Fig. 7. ”Dropping hand” at radial nerve mononeuropathy.
Mononeuropathy of the ulnar nerve:
weakness of forearm and hand elbow flexors, IV and V fingers flexors – impossibility of bending of the IV i V fingers of hand
weakness of I finger adductors – impossibility of adduction of I finger
atrophy of hand interossei muscles – impossibility of adduction and abduction of all fingers – „claw hand“ (Fig. 8)
Fig. 8. „Claw hand“ at ulnar nerve mononeuropathy.
Froment's sign at ulnar nerve mononeuropathy - a patient is asked to hold an object, usually a flat object such as a piece of paper, between their thumb and index finger - in right hand, the patient will experience difficulty maintaining a hold and will compensate by flexing the flexor pollicis longus (innervated by median nerve) of the thumb to maintain grip pressure causing a pinching effect (Fig. 9).
Right hand Left hand
Fig. 9. Froment's sign.
anesthesia of ulnar surface of forearm, hand, IV, V fingers (Fig. 10).
Fig. 4. Anesthesia of ulnar surface of hand at ulnar nerve mononeuropathy.
Mononeuropathy of the median nerve:
atrophy of thenar - brush like "monkey's paw" (finger I set in the same plane with other fingers)
weakness of hand radial flexors and I, II, III fingers flexors – impossibility of bending of the first three fingers (Fig. 11), prophet hand (Fig. 12)
Fig. 12. Motor disorder at median nerve mononeuropathy.
Fig. 12. The prophet hand.
Froment's sign at median nerve mononeuropathy - a patient is asked to hold an object, usually a flat object such as a piece of paper, between their thumb and index finger – in left hand patient can hold a piece of paper only by m. adductor pollicis (innervated by ulnar nerve) (Fig. 9)
anesthesia of thenar and palm surface of I, II III, 1\2 radial part of IV fingers (Fig. 13)
Fig. 13. Anesthesia of lateral surface of hand at median nerve mononeuropathy.
defeat of the vegetative sympathetic fibers (vasomotor disorders, causalgia - intensive pain in hand.
8. Mononeuropathies of the lower extremities.
Mononeuropathy of femoral nerve:
impossible legs extension at the knee,
loss of knee reflex,
sensitivity disorder – at the inner surface of the tibia and the front of the thigh.
Mononeuropathy of the peroneal nerve:
paresis of foot and fingers extensors – impossibility of foot unbending and gait change - steppage (walking with high legs lifting) (Fig. 14)
impossibility of walking on heels
anaesthesia of external surface of shin and foot
Fig. 14. ”Dropping foot” at peroneal nerve mononeuropathy.
Mononeuropathy of the tibial nerve:
paresis of foot and fingers flexors – impossibility of foot bending
impossibility of walking on tiptoes
absence of Achilles reflex
atrophy of the small muscles of the foot - ”сlaw foot” (Fig. 15)
anaesthesia of posterior surface of shin and sole
