Anil - Limbs

The Carpal Tunnel The carpal tunnel is formed anteriorly at the wrist by the deep arch of carpal bones.

Contents: • Median nerve • 4 heads of tendons of flexor digitorum profundus • 4 heads of the tendons of flexor digitorum superficialis • tendon of flexor pollicis flongus Carpal Tunnel Syndrome: the entrapment syndrome caused by pressure on the median nerve. Can be caused by swelling of tendons and formation of cysts in the carpal joints (e.g. rheumatoid arthritis). Symptoms include “pins-and-needles” in the muscles in the median nerve region, weakness, loss of muscle bulk of the thenar muscles.

The fascia of the palm:  Anatomically continuous with the fascia of the forearm  Palmar fascia lies in the palm – condensations (speciliasations) form the palmer apponeurosis and the digital fibrous sheaths  The palmer apponeurosis  Well defined and overlies the long flexor tendons.  The proximal end is continuous with the flexor retinaculum and the palmaris longus tendon.  The distal end forms 4 bands which is continuous with the fibrous digital sheaths of each finger  The fibrous digital sheaths:  Are tubes which contain flexor tendons and their sheaths  The space between the palmar apponeurosis and the bones of the hands is separated into compartments by extensions of the fascia called septa  A medial septum (to the little finger metacarpal) and a lateral septum (middle finger metacarpal) divides the space into the hypothenar compartment, central compartment and thenar compartment (thenar closet to thumb, hypothenar closest to little finger)  Beneath the thenar compartment is the 4th compartment = adductor compartment which contains adductor pollicis