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What is ULNT??

Upper limb Neurodynamic (Tension) Tests

The neurodynamic tests of the upper limbs are analogous to the lumbar spine's straight leg raising test. In reality, stress is placed on all the tissues of the upper limb during these tension tests, which are meant to stretch the neurological structures of the upper limb.

It is also known as Brachial Plexus Tension or Elvey Test.

Sensitizing tests are used to distinguish between the neurological tissue. Elvey's original test has since been divided into four tests. Changing the position of the shoulder, elbow, forearm, wrist, and fingers puts more strain on particular nerves.



Each test starts with testing the good side, followed by positioning of the shoulder, then moves on to the forearm, wrist, fingers, and, due to its extensive range of motion (ROM), the elbow at last.

It is crucial to apply a constant depression force to the shoulder girdle when positioning the shoulder so that, even with abduction, the shoulder girdle stays depressed.

The test is less likely to be successful if the shoulder is not held firmly pressed. The glenohumeral joints are brought into the proper abduction position (110 or 10) while the shoulder girdle is depressed, and the forearm, wrist, and fingers are brought into the proper end-of-range position.

Positioning of limb according to types:

ULNT1:

Nerve:             Medial nerve, anterior interosseous nerve (C5, C6, C7)

Shoulder:         Depression and abduction (10)

Elbow:             Extension

Forearm:         Supination

Wrist:             Extension

Fingers and thumb: Extension

Cervical spine: Contralateral side flexion

ULNT2:

Nerve:            Median nerve, musculocutaneous nerve, axillary nerve

Shoulder:        Depression and abduction (110), lateral rotation

Elbow:            Extension

Forearm:         Supination

Wrist:             Extension

Fingers and thumb: Extension

Cervical spine: Contralateral side flexion

UTNT3:

Nerve:             Radial nerve

Shoulder:        Depression and abduction (110), medial rotation

Elbow:            Extension

Forearm:         Pronation

Wrist:              Flexion and ulnar deviation

Fingers and thumb: Flexion

Cervical spine: contralateral side flexion

ULNT4:

Nerve:            Ulnar nerve, C8 and T1, lateral rotation

Shoulder:        Depression and abduction (10 to 90), hand to ear

Elbow:            Flexion

Forearm:         Supination or pronation

Wrist:              Extension and radial deviation

Fingers and thumb: Extension

Cervical spine: Contralateral side flexion




    

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