Peripheral Neuropathies Flashcards
What is carpal tunnel syndrome
Compression of the median nerve passing through the carpal tunnel in the wrist
What are the nerve roots of the median nerve
C6-T1
What are the two primary causes of compression in Carpal Tunnel Syndrome?
- Swelling of the contents (e.g., tendon sheaths due to repetitive strain).
- Narrowing of the carpal tunnel.
Which branch of the median nerve responsible for sensory innervation of the hand is affected in carpal tunnel syndrome
Palmar digital cutaneous branch
What are some key risk factors associated with Carpal Tunnel Syndrome? (5)
- Age 40-60
- Female
- High BMI
- Pregnancy
- Diabetes, hypothyroid, acromegaly
How does Carpal Tunnel Syndrome typically present in terms of symptom onset and characteristics?
- Onset: gradual, initially intermittent and often worse at night
- Sensory: numbness, paraesthesia, pain
- Motor: weak pincer grip & thumb movements - difficulty opening jars, thenar muscle wasting
Which part of the hand is typically spared in Carpal Tunnel Syndrome, and why?
The palm is usually spared because the palmar cutaneous branch, responsible for its innervation, does not travel through the carpal tunnel.
What are the two special tests used for Carpal Tunnel Syndrome?
Phalen’s test
Tinel’s test
What is considered the diagnostic test of choice for Carpal Tunnel Syndrome and what would be a positive finding?
Electromyography (EMG).
* focal slowing of conduction velocity in the median sensory nerves across the carpal tunnel
What are the management options for Carpal Tunnel Syndrome?
*Rest and altered activities.
* Wrist splints - neutral position, worn every night for 1-2m
* Steroid injections: methylprednisolone
* Severe= surgical release
In surgical intervention for Carpal Tunnel Syndrome, what structure is typically cut to release pressure on the median nerve?
The flexor retinaculum, aka the transverse carpal ligament
What is the most common mononeuropathy
Carpal tunnel syndrome
What are the nerve roots of the median nerve
C5-T1
What group of muscles does the radial nerve mainly innervate
Extensor muscles of the hand
How does a radial nerve palsy present
Wrist drop
