Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Comprises of assessment and diagnostic techniques of neurodynamics.
it includes both the mechnaical interface and neurological aspect, along with the level of application of diagnostic as well as treatment part of neurodynamics
A very old school of manual therapy which comprises of two main principle centralization and peripheralization thought given by Robin McKenzie. The slideshow explain theoretical and practical part of both entire spine and extremities as well
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
Axons of the peripheral nervous system have the potential for regeneration, after they are severed.
Axons of the peripheral nervous system have the potential for regeneration, after they are severed.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Comprises of assessment and diagnostic techniques of neurodynamics.
it includes both the mechnaical interface and neurological aspect, along with the level of application of diagnostic as well as treatment part of neurodynamics
A very old school of manual therapy which comprises of two main principle centralization and peripheralization thought given by Robin McKenzie. The slideshow explain theoretical and practical part of both entire spine and extremities as well
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
Axons of the peripheral nervous system have the potential for regeneration, after they are severed.
Axons of the peripheral nervous system have the potential for regeneration, after they are severed.
12th publication - Dr Rahul VC Tiwari - Department of oral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509. IJADS JOURNALS
trigeminal nerve and pathology/rotary endodontic courses by indian dental aca...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Peripheral nerve injuries-ASSESSMENT AND TENDON TRANSFERS IN RADIAL NERVE PALSYsuchitra_gmc
A presentation to understand peripheral nerve injuries assessment, evaluation and management. Includes principles of tendon transfer and techniques of tendon transfer for radial nerve palsy. Also, post operative rehabilitation is included.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
3. CONCEPT OF CONTINUOUS TISSUE TRACT
Connective tissues are continuous
Neurons are interconnected
Continuous chemically
4. The neuron
Consist of a cell body,some dendrites and usually
one Axon
Axons are either myelinated or non myelinated
Axon grouped together in to bundles or fascicles
Axons –Nerve fibers
Cytoplasm of neuron-Axoplasm
6. A distensible ,elastic structure made up of
matrix of closely packed collagenous tissue
surrounding the basement membrane is the
endoneurial tube.
Protects axons from tensile force
Maintains the endoneurial space and fluid
pressure,A slight positive pressure .
7.
8. Each fascicle is surrounded by a thin
lamellated sheath known as Perineurium
Protecting the content of endoneurial tubes
Acting as mechanical barrier to External forces
Serving as a diffusion barrier
Most resistant to tensile forces
9. The outermost connective tissue investment
surrounds ,protects and cushions the
Fascicles.
Keep the fascicles apart(internal epineurium)
Definite sheath around the fascicles (external
epineurium)
Facilitate gliding between the fascicles
10. Mesoneurium is a loose areolar tissue
peripheral nerve trunks .
Blood vessels enter the nerve via mesoneurium
Allows the nerve to glide along the adjacent
tissue.
11. Nerves are not uniform
Run in wavy course throught the nerve
course
Constantly changing the plexus within the
trunk
Inverse relation between size and number of
fascicle
More number –more protection from
compressive forces.
12.
13. THE NERVE ROOT
Each roolet emerged was ensheathed by a
pial layer the outer most covering which
formed a covering around individualfascicle.
Injuries to nerveroot –not commonly from
traction but directly from neighing structure
such as discs and zygopophyseal joints.
14.
15. 4th ,5th,6th cervicalsipnal nerve have a strong
attachment to the gutter of the respective
transverse process.
Open endedness of perineurium continuos
with the dura /arachnoid and the inner layer
forms pial sheeth.best for force distribution.
Duralsleeve forms a plugging
mechanism(traction force transmitted to
cord via the denticulate lig –ease the tension
on NR)
Angulated nerve roots being proteted from
tethered
16.
17. The supply of blood to the nervous system
The axonal transport nervous system
The innervations of the connective tissues of
nervous system
18. Lattice collagen arrangement
When cord is elongaed the vessels running
longitudinally are streched while those runing
transversly are folded.
Veins in the spinal canal are valveless and allows
flow reversibility .
Critical vascular zone fromT4 to T9
19.
20. Arrest of blood at 8%elongation
Complete arrest at 15% elongation
Two barriers maintain endoneurial
environment:
The perineurial diffusion barrier(resistant to
trauma even after surgery to epineurium)
-Blood nerve barrier(at endoneurial microvessels)
21. Three flow identified:
Axo plasm flow from cell body to target
tissue(Antegrade flow)
From target tissue to cell body(retrograde flow)
Bidirectional flow.
Flow interruption induces cell body reaction
Consriction,loss blood supply, viruses may impede
the flow.
22.
23. Innervation of nervous system means
innervation connective tissues of nervous
system.
Dura matter innervated by segmental
,bilateral,sinuvertebral nerves
Sinuvertebralnerve innervates directly or via
PLL
Innervation density varies deppending on
spinal segment
Rich in superficial than in deeper
Innervation aracchnoid and pia less
experimental attention.
24. Ventral nerve root innervation from DRG
Anterior nerve roots from branches from sinu
vertebralnerves.
The connective tisues of PNS,ANS, have an
intrinsic innervation :the nervi nervorum
from localaxonal branching
Also extrinsic innervation from fibers
entering the nerve from the perivascular
plexuses.
25. MECHANICAL INTERFACE
Defined as that tissue or material adjacent to the
nervous system that can move independently to
the system.
28. NERVOUS SYSTEM ADAPTATIONS TO
MOVEMENT
1.the development of tension or increased
pressure within the tissues
2.gross movement or intraneuralmovement
Grossmt example:median nerve movement in caarpal
tunnel.
Intraneural mt:Spinalcord mt in relation to duramatter.
29. RELATIONSHIP BETWEEEN MOVEMENT AND
TENSION
If a body part is moved with other body part is in
neutral position –less tension more movement
Conversly if the same movement performed with
body parts in tension,there will be a great
increase in intraneural tension but little mt of
the nervous system.
EX:ULTT1 with neck in neutral
ULTT1 with neck laterally flexed to opposite side.
30. Neuraxialand meningeal adaptive
mechanism:
Ex:the slump test and passive neck flexion test
Both employ spinal flexion test
In flexion –moves anteriorly
In extension –moves posteriorly
In rotation stays constant
C6,T6,L4 vertebral levels –no nervous system
movement in relation to interfaces.
From spinal extension to flexion the cord
converge towards C4,C5 disc.
31. Sciatic and tibial nerve superior to knee moves
caudal in direction
Tibial nerve below the knee moves cephalad in
direction.
Posterior to knee joint –no movement of nerve occurs
in relation to interface.
When tension applied to the nerve, the intraneural
pressure will increase as the cross sectional area
decreases.ex:siting to standing.
Blood supply will diminish at around 8 % elongation,
and stop around 15 % elongation.
The biomechanic of additional movements which
further sensitises the test such as ankle DF,hip
adduction,medialrotation and cervical flexon etc.
32. I.MOVEMENT
MEDIAN NERVE
Finger extension-pulled the nerve downward of
7.4 cm
Flexion of elbow allowed upward movement of
4.3 cm
Arm movement allowed 2-3 cm
ULNAR NERVE
Migrated proximally during flexion of elbow.
33. II.DEVELOPMENT OF PRESSURE OR TENSION IN
THE SYSTEM.
The two adaptive mechanism of tension and
movement must occur simultaneously in some
situation one will predominate..
Pathological processes or injury may affect one
or both of these adaptive mechanisms.
34. Site of injury
Soft tissues ,osseus or fibro- osseus tunnels.
Where the nervous system branches
Where the system is relatively fixed
Unyielding interfaces.
Tension points.
35. Kind of injury
Mechanical and physiological consequences of
friction ,compression, stretch and occasionally
disease.
Unphysiological movements, body postures, and
repetitive muscle contraction.
Secondary injury to nervous system such as blood
and edema from damaged interface.
Change in shape of interface.
37. Extra neural pathology
Nerve bed
Blood in nerve bed or epidural space
Mechanical inetrface
`swelling of bone and muscle adjacent to a nerve
trunk.
38. PATHOLOGICAL PROCESS
VASCULAR FACTORS IN JNIURY
Hypoxia
Edema
Fibrosis
MEHANICAL FACTORS
The myelin on one side of the node becomes
streched
The myelin on the other side becomes
invagenated
Displacement of node of Ranvier
39. Injury and axoplasmic flow
Trophic changes in target tissue(skin,muscle)
Damage to cell body and axon
Blood supply compromise affect the axonal flow
Mild compression of 30-50 mmhg interrupt both
antegrade and retrograde flow.
an axoplsmic transport block by a 50 mmhg
For 2 hours was reversible in 24 hours.
2 hours of compression at 200 mmhg was reversible
within 3 days.
40.
41. Nucleus looses its information gathering
mechanism about the state of target tissue
and the neuronal environment.
Ability to produce neurotransmitters
diminished
Cytoskeletal elements for the neuron
diminished.
42. Further consequences of nerve injury
Fibrosis
Double crush syndrome
Triple and multiple crush syndromes
Abnormal impulse generating mechanism
43. SIGNS AND SYMPTOMS FOLLOWING INJURY
AREA OF SYMPTOMS
KINDS OF SYMPTOMS
HISTORY
POSTURAL AND MOVEMENT PATTERNS
44. SIGNS AND SYMPTOMS
Level of involvement(UMN,LMN,SEGMENTAL)
Severity of involvement
The tissue components involved(neural tissue or
connective tissue)
From local or remote sources.
Whether an intraneural or extraneural process is
evedent
The sstage of the disorder(acute or chronic)
The progression of the disorder
45. AREA OF THE SYMPTOMS
Vulnerable areas ex:carpaltunnel,head of fibula
Symptoms donot fit to the familiar patterns such
as a dermatomal or myotomal.(cyriax-
extrasegmental patterns from dura matter)
symptoms fit nerve anatomy
significant(conducting tissue injury)
Symptoms may link up(double crush syndrome
such as co existent tennis elbow and carpal
tunnel syndrome)
Lines and clumps of pain can occur(around the
joints or tension points)
46. KIND OF SYMPTOMS
Constant or intermittent
Sensation of swelling(ans)
Paraesthesia or anaesthesia(with or with out
pain)
Weakness(impairment in efferent
impulses,pain inhibited weakness)
Symptoms worse at night(peripheral nerve
entrapment)
Worse at the end of the day(chronic nerve
root iritaion)
47. HISTORY
MECHANISM OF INJURY
PREVIOUS INJURY
PREVIOUS TREATMENT
OTHER CONTRIBUTING FACTORS
48. POSTURAL AND MOVEMENT PATTERNS
ANTALGIC TENSION POSTURE
POKED CHIN POSTURE
SCOLIOSIS
THORACIC KHYPHOSIS
READING IN LONG SITTING IN BED(SLR)
GETTING IN TO A CAR(SLUMP,SLR)
REACHING UP TO A CLOTH LINE
SHOULDER GIRDLE DEPRESSION
SMALL REPETITIVE MOVEMENTS(KEYBOARD,PLAYING
MUSICAL INSTRUMENT)
IRREGULAR PATTERNS ON MOVEMENT PROVOKING
SYMPTOMS –OTHER THAN JOINT.
49. SUBJECTIVE NEUROLOGICAL EXAMINATION
DIZZNESS( VBI,dural attachment,)
INVOLVEMENT OF CAUDA EQUINA (functions of
bladder,bowel,perianal,genital sensation)
CORD SYMPTOMS(spasticity,gross
alteredmovement patttern,paralysis,bilateral
pins and needles,broad based jerky gait,diffuse
non specific weakness,Tethered cord syndrome -
complete numbness ,hair tufts,dermal
sinuses,tight calves and hamstring)
GENERAL HEALTH(diabetes,AIDS,Multiple
sclerosis,poly neuropathies)
50. PHYSICAL EXAMINATION OF SENSATION
LIGHT TOUCH
PIN PRICK
VIBRATION
PROPRIOCEPTION
TWO POINT DISCRIMINATION
51. EXAMINATION OF MOTOR FUNCTION
WASTING
REFLEX TESTING
MUSCLE POWER TESTING
TEST FOR SEGMENTALLEVEL
C4-SCAPULAR ELEVATORS
C5-DELTOID
C6-BICEPS
C7-TRICEPS
C8-LONG FINGER FLEXORS
T1-INTERROSSEI AND LUMBRICALS
52. TEST FOR INDIVIDUAL NERVE TRUNK
RADIAL NERVE-RESIST THE WRIST EXTENSION
MEDIAN NERVE-RESIST THE DISTAL IP JOINT OF INDEX
FINGER
ULNAR NERVE-RESIST ABDUCTION OF INDEX FINGER.
DORSAL SCAPULAR NERVE-THE RHOMBOIDS
LONG THORACIC NERVE-SERRATUS ANTERIOR
53. MUSCLE TESTING LOWER LIMB
L2-HIP FLEXORS
L3-KNEE EXTENSORS
L4-ANKLE DORSIFLEXORS
L5,S1-EXTENSORS OF THE DISTAL PHALANX OF THE
GREAT TOE
S1-EVERTORS OF ANKLE
S1,S2-ANKLE PLANTOR FLEXORS
S2-TOE FLEXORS
54. Cord function test
Ankle clonus
Babinski test
ELECTRO DIAGNOSIS
NEUROPATHY IS FROM PERIPHERALNERVE OR MYOPATHY
SYSTEMIC CONDITIONS(alcoholic,diabettic neuropahy)
ASSISTING FOR SURGICAL INTERVENTION
OBJECTIVE MEASUREMENT FOR TREATMENT
IDENTIFICATION OF ANAMALIES.
55. UPPER LIMB TENSION TEST 1-median nerve
dominant utilizing shoulder abduction
UPPERLIMB TENSION TEST 2-radial nerve
dominant utilising shoulder girdle depression
plus internal rotation of the shoulder
UPPERLIMB TENSION TEST 3-ulnar nerve
dominant utilising shoulder abduction and
elbow flexion.
56. ULTT1:
METHOD:
Patient positioned in supine
A constant depression force placed on shoulder
girdle
Forearm supiated ,wrist and fingers extended.
The shoulder is laterally rotated
The elbow is extended.earlier component
positions must be maintained
With this position ,cervical lateral flexion to the
left then to the right are added.
57.
58. NORMAL RESPONSES
A deep stretch or ache in the cubital fossa
A definite tingling sensation in the thumb and
first three fingers
A small percentage of subjects may feel stretch
in the anterior shoulder area.
Cervical lateralflexion away from tested side
increases the response in approximatelyn90 % of
individuals.
59. Upper limb tension test 2
Supine lying
Shoulder depression maintained
Shoulder medially rotated
Forearm pronated ad wrist flexion
Flexion of thumb joints and ulnar deviation
further sensitises the radial nerve.
NO STUDIES HAVE BEEN UNDERTAKEN REGARDING
NORMAL RESPPONSE OF ULLT2
60.
61. UPPERLIMB TENSION TEST 3
Starting position same as ULTT1
wrist exended and fore armsupinated
Elbow fully flexed
With maintaining Shoulder depression ,abduction
added
NORMAL RESPONSE
In asymptomatic people ,a commo response is burning
and tingling in the ulnar nerve distribution in the hand
or medial aspect of elbow.
62.
63. PASSIVE NECK FLEXION TEST(PNF)
STRAIGHT LEG RAISE TEST(SLR)
SLUMP TEST
PRONE KNEE BEND(PKB)
64. PASSIVE NECK FLEXION TEST
PATIENT LIES SUPINE
LIFT HEAD OFF THE BED A LITTLE
PASSIVELY FLEXING THE NECK TOWARDS CHIN ON
CHEST DIRE CTION
During the movement symptom responses
,ROM,resistance encountered through the
movement are noted and analysed.
65. STRAIGHT LEG RISE TEST
Supine lying
Hip and trunk neutral
The leg is lifted perpendicular to the bed,hand
above knee joint prevents knee flexion.
The responses must compared with the responses
of other leg.
SENSITISING
Ankle dorsiflexion(tibial tract)
Ankle plantar flexion(common peroneal nerve)
66. PRONE KNEE BEND
Patient lies prone
Grasp the lower leg and flexes the knee
Check for symptom response
Compare to contralateral leg
67. THE SLUMP TEST
High sitting at the end of the plinth thighs fully
supported and knees together.
Patient asked to slump or sag with Cervical spine in
neutral
With spinal flexion position patient asked to bend
chin to chest and then over pressure in the same
direction.
The patient is asked to extend the knee actively and
the response assesed
Then dorsiflexion added
Neck flexion slowly released and the response
carefully assessed
The same procedure repeated for the other leg
If there is any change in symptom in hamsring area
after releasing the neck flexion –neurogenic in origin.
68.
69. Analysis of tesion test
The range of movement at which symptom first
start.
Whether the disorder is non irrritable
The type and area of symptoms
The resistance encountered during the test
The above findings must be compared to the
testof the contralateral limb.
70. POSITIVE TENSION TEST
It reproduces the patients symptoms
The test responses can be altered by the
movement of the body parts.
There are differences in the test from the
left side to the right side
Range of movement
Resistance encountered duringthe movement
Symptom response during the movement.