How To Check for Carpal Tunnel Syndrome - Dr Gill
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- Опубликовано: 1 авг 2024
- How to Examine Carpal Tunnel Syndrome - Clinical Skills Deep Dive - Dr Gill
When a patient complains of numbness, pins and needles, or weakness in one or both hands carpal tunnel syndrome should be considered. In this video, we will do a step-by-step explanation of how to examine for median nerve compression, which is the cause of carpal tunnel syndrome
Important to make sure that you are confident in performing these three special tests, which may give you further insight into the underlying pathology in order to make your diagnosis - those tests are Tinel's test, Phalen's Test and Durkan's Test. We will go through and explain each of the carpal tunnel special tests in this video
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleod's Clinical Examination - a recognized standard textbook for clinical skills.
Some patience watching this video may experience an ASMR phenomenon
#CarpalTunnel #ASMR #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
00:47 - Patient Verification
01:00 - Identifying Symptoms and Affected Fingers
01:29 - Assess Dominant Hand
01:54 - Physical Examination: Observing the Hands
02:48 - Checking for Muscle Wasting and Symmetry
04:39 - Testing Thumb Movements and Strength
05:13 - Testing Thumb Opposition and Strength
06:45 - Sensation Testing: Median Nerve Distribution
07:48 - Using a Neurotip for Sensory Assessment
09:28 - Special Tests for Carpal Tunnel: Tinel's, Phalen's, and Durkan's Tests
11:39 - Performing Phalen's Test
12:29 - Conducting Durkan's Test
15:08 - Testing Hand Functionality
15:52 - Discussion on Management and Referral for Neurophysiology Testing
16:24 - Advice on Ergonomics and Preventive Measures
17:01 - Closing Thoughts
i love that you stripped your patient of his skin, revealing his flesh and skeletal system at 2:10, truly showing the depth of visual aids for us viewers
Holy molyyyyyyyy the patient had a question!!!! 😱
😂 going off script *sigh*
Nog koenkies over? Ik kan een pratende papegaai nadoen voor je
Came for the ASMR, stayed for the information 🤓👌🏼
I hope it was useful
This is exactly why I watch these videos. They help me learn a little about a lot.
I’m not sure if it would fall under the interest of your viewers but something going through spinal tracts would be absolutely amazing. Loving all the videos per usual!
Spinal tracts are not a common area for me at work. We did try to look at the simple reflex, but I suppose we could look at dorsal column issues
ruclips.net/video/tl7EZydFQ9s/видео.html
Took me three tries to make it through this video. I fell asleep each time. And let me tell you, that is a very good thing for me. Thank you so much from the bottom of my heart.
Ik right 😊 I wonder if Dr James knows he's on his way to be an unintentional asmr creator
The visual difference in sitting posture is staggering… I strive to have and keep great posture such as yourself sir.😊
Thanks Dr! Always a delight when your notification comes through!
Another great video by RUclips's best doctor
Awesome video, Dr.! I think a good deep dive video for med students would be communication of bad news.
Cheers from São Paulo, Brazil.
I know nothing about Doctor stuff but it's really cool to hear u talk about what's going on and what u can see
I was just wondering about what hands were and why they were drilling tunnels in them (seems like this has just started happening recently??) so this video has been extremely informative
Dr Gill out here curing the Thursday night blues with a wee cheeky Thursday night video.
After work delight, keep up the good work Doc!
👍
I am really happy doc that you can help this patient
Thank you
I would love to see a breakdown of an Ulnar nerve test with information on that, as that is something that, after learning a bit about the Ulnar nerve from this video, I might have an issue with and would love some extra info on that area of the wrist, and possibly leading up to the elbow as well
I am offically addicted to your videos. I went to college for health informatics. Coding and all medical systems records. But Itt tech failed us all. I miss the classes. 😮
my mans i love these vids thanks 🦅🦅
Unintentional ASMR and educational!
I think you just earned a sub just from voice alone, my guy 👍
I actually think I'm am learning something from this I may not have the skills to know and help someone but fell like I'm actually learning something interesting so thank you
Learning is always good, on many levels 😊
Glad you found this useful
Awesome video!
@Dr Gill From all the information from your videos we will end up becoming arm chair physicians
Any chance of being able to make a video on the Babinski test doc?
I work in Neurology. I perform a lot of nerve conduction studies on patients to verify carpal tunnel.
Thank you for your work there then! How often do you find patients with symptoms have unremarkable tests?
Would like to see a video on trigger finger/thumb.
If only I had 4 hands. So that I could give this video 4 thumbs up.
Learning so much and you help me sleep thank you so much ❤
Glad you are finding it useful
I mostly come to your videos for the ASMR, and i watch them at night, muted, so that the only stimuli my brain gets is the image and the movement... so, i likely miss a lot of the spoken information :// but sometimes, as i get sleepy, questions come up to my head... for example, Dr. Gill,
- Is there a specific reason why you didn't check both hands, like you usually do on the other videos? Was it because the issue was already known to be in that one hand?
- As a doctor yourself, how often do you go to the doctor? :))
Informative as always, although now I'm confused as to why Phalen's test resulted in both of my little fingers moving involuntarily outwards when it's outside of the carpal tunnel 🤔
I’ll be honest I’m not entirely sure!
@@DrJamesGill Could it be related to the Cubital Tunnel in some way, or am I just special? 😁
I know I'm not supposed to do this but I've been following along with deep dive videos and doing as many tests on myself as I have ability to do (reflex is practically impossible solo) to figure out what is wrong with me since specalists are hard to come by in my area and far too expensive, now I've been able to rule out Carpal Tunnel Syndrome for the most part.
I had sympathetic pain in my right pinkie finger during part of this exam. Weird! No problem with carpel tunnel, that I know of. Can have problems if I have my hand above shoulder height (on a bus for e.g.) for any length of time. Then I get a numbness that can last for the right half of my middle, all the ring, and pinkie fingers of my right hand. Not surprisingly, I try to avoid having my hand/arm in that position.
Might be worth while talking to your doctor
@@DrJamesGill I did, years ago. Found no issues. I'm just careful and always try to get a seat on the bus. It's no fun getting old (69 in August). Lots of chronic conditions, with no relief for any of them. Such is life.
I have a brace and am getting the nerve test done again soon. My symptoms have come back and are getting worse and not going away. This was like so therapeutic to watch for some reason. I could do this for so long.
My symptoms have always been spot on for carpal tunnel. But the first time I got the nerve test done I wasn’t formally diagnosed bc numbers weren’t completely matching up 🤷🏻♀️ and I’m apparently to young for surgery but I’ve been managing and it’s not really getting better so we’ll see. When doing the phalens test I can barely have my right wrist at a full 90 degree it hurts.
The patient’s posture also hurt my back watching lol but love the videos
This good 👍
The intro song is the same one that my GP plays when im on hold for 2 hours trying to get an appointment and I swear to god i nearly threw my phone
Hi, could you do Intersection syndrome video, please?
The GOAT
Patient has a weird bendy pinky. What is that called?
What about finger twitching and also other spasms that seem not connected to any muscle. It's like your skin is contracting
That should be looked at by your doctor, as the cause needs identifying
Had to have both ligaments removed, literally scraped them off the nerves, I remember the sensation, it was like scraping sandpaper with a scalpel.
😵💫 - I hope everything improved however after?
How often would many of these tests be performed by GPs in a clinical setting? At what stage would one expect to be referred for an EMG/nerve conduction study?
Several times a week I go this. I always refer to confirm
If I’m very confident, and there is clear nerve damage I’ll refer to Ortho at the same time to speed things up
Patient was born in 2000... I feel old now. 😑
Nah don't think he was. They just say a random date
You should have add physiotherapy to the option... Because they do play a major role in managing CTS.
Very true, physio is a great tool, but tends to be more utility after surgery, as to the best of my knowledge physio can’t adjust the inflammation in many cases
If we receive self referrals for suspected carpel tunnel without concerns of underlying additional features we would always splint at night for 6 weeks, some hand and wrist exercises / neural glides and if no improvement generally would be referral to hand teams if patient willing anyway. Most people just need to modify tasks to avoid aggravating symptoms for sensitivity to reduce rather than NCS / ortho opinion. Thanks for the vid doc 😊
I’m sure you’ve had tons of comments like this one. However, I originally came here only for the ASMR, but I’ve actually learned quite a bit. My girlfriend is anemic, and she was feeling super dizzy and tired one day, so I checked her capillary refill and recommended that she take an iron supplement with a full glass of water and eat a banana just in case. She felt much better after that.
If she thinks she is anaemic, it would be worth while getting her to see her doctor, as the question would be “why anaemic”
Do cubital tunnel syndrome next lol
Nice james hills are you good man
Andy Dick jumpscare questionnaire in one of my bingo boxes, lol. Hi 2023
just what the doctor order
Why not put a pitta paper? 😞
Sir do you earn 120000 pound sterlings a year as a doctor in UK? Plz reply. Thanks a lot.
Dudes been jaggin it too much
Ima li nas balkanci
Navsqkude ni ima 🕴️
Can you do a video on vertigo?
We’ve a video on the HINTS test for acute vertigo
ruclips.net/video/q5AJNgZXDxs/видео.html
But yes, maybe some more detail on vertigo could be good
"You join myself..." Argh NO! Still suffering from reflexive hypercorrection I see.
You had me at penetrate, Doc. 6:29
💚💜💚💜💚💜💚
👍
I literally suffer with this in both hands
10:37TINEL S TEST
4:25 holy based
Carpal diem!
😂😂
Ironically they can't seize anything :D
NHS on its arse?
Can’t get an appointment for love nor money?
Dr Gill; “Hold my Pint!”👨🏻⚕️
1st
I was about to comment on the previous video regarding the patient’s posture. It’s painful to watch, that back arch 🙃