Wednesday - severson - Dorsal hand

Question 1

What muscles flex the MP joint and extend the distal phalanges?

Answer 1

Both the lubricals and the interossei.

Question 2

What clinical manifestation does proximal median nerve palsy cause?

Answer 2

Hand of benediction. (cannot flex 2nd and 3rd fingers.) (Thumb is laterally rotated and adducted, loss of thumb flexion.)

Question 3

What clinical manifestation does distal median nerve injury cause?

Answer 3

Carpal tunnel syndrome (loss of coordination and strength in the thumb, weakened flexion of 2nd and 3rd MP joints, Phalen test positive.)

Paresthesia in lateral three and a half fingers.

No abnormal sensation in the palm of the hand, that area is innervated by the palmar cutaneous branch of the median nerve before it passes through the carpal tunnel.

Question 4

Paresthesia

Answer 4

Sense of tingling, prickling.

Question 5

What clinical manifestation does proximal ulnar nerve palsy cause?

Answer 5

Claw hand, loss of flexion at the 4th and 5th DIP (loss of innervation of the Flexor digitorum profundus).

Loss of innervation of the 3rd and 4th lumbricals as well, causes hyperextension of the MP joint.

Atrophy of interossei

Question 6

What clinical mannifestation does an injury to the radial nerve cause?

Answer 6

Inability to extend the wrist and fingers at the metacarpal-phalanges joint. Wrist is partially flexed (wrist drop)

Question 7

How can a kid get messed up if you swing him by the arms?

Answer 7

Can cause subluxation and dislocation of the radial head. (head of the radius is pulled out of the anular ligament.)

sometimes called nursemaid’s elbow or pulled elbow.