A physical therapist performs the carpal compression test (Durkan's test) on a patient who complains of pain and paresthesia in their hand. The purpose of this test is to compress which of the following structures?

Option 1- Median nerve
Option 2- Radial artery
Option 3- Ulnar nerve
Option 4- Ulnar artery

Transcript

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The Carpal Compression Test
 The carpal compression test, or Durkan's test, is a neural provocation test used to identify carpal tunnel syndrome. During the test, the therapist applies direct pressure over the carpal tunnel to see if it reproduces symptoms such as numbness, tingling, or pain in the hand.

This is a straightforward question once you know two things - what structure passes through the carpal tunnel, and where the carpal tunnel is located. The question is essentially asking you to connect the test to the structure it targets. Let's make sure that connection is crystal clear.

Let's explore each of the options:

Option 1 - Median nerve

The carpal compression test, also known as Durkan's test, involves direct pressure over the carpal tunnel, compressing the median nerve in the carpal tunnel to reproduce symptoms of carpal tunnel syndrome.

Option 2 - Radial artery

The radial artery runs along the lateral aspect of the wrist near the thumb. It would not be compressed during the carpal compression test.

The radial artery is on the wrong side of the wrist for this test. It does not pass through the carpal tunnel, and applying pressure over the carpal tunnel would not significantly compress it.

Option 3 - Ulnar nerve

The ulnar nerve passes through Guyon's canal at the medial aspect of the anterior wrist. It would not be compressed during the carpal compression test.

This is a completely different passageway from the carpal tunnel. Compression of the ulnar nerve at Guyon's canal would produce symptoms in the ulnar nerve distribution - the little finger and medial half of the ring finger. Durkan's test targets the carpal tunnel, not Guyon's canal.

Option 4 - Ulnar artery

The ulnar artery also travels through Guyon's canal, alongside the ulnar nerve. It would not be compressed during the carpal compression test. This option and Option 3 can essentially be eliminated for the same anatomical reason.

When we place our thumbs over the carpal tunnel and apply direct pressure, there is only one neural structure in that space that we are targeting - the median nerve. Everything else is in a different location entirely.

The correct answer is Option 1.

Let's explore the all student data:

89% of students selected Option 1 - Median nerve - the correct response
3% of students selected Option 2 - Radial artery
6% of students selected Option 3 - Ulnar nerve
2% of students selected Option 4 - Ulnar artery

System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out page 109 in PTEXAM: The Complete Study Guide.