Carpal Tunnel Syndrome Symptoms and Special Tests

Wrist stability primarily provided by the ligaments = A Most common cause is a fall with the wrist hyperextended = B Wrist sprains are usually self-limiting = C Once sprained, the ligaments are lax = D

Finklestein’s Test = Oppose and hold thumb under other digits.Then actively ulnar deviate and evaluate.Pain is positive test Tinel's Sign Test = Tapping over the median nerve at the wrist crease elicits tingling or pins and needles sensation in the distribution of the median nerve

Wrist and thumb immobilization, modalities, to decrease swelling and pain = A Resistance exercise of affected area must focus on contractions that do not produce symptoms = B Possible use of corticosteroids = C Post-op care resembles that of CTS = D

<p>Pain and swelling at the radial styloid = A Reduced motion of the thumb = B</p> Signup and view all the answers

<p>Provides support for the hand's arches = A Assists in grip strength during functional activities = B</p> Signup and view all the answers

<p>DeQuervain's Tenosynovitis affects tendons of the abductor pollicis longus and extensor pollicis brevis = A Results from repetitive ulnar deviation (stress of thumb tendons from ulnar deviation) = B</p> Signup and view all the answers

<p>Radial collateral ligament = Attaches to radial styloid and trapezium and scaphoid; provides lateral support Ulnar collateral ligament = Attaches to ulnar styloid and pisiform and triquetrum; provides medial support Palmar radiocarpal ligament = Limits wrist extension; attaches to the anterior ulna and radius and to the anterior surface of the proximal carpals Dorsal radiocarpal ligament = Limits wrist flexion; attaches from posterior surface of the distal radius to posterior scaphoid, lunate, and triquetrum</p> Signup and view all the answers

<p>Palmar radiocarpal ligament = Located on the anterior side; limits wrist extension Dorsal radiocarpal ligament = Located on the posterior side; limits wrist flexion Radial collateral ligament = Provides lateral support to the wrist joint Ulnar collateral ligament = Provides medial support to the wrist joint</p> Signup and view all the answers

<p>Palmar fascia (palmar aponeurosis) = Superficial triangular fascia on palm of hand; attachment for palmaris longus and flexor retinaculum Radial collateral ligament = Provides lateral support to the wrist joint Ulnar collateral ligament = Provides medial support to the wrist joint Dorsal radiocarpal ligament = Limits wrist flexion</p> Signup and view all the answers

<p>Carpal Tunnel Syndrome (CTS) = Affects 4% of the entire US workforce; involves entrapment of median nerve within carpal tunnel Radial collateral ligament injury = Results in compromised lateral support of the wrist joint Ulnar collateral ligament injury = Results in compromised medial support of the wrist joint Palmar fascia inflammation = Leads to pain and stiffness in the palm of the hand</p> Signup and view all the answers

<p>Phalen's test = Used to diagnose Carpal Tunnel Syndrome (CTS) Tinel's sign = Used to assess for median nerve irritation in Carpal Tunnel Syndrome (CTS) Finkelstein test = Used to diagnose De Quervain tenosynovitis Watson shift test = Used for Scapholunate instability evaluation</p> Signup and view all the answers

<p>Transverse ligament = Responsible for holding the carpal bones together and forming the carpal tunnel Dorsal radiocarpal ligament = Supports the dorsal aspect of the wrist joint Palmar radiocarpal ligament = Provides stability to the palmar aspect of the wrist joint Triangular fibrocartilage complex (TFCC) = Supports the distal radioulnar joint and helps in load transmission</p> Signup and view all the answers

<p>Palmar fascia = Provides support and protection to the structures in the palm of the hand Flexor retinaculum = Forms the roof of the carpal tunnel and protects structures passing through it Palmar aponeurosis = A thickening of the palmar fascia that helps maintain grip strength Ulnar collateral ligament of wrist = Supports the ulnar side of the wrist joint</p> Signup and view all the answers

<p>Carpal tunnel syndrome = Numbness and tingling in median nerve distribution, pain in wrist, weak grip in thumb action De Quervain's tenosynovitis = Pain at base of thumb, swelling in hand and forearm, clumsiness in hand activities Wrist ganglion cyst = Visible or palpable lump on wrist, discomfort with wrist movement, possible weakness in grip strength Intersection syndrome = Pain and swelling 2-3 inches above wrist, pain with wrist flexion and extension, possible crepitus</p> Signup and view all the answers

<p>Phalen's test = To provoke tingling by wrist flexion to diagnose carpal tunnel syndrome Tinel's sign = To stimulate tingling response in median nerve by tapping ventral wrist Digital Allen Test = To evaluate circulatory recovery by assessing color return to both sides of palm evenly Finkelstein's test = To diagnose De Quervain's tenosynovitis by causing pain at base of thumb</p> Signup and view all the answers

<p>Splinting in 0-20 degrees of extension = To immobilize the affected wrist and reduce symptoms from certain motions ASTYM therapy = May be a better choice than surgery for carpal tunnel syndrome due to scarring risks associated with surgery Immobilization for 2 to 14 days = Encourages improper scar tissue development and may not be an effective long-term solution Exercise of affected limb primarily focusing on elbow and shoulder ROM = To strengthen the affected wrist as tolerated and maintain range of motion</p> Signup and view all the answers

<p>Transverse ligament = Digital Allen Test - tests radial and digital artery by compressing arteries and evaluating circulatory recovery Dorsal radiocarpal ligament = Palmar radiocarpal ligament = Triangular fibrocartilage complex (TFCC) =</p> Signup and view all the answers