Carpal Tunnel Syndrome CAT Flashcards
What creates the carpal tunnel?
- Transverse carpal ligament
- Scaphoid tuberosity
- Trapezium
- Hook of the hamate and pisiform
- Volar radiocarpal ligament
- Volar ligamentous extensions b/t carpal bones
What causes carpal tunnel syndrome?
Compression of the median nerve
Normal pressure in the carpal tunnel?
2-10 mmHg
What is the pressure present in carpal tunnel syndrome?
> 30 mmHg, which increases w/ flexion and extension at the wrist
What demographics are most impacted by carpal tunnel syndrome?
- 35-55 years old
- Females > males
Clinical presentation for carpal tunnel syndrome
- Sensory and motor disturbances along the medial nerve distribution of the hand
- May radiate into the upper extremity, shoulder, and neck
Symptoms of carpal tunnel syndrome
- Weakness of the hand
- Muscle atrophy
- Decreased grip strength
- Decreased wrist mobility
- Night pain
Which muscles are most susceptible to atrophy?
Abductor pollicis brevis, progresses to thenar muscles
What imaging is used with carpal tunnel?
- EMG and electroneurographic studies to test the nerves
- MRI to ID inflammation of the median nerve
What tests are used for confirming diagnosis?
- Tinel’s sign
- Phalen test
Pharmacological management of carpal tunnel syndrome
- methylprednisolone injected proximal to the tunnel
Conservative management of carpal tunnel syndrome
- Corticosteroids
- Splinting
- Physical therapy
Timeline for treatment of carpal tunnel syndrome
4-6 weeks, possibly 6-8 weeks
What condition is similar to carpal tunnel syndrome?
- Compression in the tunnel of Guyon
- Presents w/ paresthesias along the ulnar distribution, weakness and atrophy of the hypothenar musculature, decreased mobility of the pisiform, and impaired grip strength
