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Anatomy

Upper Limb

Question 18 of 239

A 21 year old mechanic presents to ED after sustaining a crush injury to his middle finger whilst at work. Which of the following muscles is least likely to be affected:

Answer:

The palmar interossei insert into the extensor hoods of the index, ring and little finger; there is no palmar interosseous muscle attaching to the middle finger and hence it is least likely to be affected in this injury.

Interosseus Muscles

Anatomy / Upper Limb / Wrist and Hand

Last Updated: 10th April 2019

Attachments

  • The interossei muscles originate from and lie between the metacarpal bones.
  • The dorsal interossei insert into the extensor hoods and proximal phalanges of the index, middle and ring finger.
  • The palmar interossei insert into the extensor hoods of the index, ring and little finger.

Function

  • The four dorsal interossei act to abduct the index, middle and ring fingers at the MCPJs (DAB).
  • The three palmar interossei act to adduct the index, ring and little fingers at the MCPJs (PAD).
  • Because the interossei muscles insert into the extensor hoods, they also contribute to the complex flexion and extension movements of the interphalangeal joints of the digits.

Innervation

  • The interossei muscles are all innervated by the ulnar nerve.

Modified by FRCEM Success. Original by By OpenStax [CC BY 4.0 , via Wikimedia Commons

Interossei Muscles. (Image modified by FRCEM Success. Original by OpenStax [CC BY 4.0 , via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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