【解剖】手の運動・神経支配（USMLE対策）

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ECRL: Extensor carpi radialis longus, C6, R

ECRB: Extensor carpi radialis brevis, C6, R

ECU: Extensor carpi ulnaris, C7, R

FCR: Flexor carpi radialis, C7, M

FCU: Flexor carpi ulnaris, C8, U

EDC: Extensor digitorum communis, C7, R

EIP: Extensor indicis proprius, C7, R

EDM: Extensor digiti minimi, C7, R

FDS: Flexor digitorum superficialis, C8, M

FDP: Flexor digitorum profundus, C8, M, U

EPB: Extensor pollicis brevis, C8, R

FPB: Flexor pollicis brevis, C8, M

APB: Abductor pollicis brevis, C8, M

OP: Opponens pollicis, C8, M

FPL: Flexor pollicis longus, C8, M

APL: Abductor pollicis longus, C8, R

EPL: Extensor pollicis longus, T1, U

AP: Adductor pollicis, T1, U

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"Claw hand"

Claw hand: Extension of MP + Flexion of both PIPs and DIPs.

Lumbricals are preventing "claw hand."

Lumbricals flex MP joints as well as extend both PIPs and DIPs.

Median claw hand: dysfunctional Lumbricals on the median side due to distal median nerve injury (or proximal ulnar nerve injury).

Ulnar claw hand: dysfunctional Lumbricals on the ulnar side due to distal ulnar nerve injury (or proximal median nerve injury).

Claw hand (median + ulnar): dysfunctional Lumbricals of all due to C8 root injury as Klumpke palsy resulting in both median and ulnar nerve injury.

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References:

• Schwartz's Principles of Surgery (McGraw-Hill Education)
• Michigan Manual of Plastic Surgery (Lippincott Manual Series)
• First aid for the USMLE step 1 (McGraw-Hill Education)

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