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Carpal tunnel
 
 
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The human
Human

A human being, also human or man, is a member of a species of bipedalism primates in the family Hominidae . Mitochondrial DNA evidence indicates that modern humans originated in east Africa about 200,000 years ago....
 wrist
Wrist

In human anatomy, the wrist is the flexible and narrower connection between the forearm and the hand. The wrist is essentially a double row of small short bones, called carpals, intertwined to form a malleable hinge....
 contains a sheath
Sheath

Sheath may refer to:* Scabbard, a container for a sword or other large blade* Condom, a kind of contraception* Vagina, the internal structure of the female genitalia...
 of tough connective tissue
Connective tissue

Connective tissue is a form of fibrous biological tissue.It is one of the four types of tissue in traditional classifications .Collagen is the main protein of connective tissue in animals and the most abundant protein in mammals, making up about 25% of the total protein content....
 (the flexor retinaculum
Flexor retinaculum of the hand

The flexor retinaculum is a strong, fibrous band, which arches over the carpus, converting the deep groove on the front of the carpal bones into a tunnel, the carpal tunnel, through which the Flexor tendons of the digits and the median nerve pass....
) which envelops and protects several structures. The carpal tunnel is the space between this sheath (above) and the bones (below) making up the wrist and hand (carpal bones).


Some sources also include the flexor carpi radialis, although it is more precise to state that it travels in the flexor retinaculum
Flexor retinaculum of the hand

The flexor retinaculum is a strong, fibrous band, which arches over the carpus, converting the deep groove on the front of the carpal bones into a tunnel, the carpal tunnel, through which the Flexor tendons of the digits and the median nerve pass....
 which covers the carpal tunnel, rather than running in the tunnel itself.



term 'carpal tunnel' is also used quite commonly to refer to 'carpal tunnel syndrome
Carpal tunnel syndrome

Carpal tunnel syndrome , or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand....
' which is a condition where the median nerve is compressed within the tunnel and causes pain and/or numbness of the wrist/hand, never proven to be the result of repetitive motion such as painting
Painting

Painting is the practice of applying paint, pigment, color or other medium to a surface . In art, the term describes both the act and the result, which is called a painting....
 or typing.






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Encyclopedia


The human
Human

A human being, also human or man, is a member of a species of bipedalism primates in the family Hominidae . Mitochondrial DNA evidence indicates that modern humans originated in east Africa about 200,000 years ago....
 wrist
Wrist

In human anatomy, the wrist is the flexible and narrower connection between the forearm and the hand. The wrist is essentially a double row of small short bones, called carpals, intertwined to form a malleable hinge....
 contains a sheath
Sheath

Sheath may refer to:* Scabbard, a container for a sword or other large blade* Condom, a kind of contraception* Vagina, the internal structure of the female genitalia...
 of tough connective tissue
Connective tissue

Connective tissue is a form of fibrous biological tissue.It is one of the four types of tissue in traditional classifications .Collagen is the main protein of connective tissue in animals and the most abundant protein in mammals, making up about 25% of the total protein content....
 (the flexor retinaculum
Flexor retinaculum of the hand

The flexor retinaculum is a strong, fibrous band, which arches over the carpus, converting the deep groove on the front of the carpal bones into a tunnel, the carpal tunnel, through which the Flexor tendons of the digits and the median nerve pass....
) which envelops and protects several structures. The carpal tunnel is the space between this sheath (above) and the bones (below) making up the wrist and hand (carpal bones).

Contents

  • Tendons of the following muscles (not the muscles themselves):
    • flexor digitorum profundus
    • flexor digitorum superficialis
    • flexor pollicis longus


Some sources also include the flexor carpi radialis, although it is more precise to state that it travels in the flexor retinaculum
Flexor retinaculum of the hand

The flexor retinaculum is a strong, fibrous band, which arches over the carpus, converting the deep groove on the front of the carpal bones into a tunnel, the carpal tunnel, through which the Flexor tendons of the digits and the median nerve pass....
 which covers the carpal tunnel, rather than running in the tunnel itself.

  • Nerves:
    • Median nerve
      Median nerve

      The median nerve is a nerve that runs down the arm and forearm. It is one of the five main nerves originating from the brachial plexus.The median nerve is formed from parts of the medial and lateral cords of the brachial plexus, and continues down the arm to enter the forearm with the brachial artery....
       between tendons of Flexor digitorum profundus and Flexor digitorum superficialis


Clinical significance

The term 'carpal tunnel' is also used quite commonly to refer to 'carpal tunnel syndrome
Carpal tunnel syndrome

Carpal tunnel syndrome , or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand....
' which is a condition where the median nerve is compressed within the tunnel and causes pain and/or numbness of the wrist/hand, never proven to be the result of repetitive motion such as painting
Painting

Painting is the practice of applying paint, pigment, color or other medium to a surface . In art, the term describes both the act and the result, which is called a painting....
 or typing. (However, the idea that Carpal Tunnel can be diagnosed using 'Pain' is quite controversial. Pain is a sensation and therefore is interpreted by the cortex of the brain which receives information from a sensory neuron which was first stimulated by a sensory receptor peripherally. The sensory component of the median nerve is above the flexor retinaculum. This retinaculum is what initiates and compresses the median nerve and distrupts nerve flow, but only to the motor component of the nerve, which is below the retinaculum. Therefore, for irritation to occur, the structures or nerves have to be located below the flexor retinaculum and because the sensory component is above it anatomically, this leads some clinicians to believe pain, tingling, and pins & needles (which are sensory) to not be associated as part of the diagnosis involving a patient with Carpal Tunnel) It has been shown to be associated with obesity
Obesity

Obesity is a condition in which excess body fat has accumulated to an extent that health may be negatively affected. It is commonly defined as a body mass index of 30 kg/m2 or higher....
, hypothyroidism
Hypothyroidism

Hypothyroidism is the disease state in humans and in animals caused by insufficient production of thyroid hormone by the thyroid gland. Cretinism is a form of hypothyroidism found in infants....
, diabetes, pregnancy
Pregnancy

Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or Multiple birth....
, family history, rheumatoid arthritis
Rheumatoid arthritis

Rheumatoid arthritis is a chronic, systemic disease inflammation that may affect many tissues and organs, but principally attacks the joints producing a inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints....
 and wrist shape. It can be associated with certain fractures of the forearm and wrist. Work relatedness is less than is currently thought by the lay public and by non-hand surgeons. Even work that has high force and high repetitions is only partially related to the development of carpal tunnel syndrome. The carpal tunnel is important because the median nerve can be compressed in cases such as the following:
  • Carpal tunnel syndrome
    Carpal tunnel syndrome

    Carpal tunnel syndrome , or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand....
  • Wrist dislocations
    Dislocation (medicine)

    Joint dislocation, or luxation , occurs when bones in a joint become displaced or misaligned. It is often caused by a sudden impact to the joint....
  • Fractures around the wrist


See also

  • tarsal tunnel
    Tarsal tunnel

    The tarsal tunnel is found along the inner leg behind the medial malleolus.The tarsal tunnel is made up of bone on the inside and the flexor retinaculum on the outside....


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