Neurodynamic Testing- Lab

Question 1

• ULNTT 1 (A)*
• Median Nerve* (C6-T1)

Nerve palpation

Answer 1

• Medial btwn biceps an/humerus
• Medial to biceps tendon
• Carpal tunnel

Question 2

ULNTT 1 (A)

Median Nerve (C6-T1)

Test Description

Answer 2

• Pt. supine on edge of table
• Maintain the shoulder complex in shoulder neutral elevation
• ABD shoulder to 90’ w/forearm in supination
• ER up to 90’
• Extend the wrist and fingers (pistol grip)
• Elbow extension
• Qualifiers: cervical SB, wrist ROM

* measure elbow extension

Question 3

ULNTT 1 (A)

Median Nerve (C6-T1)

Differentiation

Answer 3

• Scapular depression
• Wrist and hand flex/ext
• Cervical side bending

Question 4

Ulnar Nerve (C8-T1) – ULTT 3

Nerve palpation

Answer 4

• Medial btwn triceps/humerus at the mid part of the arm
• Ulnar groove
• Tunnel of Guton

Question 5

Ulnar Nerve (C8-T1) – ULTT 3

Test description

Answer 5

• Pt. supine on edge of table
• First shoulder depression
• Shoulder ABD 90’
• Add GHJ ER, forearm pronation
• Add wrist & finger extension (pistol grip) and pronation
• Add elbow flexion

* measure elbow flexion

Question 6

Ulnar Nerve (C8-T1) – ULTT 3

Differentiation

Answer 6

• Wrist and finger flex/ext
• Scapular depression
• Cervical SB

Question 7

Radial Nerve (C5-T1) – ULTT 2b

Nerve palpation

Answer 7

• Radial notch
• Through supinator
• Distal cutaneous br through snuff box

Question 8

Radial Nerve (C5-T1) – ULTT 2b

Test description

Answer 8

• Pt. supine on edge of table
• Therapist positioned towards pt. feet (thigh stops shoulder from elevating)
• Add wrist and finger flexion
• Add elbow extension
• GHJ IR and forearm pronation
• GHJ ABD
• Qualifiers: cervical SB

*measure GHJ ABD *

Question 9

Radial Nerve (C5-T1) – ULTT 2b

Differentiation

Answer 9

• Scapular depression
• Wrist and hand flex/ext
• Cervical SB

Question 10

Neurodynamic testing: General rules

Answer 10

• Always compare symptomatic side to non-symptomatic side
• Make sure as you are performing the test that there is absolute consistency throughout the test and any subsequent re-testing.
• Clinical Decision Making: Musculoskeletal or Neural?
  
  • If symptoms DO NOT change with structural differentiation then MUSCULOSKELETAL
  • If symptoms change with differentiation then NEURAL
  • If the change is a “normal response” then no neural dynamic treatment is required.
    
    • Symmetrical Bilaterally in quality and quantity
    • Does not reproduce patient’s symptoms
  • If the change is an “abnormal response” then treat the neurodynamic finding.
    
    • Asymmetrical in ROM or Resistance (R1)
    • Reproduces patients symptoms or there is a distal response (neural in quality)