Upper Limb Tension Tests

Question 1

ULNT1 (Median Nerve Bias), Testing Position

Answer 1

Shoulder: Depression and Abduction (110 degrees)
Elbow: Extension
Forearm: Supination
Wrist: Extension
Fingers: Extension
Shoulder (additional): null
Cervical Spine: Contralateral Side Flexion

Question 2

ULNT3 (Radial Nerve Bias), Testing Position

Answer 2

Shoulder: Depression, IR, Abduction (40), Extension (25).
Elbow: Extension
Forearm: Pronation
Wrist: Flexion + Ulnar Deviation
Fingers: Flexion
Shoulder (additional): IR
Cervical Spine: Contralateral Side Flexion

Question 3

ULNT4 (Ulnar Nerve Bias), Testing Position

Answer 3

Shoulder: Depresion + Abduction, Hand to Ear
Elbow: Flexion
Forearm: Pronation
Wrist: Extension + Radial Deviation
Fingers: Extension
Shoulder (additional): ER
Cervical Spine: Contralateral Side Flexion

Question 4

What side should be tested first during ULNT tests?

Answer 4

Test the “good” side or uninvolved side first

Question 5

When are Nerve Tension Tests Contraindicated?

Answer 5

Neurological Signs are Worsening
Damage in the Acute Phase

Question 6

When positioning the shoulder what motion is essential and should be maintained?

Answer 6

CONSTANT Shoulder Depression!

Question 7

What motion should be applied to the Cervical Spine during all Upper Limb Tension Tests?

Answer 7

Contralateral Lateral Flexion

Question 8

What constitutes a Positive (pathological) upper limb tension test?

Answer 8

Reproduction of patients symptoms (MOST IMPORTANT FINDING)

Different symptoms felt in Right and Left sides

Question 9

Straight Leg Raising Test (Lasegue’s Test), Testing Procedure?

Answer 9

Patient in Supine

Hip: Flexion + Adduction
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: Sciatic Nerve + Tibial Nerve

Therapist passively flexes the hip until onset of pain or tightness in back of leg

Question 10

During a SLR Test, what inference can be made if the patient is experiencing reproduction of “Back Pain Only”?

Answer 10

Pathology causing pressure is more central

Disc prolapse may be Smaller/More Central

Question 11

During a SLR Test, what inference can be made if the patient is experiencing reproduction of pain primarily in the leg

Answer 11

Expecting a more lateral lesion

Question 12

During a SLR Test, what additional motions can be done to further sensitize neural tissues?

Answer 12

Ankle Dorsiflexion (usually done first)

or

Cervical Flexion

Question 13

Slump Test (ST1), Testing Position + What Tissues are being biased?

Answer 13

Cervical Spine: Flexion
Thoracic and Lumbar Spine: Flexion
Hip: (90 degrees +)
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: Spinal Cord, Cervical and Lumbar Roots, Sciatic Nerve

Question 14

Long Sitting Slump Test (ST4)

Answer 14

Cervical Spine: Flexion, Rotation
Thoracic and Lumbar Spine: Flexion (Slump)
Hip: Flexion (90 degrees +)
Knee: Extension
Ankle: Dorsiflexion
Nerve Bias: Spinal Cord, Cervical and Lumbar Roots, Sciatic Nerve

Question 15

Cross (Well Leg Sign) SLR5, Testing Procedure + What is Indicated

Answer 15

Testing of the Uninvolved side, reproduces symptoms in the Involved side, the uninvolved side or both.

Hip: Flexion + Adduction
Knee: Extension
Ankle: Dorsiflexion

Nerve Bias Nerve Root (Significant Nerve Root Compression) (Disc Prolapse)

Question 16

What degree of hip flexion do we normally see the Sciatic Nerve being completely Stretched?

Answer 16

70 degrees

Question 17

What can be inferred if pain occurs after 70 degrees of stretch during SLR?

Answer 17

Joint pain from lumbar area or sacroiliac joints

Possible Hamstring Tightness

Question 18

What testing procedure can be utilized if a patient is unable to tolerate lying in supine during the SLR test?

Answer 18

Side Lying

Question 19

What is the Special Test name for the Ankle Dorsiflexion Movement during SLR test?

Answer 19

Bragard’s Test

Question 20

Names for the Neck Flexion movement during SLR test?

Answer 20

Soto-Hall Test

Brudzinski’s Sign

Question 21

With the Addition of foot eversion during the SLR (SLR2) what nerve tissue is being biased?

Answer 21

Tibial Nerve

Question 22

With the Addition of foot inversion during the SLR (SLR3) what nerve tissue is being biased?

Answer 22

Sural Nerve

Question 23

With the Addition of ankle plantar flexion + foot inversion during the SLR (SLR4) what nerve tissue is being biased?

Answer 23

Common Peroneal Nerve

Question 24

ULTT (1) is used to bias what structures?

Answer 24

• Median Nerve
• Anterior Interosseus Nerve

Question 25

ULTT (2) is used to bias what structures?

Answer 25

• Median Nerve
• Musculocutaneous Nerve
• Axillary Nerve

Question 26

ULTT (3) is used to bias what structures?

Answer 26

• Radial Nerve

Question 27

ULTT (4) is used to bias what structures?

Answer 27

• Ulnar Nerve
• C8, T1 Nerve Roots

Question 28

What are the degrees of Abduction for the ULTT1 and ULTT2

Answer 28

ULTT1:

• 110 Degrees Abduction

ULTT2:

• 10 Degrees Abduction