carpal tunnel

Question 1

what digits are affected in carpal tunnel?

Answer 1

half of ring finger, pointer finger, and thumb

NOT pinky

Question 2

what nerve is compressed in carpal tunnel syndrome?

Answer 2

median

Question 3

what ligament forms the top of the tunnel (what compresses the nerves)?

Answer 3

transverse carpal ligament (flexor retinaculum)
located on the PALMAR side

Question 4

what comprises the dorsal side of the carpal tunnel?

Answer 4

bony arch makes up the “floor” of the capal tunnel

Question 5

explain the progression of carpal tunnel:

Answer 5

initially dull ache and discomfort
inflammation spreads to nearby tendons and tissues
causes edema
eventually turns into pins and needles (paresthesia) that can travel up the arm
muscle weakness
thenar muscle wasting due to decreased innervation

Question 6

what nerve is the thenar eminence innervated by?

Answer 6

recurrent branch (median nerve branch, downstream of carpal tunnel)

Question 7

is there loss of palm sensation too?

Answer 7

no
the palmar branch branches upstream to the tunnel
therefore, no loss of central palm sensation

Question 8

risk factors for carpal tunnel:

Answer 8

obesity
pregnancy
rheumatoid arthritis

Question 9

carpal tunnel maneuvers:

Answer 9

phalen’s maneuver
tinel’s sign
durkan’s test

Question 10

phalen’s maneuver

Answer 10

flex wrists together for a minute

Question 11

tinel’s sign

Answer 11

tap on the nerve directly, reproducing pain

Question 12

durkan’s test

Answer 12

manually compress transverse carpal ligament for 30 seconds

Question 13

medicine treatment for carpal tunnel:

Answer 13

corticosteroids