Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension...
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Transcript of Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension...
![Page 1: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/1.jpg)
Neuro Anatomy
Lumbar Spine
![Page 2: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/2.jpg)
Neuro Anatomy
• Important for neurological assessment• Helps with tension testing and neurodynamic
treatments• Knowing anatomy will help identify potential
causes of radicular pain or radiculopathy• E.G paraesthesia in the hand- is this in a
dermatome pattern or a peripheral nerve pattern
![Page 3: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/3.jpg)
Spinal Nerves
![Page 4: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/4.jpg)
Spinal Nerves
![Page 5: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/5.jpg)
Lumbar Plexus
![Page 6: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/6.jpg)
Lumbar Plexus
![Page 7: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/7.jpg)
Femoral Nerve
![Page 8: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/8.jpg)
Obturator Nerve
![Page 9: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/9.jpg)
Lumbosacral Plexus
![Page 10: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/10.jpg)
Lumbosacral Plexus
![Page 11: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/11.jpg)
Sciatic Nerve
![Page 12: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/12.jpg)
Peroneal Nerve
![Page 13: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/13.jpg)
Tibial Nerve
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Sural Nerve
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Dermatomes and Myotomes Vs Peripheral Nerve
• Remember the cutaneous and motor distribution of a peripheral nerve IS NOT the same as dermatome and myotome patterns
• Nerve roots will progress into multiple peripheral nerves
• E.g C8 nerve root is present in ulnar, median and radial peripheral nerves
![Page 16: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/16.jpg)
Neurodynamics
Lumbar Spine
![Page 17: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/17.jpg)
The Neurodynamic System
• Interaction of 3 components– Mechanical Interface– Neural Structures– Innervated Tissues
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Abnormal Neurodynamic System
• Can be the result of one or a combination of:– Dysfunctional Tension– Dysfunctional Sliding– Dysfunctional Compression
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Tension
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Sliding
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Compression
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Movement of the Neural System
• The nervous system will generally slide towards the moving joint distally and proximally to increase the available slack
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Femoral Nerve Testing
![Page 24: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/24.jpg)
Sciatic Nerve Testing
![Page 25: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/25.jpg)
Peroneal Nerve Testing
![Page 26: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/26.jpg)
Tibial Nerve Testing
![Page 27: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/27.jpg)
Sural Nerve Testing
![Page 28: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/28.jpg)
Slump Testing Upper Lumber Nerve Roots
![Page 29: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/29.jpg)
Look for…..
• Pain• ROM• Paraesthesia or Numbness
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Structural Differentiation
• Perform the test• Make a change 2 joints away from the symptoms• Does it increase or decrease symptoms?• Does it make no change?
![Page 31: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/31.jpg)
Dermatomes
![Page 32: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/32.jpg)
Dermatomes
![Page 33: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/33.jpg)
Dermatomes
![Page 34: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/34.jpg)
Myotomes
L2 L3
![Page 35: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/35.jpg)
Myotomes
L4 L5
![Page 36: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/36.jpg)
Myotomes
S1 S1
![Page 37: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/37.jpg)
Myotomes
S1 - 2
![Page 38: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/38.jpg)
Management
• Soft tissue release• Joint mobilisations– Sliders and Tensioners
![Page 39: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/39.jpg)
Sliders
![Page 40: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/40.jpg)
Tensioners
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Manual TherapyCorkskrew
![Page 42: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/42.jpg)
Home Exercise ProgrammeLeg Swings
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Home Exercise ProgrammeHeel To Sky
![Page 44: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/44.jpg)
Home Exercise ProgrammeFemoral Nerve
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Home Exercise ProgrammeCranio Cervical Flexion Straight Leg Raise
![Page 46: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/46.jpg)
Home Exercise ProgrammeSeated Slump Part 1
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Home Exercise ProgrammeSeated Slump Part 2
![Page 48: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/48.jpg)
Home Exercise ProgrammeSeated Slump Part 3
![Page 49: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/49.jpg)
Home Exercise ProgrammeSeated Slump Part 4
![Page 50: Neuro Anatomy Lumbar Spine. Neuro Anatomy Important for neurological assessment Helps with tension testing and neurodynamic treatments Knowing anatomy.](https://reader036.fdocuments.us/reader036/viewer/2022081506/5697bf731a28abf838c7f470/html5/thumbnails/50.jpg)
Neurodynamic Treatments
• Be inventive• Decide on what aspect of the nerve you need to
target• Decide whether you need to perform a slider or a
tensioner• Decide if you want to tension the entire spinal
cord and dura mater• HEP or Manual Therapy? Eg MTrP release in neural
load, Hip distraction mobilisations in neural load