Upper Limb Compressive Neuropathies Flashcards Preview

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Flashcards in Upper Limb Compressive Neuropathies Deck (19):

What is the carpal tunnel of the wrist formed by?

Carpal bones and flexor retinaculum


Which nerve passes through the carpal tunnel?

Median nerve


As well as the median nerve, what else passes through the carpal tunnel?

9 flexor tendons

(Flexor digitorum superficialis - 4 tendons, Flexor digitorum profundus - 4 tendons and Flexor pollicis longus tendon)


What is the principle behind carpal tunnel syndrome?

Compression of the carpal tunnel causes median nerve compression


Most cases of carpal tunnel syndrome are __________



Carpal tunnel syndrome can occur secondary to which pathologies?

  1. RA
  2. Conditions resulting in fluid retention e.g. pregancy, diabetes, chronic renal failure, hypothyroidism
  3. Fractures around the wrist


A Colles' fracture is a fracture associated with carpal tunnel syndrome, what is it?

A fracture of the distal radius in which the fractured radius bend backwards


Which sex is affected more by carpal tunnel syndrome?



How will patients with carpal tunnel present?

  1. Parasthesia/clumsines in median nerve affected digits - thumb and radial 2 1/2 fingers
  2. Pain is usually worse at night 
  3. Loss of sensation
  4. Weakness of thumb


What may be found on examination for carpal tunnel syndrome?

  1. Loss of sensation
  2. Muscle wasting at thenar eminence


Which tests can reproduce symptoms of carpal tunnel syndrome?

  1. Tinel's test - pecussion over medial nerve
  2. Phalen's test - holds wrists hyper-flexed


How can carpal tunnel syndrome be diagnosed?

Nerve conduction studies


What are the treatment options for carpal tunnel syndrome?

  1. Non surgical - wrist splints, injection of corticosteroid
  2. Surgical - carpal tunnel decompression (division of transverse carpal ligament)


Cubital tunnel syndrome involves compression of which nerve?

Ulnar nerve


Where does compression of the ulnar nerve take place in cubital tunnel sydrome?

Elbow behind the medial epicondyle


How do patients present with cubital tunnel syndrome?

Parasthesia of ulnar 1 1/2 fingers


Which clinical tests can aid in the diagnosis if cubital tunnel syndrome

Tinel's test (over cubital fossa)

Froment's test - weakness of ulnar innervated muscles may be present e.g. adductor pollicis - the patient is asked to hold an object between their thumb and index finger and the examiner tried to pull it out



What may cause compression of the ulnar nerve in cubital tunnel syndrome?

Osbourne's fascia - ight band of fascia forming around the roof of the tunnel


What can confirm the diagnosis of cubital tunnel syndrome?

Nerve conduction studies

(surgical release of any tight structures may then be required)

Decks in The Musculoskeletal System Class (58):