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200
38

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Anatomy

Upper Limb

Question 26 of 239

A 27 year old woman sustains an injury to the proximal median nerve after cutting herself whilst separating frozen chicken breasts using a knife. Which of the following muscles would you NOT expect to be affected:

Answer:

The thenar muscles (opponens pollicis, abductor pollicis brevis and flexor pollicis brevis) are all innervated by the median nerve. The flexor pollicis longus in the anterior forearm is also innervated by the median nerve. The adductor pollicis, an intrinsic hand muscle, is innervated by the ulnar nerve. The muscles of the hand supplied by the median nerve can be remembered using the mnemonic, "LOAF" for Lumbricals 1 & 2, Opponens pollicis, Abductor pollicis brevis and Flexor pollicis brevis.

Thenar Muscles

Anatomy / Upper Limb / Wrist and Hand

Last Updated: 10th April 2019

The thenar eminence consists of the opponens pollicis, the abductor pollicis brevis and the flexor pollicis brevis muscles.

The thenar muscles are all innervated by the median nerve.

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

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

Function

Table: Function and Innervation of the Thenar Muscles

Muscle Function Innervation
Opponens pollicis Medially rotates thumb Median nerve
Abductor pollicis brevis Abducts thumb at MCPJ Median nerve
Flexor pollicis brevis Flexes thumb at MCPJ Median nerve

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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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