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Examination of Pediatric Hand and Wrist
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Mohsina Subair, Satyaswarup Tripathy, Ranjit Kumar Sahu
Palmar surface (Figure 7.1a): Thenar eminence: On the thumb side; formed by intrinsic muscles of the thumb.Hypothenar eminence: On the little finger side, formed by intrinsic muscles of the little finger.Palmar creases: Longitudinal and transverse creases are present.Kaplan’s cardinal line: Transverse line from the apex of first web space to the pisiform bone running parallel to the proximal palmar crease.2 Used as a surface guide during carpal tunnel surgery (Figure 7.2). The intersection of Kaplan’s line with a perpendicular line along the radial border of the middle finger corresponds to the recurrent motor branch of the median nerve and superficial palmar arch (Figure 7.2).The intersection of Kaplan’s line with a perpendicular line along the ulnar border of the ring finger corresponds to the distal margin of the transverse carpal ligament (Figure 7.2).
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Early stages of proximal lesions show weakness and wasting of the hypothenar eminence and first dorsal interosseous. Flexor carpi ulnaris and flexor digitorum profundus are rarely weak or wasted initially.
Surgery of the Peripheral Nerve
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ravikiran Shenoy, Gorav Datta, Max Horowitz, Mike Fox
The hypothenar eminence and transverse wrist skin crease are important surface landmarks. The bony landmarks of Guyon's canal (Table 5.1) are palpated and marked; the hook of hamate lies 1 cm radial and distal to the pisiform, which is easily palpated at the base of the hypothenar eminence.
Misconceptions in IONM Part II: Does Anodal Blocking Occur and Is Bipolar Stimulation Necessary with Intraoperative Somatosensory Evoked Potentials?
Published in The Neurodiagnostic Journal, 2022
David W. Allison, Randy S. D’Amico, Justin W. Silverstein
Methods unique to part two: Monopolar stimulation was delivered at supramaximal stimulation utilizing 20 mm × 27 mm adhesive surface electrodes. For upper extremity SSEP stimulation, the monopolar electrode was placed just proximal to the crease of the wrist over the median or ulnar nerves and the distant electrode was placed distally at the base of the thumb over the thenar eminence for median nerve SSEPs and near the base of the pinky finger over the hypothenar eminence for ulnar nerve SSEPs proximal the metacarpophalangeal joint (Figure 1F,G). For tibial nerve SSEP stimulation, the monopolar electrode was placed at the medial ankle midway between the medial malleolus and the Achilles tendon, and the distant stimulation electrode was placed 5–6 cm distal on the heel (Figure 1I).
Severe Heloderma spp. envenomation: a review of the literature
Published in Clinical Toxicology, 2021
Jean-Philippe Chippaux, Karim Amri
We collected in the literature twenty-two documented Heloderma bites that are summarized in Table 1. Pain is constant and accompanied by regional ecchymotic edema of variable severity. Although the trauma of the bite can be significant, local lesions are usually moderate. Stahnke et al. [17] described hypoxic aspect of the bitten finger which they had attributed to a local arterial spasm; however, the patient had been treated before with local cryotherapy which may explain the spasm [18]. In another patient bitten in the hypothenar eminence, the radial pulse was impalpable while the Doppler showed normal arterial flow and venous return [18,19]. In most cases, general signs (diaphoresis, dizziness, nausea, vomiting) occur 5–15 min after the bite.
Predictors of clinical success with stabilization exercise are associated with lower levels of lumbar multifidus intramuscular adipose tissue in patients with low back pain
Published in Disability and Rehabilitation, 2020
Jeffrey J. Hebert, Edward C. Le Cara, Shane L. Koppenhaver, Martin D. Hoffman, Robin L. Marcus, Alasdair R. Dempsey, Wayne J. Albert
With the participant prone on a table, the examiner used their hypothenar eminence to apply a posterior-to-anterior pressure to the lumbar spinous process. The examiner made a judgment of normal, hypomobile, or hypermobile for each of the lumbar segments. The results were interpreted in a dichotomous fashion relating to the presence or absence of hypomobility and hypermobility. The test was considered to be positive when the presence of hypermobility was reported at one or more segments. This procedure has previously demonstrated fair reliability (κ = 0.30) despite relatively high levels of agreement (76%), which may result from bias owing to the low prevalence of hypermobile ratings [30].