The Numb Hand (pdf)

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Advanced Phase • Continuous edema and compression induce intraneural fibrosis • Irreversible damage with some permanent loss of sensation and motor function • Surgery stops the continuing nerve damage but does not assure full recovery – Permanent nerve damage already exists before surgery Atrophy (loss of muscle mass, tone and function) due to prolonged, advanced nerve compression
Double Crush Phenomenon • 2 separate points of nerve compression – Compression proximally lowers the threshold for compression neuropathy at a distal point • Interrupted transport of enzymes and neurotransmitters along the axon
Page 1 and 2: The Numb Hand James T. Mazzara, M.D
Page 3 and 4: The Nerve • 3 Types of nerves - M
Page 5 and 6: Toxic Nerve Damage • Lead, mercur
Page 7 and 8: Inflammatory Nerve Damage Infectiou
Page 9 and 10: Anatomy The nerves then pass down t
Page 11 and 12: Sensory Nerve Anatomy This is the a
Page 13 and 14: Types of Nerve Injury • Axonotmes
Page 15 and 16: Our Focus • Nerve compression con
Page 17 and 18: Epidemiology Carpal Tunnel Syndrome
Page 19 and 20: Contributing Factors • Work place
Page 21 and 22: Contributing Factors • Definitive
Page 23 and 24: Contributing Factors • Occupation
Page 25 and 26: Contributing Factors •Nerve compr
Page 27 and 28: •Early Phases of Compressive Neur
Page 29: Intermediate Phase • Intraneural
Page 33 and 34: Clinical Presentation • Dynamic -
Page 35 and 36: Carpal Tunnel Syndrome • Anatomic
Page 37 and 38: Carpal Tunnel Syndrome • Inflamma
Page 39 and 40: Carpal Tunnel Syndrome • Position
Page 41 and 42: Carpal Tunnel Syndrome • Immobili
Page 43 and 44: Carpal Tunnel Syndrome • Phalen
Page 45 and 46: Carpal Tunnel Syndrome • Compress
Page 47 and 48: Carpal Tunnel Syndrome • 2-point
Page 49 and 50: Carpal Tunnel Syndrome • Semmes-W
Page 51 and 52: Carpal Tunnel Syndrome • Nerve co
Page 53 and 54: Carpal Tunnel Syndrome • EMG - Te
Page 55 and 56: Carpal Tunnel Syndrome • Most sen
Page 57 and 58: Carpal Tunnel Syndrome • Conserva
Page 59 and 60: Carpal Tunnel Syndrome • Injectio
Page 61 and 62: Carpal Tunnel Syndrome • Alternat
Page 63 and 64: Carpal Tunnel Release • Advanced
Page 65 and 66: Carpal Tunnel Release • Endoscopi
Page 67 and 68: Carpal Tunnel Release • Mini-open
Page 69 and 70: Carpal Tunnel Syndrome • May be a
Page 71 and 72: Carpal Tunnel Release • Post op c
Page 73 and 74: Pronator Syndrome • Median nerve
Page 75 and 76: Pronator Syndrome • Diagnostic fi
Page 77 and 78: • Compression @ pronator muscle P
Page 79 and 80: Pronator Syndrome • Nerve conduct
Page 81 and 82:
Anterior Interosseous Nerve • Exa
Page 83 and 84:
Anterior Interosseous Nerve • Non
Page 85 and 86:
Cubital Tunnel Syndrome • Ulnar n
Page 87 and 88:
Cubital Tunnel Syndrome • Symptom
Page 89 and 90:
Cubital Tunnel Syndrome • Pain an
Page 91 and 92:
Cubital Tunnel Syndrome • Intrins
Page 93 and 94:
Cubital Tunnel Syndrome • Thumb a
Page 95 and 96:
Cubital Tunnel Syndrome • Examine
Page 97 and 98:
Cubital Tunnel Syndrome • Ulnar n
Page 99 and 100:
Cubital Tunnel Syndrome • Nonoper
Page 101 and 102:
Cubital Tunnel Syndrome • Medial
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Cubital Tunnel Syndrome • Submusc
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Cubital Tunnel Syndrome • Surgica
Page 115 and 116:
Ulnar Tunnel Syndrome • Causes of
Page 117 and 118:
Ulnar Tunnel Syndrome • Treatment
Page 119 and 120:
Radial Nerve • Compression above
Page 121 and 122:
Posterior Interosseous Nerve • Mo
Page 123 and 124:
Posterior Interosseous Nerve • EM
Page 125 and 126:
Posterior Interosseous Nerve • Co
Page 127 and 128:
Radial Tunnel Syndrome • Pain •
Page 129 and 130:
Radial Tunnel Syndrome • Examinat
Page 131 and 132:
Radial Tunnel Syndrome • EMG-NCS
Page 133 and 134:
Radial Tunnel Syndrome • Surgical
Page 135 and 136:
Wartenberg’s Syndrome • Sensory
Page 137 and 138:
Wartenberg’s Syndrome • Examina
Page 139 and 140:
Wartenberg’s Syndrome • Surgica
Page 141:
The End
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