Hand innervation |
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Main nerves; ulnar, radial, median, cutaneous nerves |
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Ulnar nerve |
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Passes anterior to flexor retinaculum and divides into superficial and deep branches
Superficial: supplies palmaris brevis and medial one and half fingers
Deep branch- this arches deep in the concavity of the deep palmar arch and gives motor braches to
- hypothenar muscles
- medial two lumbricals
- 8 interrossei
- deep head of flexor pollicis brevis
- heads of adductor hallucis
Ulnar nerve injury presents with
- Claw hand
- Loss of sensation medial one and half fingers
- Loss of finger abduction
- Loss of finger adduction
- Atrophy of hypothenar eminence and inter-metatarsal spaces
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Median nerve |
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- Deep to flexor retinaculum
- Gives a recurrent branch to thenar muscles
- The nerve then gives a medial and a lateral branches
- The medial branch gives 2 common digital for 2nd and 3rd clefts and sides of ring middle and index fingers.
- The lateral supplies palmar skin, radial side of index and whole of the thumb on the palmar surface and distal dorsal surface.
The branch to the index finger supplies the 1 st lumbrical
Medial nerve injury
- The hand position is described “papal hand”
- There is loss of sensation on the palmar medial three and half fingers to include their nail beds
- Loss of opposability with atrophy of thenar muscles.
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Radial nerve |
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- It is a continuation of superficial terminal branch
- At dorsum of hand it divides into 4-5 dorsal digital branches
- Supplies lateral three and half fingers on the dorsal side except the nail beds
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