A 42-year-old typist presents with pain, numbness over the radial 3.5 fingers, and thenar wasting. Nerve conduction studies show prolonged distal motor latency of the median nerve at the wrist. Conservative treatment has failed. At surgery, the transverse carpal ligament is released. The roof of the carpal tunnel is formed by:

• A Palmar aponeurosis
• B Palmar carpal ligament
• C Palmaris longus tendon sheath
• D Flexor retinaculum (transverse carpal ligament) ✓

Explanation

The carpal tunnel is an osteofibrous channel whose floor and walls are formed by the carpal bones (arranged in an arch) and whose roof is the flexor retinaculum (also called the transverse carpal ligament or TCL). The palmar aponeurosis lies superficial to the TCL but is not the roof of the carpal tunnel proper. Division of the TCL decompresses the median nerve by releasing the unyielding roof. The palmar carpal ligament is a thin fascial layer proximal to the TCL.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.