Carpal tunnel syndrome is compression of?

Appeared in: KPSC Staff Nurse - 2021

Explanation

Carpal Tunnel Syndrome (CTS) is defined by the compression of the median nerve within the carpal tunnel at the wrist.
The carpal tunnel is a narrow passageway formed by the carpal bones and the transverse carpal ligament.
Compression of the median nerve leads to sensory symptoms like numbness and tingling in the thumb, index finger, middle finger, and the radial (thumb-side) half of the ring finger.
In advanced cases, it can cause weakness and atrophy of the thenar muscles at the base of the thumb.

Option A: Compression of the radial nerve typically occurs in the axilla or along the humerus, not in the carpal tunnel. It leads to 'wrist drop,' which is the inability to extend the wrist and fingers.
Option C: Compression of the ulnar nerve typically occurs at the elbow (cubital tunnel syndrome) or wrist (Guyon's canal). It affects the little finger and the ulnar half of the ring finger.
Option D: 'Metacarpal nerve' is not a recognized anatomical term for a major nerve trunk that can be compressed in this manner. The nerves in the hand are primarily the median, ulnar, and radial nerves and their branches.

Clinical Relevance

Nursing practice connection: Knowing Anatomy and pathophysiology of Carpal Tunnel Syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a key role in identifying CTS symptoms and educating patients on conservative management, such as wearing wrist splints (especially at night) to maintain a neutral position and reduce pressure on the median nerve.
Patient education includes activity modification, such as avoiding repetitive wrist movements, taking frequent breaks, and using ergonomic equipment to minimize strain.
A key nursing assessment includes performing Tinel's sign (tapping over the nerve) and Phalen's maneuver (flexing the wrist) to reproduce symptoms, which helps in screening for CTS.

How to Approach the Question

First, identify the key term in the question: 'Carpal tunnel syndrome'.
Recall the basic anatomy of the wrist and the structures that pass through the carpal tunnel.
Remember that the carpal tunnel is a specific anatomical space at the wrist.
Associate 'carpal tunnel syndrome' directly with the nerve that runs through this tunnel, which is the median nerve.
Differentiate this from other major nerves of the hand by recalling their primary compression sites and symptom patterns (e.g., radial nerve and wrist drop; ulnar nerve and little finger numbness).
Eliminate anatomically incorrect options like 'Metacarpal nerve'.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 1517-1519

E6 Anatomy BDChaurasia V1 10e p. 128-130

E6 Anatomy MindMaps BDChaurasia V1 10e p. 6-8

Practise the full KPSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.