Carpal Tunnel Flashcards

1
Q

define carpal tunnel

A

distal pain, numbness and weakness from median nerve entrapment and compression at the wrist

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2
Q

which nerve is involved in carpal tunnel

A

median

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3
Q

where do people experience carpal tunnel pain

A

palmar aspects of thumb, index finger, middle finger and radial aspect of 4th finger

nocturnal

relief attempted by shaking fingers

pain may radiate up forearm

aggravated by activity

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4
Q

how does carpal tunnel weakness present

A

grasping and pinching is difficult

possible thenar atrophy

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5
Q

what causes carpal tunnel

A

repetitive trauma

systemic diseases

rule out cervical abnormality and underlying conditions

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6
Q

what systemic diseases can cause carpal tunnel

A
diabetes
RA
pregnancy
hypothyroid
hyperparathyroid
amyloidosis
sarcoidosis
acromegaly
AV dialysis shunt
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7
Q

physical exam for carpal tunnel

A

exam for atrophy of the thenar group

pinprick and light touch over hand

Phalens test

Tinels sign

examine neck for abnormalities

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8
Q

what is phalen’s test

A

30-60 seconds of wrist flexion exagerrates or reproduces pain

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9
Q

what is tinels sign

A

paresthesias or pain when tapping on the carpal tunnel

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10
Q

what investigations should be done for carpal tunnel

A

clinical diagnosis

can consider nerve conduction studies or blood work for other etiologies

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11
Q

treatment of carpal tunnel

A

rest, modify hand activity

splinting

NSAIDs

steroid injection

surgical decompression

treat underlying conditions

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