Symptoms Of The Carpal Tunnel Syndrome

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Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a common complaint in patients seen by the Family Nurse Practitioner (FNP). Patients that complain of numbness, tingling or pain to the first three fingers and part of the ring finger of the hand are describing CTS. The patient may also complain of weakness to the affected hand. In patients that have experiences these symptoms chronically, there may also be muscle wasting to the thenar eminence near the base of the thumb (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The typical patient that has symptoms of CTS is a pregnant or middle aged female as women are more likely than men to for CTS. Typically, the symptoms worsen at night and the patient may be wakened from sleep by wrist or
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Thus, CTS can be triggered by hormonal changes, underlying musculoskeletal disorders and diseases that cause fluid retention. Carpal tunnel syndrome also has a genetic predisposition as it runs in families. The transverse carpal ligament, also known as the flexor retinaculum, and the carpal bones of the wrist form the carpal tunnel. The structures that pass through the flexor retinaculum include the median nerve and nine flexor tendons from the forearm Carpal tunnel syndrome occurs when excess pressure to the median nerve occurs, causing entrapment and peripheral neuropathy (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The resulting symptoms may occur in the hand and…show more content…
The symptoms of pain, numbness, tingling or weakness are the result of the inflammatory process within the carpal tunnel that leads to compression of the median nerve. The compression and resulting impingement of the median nerve results in ischemia. The ischemia leads to the symptoms of numbness, tingling, pain and weakness of the hand and/or forearm. The FNP should inspect the wrist and hands of the patient with symptoms of CTS, looking for skin color and temperature changes, deformities and muscle wasting. The active and passive range of motion (ROM) of the neck, shoulders, elbows, wrists and fingers should be accessed. Muscle strength should be assessed at the shoulder, elbow, wrist and fingers. Spurling’s test for cervical radiculopathy should be performed. A plain x-ray can be ordered by the FNP if ROM of the wrist is limited. The FNP should also assess capillary refill of the fingers (Dunphy, Winland-Brown, Porter, & Thomas,
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