carpal tunnel syndrome Flashcards
what is carpal tunnel syndrome caused by
compression of the medial nerve as it travels through carpal tunnel
compression of carpal tunnel contents is the result of either…
- swelling of contents
- narrowing of tunnel
palmar digital cutaneous branch of median nerve - sensory functions
palmar aspects and fingertips of
- thumb
- index finger
- middle finger
- lateral half of ring finger
palmar cutaneous branch of median nerve
provides sensation to palm
this branch originates before the carpal tunnel (doesnt travel through it) and so is not affected by carpal tunnel syndrome
median nerve - motor function to hand
three thenar muscles
- abductor pollicis brevis
- opponens pollicis
- flexor pollicis brevis
risk factors
repetitive strain obesity perimenopause rheumatoid arthritis diabetes acromegaly hypothyroid
patient with bilateral carpal tunnl syndrome…
look for featues that might suggest underlying cause
- RA
- acromegaly
- hypothyroid
- diabetes
presentation
symptoms worse at night
sensory: parasthesia, numbness, burning, pain
motor: weak thumnb movements, weak grip, wasting thenar muscles
special tests
phalens
tinnels
carpal tunnel questionaite
- do symptoms wake you at night
- do you have trick movements (e.g. shaking hand) to improve symptoms
- is little finger affected
primary investigation
nerve conduction studies
Mx options
rest
wrist splints
steroid injections
surgery
