Name
The term "hand of benediction" refers to the similarity to a sign commonly used in Catholicism, which is said to originate from Saint Peter. Some sources speculate that Peter himself may have had ulnar nerve entrapment. [4] [5] [6]
The hand of benediction, also known as benediction sign or preacher's hand, has been said to occur as a result of prolonged compression or injury of the median nerve at the forearm or elbow. [1]
More recently it has been shown that the clinical appearance of a high median nerve palsy is different from the classical hand of benediction or preacher's hand posture pointing finger. [2]
The term "hand of benediction" has been used to refer to damage of the median nerve. However, the name is misleading as the patients with this median nerve problem usually can flex all fingers except for the index finger. The index finger is still extended at the metacarpophalangeal joint (MCP joint) when the ulnar nerve innervated muscles (the interossei muscles) are still working. The index finger is not flexed at the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, which looks like a pointing finger. Pointing Finger is therefore a much better term to recognize this condition.[ citation needed ]
The middle finger is flexed because of the connection between the flexor digitorum profundus (FDP) tendons, which is called the Quadriga phenomenon. [3] [2]
The term "hand of benediction" refers to the similarity to a sign commonly used in Catholicism, which is said to originate from Saint Peter. Some sources speculate that Peter himself may have had ulnar nerve entrapment. [4] [5] [6]
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 lumbricals are intrinsic muscles of the hand that flex the metacarpophalangeal joints, and extend the interphalangeal joints.
The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers. It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm.
Flexor digitorum superficialis is an extrinsic flexor muscle of the fingers at the proximal interphalangeal joints.
In human anatomy, the ulnar nerve is a nerve that runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.
Froment's sign is a special test of the wrist for palsy of the ulnar nerve, specifically, the action of adductor pollicis. Froment's maneuver can also refer to the cogwheel effect from contralateral arm movements seen in Parkinson's disease.
The extensor digitorum muscle is a muscle of the posterior forearm present in humans and other animals. It extends the medial four digits of the hand. Extensor digitorum is innervated by the posterior interosseous nerve, which is a branch of the radial nerve.
The flexor pollicis longus is a muscle in the forearm and hand that flexes the thumb. It lies in the same plane as the flexor digitorum profundus. This muscle is unique to humans, being either rudimentary or absent in other primates. A meta-analysis indicated accessory flexor pollicis longus is present in around 48% of the population.
In human anatomy, the palmar or volar interossei are four muscles, one on the thumb that is occasionally missing, and three small, unipennate, central muscles in the hand that lie between the metacarpal bones and are attached to the index, ring, and little fingers. They are smaller than the dorsal interossei of the hand.
In human anatomy, the dorsal interossei (DI) are four muscles in the back of the hand that act to abduct (spread) the index, middle, and ring fingers away from hand's midline and assist in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints of the index, middle and ring fingers.
In human anatomy, the abductor digiti minimi is a skeletal muscle situated on the ulnar border of the palm of the hand. It forms the ulnar border of the palm and its spindle-like shape defines the hypothenar eminence of the palm together with the skin, connective tissue, and fat surrounding it. Its main function is to pull the little finger away from the other fingers.
The flexor retinaculum is a fibrous band on the palmar side of the hand near the wrist. It arches over the carpal bones of the hands, covering them and forming the carpal tunnel.
The flexor digiti minimi brevis is a hypothenar muscle in the hand that flexes the little finger at the metacarpophalangeal joint. It lies lateral to the abductor digiti minimi when the hand is in anatomical position.
Ulnar nerve entrapment is a condition where pressure on the ulnar nerve as it passes through the cubital tunnel causes nerve dysfunction (neuropathy). The symptoms of neuropathy are paresthesia (tingling) and numbness primarily affecting the little finger and ring finger of the hand. Ulnar neuropathy can progress to weakness and atrophy of the muscles in the hand. Symptoms can be alleviated by attempts to keep the elbow from flexing while sleeping, such as sticking one’s arm in the pillow case, so the pillow restricts flexion.
The muscles of the hand are the skeletal muscles responsible for the movement of the hand and fingers. The muscles of the hand can be subdivided into two groups: the extrinsic and intrinsic muscle groups. The extrinsic muscle groups are the long flexors and extensors. They are called extrinsic because the muscle belly is located on the forearm. The intrinsic group are the smaller muscles located within the hand itself. The muscles of the hand are innervated by the radial, median, and ulnar nerves from the brachial plexus.
An ulnar claw, also known as claw hand, is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals. A claw hand presents with a hyperextension at the metacarpophalangeal joints and flexion at the proximal and distal interphalangeal joints of the 4th and 5th fingers. The patients with this condition can make a full fist but when they extend their fingers, the hand posture is referred to as claw hand. The ring- and little finger can usually not fully extend at the proximal interphalangeal joint (PIP).
A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala are often described as having "hands" instead of paws on their front limbs. The raccoon is usually described as having "hands" though opposable thumbs are lacking.
Pronator teres syndrome is a compression neuropathy of the median nerve at the elbow. It is rare compared to compression at the wrist or isolated injury of the anterior interosseous branch of the median nerve.
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.
Quadriga phenomenon is a condition wherein the middle finger is flexed because of the connection between the flexor digitorum profundus (FDP) tendons.