The neural tension test for the ul nnar nerve is used to differentiate nerve root involvement from thoracic outlet syndrome.

• A. Median nerve tension test
• B. Radial nerve tension test
• C. Ulnar nerve tension test
• D. Spurling's test

Answer: (C)

Upper limb neural tension tests bias a single nerve to help distinguish nerve root (radicular) involvement from peripheral nerve entrapment such as thoracic outlet syndrome. The ulnar nerve tension test specifically stretches the ulnar nerve along its course from the neck to the hand, isolating this nerve’s neural tissue. If you reproduce symptoms in the ulnar distribution with this test, yet provocative tests for cervical nerve roots (like Spurling’s) are negative, it points toward a peripheral issue rather than a cervical radiculopathy. This helps separate root symptoms from thoracic outlet syndrome, which is a peripheral entrapment rather than a spinal root problem. The other nerve tension tests bias different nerves (median or radial), so they’re less informative for distinguishing root involvement from thoracic outlet syndrome in the ulnar distribution.