Carpal + Cubital Tunnel Syndrome Flashcards
what forms the carpal tunnel
carpal bones + flexor retinaculum
what nerve passes through the carpal tunnel
median nerve
what are the roots of the median nerve
C6, C8, T1
What muscles of the hand are supplied by the median nerve
LOAF
Lateral two lumbricals
Opponens pollicis
Abductor pollicis
Flexor pollicis brevis
sensory innervation of median nerve
palmar aspect of lateral 3.5 fingers
presentation of carpal tunnel syndrome
tingling, discomofort + loss of sensatation in median nerve innervated digits (lateral 3.5 fingers) which is worse at night
what area may be wasted in carpal tunnel syndrome
thenar eminence
what conditions can cause carpal tunnel syndrome
RA - Synovitis causes less space in carpal tunnel
Conditions that cause fluid retention:
pregnancy
diabetes
CKD
Hypothyroidism
what fracture can cause carpal tunnel syndrome?
colles fracture
- fracture of distal radius
- fall onto wrist in extension
- dinner fork derformity
what is tinels test
what does a +ve test indicate?
perucussing over median nerve - will cause symptoms in carpal tunnel syndrome
what is durkans test
what does a +ve test indicate
compression of carpal tunnel for 30s - will cause symptoms in carpal tunnel syndrome
what is phalens test
what does a +ve test indicate
holding wrists hyperflexed (compresses carpal tunnel) for 60s - will cause symptoms in carpal tunnel syndrome
treatment of carpal tunnel
Treat any underlying cause (most cases are idiopathic)
NSAIDs + wrist splints at night
Corticosteroid injections
Surgery: division of transvere carpal ligament
what nerve passes through the cubital tunnel
ulnar nerve
what are the roots of the ulnar nerve
C8, T1
what test causes symptoms in cubital tunnel syndrome
Froments sign
- ask patient to grip paper between thumb + index finger
- pull paper away
- weak adductor pollicis causes flexion of thumb at IPJ
