Phalen Maneuver
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Phalen Maneuver
Phalen's maneuver is a diagnostic test for carpal tunnel syndrome by an American orthopedist named George S. Phalen. Technique The patient is asked to hold their Wrist, wrists in complete and forced flexion (pushing the dorsal surfaces of both hands together) for 30–60 seconds. The lumbricals attach in part to the flexor digitorum profundus tendons. As the wrists flex, the flexor digitorum profundus contracts in a anatomical terms of location#Relative directions, proximal direction, drawing the Lumbricals of the hand, lumbricals along with it. In some individuals, the lumbricals can be "dragged" into the carpal tunnel with flexor digitorum profundus contraction. As such, Phalen's maneuver can moderately increase the pressure in the carpal tunnel via this mass effect, pinching the median nerve between the anatomical terms of location#Relative directions, proximal edge of the transverse carpal ligament and the anterior border of the distal end of the radius (bone), radius. ...
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Median Nerve
The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, and has contributions from ventral roots of C5-C7 (lateral cord) and C8 and T1 (medial cord). The median nerve is the only nerve that passes through the carpal tunnel. Carpal tunnel syndrome is the disability that results from the median nerve being pressed in the carpal tunnel. Structure The median nerve arises from the branches from lateral and medial cords of the brachial plexus, courses through the anterior part of arm, forearm, and hand, and terminates by supplying the muscles of the hand. Arm After receiving inputs from both the lateral and medial cords of the brachial plexus, the median nerve enters the arm from the axilla at the inferior margin of the teres major muscle. It then passes vertically down and courses lateral to the brachial ar ...
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Tinel's Sign
Tinel's sign (also Hoffmann-Tinel sign) is a way to detect irritated nerves. It is performed by lightly tapping ( percussing) over the nerve to elicit a sensation of tingling or " pins and needles" in the distribution of the nerve. Percussion is usually performed moving distal to proximal. It is named after Jules Tinel.Tinel, J. (1978) The "tingling sign" in peripheral nerve lesions (Translated by EB Kaplan). In: M. Spinner M (Ed.), Injuries to the Ma jor Branches of Peripheral Nerves of the Forearm. (2nd ed.) (pp 8–13). Philadelphia: WD Saunders CoTinel, J. (1915) Le signe du fourmillement dans les lésions des nerfs périphériques. Presse médicale, 47, 388–389Tinel, J., Nerve wounds. London: Baillère, Tindall and Cox, 1917 It is a potential sign of carpal tunnel syndrome, cubital tunnel syndrome Ulnar nerve entrapment is a condition where the ulnar nerve becomes physically trapped or pinched, resulting in pain, numbness, or weakness, primarily affecting the little fing ...
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Sensitivity (tests)
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ...
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Reverse Phalen's Maneuver
Reverse or reversing may refer to: Arts and media * ''Reverse'' (Eldritch album), 2001 * ''Reverse'' (2009 film), a Polish comedy-drama film * ''Reverse'' (2019 film), an Iranian crime-drama film * ''Reverse'' (Morandi album), 2005 * ''Reverse'' (TV series), a 2017–2018 South Korean television series *"Reverse", a 2014 song by SomeKindaWonderful * REVERSE art gallery, in Brooklyn, NY, US *Reverse tape effects including backmasking, the recording of sound in reverse * '' Reversing: Secrets of Reverse Engineering'', a book by Eldad Eilam *''Tegami Bachi: REVERSE'', the second season of the ''Tegami Bachi'' anime series, 2010 Driving * Reverse gear, in a motor or mechanical transmission * Reversing (vehicle maneuver), reversing the direction of a vehicle * Turning a vehicle through 180 degrees Sports and games *Reverse (American football), a trick play in American football *Reverse swing, a cricket delivery *Reverse (bridge), a type of bid in contract bridge Technology *Revers ...
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Specificity (statistics)
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ...
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Sensitivity And Specificity
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ...
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Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is the collection of symptoms and signs associated with median neuropathy at the carpal tunnel. Most CTS is related to idiopathic compression of the median nerve as it travels through the wrist at the carpal tunnel (IMNCT). Idiopathic means that there is no other disease process contributing to pressure on the nerve. As with most structural issues, it occurs in both hands, and the strongest risk factor is genetics. Other conditions can cause CTS such as wrist fracture or rheumatoid arthritis. After fracture, swelling, bleeding, and deformity compress the median nerve. With rheumatoid arthritis, the enlarged synovial lining of the tendons causes compression. The main symptoms are numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. People often report pain, but pain without tingling is not characteristic of IMNCT. Rather, the numbness can be so intense that it is described as painful. Symptoms are ...
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Carpal Tunnel
In the human body, the carpal tunnel or carpal canal is the passageway on the palmar side of the wrist that connects the forearm to the hand. The tunnel is bounded by the bones of the wrist and flexor retinaculum from connective tissue. Normally several tendons from the flexor group of forearm muscles and the median nerve pass through it. There are described cases of variable median artery occurrence. When any of the nine long flexor tendons passing through the narrow carpal canal swell or degenerate, the narrowing of the canal may result in the median nerve becoming entrapped or compressed, a common medical condition known as carpal tunnel syndrome (CTS). Structure The carpal bones that make up the wrist form an arch which is convex on the dorsal side of the hand and concave on the palmar side. The groove on the palmar side, the ''sulcus carpi'', is covered by the flexor retinaculum, a sheath of tough connective tissue, thus forming the carpal tunnel. On the side of the ...
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Radius (bone)
The radius or radial bone is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna. The ulna is usually slightly longer than the radius, but the radius is thicker. Therefore the radius is considered to be the larger of the two. It is a long bone, prism-shaped and slightly curved longitudinally. The radius is part of two joints: the elbow and the wrist. At the elbow, it joins with the capitulum of the humerus, and in a separate region, with the ulna at the radial notch. At the wrist, the radius forms a joint with the ulna bone. The corresponding bone in the lower leg is the fibula. Structure The long narrow medullary cavity is enclosed in a strong wall of compact bone. It is thickest along the interosseous border and thinnest at the extremities, same over the cup-shaped articular surface (fovea) of the head. The trabeculae of the spongy tissue are some ...
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Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is the collection of symptoms and signs associated with median neuropathy at the carpal tunnel. Most CTS is related to idiopathic compression of the median nerve as it travels through the wrist at the carpal tunnel (IMNCT). Idiopathic means that there is no other disease process contributing to pressure on the nerve. As with most structural issues, it occurs in both hands, and the strongest risk factor is genetics. Other conditions can cause CTS such as wrist fracture or rheumatoid arthritis. After fracture, swelling, bleeding, and deformity compress the median nerve. With rheumatoid arthritis, the enlarged synovial lining of the tendons causes compression. The main symptoms are numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. People often report pain, but pain without tingling is not characteristic of IMNCT. Rather, the numbness can be so intense that it is described as painful. Symptoms are ...
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Transverse Carpal Ligament
The flexor retinaculum (transverse carpal ligament, or anterior annular ligament) is a fibrous band on the palmar side of the hand near the wrist. It arches over the carpal bones of the hands, covering them and forming the carpal tunnel. Structure The flexor retinaculum is a strong, fibrous band that covers the carpal bones on the palmar side of the hand near the wrist. It attaches to the bones near the radius (bone), radius and ulna. On the ulnar side, the flexor retinaculum attaches to the pisiform bone and the hamate, hook of the hamate bone. On the radial side, it attaches to the tubercle of the scaphoid bone, and to the medial part of the palmar surface and the ridge of the trapezium (bone), trapezium bone. The flexor retinaculum is continuous with the palmar carpal ligament, and deeper with the palmar aponeurosis. The ulnar artery and ulnar nerve, and the cutaneous branches of the median and ulnar nerves, pass on top of the flexor retinaculum. On the radial side of the retin ...
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