Wrist/Hand Pathology - Median N Compression/Carpal Tunnel Syndrome Flashcards
The carpal tunnel is made up of the ? bones, covered by the flexor ?.
It contains ? flexor ? (4 flexor digitorum ?, 4 flexor
digitorum ?, and 1 flexor pollicis ?), and the ? nerve.
Carpal tunnel syndrome is a ? ? of the ? nerve as
it passes through the carpal tunnel.
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It is technically median nerve compression until there is ? ? wasting, at which point it can be called carpal tunnel syndrome.
Most cases (95%) are ?, but entrapment is also seen in a range of other conditions;
o ??, ??, hyp?thyroidism, ?and trauma (?’ fracture).
It is three times more common in ?.
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Presentation;
Pain / ? in the hand, worst in the ?;
o Due to wrist ? when asleep.
o May wake the patient from sleep, and they ‘?’ the hand or ? it over the side of the bed for relief.
paraesthesia morning flexion shake hang
Presentation
? muscle weakness/?, first noticed as ‘?’;
o E.g. ? shopping bags due to loss of ? strength.
? loss in the ?/ radial 3 ½ fingers (rarely noticed).
thenar wasting clumsiness dropping opposition sensory palm
On examination;
0 LOOK: ? to see, thenar ? in advanced cases.
0 FEEL: maybe reduced thenar ? (? pollicis ? first to go).
0 MOVE: active thumb ? and active thumb ? affected.
0 TEST: Positive ? (tapping leads to paraesthesia) and ? (phlexion for ? leads to pain) test positive. Test ? between sides, and between ? on the same side.
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Nerve ? studies showing ? at the wrist indicates compression, but nerve tests can still be ?.
Management ;
Conservative: ?, night time ?, ?/ steroid injections to reduce ? around the tunnel can be effective.
Surgical: division of the ? ?(leads to a scar in the ?).
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