dipti
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As the result of a fall onto a hard surface, a 20-year-old woman sustains a fracture of the medial humeral epicondyle, and a nerve is injured. Which action will be most affected by this nerve injury?
A) Adduction of all digits
B) Extension of all digits
C) Flexion of all digits
D) Pronation of the forearm
E) Supination of the forearm
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| robin082006
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A
ulnar nerve injury, loss of abduction and adduction, hypothenar hypotrophy, , weakened flexion of wrist and digits 4 and 5, sensory loss of digit 5 and half of 4.
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| r_albayunen
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thats right .. A
lesions on medial epicondyle and also in lesions of the clavicle ...
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| dipti
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thanks
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| tn1kinobe
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Does anyone else think it can be choice B) at all????
Think about this. Ulner injuries cause "claw hand" which is damage of C8-T1. Claw hand is a result of inability to extend fingers, and the unopposed digit flexors create the claw appearance. I'm torn between A and B.
ANyone?
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| mediocre
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Trauma to Ulnar Nerve:
- combined lesions of the median and ulnar nerves:
- high ulnar nerve lesions
- low ulnar nerve injury
- division of ulnar nerve at wrist results in paralysis of all small muscles of hand
except first & second lumbricales & most of thenar muscles;
- paralysis of adductor pollicis produces Froment's sign;
- when grasping piece of paper between thumb and index finger, FPL fires (IP joint flexion) since adductor does not work;
- if ulnar nerve is divided below mid-forearm, ulnar claw hand is produced; (low ulnar nerve lesions);
- w/ this lesion, 4th & 5th fingers are hyperextended at MP joints by long extensors but flexed at interphalangeal joints;
- this posture is sometimes called hand of benediction;
- if ulnar nerve lesion is above midforearm, clawing of ulnar two fingers does not occur, because extrinsic
muscles producing IP joint flexion are also denervated (see high ulnar nerve lesion);
- in complete claw hand, produced by low lesion of median nerve & ulnar nerves, MP joints are
extended & interphalangeal joints flexed by still-functional extrinsics;
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| mediocre
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HIGH ULNAR NV INJURY
- ulnar innervated intrinsic muscles of hand, FCU, & FDP units to ring & little fingers & part of long finger;
- functional deficit:
- opening the hand:
- power grip:
- pts w/ high ulnar nerve lesions may lose 60-80% of their grip strength;
- grasping and closing the hand;
- w/ ulnar nerve lesion, there is a noticeable deficit in all activities requiring pinch and grasp;
- becacuse of loss of intrinsics, pinch strength in ulnar nerve palsy is reduced by over 80%, w/ palmar
adduction strength reduced by 75%;
- results of nerve repair:
- after repair of ulnar nerve lacerations above the elbow, return of extrinsic
function can be expected, but return of intrinsics are often poor
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| mediocre
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Reference: wheeless textbook of orthopedics
So data shows -upto 80% of loss of hand grip/flexion of fingers(c)
but i am still not sure if it is justified for ALL fingers as aked in Q?
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| mediocre
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just as I feared,as far as ALL the fingers are concerned,the most appropriate answer is Abduction(not in the ans),and Adduction.
Reference: Consultant Orthopedics,(in flesh and bones)
Anyway,I hope the above data is useful
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| klimt
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Thanks mediocre. good research
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| yasmeen
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A
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| ManuNastai
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A
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