NBCOT Upper Extremity Practice Test

Screening for carpal tunnel relies on provocative tests that reproduce symptoms in the median nerve distribution. Phalen's test is performed by having the patient hold the wrists in full flexion to compress the carpal tunnel; if numbness or tingling develops in the thumb, index, or middle finger, it supports median nerve compression. Tinel's sign involves tapping over the carpal tunnel; elicited tingling in the same median nerve areas indicates irritation consistent with carpal tunnel syndrome. Using both tests together is common because they are quick, noninvasive, and directly assess median nerve involvement in the carpal tunnel. The other options target different conditions—Finkelstein test checks for De Quervain's tenosynovitis, and Froment's sign assesses ulnar nerve palsy affecting the thumb—so they’re not standard screening tests for carpal tunnel.