16 March 2010

Ulnar nerve

Inspection:
  • screening - ?claw hand (flexed PIPJ - median n)
  • wasting of small hand muscles
    • hypothenar
    • 1st dorsal web
    • medial forearm (if above wrist)
  • cubital vulgus/varus
  • scars/deformity
palpate:
  • medial edicondyle
  • wrist
sensation:
  • hypothenar emience
Power:
  • froment - abductor pollicis
  • interossei
  • abduction - esp abductor digiti minimi
tinel

determine level:
  • flexor digitorum profundus (DIPJ flex)
    • high lesion
  • flexor carpi ulnaris
Levels:
  • ulnar tunnel - between pisiform and hook of hamate
  • wrist
  • distal to elbow - compression by 2 heads of flex carpi ulnaris
  • medial epicondyle
  • brachial plexus