A 36-Year-Old Woman Is Evaluated for Several Months of Tingling

question 73

Multiple Choice

A 36-year-old woman is evaluated for several months of tingling and numbness of the right hand and fingers that has progressed to dull, aching pain.  The symptoms initially were intermittent but have become persistent, with the pain worsening overnight.  The patient works as an office secretary and has had difficulty typing and holding the phone due to hand weakness.  On examination, she has weakness of thumb opposition and atrophy of the thenar eminence.  The patient attempted treatment with conservative measures but had no significant improvement and has now been referred for surgery.  During surgery, incision of which of the following structures is most likely to improve this patient's symptoms?

• A)Fibrous flexor sheaths
• B)Flexor carpi ulnaris aponeurosis
• C)Palmar aponeurosis
• D)Synovial sheaths of flexor tendons
• E)Transverse carpal ligament

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Definitions:

Right-Sided Heart Failure

A condition where the right ventricle of the heart is unable to pump blood efficiently, leading to fluid build-up in the body, particularly in the limbs and organs.

Antihypertensive Medications

Drugs used to lower high blood pressure, helping to prevent heart attacks, strokes, and kidney problems.

Sinoatrial (SA) Node

A group of cells located in the right atrium of the heart that generates the electrical impulses controlling heart rate, also known as the heart's natural pacemaker.

Myocardial Infarction

A medical term for a heart attack, which occurs when blood flow to the heart muscle is blocked, causing tissue damage.