carpal tunnel syndrome

Question 1

what is carpal tunnel syndrome

Answer 1

compression of median nerve

Question 2

management of carpal tunnel syndrome

Answer 2

splintage
diagnostic steroid injection
surgery

Question 3

causes of carpal. tunnel

Answer 3

• Mostly idiopathic
• Can occur secondary to many conditions
  
  • RA - synovitis means less space
  • Acromegaly
  • Conditions resulting in fluid retention e.g. pregnancy, diabetes, chronic renal failure, hypothyroidism
    
    • In pregnancy the symptoms usually subside after birth
• Can be a consequence of fractures around the wrist
• Women affected up to 8x more than men

Question 4

are nerves sensitive to pressure

Answer 4

yes

Question 5

what is carpal relieved with

Answer 5

shaking of the hand

Question 6

symptoms of carpal tunnel syndrome

Answer 6

• Parathesiae in the median nerve innervated digits (thumb and radial 3½ fingers) which is usually worse at night
• Loss of sensation and sometimes weakness of the thumb
• Relieved by shaking the hand
• Palmar sensation often spared
• Clumsiness in the areas of the hand supplied by the median nerve

Question 7

what tests reproduce the symptoms

Answer 7

Tinel’s test (percussing over the median nerve) or Phalen’s test (holding the wrists hyper‐flexed, which decreases space in the carpal tunnel)

Question 8

surgical intervention of carpal tunnel

Answer 8

• Carpal tunnel decompression involves division of the transverse carpal ligament under local anaesthetic
• Usually a highly successful operation, although there is risk of damage to the median nerve or one of its smaller branches

Question 9

where does the median nerve supply sensory innervation to

Answer 9

palmar aspect of hand, thumb, index, middle and radial half of ring finger

Question 10

where dos the median nerve supply motor innervation to

Answer 10

LOAF muscles- below thumb and mjuscles coming down from middle and first finger