Ambulatory: Carpal Tunnel Syndrome Flashcards
What is the pathophysiology of carpal tunnel syndrome
Numbness/pain in median nerve distribution due to median nerve compression within carpal tunnel
What are associated factors that can cause carpal tunnel syndrome
Diabetes, hypothyroidism, B12 deficiency, wrist fracture, pregnancy, repetitive use of hands
What other differentials must you include, besides carpal tunnel syndrome, for hand numbness (two more things)
1.) Cervical radiculopathy (nerve root compression)2.) Peripheral neuropathy (diabetes)
What are the symptoms of carpal tunnel syndrome
1.) Numbness/pain/tingling in median nerve distribution (worse at night, could be in arm too)2.) Muscle weakness and THENAR atrophy - happens later
What are two clinical tests you can do for carpal tunnel syndrome
1.) Phalen’s test: Palmar flexion at wrist for 1 minute - paresthesias occur2.) Tinel’s sign - tap over median nerve - paresthesias
What diagnostic test can confirm carpal tunnel syndrome but is often unnecessary if clinical diagnosis can be made
EMG and nerve conduction velocity
What is four potential treatments for carpal tunnel syndrome?
1.) Wrist splint - worn at night - prevents wrist flexion2.) NSAIDS3.) Corticosteroid injection - relief longterm4.) Surgical release - very effective but use if persistent symptoms
What is wernicke’s encephalopathy
CNS manifestation of alcoholism: Thiamine deficiency from longterm alcohol use with triad of encephalopathy (confusion), oculomotor dysfunction (nystagmus and conjugate gaze palsy), and gait ataxia
What are two things that can cause wernicke’s encephalopathy
1.) Alcoholism2.) Iatrogenic - giving glucose without thiamine
What is korsakoff’s psychosis
Caused by chronic thiamine deficiency now, also known as alcohol-induced amnestic disorderIrreversible amnesia (short term memory mostly), confabulation, and apathy
