Ulnar claw Vs Hand of Benediction Flashcards
What are both Ulnar claw and Hand of Benediction a sign of?
Nerve damage
When is Ulnar claw most commonly seen?
Long term lesions of the Ulnar nerve
Which muscles are paralysed in the Ulnar claw?
Medial 2 lumbricals
Interossei
Hypothenar muscles
Adductor pollicis
What does paralysis of the medial lumbricals cause?
Loss of flexion at the metacarpal-phalangeal joint
Loss of extension at the interphalangeal joint
Why does the Ulnar claw only involve the medial 2 lumbricals?
Because the lateral 2 lumbricals are innervated by the median nerve
What causes Ulnar paradox?
A lesion of the Ulnar nerve at the elbow
In an Ulnar paradox, which extra muscles are paralysed?
Flexor carpi Ulnaris
Medial half of flexor digitorum profundus
What does an Ulnar paradox look like?
Hyperextention of the metacarpal-phalangeal joints. There is no flexion of the interphalangeal joint due to the denervation of the medial half of flexor digitorum profundus.
What causes hand of Benediction?
Damage to the median nerve
How can you test for hand of Benediction?
Ask the patient to make a fist
Which muscles are paralysed to show a hand of Benediction?
All flexors in the anterior compartment of the arm
Lateral 2 lumbricals
What does hand of Benediction look like?
Patient is asked to make a fist, ring and little finger can flex but the index and middle finger cannot flex at the metacarpal-phalangeal joint or interphalangeal joint
