NATA BOC Domain 2 Clinical Evaluation & Diagnosis Special Test Practice

Tinels sign tests irritation of the median nerve at the carpal tunnel. You tap gently on the volar (palm-facing) surface of the wrist where the median nerve passes through the carpal tunnel. A positive finding is tingling or paresthesias in the median nerve distribution of the hand (thumb, index, middle finger, and the radial side of the ring finger) following the tap. Tapping other areas, like the dorsal wrist, the palmar crease, or the forearm, wouldn’t reproduce these median-nerve sensations, so those sites don’t indicate Tinels sign. This reflex helps identify carpal tunnel syndrome by reproducing the nerve’s characteristic symptoms.