuro dynamic test or neural tension test
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Definition
Testing the mechanics and physiology of a part of the nerbous system
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Term
Definition of the mechanics of neurodyn.
Definition of physiology of neurodyn. |
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Definition
Mechanics: Stress and strain on the structures
Physiology: blood flow, conductivity, inflammation of the tissues |
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Term
| Can a neutral tension test totally isolate an nerve trunk? |
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Definition
| No, the tests can bias toward a specific trunk but not totally isolated. Others maybe involved even though it is a specific test for ____ nerve |
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Term
| What are the types of neural tension tests? |
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Definition
Upper Limb neurodynamic test (ULNT) or Upper Limb tension test (ULTT)
Straight leg raise (SLR)
Slump Test
PRone knee bend (PKB) |
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Term
| When conducting a neural tension test is it important to do things in a certian order? |
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Definition
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Term
| What is a sensitizing in a NTT? |
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Definition
| Sensitizing: Additonal movement to place more mechanical stress on the NS |
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Term
| Adverse Neural Tension Test? What does this indicate? |
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Definition
Abnormal physilogical (blood flow, conductivity, inflammation of the tissues) or mechanical (stress and strain on the structures) responses produced from the nervous system strucutes when their normal range of mvoement and stretch capabilities are tested
Indicates trauma or pathology of the nervous system |
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Term
| What requirement of the NS is there so that normal movement can occur w/o issues? |
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Definition
Slide, glide, elongation
Shortening agter elongation
Compression(ulnar nerve against the hummerus with elbow flexion)
Repetitive Forces (Medial nerve in the carpal tunnel) |
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Term
| What are the S/S of injury to the nervous system? |
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Definition
Symptoms do not fit expected pattern (severity, location, description)
Sx: in different regions seem related ( always occur together, sequentially or separately i.e neck to arm pain or both at the same time)
Description indicates nerve involvement: Buring, electric, searing, tearing, tingling (Most important for Dr. G)
Movement patterns influence symptoms |
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Term
Types of NS tissue injury?
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Definition
Friction
Compression
Stretch
Disease process (i.e. RA affects soft tissues)
Scarring of connective tissues and/or nervous tissues (movement tugs on adhesed tissues might get a buring sensation |
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Term
| A + NTT must be or have these components? |
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Definition
Must be consistent with history (area, type)
Comparable sign (reproducing they pain)
Sensitizing tests alters symptoms
Symptoms differe between sides
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Term
| When NTT what is the first step before even starting the test? |
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Definition
| Explain the procedure to the patient |
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Term
| Do you ever want to push through pain in NTT? |
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Definition
| No, bc working with very delicate tissue |
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Term
| There is one acception in the active before passive rule in NTT, what is it |
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Definition
| good question better ask? |
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Term
| Is it important to have a consistient starting position for NTT? |
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Definition
| Yes, if aptient had a pillow the first time need to have one the second time etc |
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Term
| IN NTT do you test the involved or uninvolved side first? |
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Definition
| Uninvolved, want to look for symetry |
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Term
| In NTT should the motion be done all at once or step by step? Slow or fast? |
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Definition
| Done step by step, slowly |
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Term
| explain the procedure for preforming a passive NTT? |
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Definition
Explain what you are doing with to the patinet
Make sure that they are in the same position as last time or note what position they are in
Proceed step by step
Maintain stretch as different components are added
Stop when the test becomes positive |
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Term
| In NTT stop when the test is positive at this point what else should be done? |
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Definition
Note tpe and location of response
Measure the position of the limb |
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Term
Is the Straight leg raised best assessed passively or actively?
what is the normal response? |
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Definition
Best assessed passively
The normal response is a deep stretch is felt either in the calf, posterior thigh, knee |
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Term
| What are the sensitizing tests for the straight leg raises? |
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Definition
Ankle Df
Ankle Df w/eversion
Ankle PF w/inversion
Hip ADD
Hip IR
Neck Flexion |
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Term
Prone Knee Bend targets what nerve and nerve trunk levels?
What is the normal response?
Sensitizing test |
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Definition
Femoral nerve
L3
Femoral Disc herniations: L4/L5 L3/L4
Normal Response: Stretch in the quads
Sensitizing Test: Hip ext with PKB
Basically Ely's test(remember to hold the hip down) |
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Term
Slump test:
what is the progression?
If limited when ______ extends what should be done? |
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Definition
Active then passive
Thoracolumbar slum--> Cervical Flx-->Extend knee
When the knee extends if limited then you will want to release C-spine flexion, if knee can extend farther this means that issue with nerual tension at some point along the line |
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Term
Slump Test:
Normal Response
Sensitizing Tests |
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Definition
Normal Response: Discomfort in mid thoracic region. Deep pulling behind the knee with extension
Sensitizing Test: DF ankle, hip flexion |
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Term
List the upper limb neurodynamic tests (NTT)?
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Definition
ULNT 1: Median nerve bias
ULNT 2: Radial Nerve Bais
ULNT 3: Ulnar Nerve Bais |
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Term
| How does the ULNT 1 active testprogress, what nerve is it for? |
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Definition
| Active Test: pt in standing, arm at side-->elbow at 90 deg flx-->straighten elbow-->bring arm out to the side above shoulder height-->place palm up bening wrist and fingers backward-->Tip head away |
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Term
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Definition
| ULNT 1 Active: pt lying prone elbow bent at 90 deg flexion wrist neutral--> depress shoulder gentle--> ABD arm to a ~110 deg-->ext wrist and all of the fingers-->Supinate the forearm--> ER of the shoulder--> ext elbow--> sensitizing test bend head away (active movement) |
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Term
| Normal Response for ULNT 1? |
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Definition
deep stretch/ache in cubital fossa
Stretch/ache in anterior and radial forearm and radial hand
Tingling in fingers
INcrease w/ lat neck flx away, decrease w/ toward
if get sever buring or pain need to stop |
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Term
| ULNT 2 active test for what nerve? |
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Definition
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Term
| ULNT 2 active progression? |
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Definition
| Standing w/ arm at side--> wrist flexion-->Turn palm like getting an old style watiers tip--> depress shoulder (pushing wrist towards floor)--> Tip head away |
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Term
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Definition
| Supine shoulder slight abd elbow flexed across chest--> depress shoulder girdle-->extend elbow--> IR entire arm--> flex wrist |
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Term
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Definition
Strong painful stretch over radial forearm
stretch in lateral upper arm |
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Term
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Definition
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Term
| ULNT 3 active test progression? What is the alternative test? |
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Definition
sit or stand, arm at side, elbow flexed 90 deg--> bring arm up and out as if the elbow is flexed at 90 still fingers are pointed towards the head (pronated)
mask Positiion, quick to the batcave |
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Term
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Definition
| Supine, shoulder slight ABD and flexion, elbow slight flexion--> ext wrist and fingers--> pronate forearm-->flex elbow--> ER shoulder-->depress shoulder girdle--> ABD shoulder |
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Term
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Definition
| Painful streth in hypothenar eminence and last 2 digits and tingling in the same region? |
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Term
| If the NTT is + how can it be managed? |
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Definition
use parts of the testing techniques for intervention
Begin with movements away from painful site (i.e. if painful site is the hand start at shoulder and progres through the approperiate steps till tension and the release to one step back and then go one step forward this creates a stretching effect). This is called pressure on pressure off. Can progress by increasing the # of repetition, strength of stretch, amount of load
Can be done active and passively
Do stretching effects in various components of the positioning? |
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