Carpal tunnel syndrome

528,871views

00:00 / 00:00

Videos

Notes

Carpal tunnel syndrome

Pathology

Central nervous system disorders

Spina bifida

Chiari malformation

Dandy-Walker malformation

Syringomyelia

Tethered spinal cord syndrome

Aqueductal stenosis

Septo-optic dysplasia

Cerebral palsy

Spinocerebellar ataxia (NORD)

Transient ischemic attack

Ischemic stroke

Intracerebral hemorrhage

Epidural hematoma

Subdural hematoma

Subarachnoid hemorrhage

Saccular aneurysm

Arteriovenous malformation

Broca aphasia

Wernicke aphasia

Wernicke-Korsakoff syndrome

Kluver-Bucy syndrome

Concussion and traumatic brain injury

Shaken baby syndrome

Epilepsy

Febrile seizure

Early infantile epileptic encephalopathy (NORD)

Tension headache

Cluster headache

Migraine

Idiopathic intracranial hypertension

Trigeminal neuralgia

Cavernous sinus thrombosis

Alzheimer disease

Vascular dementia

Frontotemporal dementia

Lewy body dementia

Creutzfeldt-Jakob disease

Normal pressure hydrocephalus

Torticollis

Essential tremor

Restless legs syndrome

Parkinson disease

Huntington disease

Opsoclonus myoclonus syndrome (NORD)

Multiple sclerosis

Central pontine myelinolysis

Acute disseminated encephalomyelitis

Transverse myelitis

JC virus (Progressive multifocal leukoencephalopathy)

Adult brain tumors

Acoustic neuroma (schwannoma)

Pituitary adenoma

Pediatric brain tumors

Brain herniation

Brown-Sequard Syndrome

Cauda equina syndrome

Treponema pallidum (Syphilis)

Vitamin B12 deficiency

Syringomyelia

Friedreich ataxia

Neurogenic bladder

Meningitis

Neonatal meningitis

Encephalitis

Brain abscess

Epidural abscess

Cavernous sinus thrombosis

Creutzfeldt-Jakob disease

Central and peripheral nervous system disorders

Sturge-Weber syndrome

Tuberous sclerosis

Neurofibromatosis

von Hippel-Lindau disease

Amyotrophic lateral sclerosis

Peripheral nervous system disorders

Spinal muscular atrophy

Poliovirus

Guillain-Barre syndrome

Charcot-Marie-Tooth disease

Trigeminal neuralgia

Bell palsy

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Sciatica

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Autonomic nervous system disorders

Orthostatic hypotension

Horner syndrome

Nervous system pathology review

Congenital neurological disorders: Pathology review

Headaches: Pathology review

Seizures: Pathology review

Cerebral vascular disease: Pathology review

Traumatic brain injury: Pathology review

Spinal cord disorders: Pathology review

Dementia: Pathology review

Central nervous system infections: Pathology review

Movement disorders: Pathology review

Neuromuscular junction disorders: Pathology review

Demyelinating disorders: Pathology review

Adult brain tumors: Pathology review

Pediatric brain tumors: Pathology review

Neurocutaneous disorders: Pathology review

Assessments

Carpal tunnel syndrome

Flashcards

0 / 8 complete

USMLE® Step 1 questions

0 / 2 complete

USMLE® Step 2 questions

0 / 2 complete

High Yield Notes

10 pages

Flashcards

Carpal tunnel syndrome

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 45-year-old woman presents to her primary care physician to evaluate bilateral wrist pain. The patient has worse pain at night and is associated with paresthesias of the first, second, third, and half of the fourth finger. She states, “I need to figure out what is going on. I can barely sleep at night.” Past medical history includes hypertension, type II diabetes mellitus, rheumatoid arthritis, and obesity. She smokes a pack of cigarettes daily and drinks two to three beers nightly. She currently works as an office secretary. Vital signs are within normal limits, and physical examination does not reveal any deformity or swelling of the wrist. Which of the following will best assist in diagnosing this patient’s underlying condition?  

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Acromegaly p. 345

carpal tunnel syndrome p. 456

Amyloidosis

carpal tunnel syndrome p. 456

Arthritis p. 476

carpal tunnel syndrome and p. 456

Carpal tunnel syndrome p. 455

lunate disclocation p. 456

median nerve injury p. 455

rheumatoid arthritis p. 476

Diabetes mellitus p. 352-360

carpal tunnel syndrome p. 456

Hypothyroidism p. 346, 347

carpal tunnel syndrome and p. 456

Median nerve

carpal tunnel syndrome p. 455

Pregnancy p. 657

carpal tunnel syndrome and p. 456

Rheumatoid arthritis p. 476

carpal tunnel syndrome and p. 456

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Tanner Marshall, MS

Contributors

Tanner Marshall, MS

Carpal tunnel syndrome is a nerve entrapment disorder that results from compression of the median nerve which winds its way through the wrist through a narrow passageway called the carpal tunnel.

This compression typically causes pain, numbness, and tingling in the thumb, index finger, middle finger, and the thumb side of the ring finger, which are the areas of skin innervated by the median nerve.

Now taking a cross section of the wrist, we’ll see a bony arch known as a carpal arch on the dorsal side of the hand which forms the floor of the carpal tunnel, and a sheath of connective tissue called the flexor retinaculum or transverse carpal ligament, which is on the palmar side of the hand forms the roof of the carpal tunnel.

Also there are nine flexor tendons, which go to the fingers and thumb, as well as one nerve—the median nerve—which travels down the forearm and go through the carpal tunnel.

The skin of the hand served by the median nerve includes the thumb, the index finger, and middle finger, as well as half of the ring finger that’s on the thumb side.

The other side of the ring finger and pinky are served by the ulnar nerve, and the back of the hand’s served by the radial nerve, only the median nerve goes through the carpal tunnel.

Carpal tunnel syndrome is caused by compression of the median nerve, and that typically happens as a result of inflammation of the nearby tendons and tissues, which creates local edema or swelling which increases the amount of fluid in a very tight space, and essentially puts pressure on the median nerve.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Diagnosing and managing carpal tunnel syndrome in primary care" British Journal of General Practice (2014)
  6. "The Quality and Strength of Evidence for Etiology: Example of Carpal Tunnel Syndrome" The Journal of Hand Surgery (2008)
  7. "Prevalence of Carpal Tunnel Syndrome in a General Population" JAMA (1999)
Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

RELX