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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome. Objective. Understand definition of Carpal Tunnel Syndrome. Describe the causes of CTS. Identify Risk Factors. Discuss pathophysiology , Clinical manifestations: Variable Symptom Identify Diagnostic Criteria. Identify types of Treatment . .

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Carpal Tunnel Syndrome

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  1. Carpal Tunnel Syndrome

  2. Objective • Understand definition of Carpal Tunnel Syndrome. • Describe the causes of CTS. • Identify Risk Factors. • Discuss pathophysiology , Clinical manifestations: • Variable • Symptom • Identify Diagnostic Criteria. • Identify types of Treatment .

  3. Carpal Tunnel Syndrome Carpal tunnel syndrome is a localized peripheral neuropathy that affects the hands. The median nerve travels from the forearm into your hand through a “tunnel” in your wrist. The bottom and sides of this tunnel are formed by wrist bones. The top of the tunnel is covered by a strong band of connective tissue called a ligament .

  4. Function of CT The tunnel contains nine tendons that connect muscles to bones and work to bend your fingers and thumb. These tendons are covered with a lubricating membrane called synovium.

  5. Epidemiology > Its more common in women .than men

  6. Etiology • Carpal tunnel syndrome is typically the result of increased pressure on the median nerve and tendons in the carpal tunnel This pressure may be a result of arthritis, thyroid disease, trauma or injury to the wrist. is, CTS may be caused by fluid retention due to pregnancy or menopause. • CTS sometimes may be caused by work-related, repetitive activities that involve forceful or awkward movements of the • wrist or fingers.

  7. Risk Factors • Age • Older people are at higher risk than younger. usually occurs between 40 and 60 years of age. • Sex hormones • Hormonal changes appear to play a major role in CTS • Female : Male • 3 : 2 • The explanation for this greater risk is unknown, but it may be related to the smaller size of women's carpal tunnel. • In pregnant women (CTS may occur in both wrists).

  8. Clinical manifestations (Prognosis) • Variable • range from a minor inconvenience to a disabling condition, • depending on its cause and persistence . • Many cases of CTS are mild, and when symptoms don't last long, • they often resolve (disappear) on their own. • CTS can become so crippling that people can no longer • do their jobs or even perform simple tasks at home.

  9. Symptom • Signs of CTS usually are first noticed at night • In hand and fingers: • Numbness . • Loss of movement . • Swelling . • Mild-to-severe pain (may be worse at night( • Decreased sensation • (In severe untreated cases, the muscles at the base of the thumb may effect , and loss of sensation may be permanent.) • Decreased strength. • Other symptoms may include: • Tendency to drop things. • it becomes difficult to hold small objects.

  10. Diagnosing (Investigation) • Physical examination • When you make a hand at a low level for the rest of the body, getting tingling and pain. • When you click on the wrist the patient feels pain or feeling as if an electric shock. • Neurological evaluation • Electromyography • Nerve conduction velocity test • X-ray • MRI

  11. MRI

  12. Treatment Treatment of Carpal Tunnel Syndrome – Splinting Treatment of Carpal Tunnel Syndrome – Use Of Medications Oral medications may be used to relieve the symptoms of carpal tunnel syndrome such as: anti-inflammatory medications oral corticosteroids diuretics Surgical Treatment of Carpal Tunnel Syndrome When conservative treatments fail, surgical decompression of the tunnel by release of the transverse carpal ligament and removal of tissue compressing the median nerve can be beneficial. Even after surgery though, symptoms may recur. It is important to treat carpal tunnel syndrome. Left untreated, there may be permanent nerve or muscle damage.

  13. Watch some video Carpal Tunnel Syndrome http://www.youtube.com/watch?v=C02Nyowvaw8 Carpal tunnel examination http://www.youtube.com/watch?v=xoeJbyR7k4Q&feature=related How open carpal tunnel surgery is carried out http://www.youtube.com/watch?v=N4KYSPWzUCY&feature=related

  14. Source http://www.umm.edu/patiented/articles/how_serious_carpal_tunnel_syndrome_000034_5.htm#ixzz2DGVcI9Y7 http://www.umm.edu/patiented/articles/how_carpal_tunnel_syndrome_diagnosed_000034_7.htm#ixzz2DGXa5m00 http://www.umm.edu/patiented/articles/how_can_carpal_tunnel_syndrome_be_prevented_000034_6.htm#ixzz2DGXMswj2 http://www.umm.edu/patiented/articles/how_serious_carpal_tunnel_syndrome_000034_5.htm#ixzz2DGVcI9Y7 http://www.umm.edu/patiented/articles/who_gets_carpal_tunnel_syndrome_000034_4.htm#ixzz2DGWyRwHa http://www.umm.edu/patiented/articles/what_carpal_tunnel_syndrome_000034_1.htm#ixzz2DGW9Og2R

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