8. Distortions of the hand Flashcards Preview

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Flashcards in 8. Distortions of the hand Deck (18)

Distortion of the hand - rpoximal vs distal lesions

seen best with distal lesion / less prominent in proximal lesion


distortion of the hand - defictis are present during

voluntary flexion of the digits


ulnar claw vs pope's blessing sign : location of lession

ulnar claw --> DISTAL ulnar nerve ( near to hand )
Pope's blessing --> proximal median nerve


ulnar claw vs pope;s blessing sign - more prominence during

ulnar claw --> extending fingers / rest
Pope's blessing --> making a fist


median claw sign is a result of

distal medial nerve


median claw apperance ( digits )

digits 2-3
MCP flexion
DIP and PIP extension


median claw is more prominence during

extending fingers at rest


OK gesture appearance

1-3 digits flexed


OK gesture is a result of

proximal ulnar nerve


OK gesture is more prominence in

Making a fist


thenar eminence atrophy can be seen in

1. median nerve lesion
2. recurrent branch of median nerve


• Name the function of the lumbrical muscles of the hand.

The lumbricals flex the MCP joints and extend both the DIP and PIP joints


• How does a Pope's-blessing distortion arise?

A proximal median nerve lesion causes loss of lateral finger flexion and thumb opposition—the distortion arises on trying to make a fist


• A patient has a proximal median nerve lesion. How do you expect this to affect his thumb?

It causes thenar atrophy with an impaired ability to abduct the thumb, leading to an ape-hand distortion


• To uncover an ulnar claw distortion, what do you have to ask a patient with a distal ulnar nerve lesion to do?

Extend the fingers at rest (note that attempting finger flexion with medial nerve lesions leads to a similar appearance [Pope's blessing])


• A woman receiving a mastectomy has her long thoracic nerve severed. What is the function of the muscle innervated by the LTN?

(the serratus anterior attaches the scapula to the posterior wall of the thoracic cage)llows for abduction above the horizontal position)


• You notice a patient has wasting of the thenar eminence. What nerve is likely damaged?

Median nerve


• A patient with a proximal ulnar nerve lesion attempts to make a fist. What type of hand gesture do you expect them to make?

An OK gesture with digits 1–3 flexed (similar to the claw hand of distal median nerve lesions)

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