Nerve injuries. radial nerve ulnar nerve median nerves. radial nerve:. All extensors by radial n. Triceps (ex. Of elbow) , Extensor carpi radialis longus & brevis (ex. Of the wrist in radial deviation) & Brachioradialis Then divide into : Sensory:
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All extensors by radial n.
Then divide into :
By superficial branch of radial n. which supplies Lat. 2/3 of the dorsum of the hand & the dorsal surface of the of the lat. 3 ½ fingers.
By post. Interosseous n. which supplies the ex. of the forearm + supinator m.
Biceps is also a supinator & it’s more stronger than supinator m.
Injury to radial n. high up:
Supplies 4 out of 5 :pronatorteres,flexorcarpiradialis,palmarislongus & flex. Digitorumsuperficialis.
*flex. Carpi ulnaris by ulnar n.
Then divide into:
Sensory (the main trunk) : palmar surface of the lat. 3 ½ fingers.
By ant. Interosseous n. which supplies 2 ½ out of 3 m.:
Flex. Policislongus , lat. Half of flex. Digitorumprofundus & pronatorquadratus.
For the hand :
It gives supply to the 2 lumbricales (index & middle fingers) + all thenars m. except adductor pollicis.
can be remembered using the mnemonic, "LOAF" for limbricals1 & 2, Opponenspollicis, Abductor pollicisbrevis and Flexor pollicisbrevis.
Pts. Can't perform perfect o due to weakness of the Flexor pollicislongus muscle and the flexor digitorumprofundus
at wrist level :
Commonest ex. Is carpal tunnel syn.
At the level of elbow:
Ape hand deformity :
occur with an injury of the median n. either at the elbow or the wrist , impairing the thenar m.
pts. Is inable to oppose the thumb and has limited abduction of the thumb.
It supplies flex. Carpi ulnaris & flex. Digitorumprofundus of the little & ring fingers.
In the hand:
&Flexor digitiminimibrevis ).
Dorsal & palmar aspects of the med. 1/3 of the hand & the palmar aspects of the med. 1 ½ fingers.
some intrinsic may continue to function due to communication between AIN and the unlnar nerve.
when the patient is asked to grasp piece of paper between thumb and index finger patient will instead of doing adduction will hyperflex the IP joint to compensate for loss of the adductor pollicis
MCP joints are hyperextended, and the IP joints are flexed. These changes are more obvious at the ring and little fingers, because the first and second lumbrical muscles are not paralyzed.