Nerve entrapment Flashcards
Aetiology of carpal tunnel syndrome
- congenital
- acquired
traumatic
developmental
inflammatory
infective
metabolic
degenerative
neoplastic
postural
idiopathic
Symptoms of carpal tunnel syndrome
numbness altered sensation Dysaesthesia (abnormal unpleasant feeling) clumsiness night awakening pain
Special test for Carpal tunnel syndrome?
Tinnels test
(hammer hitting carpal tunnel area)
Phalens’ test (hold hands back to back)
Investigations for carpal tunnel syndrome?
Nerve conduction studies PV X-ray T4 blood glucose
Why would you check T4 levels in carpal tunnel syndrome?
Hypothyroidism can cause carpal tunnel syndrome
Can hypothyroidism cause carpal tunnel syndrome?
Yes
Why might you check glucose in carpal tunnel syndrome?
Diabetes/pre diabetes can cause carpal tunnel syndrome
Non-operative treatment for carpal tunnel syndrome
corticosteroid injection
splint
workplace task modification
How is your wrist kept in the splint for carpal tunnel syndrome?
Wrist is kept in flexion
Indications for decompression for carpal tunnel syndrome?
Failed conservative treatment Constant numbness Weakness Operative treatment: Standard open carpal tunnel release (endoscopic or mini-open) Arthroscopic
Opposition and adduction of thumb in carpal tunnel syndrome?
May have weakness, may not be able to do it very well (opposition and adduction of thumb= when you pinch your thumb and pinky together)
Which fingers are likely to tinger in cubital tunnel syndrome?
The ring and little fingers
- Pain and numbness in elbow
- Eventually you may develop a claw like deformity if you have really bad cubital tunnel syndrome
Which nerve is compressed in cubital tunnel syndrome?
The ulnar nerve
Which muscles in the hand does the Ulnar nerve supply?
The ulnar nerve is the principle motor supply to the intrinsic muscles of the hand
Froment’s sign in cubital tunnel syndrome?
Positive froments sign caused by ulnar nerve palsy
i.e. when they grip something with their thumbs, it will bend
