Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be going through Carpal Tunnel Syndrome.

And you can find written notes on this topic at zero tofinals.com slash carpal tunnel

or in the orthopedic section of the zero to finals surgery book.

So let's get straight into it.

Carpal tunnel syndrome is caused by compression of the median nerve as it travels through the

carpal tunnel in the wrist, causing pain and numbness in the median nerve distribution on the hand.

Let's start with some basic anatomy and pathophysiology.

The flexor retinaculum is a fibrous band that wraps across the front or the palmer side of the wrist.

It's also known as the transverse carpal ligament. Between the carpal bones and the flexor

retinaculum, there is a passageway from the forearm to the hand, which is called the carpal tunnel.

The median nerve and the flexor tendons of the forearm travel through the carpal tunnel. Compression of the contents of the carpal

tunnel causing carpal tunnel syndrome is the result of either swelling of the contents, for example

swelling of the tendon sheaths due to repetitive strain, or narrowing of the tunnel. The branch of

the median nerve that passes through the carpal tunnel

is called the Parmar Digital Cutaneous Branch and it's responsible for sensory innovation

of the Parma aspects and the full fingertips of the thumb, index a middle finger and the lateral half of the ring finger.

It's worth noting that the palmer cutaneous branch of the median nerve provides sensation to the palm.

However, this branch originates before the carpal tunnel and it doesn't travel through the carpal tunnel.

Therefore, it's not affected by carpal tunnel syndrome it doesn't travel through the carpal tunnel. Therefore, it's not affected by

carpal tunnel syndrome. The median nerve also supplies the motor function to the three

thinner muscles. These three thinner muscles make up the muscular bulge at the base of the thumb

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