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18 Cards in this Set
- Front
- Back
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1. Mechanism of Carpal Tunnel Syndrome (CTS) Disorder?
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a. Compression of Median nerve.
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2. What is affected by CTS?
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a. Paraesthesias of the Radial three fingers and sometimes hand weakness.
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3. Relationship of median nerve to transverse carpal ligament?
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a. Dorsal to it.
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4. Best initial management of CTS?
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i. Night-time splint for wrist and avoidance of excessive activity of the hand.
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5. What is exacerbation of CTS sx at night thought to be caused by?
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a. Oedema
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6. With what 6 systemic conditions is CTS associated?
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1. Endocrine conditions
2. Diabetes 3. Myxedema 4. Hyperthyroidism/Hypothyroidism 5. Acromegaly 6. Pregnancy |
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7. With what other conditions id CTS associated?
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a. Autoimmune disorders
b. Lipomas of the canal c. Bone abnormalities d. Hematomas |
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8. Who is more commonly affected by CTS, men or women?
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a. Women 3:1.
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9. How is CTS diagnosed?
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a. Clinically.
b. The exertion of direct digital pressure by the examiner over the median nerve at the carpal tunnel frequently reproduces the symptoms in approximately 30 seconds. c. Also Phalen’s and Tinels |
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10. What signs on physical exam may be seen in CTS?
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a. Sensory loss, particularly vibration sense, and motor loss may be present w/thenar muscle wasting and decreased abductor muscle resistance.
b. Note: Because CTS is found bilaterally in up to half of pts, comparison to the contralateral hand can be misleading. |
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11. What else can be used to dx CTS?
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a. Electrophysiologic studies.
b. Radiographs, including a “carpal tunnel view” are recommended to detect arthritis or fractures c. MRI and CT are rarely needed unless a pt is symptomatic w/equivocal EMG findings. |
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12. What test has the greatest sensitivity and specificity in the evaluation of CTS?
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a. MRI.
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13. Tx of CTS?
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a. Splints and NSAIDs.
i. Splints should be light and hold the wrist in a neutral or slightly extended position. b. Local steroid injections are effective in 80-90% of pts, but sx tend to return after months or sometimes years. c. Injections should not be give more frequently than 2-3 occasions per year. |
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14. When is surgery indicated for CTS?
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a. For intractable sx that are refractory to medical management.
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15. What does surgery for CTS consist of?
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a. Complete division of the transverse carpal ligament extending distally from the ulnar side of the median nerve.
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16. Sensory innervation of the little finger and ulnar side of ring finger is by what nerve?
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a. Ulnar nerve.
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17. Is Diabetes Insipidus associated with CTS?
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a. No
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18. What might you do when the clinical findings are present but the EMG studies are equivocal?
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a. MRI
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