 لگ cooks کررہے ہیں my socio نے اسی طرح لگچائن کے مجھ سار guys کررہا ہے اور جانبہ دوسری اس کے بوجلہ لنонд اندر اف Protect ج account something اس hi کردتم بнибудь اس پان Hallan اندر ایک فرمار um پاس د کحملüssت دی ب ہے۔ لیکن یہ ایک کوتر جو یہ mistake کہ یہ عطا معاکی حررتان کلام کی dünyان ہو گئی ہے۔ یہیاں Where the rolling työ How many Judas او x دائیل او vê ایماریات گوشارو ۔ بمر ایسیumpy is seek دی ہے. بہت extraordinaryậnج come ico عاوش你 اolis باہر تل candidates like this okay go ahead are you a left-handed person or right-handed person this okay yes she's cutting the flixer at nukle with the point i would like you to remember is that it's a very tough structure okay just one second wait now cut between my instrument good there's a little more left wait wait wait cut between the instruments so we have cut open the carpal tunnel so i would like you to take a look at the margins of the flexor retinaculum please zoom the camera to the margins of the flexor retinaculum can you see how thick it is this is one margin and this is the other cut margin which i'm going to reflect now can we see the margin it is almost as thick as a cartilage so this is the flexor the cut edges of the flexor retinaculum and by so doing we have opened up the carpal tunnel so in a sense we have done a carpal tunnel release surgery and when we do a carpal tunnel release surgery in actual life there are a couple of structures which we need to save card one of them is this structure here this is the superficial palmar arch so when we are cutting we have to make sure we don't cut the superficial palmar arch the second structure we need to save guard is this this is the communication between the ulnar nerve and the median nerve when we are cutting we are supposed to make sure we do not cut this communicating nerve and the third structure we need to save guard which is not visible here is the recurrent branch of the median nerve which supplies the t-nar muscles once we have opened up the carpal tunnel now we can see this philby structure that we see here this is the synavel sheet this is the combined synavel sheet of the long flexor tendons namely the flexor digital superficialis and the flexor digital profundus so let me pick up the flexor digital superficialis here first so these are the flexor digital superficialis tendons and under that this is the flexor digital profundus tendon i picked them up both and we can see the four tendons of the superficialis and the four tendons of the profundus they are all passing through the carpal tunnel and then they will run through the central compartment of the palm which is just under the palmar aponeurosis and then they will go into the respective digits so this is the carpal tunnel that we have been talking about and finally the most important structure in the carpal tunnel so what we will do is we will reflect one margin of the carpal tunnel with this instrument here please hold it here we will reflect the other end by holding it here please hold it here the most important structure the most vulnerable structure is this one here what is this the the median nerve the median nerve is the one which goes through the carpal tunnel and then it comes and divides into its branches compression of the median nerve will produce carpal tunnel syndrome in the carpal tunnel okay stop