Upper Limb Compressive Neuropathies Flashcards
Carpal Tunnel
Space between the carpal bones of the wrist and the connective tissue (retinaculum) over flexor tendons.
Contains flexor tendons and median nerve
Carpal Tunnel: Flexor Tendons (9)
Flexor Digitorum Superficialis (4 tendons)
Flexor Digitorum Profundus (4 tendons)
Flexor polices longus tendon
Carpal Tunnel Syndrome
Compression of the carpal tunnel causes median nerve compression
Carpal Tunnel Syndrome Aetiology
Idiopathic
Secondary to
- Rheumatoid Arthritis
- Conditions resulting. in fluid. retention (diabetes, pregnancy, CKD, hypothyroidism)
- Fractures around the wrist
Carpal Tunnel Syndrome Epidemiology
More common in females
Carpal Tunnel Syndrome Presentation
Paraesthesia/ clumsiness in the median nerve affected digits
- thumb and radial 2 ½ fingers
pain
- Worse at night
Loss of sensation
Weakness of thumb
Carpal Tunnel Syndrome Examination
Loss of sensation
muscle wasting of thenar eminence
Tinel’s Test
- Percussion over median nerve
Phalen’s Test
- Holds wrists hyperflexed
Carpal Tunnel Syndrome Diagnosis
nerve conduction studies
Carpal Tunnel Syndrome Treatment
Non-surgical
- Wrist splints
- Injection of corticosteroids
Surgical
- Carpal Tunnel decompression
- Division of transverse carpal ligament
Cubital Tunnel Syndrome
Compression of the ulnar nerve.
in the elbow below the medial epicondyle
Cubital Tunnel Syndrome Presentation
Paraesthesia of 1 ½ fingers
Cubital Tunnel Syndrome Tests
Tinel’s Test
Froment’s Test
- Weakness of ulnar innervated muscles may be present
Cubital Tunnel Syndrome Diagnosis
Nerve conduction studies
Cubital Tunnel Syndrome Treatment
Surgical release of tight structures
