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Questions Answered: 26

Final Score 46%

12
14

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Anatomy

Upper Limb

Question 11 of 180

A 43 year old man sustains an injury to the proximal ulnar nerve after falling through a greenhouse door. Which of the following muscles would you NOT expect to be affected:

Answer:

The hypothenar muscles (opponens digiti minimi, abductor digiti minimi and flexor digiti minimi) are all innervated by the ulnar nerve. The flexor carpi ulnaris in the anterior forearm is also innervated by the ulnar nerve. The extensor digiti minimi in the posterior forearm is innervated by the radial nerve.

Hypothenar Muscles

The hypothenar muscles are the opponens digiti minimi, the abductor digiti minimi and the flexor digiti minimi, all innervated by the ulnar nerve.

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

Hypothenar Eminence: Abductor Digiti Minimi (green), Flexor Digiti Minimi (red), Opponens Digiti Minimi (blue). (Image modified by FRCEM Success. Original by OpenStax [CC BY 4.0 , via Wikimedia Commons)

Function

Table: Function and Innervation of the Hypothenar Muscles

Muscle Function Innervation
Opponens digiti minimi Laterally rotates little finger Ulnar nerve
Abductor digiti minimi Abducts little finger at MCPJ Ulnar nerve
Flexor digiti minimi brevis Flexes little finger at MCPJ Ulnar 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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