Upper Limbs Neurodynamic Tests

• Brachial Plexus Tension Test

  designed to put stress on neuro structures of the upper limb by elongating them

  assesses peripheral nerve mobility + compression

  depress the shoulder, shoulder abd at 110, ext rotate, elbow flex at 90, forearm supinated, extend wrists + fingers

  then extend elbow slowly, ask pt to contralaterally flex neck to provoke symptoms
• Myotomes

  C4 - shoulder girdle elevation

  C5 - shoulder abd

  C6 - elbow flx

  C7 - elbow ext

  C8 - thumb extension

  T1 - finger adduction
• Reflexes - Bicep

  C5-6 - keep arm supported, elbow slighlty flexed + forearm relaxed, place tumb firmly over the bicep tendon in cubital fossa, tap the tendon = contraction of biceps brachii, flexion of elbow

  
• Reflexes - Triceps

  C7

  pt arm relaxed, behind torso, hold auxillary, elbow slightly flexed + forearm hanging loose

  triceps tendon = located above olecranon process

  tap w sharp end

  = elbow extension + triceps will contract

  
• Tinel's Sign (Tapping Brachial Plexus)

  used to detect nerve irritation/damage

  percuss a nerve to elicit a tingling/pins & needles sensation

  percuss the supraclavicular fossa, above collarbone

  pos test = pt experiences the sensations in the distribution of the brachial plexus, typically radiating, down the arm, forearm + hand

  
• Upper Limbs Dermatomes

  upper limbs dermatomes

  
• Tinel's Sign (Tapping Ulnar Nerve)

  checks for cubital tunnel syndrome = ulnar nerve entrapment

  tap on ulnar nerve at elbow, pos signs = tingling, numbness or shock-like sensation in the ring + lil fingers and inner side of forearm

  
• Cubital Tunnel Syndrome

  caused by compression/irritation of the ulnar nerve at the elbow

  nerve runs along the inside of the elbow + controls sensation in the lil finger + part of the ringe finger, as well as some hand muscles

  prolonged elbow flx for 5 mins provoke symptoms
• Pinch Grip Test

  asesses the strength + function of the hand + fingers, particularly for fine motor skills + tasks requiring dexterity

  measures the strength required to pinch objects between fingers

  helps detect problems like compression of the median nerve, responsible for fine motor control of the hand
• Pinch Grip Test Method

  pt pinch tips of the thumb and index finger, pinching a paper

  inability to form a tip-to-tip pinch = pos sign
• Pronator Syndrome

  median nerve compression/pinched in forearm near the pronator teres muscle

  causes pain, numbness + weakness in forearm, hand + fingers

  tap median nerve near the muscle

  
• Radial Tunnel Syndrome

  radial nerve is compressed in the radial tunnel a narrow space near the elbow

  activities involving repetitive pronation + supination can contribute to compression

  percuss/palpate radial tunnel

  nerve glide - flexion + extension of elbow, keeping wrist flexed