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29 Cards in this Set
- Front
- Back
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What are the possible sites of compression resulting in ulnar neuropathy at the elbow?
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Between FCU heads
Arcade of Struthers (IM septum) Tunnel (ligament) Anconeus epitrochlearis |
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What is Froment's sign?
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Intrinsic weakness due to ulnar nerve injury
Tests pinch strength FPL compensates for weakness of adductor pollicis |
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How can one test for Froment’s sign?
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Sheet of paper between thumb and
index, key pinch grip Thumb flexes at IP because no adductor function |
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What is ]eanne’s sign?
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Thumb MP hyperextension during attempted active thumb flexion
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What is a positive Pollock test?
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Ulnar two FDPs weak
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What is a poorly prognostic factor for cubital tunnel syndrome?
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Intrinsic atrophy
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What is the preferred method for ulnar nerve transposition?
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Better to transpose submuscularly with muscuolofascial lengthening
technique |
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What is the ideal position for splinting the elbow for cubital tunnel?
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Elbow at 30 to 45 degrees of extension
Forearm neutral (to relax FCU) |
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What are the walls of Guyon’s canal?
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Floor: transverse carpal and pisohamate ligament
Roof: volar carpal ligament Ulnar: pisiform Radial: hamate |
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What are the three zones? . What is a common cause of compression in each zone?
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l: motor and sensory deficits
(ganglia—80% nontraumatic, hook of hamate fracture) II: motor deficit only (same as zone I) lll: sensoiy deficit only (ulnar artery thrombus) |
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lf thrombosis leads to embolus, what is the resulting clinical effect?
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Sympathetic nerve response
Further limitation of flow to ring finger, due to takeoff angle of common digital arteries at 3-4 webspace |
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What is the treatment for embolus?
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Resection of thrombotic segment,with or without arterial repair or vein graft
Sympathectomy |
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How does a hook of hamate fracture classically present?
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Stick-handling sports (e.g., baseball, golf)
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What complication is associated with hook of hamate fracture?
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lrritation or attritional rupture of ulnar sided flexor
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The superficial branch of the ulnar nerve supplies what structures?
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Dorsal and volar aspect of ulnar side of ring
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What structures does the deep branch supply?
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Hypothenar muscles
lntrinsics, except first two lumbricals Adductor pollicis |
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The deep branch courses with what structure?
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Deep (palmar) branch of ulnar artery
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What is the most important secondary adductor (non-ulnar)?
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EPL
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What is the relationship of the ulnar nerve and arteiy in forearm and Guyon’s canal?
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Ulnar nerve is ulnar to artery in forearm and Guyon’s canal
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What is the blood supply to the ulnar nerve?
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Superior ulnar collateral artery (major)
Inferior ulnar collateral artery (minor) Post-ulnar recurrent artery (major) |
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What is the Martin-Gruber anastomosis?
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Motor connection in forearm between median and ulnar nerves
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Where does the anastomosis originate?
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Median nerve proper or AIN
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At which location does the intrinsic innervation revert to the ulnar nerve?
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Elbow
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If an anastomosis is present, and the median nerve is cut in the arm, then what?
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Intrinsics are also lost
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If the ulnar nerve is cut, then what?
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Intrinsics are spared
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The nerve of Henle is a branch of what nerve?
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Ulnar nerve
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To which location does it provide sensation?
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Distal forearm
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To what structure does the nerve of Henle also provide sympathetic innervation?
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Ulnar artery
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What structures are principally at risk with ulnar nerve transposition?
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Median antebrachial cutaneous nerve
Medial brachial cutaneous nerve |
