Carpal Tunnel Syndrome

Question 1

What is carpel tunnel syndrome.

Answer 1

Compression of the median nerve within the carpal tunnel (deep to the flexor retinaculum).

Question 2

What is carpel tunnel syndrome associated with. (4)

Answer 2

Pregnancy.
Rheumatoid arthritis.
Acromegaly.
Hypothyroidism.

Question 3

What are the clinical sings of carpel tunnel syndrome. (4)

Answer 3

Pain and paraesthesia in radial three digits (especially at night) - pain is relieved by hanging the hand over the edge of the bed and shaking in ‘wake ad shake’.
Pain and paraesthesia in arm.
Wasting of the thenar muscles.
Light touch, 2 point discrimination and sweating may be impaired.

Question 4

What are the treatment options of carpel tunnel syndrome. (2)

Answer 4

Conservative.

Surgical.

Question 5

What is conservative management of carpel tunnel syndrome.

Answer 5

Splinting.

Question 6

What is surgical management of carpel tunnel syndrome. (2)

Answer 6

Steroid injection.

Surgical carpal tunnel decompression (division of flexor retinaculum).

Question 7

What are some causes of median nerve entrapment. (11)

Answer 7

MEDIAN TRAPS.

Myxoedema. 
Enforced flexion. 
Diabetic neuropathy. 
Idiopathic. 
Acromegaly. 
Neoplasms. 
benign Tumours (lipomas, ganglioma). 
Rheumatoid arthritis. 
Amyloidosis. 
Pregnancy/premenstrual oedema. 
Sarcoidosis.

Question 8

What is Tinel’s test.

Answer 8

Tapping over the nerve at the wrist induces tingling in carpel tunnel syndrome (non specific).

Question 9

What is Phalen’s test.

Answer 9

Maximal wrist flexion for 1min may elicit symptoms (unreliable).