Ape Hand Deformity
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Ape Hand Deformity
Ape hand deformity is a deformity in humans who cannot move the thumb away from the rest of the hand. It is an inability to abduct the thumb. Abduction of the thumb refers to the specific capacity to orient the thumb perpendicularly to the ventral (palmar) surface of the hand. Opposition refers specifically the ability to "swing" the first metacarpal such that the tip of the thumb may touch the distal end of the 5th phalanx and if we put the hand on the table as the palm upward the thumb can not point to the sky. The Ape Hand Deformity is caused by damage to the distal median nerve (also called a Median Claw lesion), and subsequent loss of opponens pollicis muscle function. The name "ape hand deformity" is misleading, as some apes do not have opposable thumbs. It can occur with an injury of the median nerve either at the elbow or the wrist, impairing the thenar muscles and opponens pollicis muscle. Ape hand deformity is one aspect of median nerve palsy, which is usually caused ...
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Anatomical Terms Of Motion
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatomica ...
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Median Nerve
The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, and has contributions from ventral roots of C5-C7 (lateral cord) and C8 and T1 (medial cord). The median nerve is the only nerve that passes through the carpal tunnel. Carpal tunnel syndrome is the disability that results from the median nerve being pressed in the carpal tunnel. Structure The median nerve arises from the branches from lateral and medial cords of the brachial plexus, courses through the anterior part of arm, forearm, and hand, and terminates by supplying the muscles of the hand. Arm After receiving inputs from both the lateral and medial cords of the brachial plexus, the median nerve enters the arm from the axilla at the inferior margin of the teres major muscle. It then passes vertically down and courses lateral to the brachial ar ...
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Opponens Pollicis
The opponens pollicis is a small, triangular muscle in the hand, which functions to oppose the thumb. It is one of the three thenar muscles. It lies deep to the abductor pollicis brevis and lateral to the flexor pollicis brevis. Structure The opponens pollicis muscle is one of the three thenar muscles. It originates from the flexor retinaculum of the hand and the tubercle of the trapezium. It passes downward and laterally, and is inserted into the whole length of the metacarpal bone of the thumb on its radial side. Innervation Like the other thenar muscles, the opponens pollicis is innervated by the recurrent branch of the median nerve. In 20% of the population, opponens pollicis is innervated by the ulnar nerve. Blood supply The opponens pollicis receives its blood supply from the superficial palmar arch. Function ''Opposition of the thumb'' is a combination of actions that allows the tip of the thumb to touch the tips of other fingers. The part of apposition that this musc ...
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Thumb
The thumb is the first digit of the hand, next to the index finger. When a person is standing in the medical anatomical position (where the palm is facing to the front), the thumb is the outermost digit. The Medical Latin English noun for thumb is ''pollex'' (compare ''hallux'' for big toe), and the corresponding adjective for thumb is ''pollical''. Definition Thumb and fingers The English word ''finger'' has two senses, even in the context of appendages of a single typical human hand: # Any of the five terminal members of the hand. # Any of the four terminal members of the hand, other than the thumb Linguistically, it appears that the original sense was the first of these two: (also rendered as ) was, in the inferred Proto-Indo-European language, a suffixed form of (or ), which has given rise to many Indo-European-family words (tens of them defined in English dictionaries) that involve, or stem from, concepts of fiveness. The thumb shares the following with each of the o ...
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Median Nerve
The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, and has contributions from ventral roots of C5-C7 (lateral cord) and C8 and T1 (medial cord). The median nerve is the only nerve that passes through the carpal tunnel. Carpal tunnel syndrome is the disability that results from the median nerve being pressed in the carpal tunnel. Structure The median nerve arises from the branches from lateral and medial cords of the brachial plexus, courses through the anterior part of arm, forearm, and hand, and terminates by supplying the muscles of the hand. Arm After receiving inputs from both the lateral and medial cords of the brachial plexus, the median nerve enters the arm from the axilla at the inferior margin of the teres major muscle. It then passes vertically down and courses lateral to the brachial ar ...
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Elbow
The elbow is the region between the arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term ''elbow'' is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used. The name for the elbow in Latin is ''cubitus'', and so the word cubital is used in some elbow-related terms, as in ''cubital nodes'' for example. Structure Joint The elbow joint has three different portions surrounded by a common joint capsule. These are joints between the three bones of the elbow, the humerus of the upper arm, and the radius and ...
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Wrist
In human anatomy, the wrist is variously defined as (1) the Carpal bones, carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal bones." (2) the wrist joint or radiocarpal joint, the joint between the radius (bone), radius and the Carpal bones, carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as ''wrist joints''. "With the large number of bones composing the wrist (ulna, radius, eight carpas, and five metacarpals), it makes sense that there are many, many joints that make up the structure known as the wrist." This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the Flexor retinaculum of the hand, flexor retinaculum, and the ex ...
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Thenar Muscles
The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the muscles of the thumb#Intrinsic, intrinsic group of muscles of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes . Structure The following three muscles are considered part of the thenar eminence: * Abductor pollicis brevis abduction (anatomy), abducts the thumb. This muscle is the most superficial (anatomy), superficial of the thenar group. * Flexor pollicis brevis, which lies next to the abductor, will flexion, flex the thumb, curling it up in the palm. (The Flexor pollicis longus, which is inserted into the distal phalanx of the thumb, is not considered part of the thenar eminence.) * Opponens pollicis lies deep to abductor pollicis brevis. As its name suggests it Anatomical terms of motion, opposes the thumb, bringing it against the fingers. This is a very important movement, as most of human hand dexte ...
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Median Nerve Palsy
Injuries to the arm, forearm or wrist area can lead to various nerve disorders. One such disorder is median nerve palsy. The median nerve controls the majority of the muscles in the forearm. It controls abduction of the thumb, flexion of hand at wrist, flexion of digital phalanx of the fingers, is the sensory nerve for the first three fingers, etc. Because of this major role of the median nerve, it is also called the eye of the hand. If the median nerve is damaged, the ability to abduct and oppose the thumb may be lost due to paralysis of the thenar muscles. Various other symptoms can occur which may be repaired through surgery and tendon transfers. Tendon transfers have been very successful in restoring motor function and improving functional outcomes in patients with median nerve palsy.http://www5.aaos.org/oko/description.cfm?topic=HAN027&referringPage=mainmenu.cfm Signs and symptoms *Lack of ability to abduct and oppose the thumb due to paralysis of the thenar muscles. This ...
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Recurrent Branch Of The Median Nerve
The recurrent branch of the median nerve is the branch of the median nerve which supplies the thenar muscles. It is also occasionally referred to as the thenar branch of the median nerve, or the thenar muscular branch of the median nerve. Structure An earlier branch of the median nerve also supplies the lumbricals 1 & 2. All other intrinsic muscles of the hand receive their motor innervation from branches of the ulnar nerve. It usually passes distal to the transverse carpal ligament. It ends in the opponens pollicis. Function In the thenar eminence, the recurrent branch of the median nerve provides motor innervation to: * opponens pollicis muscle. * abductor pollicis brevis muscle. * the superficial part of flexor pollicis brevis muscle. Clinical significance The recurrent branch of the median nerve may be affected in carpal tunnel syndrome, or from its own separate peripheral neuropathies. Surgery The recurrent branch of the median nerve is also colloquially called the ...
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