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Musculoskeletal > Carpal tunnel syndrome > Flashcards

Carpal tunnel syndrome Flashcards

1
Q

What is carpal tunnel syndrome?

A

A condition in which inflammation of the carpal tunnel affects nerves and muscles supplying the hand

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2
Q

Who is most at risk of carpal tunnel syndrome?

A

Females
Over 30

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3
Q

What are some conditions that can predispose to carpal tunnel syndrome?

A
  • Diabetes
  • Hypothyroidism
  • Pregnancy
  • Rheumatoid arthritis
  • Obesity
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4
Q

What structures form the lateral floor of the carpal tunnel?

A

Scaphoid tubercle
Trapezium

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5
Q

What structures form the medial floor of the carpal tunnel?

A

Hook of hamate
Pisiform

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6
Q

What structure forms the superficial roof of the carpal tunnel?

A

Transverse carpal ligament

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7
Q

What structure forms the deep roof of the carpal tunnel?

A

Bony carpus

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8
Q

What is contained in the carpal tunnel?

A

9 flexor tendons
Median nerve

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9
Q

What muscles are supplied by the median nerve?

A

LOAF:
L - Lumbricals (IF and MF)
O - Opponens
A - Abductor pollicis brevis
F - Flexor pollicis brevis

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10
Q

How will carpal tunnel present in early disease?

A

Pins and needles of the hand
Some pain
Clumsiness

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11
Q

How will carpal tunnel present in late disease?

A

Numbness
Weakness of the hand
Functional deficit

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12
Q

What are some clinical signs of carpal tunnel syndrome?

A

Thenar atrophy (Thumb)
Altered sensation

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13
Q

What are some clinical tests available in carpal tunnel syndrome?

A

Durkin’s test
Tinnel’s test
Phalen’s test

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14
Q

What is performed in the Durkin’s test for carpal tunnel?

A

Compression of the carpal tunnel, which will cause numbness in the hand

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15
Q

What is performed in Tinnel’s test for carpal tunnel?

A

Tapping on the carpal tunnel will cause shooting pains in the hand

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16
Q

What is performed in Whalen’s test for carpal tunnel

A

Volar flexion (Reverse prayer) will cause numbness in the hands

17
Q

What is a questionnaire that can suggest carpal tunnel syndrome?

A

Kamath and Stothard

18
Q

What are some investigations used in carpal tunnel syndrome?

A

Clinical testing
Questionnaires
Nerve conduction study
Electromyogram

19
Q

How can mild to moderate carpal tunnel syndrome be managed?

A

Splintage
Physiotherapy
Possible steroid injections

20
Q

How can severe carpal tunnel syndrome be managed?

A

Carpal tunnel decompression

21
Q

How is carpal tunnel decompression done?

A

It is a day surgery performed under local anaesthetic in which the transverse carpal ligament is divided

22
Q

Describe the rehabilitation pathway for carpal tunnel decompression

A
  • 2 days reduce dressings
  • 5 days keep dry
  • 10 days for sutures
  • 6 weeks return pincher grip
  • 12 weeks grip strength
23
Q
A

Musculoskeletal (123 decks)

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