Suprascapular Nerve ULNT

[emad]

Hi all ;

The discussion went on there regarding shoulder which elicited the suprascuplar nerve ,as well there a thread regarding it there on NOI .Seems it includes significant number of our patients with shoulder diagnoses ( Is this plural form correct for diagnosis), painful arc syndromes,supraspinatus syndromes.................................................................. .......


What are the compnents for testing Suprascuplar nerve tension ??

Regards
Emad

[nari]

emad

Have a look at the track of the nerve and imagine what happens when you elevate and depress the shoulder. That tends to relax and tension the proximal end. If you add ULNT plus contralateral neck rotation, you add tension. My thoughts are it is a major player in shoulder dysfunctions.

Have a look at the thread on Surgeons...there is a bit of a discussion there starting.

Nari

[Xaniel]

Hi emad,

here is my opinion:

(1) horizontal flexion G/H
(2) lateral flexion Cx
(3) protraction (Do you know what I mean?) Thorax
(4) medial rotation scapula

The four components may vary order.



Xaniel

[emad]

Hi Xaniel;

Well, thank you i know most of the motions you mentioned ,except scapular rotation .

I think we need to put the mtions in images.

Regards
Emad

[Xaniel]

Hi emad,

medial rotation means that you push the inferior angle to the spine (and it goes medial).

I will work on a picture that shows the directions clearly.


So long

Xaniel

[Xaniel]

Sorry about the delay but I forgot to subscribe to this thread in my User CP!

Here are some pitures of scapular movement I found on the WWW:
http://www.pt2001.de/hd/somasimple/ShoulderGirdleElevationDepression.jpg
http://www.pt2001.de/hd/somasimple/ShoulderGirdleProtractionRetraction.jpg
http://www.pt2001.de/hd/somasimple/ShoulderGirdleRotation.jpg

So, the ULNT for N. suprascapularis goes like this:
1) gleno-humeral horizontal Flexion (elevate the arm up to 90° of flexion)
2) cervical lateral flexion (bend the head to the opposite site)
3) scapular protraction
4) scapular downward rotation

I prefer to do this test with my patient sitting on the bench but can also do is with the patient supine (if you can handle the scapula).
It is also possible as a "quick test" when your patient gives you a functional demo with the arm in horizontal flexion - just add the movements of the head and the scapula.

Have fun with it!


Daniel

[emad]

Hi Daneil ;

Thanks for the images , i do not know if i agree with you or not ,because i do not know the nerve course , if you can find clear anatomical image this is will be good .I will try to find clear image .Because i feel the tenion on that nerve is by retraction not protraction .

Emad

[Xaniel]

Hi emad,

here is an image I accidentally found a few day ago:
http://www.pt2001.de/hd/somasimple/suprascapular_nerve_course.gif

The image is form the following article:
http://www.ptjournal.org/PTJournal/Apr2004/v84n4p359.cfm

It's a pity they did not use any ULTT:
Because this evidence was not published at the time we saw our patients, we did not use the ULTT.

Maybe I find some more good pictures in my books. If so I put the book on my flat bed scanner and put it on here.


Daniel