Ulnar nerve Nausheen Tamboli

nerve root course clinical anatomy ICF

1. Ulnar nerve

2. Objectives Introduction Course Motor and Sensory supply Clinical anatomy Diagnosis ICF

3. Introduction Ulnar nerve is also known as the nerve of the hand or the musicians nerve. It is the continuation of the medial cord of brachial plexus which arises from the anterior division of the lower trunk and the root value is C7,C8,T1

4. course The course is divided in the following three areas: The Arm The Forearm The Hand

5. Hand It runs superiorly and is superficial to the flexor retinaculum and enters the hand through the Guyon’s canal( formed between the hook of hamate and pisiform bone)

6. Branches Articular branches to elbow joint and wrist joint Motor branch innervates Two heads of flexor carpi ulnaris Medial half of FDP Palmaris brevis Deep branch innervates Hypothenar muscles Palmar and Dorsal Interossei 3 rd and 4 th Lumbricals Adductor pollicis brevis

7. Sensory branches to the medial aspect of forearm and the medial side of palm (dorsal and palmar aspect) to one and half fingers

8. Clinical anatomy Cubital tunnel syndrome Causes Swelling around medial epicondyle Leaning on elbow Prolonged flexion Tumours and Hematomas Diabetes

9. Guyon’s canal syndrome Causes Direct pressure on wrist Ganglion cysts Prolonged typing Weightlifters

10. Diagnosis

11. Icf Impairment Supportive findings Clinical reasoning Neuropraxia NCV Compression of the ulnar nerve Axontomosis NCV Prolonged compression causing axonal damage Neurotomosis NCV Compression causing severe nerve injury Atrophy of 1. Interosseous muscles 2. Adductor pollicis 3. Lumbricals On observation + ve Wartenberg sign + ve Froment sign Prolonged muscle weakness Swelling at medial epicondyle On observation Due to inflammation Structural Impairment

12. Functional impairment Impairment Supportive finding Tingling, numbness On history + ve Tinel test + ve ULTT for ulnar nerve Loss of sensation on the medial aspect of forearm, medial side of palm (dorsal and palmar aspect) and to the 3 rd and 4 th digits On history Superficial sensory testing Reduced strength of 1.Interosseous muscles 2.Adductor pollicis 3.Lumbricals MMT + ve Wartenberg sign + ve Froment sign

13. Thank you