High Median Nerve Palsy Quiz

In high median nerve palsy, which digits are MOST affected?

Which presentation is characteristic of a high median nerve palsy when a patient attempts to make a fist (traditional presentation)?

If a patient presents with thenar wasting and impaired thumb abduction, which nerve is MOST likely affected?

What is the typical hand posture at REST in someone with a high median nerve palsy?

Which muscles of the hand are typically paralyzed in high median nerve palsy (select all that apply)?

High Median Nerve Palsy ("Hand of Benediction")

Nerve Involved: Median nerve
Site of injury: High or proximal to the elbow
Digits affected: Digits 2 and 3 are most commonly affected.
Muscles Paralyzed:
- Lateral half of Flexor Digitorum Profundus (FDP)
- Lumbricals (digits 2-3)
- Thenar muscles
Presentation with open palm at rest: Normal
Presentation when making a fist (traditional)
- MCP (metacarpophalangeal) joints 2-3 are hyperextended
- IP (interphalangeal) joints 2-3 have no flexion
- MCP and IP joints 4-5 have full flexion
Presentation when making a fist (revised)
- MCP joints 2-3 are flexed
- PIP (proximal interphalangeal) and DIP (distal interphalangeal) joints of the 2nd digit are extended
- DIP joint of the 3rd digit is flexed
- MCP and IP joints 4-5 have full flexion
Additional clinical signs:
- Thenar muscle atrophy or flattening
- Loss of thumb opposition
- Impaired thumb abduction
- Impaired wrist pronation and flexion

Test your knowledge on High Median Nerve Palsy, specifically focusing on the implications of median nerve injury high at the elbow. This quiz covers affected digits, muscle paralysis, and clinical presentations of the condition. Challenge your understanding of the clinical signs and anatomical considerations involved in this nerve palsy.