MS III cervical c

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Author:
shmvii
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246126
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MS III cervical c
Updated:
2013-11-10 13:19:36
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MS III
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MS III
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  1. adverse neural tension def
    discomfort when stretching nerves

    "abnormal physiological and mechanical responses produced from nervous tissue structures when their normal range of movement and stretch capabilities are testes"
  2. 3 contraind to upper limb tension tests
    • acute & unstable neuro signs
    • cauda equine lesions
    • injury to spinal cord
  3. 3 precautions to upper limb tension tests
    • easier to aggravate UE sx than LE
    • UE nerves are weaker and run more complex courses
    • UE tests are more complex (easier to irritate these structures)
  4. 5 considerations for UE tension testing
    • ID pt's complaints and symptoms
    • note what sx was present in starting pos (if it's present initially, can't say the pain made a test pos)
    • note changes at each step of a test
    • move limb only to point of onset or change in sx
    • compare to contralat side and to what's considered normal
  5. 3 flavors of pos findings on tension tests
    • 1) reproduces pt's symptoms
    • 2) response can be altered by moving distant body parts that alter tension on neural tissues alone
    • 3) response is diff from side to side or from expected norm
  6. upper limb tension test 1 works on what nerve?
    median
  7. ULTT 1 -- how?
    • pt supine
    • depress shoulder girdle
    • abd arm to 110 degrees (elbow bent at this point)
    • ext wrist and fingers
    • supinate forearm
    • ER shoulder
    • ext elbow

    laterally flex c-spine to see if going away from arm increases and towards arm decreases symptoms
  8. basic procedureĀ for allĀ ULTTs
    do one part of test, hold, note any symptom changes, then add next component
  9. indication for doing ULTT 1
    pts w symptoms anywhere in arm, head, neck, or t-spine
  10. 4 normal responses to ULTT 1
    • ache or stretch in cubital fossa
    • tingling in thumb and first 3 fingers
    • stretch in ant shoulder
    • increase/decrease w SB away/toward arm
  11. ULTT 2 - median bias, how?
    • pt supine
    • PT - one hand on shoulder, one on wrist

    • abd shoulder 10 degrees
    • depress shoulder with thigh
    • extend elbow
    • ER arm
    • ext wrist, fingers, thumb
    • shoulder abd
  12. ULTT 2 - radial bias -- how?
    pt supine

    • shoulder depressed (with your hip)
    • elbow ext
    • IR shoulder
    • flex wrist, thumb
    • ulnar dev wrist
    • abd shoulder (if needed)
  13. indications for ULTT 2 (both varieties)
    • all disorders of c-spine, t-spine, upper limbs
    • diagnosis of tennis elbow and dequervain's disease
  14. normal responses to ULTT 2
    strong painful stretch over radial aspect of prox forearm, biceps, or dorsal aspect of 3-5th fingers
  15. ULTT 3 - for what nerve?
    ulnar
  16. which ULTT for each nerve
    • ulnar - ULTT 3
    • radial - ULTT 2 for radial
    • median - ULTT 2 for median and ULTT 1
  17. main motions of each of the ULTTs
    • 1 - shoulder bd
    • 2 median - depression and ER
    • 2 radial - depression and IR
    • 3 - abd and elbow flex
  18. ULTT 3 how
    pt supine

    • ext wrist
    • pronate forearm
    • ER
    • elbow flexed
    • shoulder depressed
    • shoulder abd
    • SB c-spine away
  19. indications for ULTT 3
    suspicion of ulnar nerve involvement (such as wrist pain w golf swing)

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