new_n_lost
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A patient has a tiny (0.2 cm), but exquisitely painful tumor under the nail of her index finger. Prior to surgery to remove it, local anesthetic block to a branch of which of the following nerves would be most likely to achieve adequate anesthesia?
A. Axillary nerve
B. Median nerve
C. Musculocutaneous nerve
D. Radial nerve
E. Ulnar nerve
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| GoodGirl
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B, median n.
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| hope4dabest
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B
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| SILVER
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median nerve
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| new_n_lost
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The correct answer is B.
The tumor in question is probably a glomus tumor, which is a benign tumor notorious for producing pain far out of proportion to its small size. The question is a little tricky (but important clinically for obvious reasons) because it turns out that the most distal aspect of the dorsal skin of the fingers, including the nail beds, is innervated by the palmar digital nerves rather than the dorsal digital nerves. Specifically, the median nerve through its palmar digital nerves supplies the nail beds of the thumb, index finger, middle finger, and half of the ring finger.
The axillary nerve (choice A), musculocutaneous nerve (choice C), and radial nerves (choice D) do not supply the nail beds. The radial nerve does supply the more proximal skin of the back of the index finger. The ulnar nerve (choice E) supplies the nail beds of the small and half of the ring finger.
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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| ieltsforall
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MEDIAN NERVE B
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