Ulnar neuropathy "at the wrist" is really in the hand. Guyon's canal is between the pisiform and hamate bones. It's close to the wrist, though.
The numbers in this image are the Zones where injuries can take place, and they each create a unique clinical picture. #tweetorial
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The numbers in this image are the Zones where injuries can take place, and they each create a unique clinical picture. #tweetorial
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Let's count down from Zone 4. The superficial terminal branch, for practical purposes, is purely sensory, supplying the palmar aspect of the digits 4-5.
FYI: The dorsal ulnar cutaneous nerve (not shown) comes off in the forearm, supplies the backs of these fingers.
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FYI: The dorsal ulnar cutaneous nerve (not shown) comes off in the forearm, supplies the backs of these fingers.
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Zone 3 is a motor branch that supplies the first dorsal interosseous. A lesion here could mimic the Split Hand in ALS, where the muscles on the side of the thumb are disproportionately weak.
I never met someone who was crucified, but I suppose that's one way to get this.
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I never met someone who was crucified, but I suppose that's one way to get this.
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Zone 2. A proximal lesion of the motor branch would cause weakness of all interossei so there would be atrophy and weakness on both sides of the hand.
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Finally, Zone 1 is the most proximal, so a lesion there would cause all of the above deficits.
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Who gets these lesions? People who put pressure on their hands or use grabbing tools:
Bikers 🚴♂️
Chefs👨🍳
Butchers 🥩
Harvesters 🍇
Gardeners🌿
A lot of these people have hypertrophied hand muscles which is also a risk factor!
(Also, as mentioned above, crucifixion victims.)
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Bikers 🚴♂️
Chefs👨🍳
Butchers 🥩
Harvesters 🍇
Gardeners🌿
A lot of these people have hypertrophied hand muscles which is also a risk factor!
(Also, as mentioned above, crucifixion victims.)
6/6
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