week 5

Question 1

Neurological Examination tests for

Answer 1

nerve conduction

Question 2

Neurodynamic Examination

Answer 2

Tests nerve movement- and it’s response to
movement.

Question 3

Neurological examination LMNL

Answer 3

reflexes, myotomes, dermatomes

Question 4

Neurological examination
UMNL

Answer 4

Babinski and clonus

Question 5

Aims of the neurological examination

Answer 5

• Indicate CI and precautions to further assessment and treatment
• Confirm/clarify findings from the history
• Establish baseline or assess progress of a condition
• Clarify whether peripheral signs and symptoms are due to a local problem or are indicative of spinal nerve root involvement.
• Differentiate lesions of the CNS (UMNL) from the PNS (LMNL)

Question 6

LMN Indications for neurological
assessment of the upper limb

Answer 6

• Spinal pain extending beyond shoulder
• Pins and needles and/or numbness in upper limb
• Weakness/clumsiness in upper limb

Question 7

UMN Indications for neurological
assessment of the upper limb

Answer 7

• Bilateral symptoms in a diffuse non-dermatomal distribution
• Disturbances of gait, balance, co-ordination
• Disturbances of bladder/ bowel function
• Saddle anaesthesia
• Severe or progressive bilateral neurological
  deficits

Question 8

Cervical Radiculopathy

Answer 8

• Referred nerve root signs and symptoms from cervical spine
• Compression of nerve root and/or inflammation of the nerve root complex

Question 9

Cervical Radiculopathy caused by

Answer 9

narrowing of intervertebral foramen

Question 10

C4 myotome

Answer 10

shoulder elevation

Question 11

C5 myotome

Answer 11

shoulder abduction

Question 13

C6 myotome

Answer 13

elbow flexion

Question 14

C7 myotome

Answer 14

elbow extension

Question 15

C8 mytomome

Answer 15

thumb extension

Question 16

T1 mytomome

Answer 16

5th finger abduction (ADM) or finger adduction (interossei)

Question 17

Deep tendon reflexes

Answer 17

Biceps jerk (C5/6)
Triceps jerk (C7)
Brachioradialis jerk (C6)

Question 18

Deep tendon reflexes G1

Answer 18

no evidence of contraction

Question 19

Deep tendon reflexes G1

Answer 19

decreased but still present

Question 20

Deep tendon reflexes G2

Answer 20

normal

Question 21

Deep tendon reflexes G3

Answer 21

super normal/ hyper-reflexic

Question 22

Deep tendon reflexes G4

Answer 22

Clonus: Repetitive shortening of the muscle after a single stimulation

Question 23

Aims of the neurodynamic
assessment

Answer 23

• Identify if patient symptoms are reproduced via palpation or movement of the nervous system
• Identify which nerve path is reproducing the patient’s symptoms
• Identify a baseline for assessing progress
• Identify contraindications and precautions to treatment

Question 24

Signs of Neural Tissue Involvement

Answer 24

1. Area of symptoms: in lines or clumps; at vulnerable sites
2. Quality of pain (descriptors): Burning
3. Behaviour: Spontaneous; latency
4. Mechanism/past history

Question 25

Contraindications to neurodynamic testing

Answer 25

* Acute nerve root injury * Recent onset of neurological signs or worsening neurological signs * Cord and Cauda equina symptoms * Upper motor neuron signs * Severe pain in which examination

Question 26

Neurodynamic Testing: Procedure

Answer 26

* Explain to patient what is happening * Ask patient to perform test actively first (e.g. quick test) * Then therapist does test passively * Ensure consistent starting position * Test ‘good’ side first * Feel for barriers to movement eg resistance * Minimise pain provocation by moving carefully * Add sensitising movements as applicable * Vary the order of movements to mimic aggravatin