UE/Hand Nerve Palsies

Question 1

Describe the Hand of Benediction

Answer 1

Meidan - 2nd and 3rd digits remain extended when attempting to make first due to median nerve damage

Question 2

Describe Ape Hand Deformity

Answer 2

Thumb becomes adducted (closer to other 4 digits) due to thenar wasting that happens with median nerve damage. Thenar and opponens policis muscle are impacted

Question 3

Claw hand

Answer 3

Ulnar nerve damage that causes inability to flex at MCP of 4th and 5th and ext at IP, so fingers are clawed with MCP hyperextension and IP hyperflexion, due to Ulnar side lumbricles not working. Opposite of lumbricle action on 4th and 5th digit to sum it up

Question 4

Wartenberg Sign

Answer 4

Fingers start abducted and have pt actively adduct. 5th digit stays abducted due to ulnar nerve damage impacting hand intrinsics that adduct 5th digit (e.g palmar interossi PAD)

Question 5

Froments Sign

Answer 5

Pinch piece of paper. Thumb should be straight/extended b/c adductor pollicis in working. If the thumb bends/flexes, the flexor pollicis is compensating due to ulnar nerve lesion impacting the adductor pollicis

Question 6

OK sign

Answer 6

Reverse of Fromont, Should be able to make the “okay” sign by making circle with 1st and 2nd fingers bending at the IP. if unable to pinch instead, then damage the anterior interossei which innervates FDP and FPL

Question 7

Erbs Palsy

Answer 7

Damage to C5/C6 nerve foot, causing extended elbow, flexed wrist (waiters tip), medial winging, arm redness due to impact on Serratus anterior, elbow flexor, and wrist extensor issues

Question 8

Klumpke’s Palsy

Answer 8

C7-T1 palsy that causes disruption to ulnar nerve and intrinsic muscles. Claw hand (MCP hyperextension and IP hyperflexion) of all digits due to lumbricals not working