Carpal Tunnel Anatomy & Contents (Easy Lesson)

Carpal Tunnel Anatomy has a lot going on and we discuss the syndrome, clinical relevancy, and more in the notes below ⤵️

👋🏼 For Carpal Tunnel Syndrome causes, symptoms, diagnosis, treatment, tests, exercises, injections and pathology (everything you need to know) — read below for a glance. But more soon!

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Carpal Tunnel Syndrome   
  
✅ Overview⁣⁣    
⁣⁣   
It’s a compression of the median nerve as it passes deep to the flexor retinaculum in the wrist. Now when we have compression in this region - we automatically sense tingling, numbness, and pain in the thumb, index, middle, and half of the ring finger. It’s because this nerve passing through the carpal tunnel controls the ‘blue’ part of our hand for its motor and sensory functions. 
   
✅ So we see  
   
*Swelling of the flexor tendons   
*Fibrosis or edema of the surrounding tissue  
*Compressive neuropathy because median nerve has no available space   
   
Pain may also extend up the arm in the forearm. So the affected person has a weaker grip, Also the patient will have issues in dexterity (which is skills of the hand such as when someone writes or draws - they can’t make perfect lines or circles).   
   
Note: Women will feel pain when undoing their bra and men when unbuttoning their top shirt button. 
   
✅ At Risk   
  
People who are obese, pregnant, diabetic OR  
hemochromatosis, rheumatoid arthritis, hypothyroidism   
  
You’ll hear patients complain of pain and paresthesias where the median nerve distributes its innervation.   
  
Severe cases - the motor function is compromised due to more compression, which affects the deeper motor nerves of the median nerve, ultimately causing weakness of thumb abduction & opposition - here we’ll also see atrophy of the thenar eminence.

✅ Causes  
 
Repetitive movements such as typing, drilling, and rapid wrist movements, may cause carpal tunnel syndrome.  
 
✅ So we see 
 
(Important) You’ll notice sparing of the thenar eminence because the palmar cutaneous branch of the median nerve actually enters the hand outside of the carpal tunnel. 
 
✅ Tests  
 
Phalen test: Eliciting the tingling sensation on holding the wrists in extreme flexion with the dorsum (back) side of the hands which are pressed against one another.  
 
Tinel sign: Eliciting tingling sensation when tapping over the median nerve at the wrist.  
 
You can also simply ask patients to raise the hand over the head and do some hyperextension (basically reproducing the symptoms) 
 
✅ Treatments  
 
For mild cases: Wrist splinting, especially during the night time, or during the day if it gets severe. It’s used to immobilize the wrist throughout the day.  
 
For severe cases: Glucocorticoid injections or surgery can be administered/performed  
 
Hope you guys liked this review! We will continue with more this week! As always - be well and don’t worry, you’re already smarter than you think you are. 
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Chapters
0:00 - Intro & Before you begin
0:42 - Draw & label general structure
1:18 - Carpal bones & Flexor retinaculum
2:18 - Let’s Label the contents
3:48 - Carpel Tunnel syndrome
5:02 - Recap & Subscribe!
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