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compression of the nerve can cause inflammation and scarring. These scarring can be located _______ or _______ where each would affect__________
Intraneural which would compromised inherent elongation
Extraneural: nerve excursion within nerve bed limited
how can we assess Adverse neural tension?
Active and passive motion dysfunction
peripheral nerve hyperalgesia (palpating nerve directly or indirectly)
local tender points
local dysfunction via c/s mobilization
Expected responses of ANT assessment (Butler)
tissues respond to movement, normal response
patient complaint reproduced locally or remotely
Clinical Physiologic response:
pain but not the pain
Expected responses of ANT assessment (Elvey)
reproduction of sx
response altered by distal components
different response when comparing L to R
Normal response for ULNT: Median nerve
may feel pain in the anterior shoulder
deep stretch/ache in cubital fossa which may extend down anterolateral forearm/hand
tingling in median nerve digits
lateral neck flexion away increase sx, while toward decrease sx.
Tension vs glide and when to use both
tension max length of nerve/vascular supply. used in patients with non-irritable conditions or low irritability
glide allows tension in one component and release another, us in patients with irritable conditions
Glide with Intraneural/extraneural
Intraneural: increase mobility away from site with intramural fibrosis
extraneural: treat interfacing tissue in conjunctionw ith glide or slide b/c immobilized
Treatment and progression of ANT
monitor sx; watch for delayed responses
gradual increase in reps/duration
add components to increase tension
no clear guidelines
spinal cord signs (bilat sx, LE weakness)
nerve root signs
severe unremitting night pain - lacking a dx
CRPS type I/II
Mechanical spine pain with peripheralization
recently repaired peripheral nerve
active inflammatory condition
neurological: acute inflammatory disease - Guillain barre and lye vs. demyelinating disease
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