Carpal Tunnel

3A Kelly Gwardzinski and Travis Scott

2B Tyler Booth and Lauren Wu
Long Flexor Muscles to digits within the Carpal Tunnel
Muscle

Origin

Insertion

Innervation

Action

Flexor Digitorum
Superficialis

Medial
Epicondyle and
upper half of
radius

Sides of middle
phalanges digits
2-5

Median n. (C8,
T1)

At elbow: weak
flexor
At wrist: MCP
and PIP joints 25; flexion

Flexor Digitorum
Profundus

Ulna and
interosseus
membrane

Distal phalanges
digits 2-5

Median n. and
Ulnar n. (C8, T1)

At wrist: MCP,
PIP, DIP joints 25; flexion

Flexor Pollicis
Longus

Radius and
interosseus
membrane

Distal phalanx of
thumb

Median n. (C8,
T1)

At wrist: Flexion
and radial
deviation
(abduction of
hand)
At thumb: CMC,
MCP, and IP
thumb joint;
flexion

(Pg. 316 of Gilroy Atlas)

Contents

Flexor Retinaculum: a strong fibrous band crossing transversely over the flexor tendons
of the carpal tunnel.
Also known as transverse carpal ligament
Bony attachments:
Ulnar side: Hamate and Pisiform
Radial side: Scaphoid and Trapezium
Note: Depending on the level of the cross-section on cadavers, the
attachments may vary.
Tendons
Flexor Digitorum Superficialis (superficial)
Flexor Digitorum Profundus (deep)
Flexor Pollicis Longus
*Flexor Carpi Radialis tendon runs in close proximity to the carpal tunnel
Synovial Tendon Sheaths

Sheaths surrounding the flexor digitorum superficialis and flexor digitorum

profundus as they pass through the carpal tunnel and extend to the digits. The
sheaths enable the tendons to slide freely during finger movements.
Median Nerve
Sensation to palmar surface of the hand, thumb, index, middle fingers and medial
side of the ring finger (digits 1-4)
Motor innervation thenar muscles (Abductor Pollicis Brevis, Flexor Pollicis Brevis
superficial head, Opponens Pollicis) and Lumbricals 1 and 2

Anterior and Inferior Views of the Right hand

Walls of the Carpal Tunnel

Anterior Wall
Posterior Wall
Lateral Walls

Clinical Problem

Etiology
Compression or irritation of the Median nerve
Symptoms
Pressure, tingling, pain, numbness of fingers
Atrophy of thenar muscles
Weakness in hand

Clinical Management of Carpal Tunnel Syndrome

Tissue/Structure Management
Splinting: prevents flexion of wrist/holds wrist where carpal tunnel pressure is lowest
(most common treatment)
Surgery: Cutting of flexor retinaculum to relieve pressure around Median nerve (second
most common treatment)