Carpal Tunnel Flashcards
1
Q
What is carpal tunnel?
A
Compression neuropathy involving the median nerve
MC compression neuropathy in the UE
2
Q
Risk Factors for carpal tunnel
A
obesity pregnancy diabetes rheumatoid arthritis hypothyroidism workplace factors
3
Q
What happens in carpal tunnel?
A
Median nerve compression –>
inflammation –>
ischemia –>
nerve damage
4
Q
Clinical manifestations of carpal tunnel
A
- vague aching that radiates into thenar area
- pain w/ numbness in median distribution
- dropped objects, cannot open jars
- pain worse w/ repetitive motion or w/ prolonged stationary periods
5
Q
What is the best test sign to identify Carpal tunnel? What is it?
A
Flick sign
pt awakens at night w/ pain or numbness and needs to “shake out” hand
6
Q
testing for carpal tunnel?
A
- inspection for thenar atrophy
- opposition against resistance= weakness
- sensation over median nerve
7
Q
What is Phalen’s test
A
- inverse praying position
- Wrist flexion reproduces symptoms
Positive test suggests median neuropathy
8
Q
What is Tinel’s sign?
A
- percuss median nerve at carpal tunnel in wrist
- reproduces pain and tingling
Positive test suggests median neuropathy
9
Q
Tx of carpal tunnel?
A
- short-term course NSAID
- PT
- ergonomic modification to workplace
- wrist splint worn at night
- orthopedic surgery consult when pt has failed conservative care
