Raj. CHO -2025: Carpal tunnel syndrome during pregnancy affects which of the following areas?

Raj. CHO -2025

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2025

Explanation

Carpal tunnel syndrome (CTS) results from the compression of the median nerve at the wrist.
The median nerve is responsible for providing sensation to the palmar side of the thumb, the index finger, the middle finger, and the lateral half of the ring finger.
Therefore, compression of this nerve causes characteristic symptoms like numbness, tingling, and pain primarily in the thumb, index, and middle fingers.

Option B: While the nerve compression occurs at the wrist, the most prominent symptoms (numbness and tingling) are experienced distally in the fingers. Limiting the affected area to 'wrist only' is inaccurate.
Option C: The little finger's sensation is supplied by the ulnar nerve, not the median nerve. Therefore, it is not affected in carpal tunnel syndrome.
Option D: The symptoms of CTS are localized to the specific distribution of the median nerve. While pain can sometimes radiate proximally up the forearm, it does not typically affect the entire arm.

Visual 1: Diagram - An illustration of the carpal tunnel in the wrist, showing the median nerve passing underneath the transverse carpal ligament along with the flexor tendons. This helps visualize the site of compression.
Visual 2: Hand Map - A color-coded diagram of the hand showing the distinct sensory territories of the median, ulnar, and radial nerves. This clearly demonstrates why CTS affects specific fingers.

Clinical Relevance

Nursing practice connection: Knowing Anatomical basis and symptom distribution of Carpal Tunnel Syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses should be aware that CTS is common during the second and third trimesters of pregnancy due to hormonal changes and fluid retention. Assessment should include checking for Tinel's sign (tapping the nerve) and Phalen's maneuver (wrist flexion).
Initial management is conservative and focuses on relieving pressure. This includes advising the patient to wear a neutral wrist splint, especially at night, to prevent wrist flexion and reduce symptoms.
Symptoms of CTS during pregnancy usually resolve on their own within a few weeks to months after delivery as fluid levels normalize.

How to Approach the Question

First, identify the core medical condition in the question stem: 'Carpal tunnel syndrome'.
Recall the basic pathophysiology of this condition, which is the compression of a specific nerve at the wrist.
Identify the nerve involved: the median nerve.
Access your knowledge of anatomy to determine the sensory distribution of the median nerve in the hand.
Evaluate each option based on this anatomical knowledge. The median nerve supplies the thumb, index, middle, and half of the ring finger.
Eliminate the options that are clearly incorrect: the 'little finger' (ulnar nerve), the 'entire arm' (too broad), and 'wrist only' (incomplete description of symptoms).

Concept Tested & Keywords

Concept Tested: Anatomical basis and symptom distribution of Carpal Tunnel Syndrome.
Stem keywords: Carpal tunnel syndrome, pregnancy, affects
Lead-in keywords: which of the following areas
Clinical cues: The mention of 'pregnancy' is a clinical cue, as fluid retention during this period is a common cause of carpal tunnel syndrome.