Strain at the subclavian artery during the upper limb tension test

Abstract

The manoeuvres of the upper limb tension test (ULTT) were described by Elvey (1983 and 1985) to identify the presence of a brachial plexus component in upper arm pain. A pilot study was undertaken to examine strain at the subclavian artery during the ULTT in two embalmed cadavers. Photographs of the artery segments were obtained at each step of the test and from these, strain scores were calculated. Results show that limb manoeuvres conducted with cervical contralateral lateral flexion produced more strain than with ipsilateral lateral flexion. Since cervical contralateral lateral flexion appears capable of increasing strain at the subclavian artery, further studies comparing strain at the artery with strain at cervical nerves are indicated.

The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

“…55 Cadaveric 13 18,30,32,52,56,57,[122][123][124] However, when the limb is in the end ULNT position, biomechanical effects from wrist movement or neck sidebending spread along the entire nerve. 18,21,22,30,52,56,57,61,65,119,122,124 These data support the concept of structural differentiation. The spread of biomechanical effects along the nerve is a plausible explanation for why movement of a distant body part can change sensory responses at the end of a ULNT.…”

“…For PNP, probable means that (1) the patient's symptoms fit a nerve-related distribution, (2) the history of symptoms is consistent with a nerve-related problem, and either (3a) a clinical neurological examination shows positive or negative sensory signs that match the innervation territory of the suspected nerve problem, or (3b) diagnostic tests, such as imaging or electrophysiological studies, confirm an injury or disease that explains the distribution of PNP. dian (ULNT MEDIAN ), 13,18,21,56,57,61,66,67,119,124,127 radial (ULNT RADIAL ), 122 and ulnar (ULN-T ULNAR ) 2,3,13,21,47,66,72,83,98,123 nerve tests increase strain in the corresponding nerve. Each test preferentially loads its corresponding nerve at the elbow and wrist, 13,56 suggesting that mechanosensitivity of a particular nerve near these joints may be most readily assessed by the corresponding ULNT.…”

The influence of a depressed scapular alignment on upper limb neural tissue mechanosensitivity and local pressure pain sensitivity

“…The most common sensory response reported by subjects from both groups with the application of the ULNT1 was "stretching", which is in agreement with Lohkamp et al 28 The term "stretching" is not predominantly neurogenic, therefore the source of sensory response we obtained with the application of the ULNT1 might not be solely neural tissue. 32,53 Interestingly, the terms "tingling" and "burning", which imply a neurogenic component in symptom response, were more frequently reported by the group with a depressed scapula alignment. This finding is consistent with the greater neural tissue sensitization reported in that group.…”