By Stephen Russell
"This booklet teaches the reader how one can adequately study a sufferer with a suspected focal neuropathy. This guideline contains the pertinent anatomy of every peripheral nerve, transparent pictures illustrating the muscular exam, and in addition dialogue on tips on how to procedure localization and prognosis. simply because a robust starting place in anatomical relationships is paramount for studying sufferers with nerve damage, this is under pressure within the textual content and through the use of quite a few illustrations. Readers can and should learn the whole booklet and paintings to memorize the extra universal difficulties and tests they are going to practice. they're going to then seek advice it both prior to or after interpreting sufferers with much less universal problems"--Provided through publisher. �Read more...
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Extra info for Examination of peripheral nerve injuries : an anatomical approach
Two sensory branches originate from the ulnar nerve in the distal half of the forearm. The first is the dorsal ulnar cutaneous nerve, which arises approximately 5 to 10 cm proximal to the wrist crease oﬀ the dorsomedial aspect of the ulnar nerve. This branch travels to the dorsum of the distal forearm between the ulna and the tendon of the flexor carpi ulnaris. Once on the dorsal surface, it pierces the antebrachial fascia and becomes subcutaneous a few centimeters proximal to the wrist. The second sensory branch from the ulnar nerve is the palmar ulnar cutaneous nerve, which is a mirror image of the palmar cutaneous branch of the median nerve.
This muscle is tested in the same fashion as for its median innervated half, except one uses the fifth digit: immobilize the proximal interphalangeal joint while the patient flexes the distal interphalangeal joint (▶ Fig. 11). ⬧ In 5% of patients, branches to the flexor carpi ulnaris originate proximal to the elbow. ⬧ Although the median nerve’s anterior interosseous branch may occasionally control distal interphalangeal joint flexion of the ring finger (in addition to the index and long fingers), the ulnar nerve always controls this movement in the fifth digit.
Therefore, it may in fact cover the bony postcondylar groove. The second segment is where the ulnar nerve passes between and under the two muscular heads of the flexor carpi ulnaris. The aponeurosis between the two heads of the flexor carpi ulnaris can be very thick in approximately 75% of the population; in which case it is called the Osborne band. As will be discussed, the Osborne band has been implicated in ulnar nerve compression. Dynamic changes in elbow anatomy are important. As the elbow flexes, the aponeurosis of the flexor carpi ulnaris becomes tense, potentially compressing the ulnar nerve underneath (▶ Fig.