Tuesday, January 14, 2014

Hand of Benediction and clawing mnemonic

"MBF"
Median nerve injury causes Hand of Benediction hand when patient is asked to make a fist (or flex fingers).

"BE U"
Hand of Benediction hand when asked to extend fingers is caused by Ulnar nerve injury.

If you wanna remember the loss of which muscles cause it, you can add more to the mnemonic - "I PROFOUNDly Dig My BF" and "BE yoUrseLf"

Loss of flexor digitorium profundus causes Bishop's hand in proximal Median nerve injury and loss of Lumbricals cause it in distal Ulnar nerve injury!

Clarification: Since the hand looks the same, I have referred both presentations as hand of benediction. But more commonly, is the proximal median nerve injury which is referred to as hand of benediction. The distal ulnar one is simply called ulnar clawing.

Mnemonic to help remember clawing:
"Clawing is due to loss of lumbricals in distal nerve injury"
CD for Clawing - Distal and the L in cLaw tells me about the loss of Lumbricals.

Ask the subject to extend fingers:
If your median nerve is lost in a distal injury, clawing will be due to loss of 2nd and 3rd lumbricals!
If your distal ulnar nerve is lost, you'll find ulnar clawing due to loss of 4th and 5th lumbricals (which looks like hand of benediction, remember the BE U mnemonic!)

This stuff can get very confusing so best to keep a mnemonic in mind for backup.

That's all guys =)

I'll update the table and diagrams on it sometime later, having exams at the moment T_T

-IkaN

2 comments:

  1. can u please add pictures as well :)

    ReplyDelete
    Replies
    1. Yes.. This week, surely! *writes it in my to do list*

      Delete

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