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Claw Hand, Ulnar Claw Hand - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim's animated educational video describing clawing of the hand - Ulnar Claw Hand. Ulnar claw hand is an abnormal hand position that develops due to injury of the ulnar nerve. The ulnar claw hand deformity occurs more with a lower ulnar nerve lesion (below the elbow) and typically causes flexion and clawing of the 4th and 5th fingers due to the unopposed action of the medial part(ulnar part) of the flexor digitorum profundus muscle. Clawing is seen when the patient is asked to extend the fingers. A hand in ulnar claw position will have the 4th and 5th fingers extended at the metacarpophalangeal (MCP) joints and flexed at the interphalangeal (IP) joints. When you ask the patient to extend the fingers, the patient will not be able to extend the interphalangeal (IP) joints of the fourth and fifth fingers. Why does this happen? The ulnar nerve innervates the ulnar ½ of the flexor digitorum profundus muscles. The ulnar nerve also innervates the 3rd and 4th lumbrical muscles, all of the interosseous muscles, the adductor pollicis muscle, and the deep head of the flexor pollicis brevis. When there is an injury to the ulnar nerve at the wrist, there will be loss of function for all the interosseous muscles and the ulnar two lumbricals. The second and third digits are mainly unaffected by this injury except in adduction and abduction of the fingers, while the fourth and fifth digits are largely affected by injury to the nerve. With this dysfunction of these muscles, the extensor digitorum is unopposed, causing hyperextension of the fourth and fifth digits at the metacarpophalangeal (MCP) joints. The extensor digitorum is very affective in extending the MCP joint. The extensor digitorum gets help from the interossei and the lumbricals to extend the IP joints through the extensor hood or the extensor expansion. At the interphalangeal (IP) joints, the extensor digitorum has to overcome and counteract the flexion force that is exerted by the functional flexor digitorum profundus. Clearly the extensor digitorum cannot do this because there is no assistance from the lumbricals or the interossei muscles (clawing of the fingers will show up). This usually occurs from a distal ulnar nerve lesion that preserves innervation to the medial half (ulnar half) of the FDP muscles. In this distal lesion, the sensation at the dorsum of the fourth and fifth fingers will be intact because the dorsal sensory nerve may be spared if the lesion is at the wrist. There will definitely be numbness of the fourth and fifth fingers on the volar aspect. You may find wasting of the first interosseous muscle. There may also be flattening of the hypothenar eminence. The fourth and fifth fingers will be stuck in a position of hyperextension at the MCP joints and flexion at the IP joints. If lesion of the ulnar nerve is high and the flexor digitorum profundus is not working, then there will be no clawing of the fingers. Definitely in a high ulnar nerve lesion, there will be a loss of sensation in the dorsal aspect of the fourth and fifth fingers. Differential Diagnosis: •Volkmann’s Ischemic Contracture •Dupuytren’s Contracture •Spastic Hand •Congenital Flexion Contracture (camptodactyly) These two conditions may appear similar however they are not the same! Claw hand occurs due to an ulnar nerve injury, usually a distal lesion. This is how the position of the hand appears. The fourth and fifth digits are flexed and the patient cannot straighten these two fingers. Sign of Benediction The sign of benediction usually occurs due to a median nerve injury, usually a high median nerve injury or anterior interosseous nerve lesion. The sign of benediction is the position of the hand that occurs when you ask the patient to make a fist and the second and third fingers will remain extended. When you ask the patient to extend the fingers, they will be able to extend them. They cannot flex the second and third digits and also cannot do the ok sign. This is a median nerve or anterior interosseous nerve injury. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 147455 nabil ebraheim
Female Reproductive System | मादा प्रजनन प्रणाली | Science | Vivek Kumar Srivastava | YouTube
Subscribe Our Youtube Channel #Vivek_Kumar_Srivastava for every topic: https://youtube.com/c/VivekKumarShreevastava The female germ-cells or eggs are made in the ovaries. They are also responsible for the production of some hormones. identify the various organs in the female reproductive system. When a girl is born, the ovaries already contain thousands of immature eggs. On reaching puberty, some of these start maturing. One egg is produced every month by one of the ovaries. The egg is carried from the ovary to the womb through a thin oviduct or fallopian tube. The two oviducts unite into an elastic bag-like structure known as the uterus. The uterus opens into the vagina through the cervix. The sperms enter through the vaginal passage during sexual intercourse. They travel upwards and reach the oviduct where they may encounter the egg. The fertilised egg, the zygote, gets implanted in the lining of the uterus, and starts dividing. We have seen in earlier sections that the mother’s body is designed to undertake the development of the child. Hence the uterus prepares itself every month to receive and nurture the growing embryo. The lining thickens and is richly supplied with blood to nourish the growing embryo. The embryo gets nutrition from the mother’s blood with the help of a special tissue called placenta. This is a disc which is embedded in the uterine wall. It contains villi on the embryo’s side of the tissue. On the mother’s side are blood spaces, which surround the villi. This provides a large surface area for glucose and oxygen to pass from the mother to the embryo. The developing embryo will also generate waste substances which can be removed by transferring them into the mother’s blood through the placenta. The development of the child inside the mother’s body takes approximately nine months. The child is born as a result of rhythmic contractions of the muscles in the uterus. #ScienceVideoLecture prepared by #Navya #Radha #Abhi #Ram & #VivekSrivastava
Views: 1804240 Vivek Kumar Srivastava
ATP & Respiration: Crash Course Biology #7
In which Hank does some push ups for science and describes the "economy" of cellular respiration and the various processes whereby our bodies create energy in the form of ATP. Crash Course Biology is now available on DVD! http://dftba.com/product/1av/CrashCourse-Biology-The-Complete-Series-DVD-Set Like CrashCourse on Facebook: http://www.facebook.com/YouTubeCrashCourse Follow CrashCourse on Twitter: http://www.twitter.com/TheCrashCourse Special thanks go to Stafford Fitness (www.staffordfitness.net) for allowing us to shoot the gym scenes in their facilities. This video uses sounds from Freesound.org, a list of which can be found, along with the CITATIONS for this episode, in the Google Document here: http://dft.ba/-25Ad Table of Contents: 1) Cellular Respiration 01:00 2) Adenosine Triphosphate 01:29 3) Glycolysis 4:13 A) Pyruvate Molecules 5:00 B) Anaerobic Respiration/Fermentation 5:33 C) Aerobic Respiration 6:45 4) Krebs Cycle 7:06 A) Acetyl COA 7:38 B) Oxaloacetic Acid 8:21 C) Biolography: Hans Krebs 8:37 D) NAD/FAD 9:48 5) Electron Transport Chain 10:55 6) Check the Math 12:33 TAGS: crashcourse, biology, science, chemistry, energy, atp, adenosine triphosphate, cellular respiration, glucose, adp, hydrolysis, glycolysis, krebs cycle, electron transport chain, fermentation, lactic acid, enzyme, hans krebs, citric acid, ATP synthase Support CrashCourse on Subbable: http://subbable.com/crashcourse
Views: 6793591 CrashCourse
Statens vegvesen - Barnekontrolløren
En film fra Statens vegvesen for å få enda flere til å feste beltet i bussen. Regissør: Jens Lien
Views: 16298 Statens vegvesen