REIDER PART 2
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328 Chaptkr 8_Cervical and Thoracic Spine

Figurę 8-44. A-F, Upper limb tension test 2 (ULTT2), median nerve dominant variation. (In B, the examiner has temporarily released the patient’s arm so that the shoulder depression can be seen by the reader.)

E    F

While maintaining the shoulder depression, the elbow cxtcnsion, and the internal rotation of the limb, the examiners right hand is used to grasp the patients right hand and flex the patients wrist,thumb, and fingers (Fig. 8-45C). As with the previous test, the rcsponse is consid-ered abnormal if this maneuver clicits radicular pain, par-ticularly in the radial nerve distribution.

Upper Limb Tension Test 3

The upper limb tension test 3 (ULTT3) is performed to assess possible irritation of the C8 and Tl nerve roots. It is designed to be ulnar nerve dominant. Owing to the relative hypomobility of the ccrvicothoracic junction, lesions of these lower nerve roots are morę difficult to assess. For this test, the patient and the examiner are positioned as for the ULTT1. The examiner should assumc a wide-based stance so that his or her weight can be shifted forward when required. To examine the right side, the patients flexed right elbow is rested against the examiner’s pelvis, just below the anterior superior iliac spine. The examiner’s left hand grasps the patient s right hand by the fingers, and the exam-iners right hand is again pressed into the examination table against the superior aspect of the shoulder to prevent eleva-tion (Fig. 8-46A). The patient s wrist is then dorsiflexcd and the forearm supinated (Fig. 8-46B). While maintaining this position, the patienfs elbow is maximally flexed (Fig.