Ape hand deformity is due to damage to which nerve?
Correct Answer: Median nerve
Description: ANSWER: (C) Median nerveREF-. Gray's anatomy 39th edition page 933See APPENDIX-7 below for "BRACHIAL PLEXUS LESIONS"As per Gray's "A combined median and ulnar nerve palsy at the wrist results in a full claw hand with thenar and hypothenar flattening, and thumb adduction and flexion. This posture is known as a simian hand because of the similarity to the appearance of the hand of an ape"But even median nerve palsy alone can cause ape hand deformity APPENDIX - 7Brachial Plexus Lesions-chart 1Nerve (Segment)Motor Deficit(s)Sensory DeficitsLong Thoracic (C 5, 6, 7)Winged Scapula- Serratus AnteriorNoneSuprascapular (C 5, 6 )Hard to start shoulder abduction - SupraspinatusNoneAxillary (C 5, 6 )Difficult abducting arm to horizontal - DeltoidLateral side of arm below point of shoulder Loss of shoulder roundness - DeltoidMusculocutaneous C 5, 6, (7)Very weak flexion of elbow joint- Biceps & BrachialisLateral forearm Weak supination of radioulnar joint -Biceps Radial (C 5 - Tl)Drop Wrist - Extensor carpi radialis iongus & brevis, Ext. carpi ulnarisPosterior lateral &arm; dorsum of hand Difficulty making a fist - synergy between wrist 1 extensors and finger flexors Median (EUR 5 - Tl) at ElbowPronation of radioulnar joints-Pronator teres & quadratusRadial portion of palm; palmar surface 8i tips of radial 3% Weak wrist flexion - FI. carpi radialisdigits Weakened opposition of thumb - thenar muscles "Ape Hand"- thumb hyper extended and adducted - thenar muscles "Papal Hand" Loss of flexion of I.P. joints of thumb & fingers 1 & 2 - Fl. pollices Iongus ; FL digit, superficialis, FL digit profundus Median (C 5 - Tl) at WristWeakened opposition of thumb - thenar musclesPalmar surface & tips of radial "Ape Hand"- thumb hyper extended and adducted - thenar muscles3% digitsUlnar (C 8, Tl) at Elbow"Clawing" of fingers 3 & 4- M.P. joints hyper extended: P.I.P. Flexed - Interossei& LumbricalsUlnar and dorsal aspect of palm and of ulnar VA digits Loss of abduction & adduction of M.P joints of fingers -Interossei Thumb - abducted and extended - adductor pollices Loss of flexion of D.I.P. joints of fingers 4 8t 5 - Fl. digit profund. Ulnar (C 8, Tl) at Wrist"Clawing" of fingers 3 & 4- M.P. joints hyper extended; P.I.P. Flexed - Interossei & LumbricalsUlnar and dorsal aspect of palm and of ulnar 1 xk digitsLoss of abduction & adduction of M.P joints of fingers - InterosseiThumb - abducted and extended - adductor pollicesUpper and Lower Root Lesions-chart 2LesionMotor DeficitsSensory DeficitsNervesErb s Palsy(C5,6)Loss of abduction, flexion and rotation at shoulder; Weak shoulder extension - deltoid, rotator cuffPosterior and lateral aspect of arm - axillary n.Axillary, Suprascapular, Upper and Lower subscapular Very weak elbow flexion and supination of radioulnar joint - biceps brachii & brachiaiisRadial side of Forearm- musculocutaneous n. Thumb and 1st finger - superficial hr. of radial; digital brs. - Median n.Musculocutaneous: Radial N. brs. to supinator & brachioradialis muscles Susceptible to shoulder dislocation - loss of rotator cuff muscles Suprascapular, Upper and Lower subscapular "Waiters Tip" position Klumke's Palsy (C8, Tl)Loss of opposition of thumb -Tnenar musclesUlnar side of forearm, hand & ulnar 1 Vi & digits - ulnar and medial antebrachial cutaneousThenar branch of Median nerve Loss of adduction of thumb - Adductor pollices Ulnar nerve Loss of following finger movements: abduction and adduction of M.P. joints; flexion at M.P. & extension of LP. joints. Lumbricals & interossei Deep branch of Ulnar & Median Very weak flexion of P.I.P. & D.I.P. joints FI Digit. Super. & Profund. Ulnar and Median
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