Upper Limb Neurodynamic Tests

Question 1

ULNT1 –

Answer 1

Median Nerve Bias (Standard)

anterior interosseous nerve
C5, C6, C7

Question 2

ULNT2 –

Answer 2

Median Nerve Bias (Alternative)

musculocutaneous nerve
axillary nerve

Question 3

ULNT3 –

Answer 3

Radial Nerve Bias

Question 4

ULNT4 –

Answer 4

Ulnar Nerve Bias

C8 and T1 nerve roots

Question 5

ULNT1
How to Perform:

Answer 5

Depress shoulder with examiner’s thigh or hand

Abduct shoulder to ~110°

Extend wrist and fingers

Supinate forearm

Laterally rotate shoulder

Slowly extend elbow

Sensitize with contralateral cervical side bend

Question 6

ULNT2
How to Perform:

Answer 6

Shoulder depressed (with belt or examiner hand)

Elbow extended

Lateral rotation of shoulder

Wrist, finger, and thumb extension

Shoulder abduction (less than ULNT1)

Cervical contralateral side bend to sensitize

Question 7

ULNT1 and ULNT2
Positive Result:

Answer 7

Reproduction of symptoms, asymmetry compared to contralateral side, and symptom change with neck movement

Question 8

ULNT3
How to Perform:

Answer 8

Depress shoulder

Extend elbow

Medially rotate shoulder

Pronate forearm

Flex wrist, fingers, and thumb

Ulnar deviation

Slight shoulder abduction

Contralateral cervical side bend to sensitize

Question 9

ULNT3
Positive Result:

Answer 9

Reproduction of lateral arm symptoms (triceps, radial side), tension, or paresthesia

Question 10

ULNT4
How to Perform:

Answer 10

Depress shoulder

Abduct shoulder to 90°

Laterally rotate shoulder

Flex elbow fully

Pronate forearm (optional)

Extend wrist and fingers

Bring patient’s hand toward their ear (“waiter tray” position)

Sensitize with contralateral cervical side bend

Question 11

ULNT4
Positive Result:

Answer 11

Tingling or symptoms along ulnar distribution (medial forearm/hand), and altered with neck movement