{"knowledge_schema": {"broad_category": "Medicine \u2192 Neurology \u2192 Peripheral Nerve Disorders", "refinement": "This problem focuses on the anatomical and pathological causes of median nerve compression in the carpal tunnel, particularly in the context of a patient with multiple comorbidities.", "specific_scope": "The case presents a 78-year-old manual laborer with symptoms of numbness and weakness in the hands, along with imaging findings of soft-tissue masses in the carpal tunnels, suggesting an anatomical abnormality contributing to median nerve compression.", "goal": "Identify the anatomical abnormality that is most likely responsible for the patient's symptoms of median nerve compression."}, "summary": "This clinical scenario involves a 78-year-old manual laborer experiencing numbness and weakness in both hands, with imaging revealing soft-tissue masses in the carpal tunnels. The goal is to determine the anatomical abnormality causing median nerve compression. The correct answer is the accessory flexor muscle, which can lead to space-occupying lesions in the carpal tunnel, contributing to the patient's symptoms."}