Hand of benediction
Encyclopedia
The hand of benediction results from a severed Median nerve
at the level of the elbow or upper arm. The ability to flex the digits 2–3 at the metacarpophalangeal joint
s, proximal interphalangeal joints
and distal interphalangeal joints is lost. This is due to the loss of innervation of the lateral 2 lumbricals of the hand
which are supplied by the median nerve. Flexion at the proximal interphalangeal joints of digits 4–5 is weakened, but flexion at the metocarpophalangeal joints and distal interphalangeal joints remains intact. The extensors are left unopposed and digits 2–3 remain extended while attempting to make a fist.
The name arises from the invocation of a blessing used in Christian circles (see Benediction
).
ing, which is a common source of confusion. Both signs have similar presentations, but the term "hand of benediction" more frequently refers only to damage to the median nerve
and is seen with attempted flexion of all the digits, while "ulnar claw" refers exclusively to damage to the ulnar nerve
and is seen with attempted extension of all the digits.
Median nerve
The median nerve is a nerve in humans and other animals. It is in the upper limb. It is one of the five main nerves originating from the brachial plexus....
at the level of the elbow or upper arm. The ability to flex the digits 2–3 at the metacarpophalangeal joint
Metacarpophalangeal joint
The metacarpophalangeal joints are of the condyloid kind, formed by the reception of the rounded heads of the metacarpal bones into shallow cavities on the proximal ends of the first phalanges, with the exception of that of the thumb, which presents more of the characters of a ginglymoid joint...
s, proximal interphalangeal joints
Interphalangeal joints
The interphalangeal articulations of the hand are the hinge joints between the phalanges of the hand .There are two sets :...
and distal interphalangeal joints is lost. This is due to the loss of innervation of the lateral 2 lumbricals of the hand
Lumbricals of the hand
The lumbricals are intrinsic muscles of the hand that flex the metacarpophalangeal joints and extend the interphalangeal joints.-Structure:There are four of these small, worm-like muscles on each hand. These muscles are unusual in that they do not attach to bone...
which are supplied by the median nerve. Flexion at the proximal interphalangeal joints of digits 4–5 is weakened, but flexion at the metocarpophalangeal joints and distal interphalangeal joints remains intact. The extensors are left unopposed and digits 2–3 remain extended while attempting to make a fist.
The name arises from the invocation of a blessing used in Christian circles (see Benediction
Benediction
A benediction is a short invocation for divine help, blessing and guidance, usually at the end of worship service.-Judaism:...
).
Distinction from Ulnar Claw
Some sources use the term "hand of benediction" to include both the condition described above and ulnar clawUlnar claw
A hand imitating an ulnar claw created by distal ulnar lesion or papal hand of a proximal median nerve lesion. The metacarpophalangeal joints of the 4th and 5th fingers are extended and the Interphalangeal joints of the same fingers are flexed....
ing, which is a common source of confusion. Both signs have similar presentations, but the term "hand of benediction" more frequently refers only to damage to the median nerve
Median nerve
The median nerve is a nerve in humans and other animals. It is in the upper limb. It is one of the five main nerves originating from the brachial plexus....
and is seen with attempted flexion of all the digits, while "ulnar claw" refers exclusively to damage to the ulnar nerve
Ulnar nerve
In human anatomy, the ulnar nerve is a nerve which runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest unprotected nerve in the human body , so injury is common...
and is seen with attempted extension of all the digits.