Carpal tunnel syndrome

Question 1

Carpal tunnel syndrome involves the compression of which nerve

Answer 1

the median nerve

Question 2

What is the carpal tunnel made up of and contain?

Answer 2

A concave collection of bones with the flexor retinaculum on the palmar side on top.

Inside is the median nerve along with tendons

Question 3

Causes of carpal tunnel syndrome

Answer 3

Colles fracture, wrist injury.. etc

Question 4

What are the nerve roots of the median nerve

Answer 4

C5-T1 (all of the brachial plexus roots)

Question 5

What muscles are innervated by the median nerve

Answer 5

All of the flexors except flexor carpi ulnaris and part of flexor digitorum profundus which are innervated by the ulnar nerve

And the thenar muscles and lateral two lumbricals

Question 6

What sensory area is innervated by the median nerve

Answer 6

The hand’s palmar side, lateral 3.5 fingers

Question 7

Symptoms of carpal tunnel syndrome

Answer 7

Tingling, numbness or pain in lateral 3.5 fingers
Worse at night, patient shakes it or hangs it over bed to revive it
Pain may radiate up arm
Weakness of grip/opposition

Question 8

If an investigation is required for suspected carpal tunnel syndrome - what is the gold standard?

Answer 8

Electroneurography - see if impulses from proximal to carpal tunnel reach thenar muscles

Question 9

Treatment of carpal tunnel syndrome

Answer 9

Injection of methylprednisolone

Surgical decompression