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  #1  
Old 06-22-2012
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Question Pope's blessing

Can someone explain Pope's blessing...
FA says it's ulnar claw hand.
DIT says it's median...
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Old 06-22-2012
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I understand the misunderstanding, but actually both of them are right,
I will explain:

Popes blessing is a sign in which the 4th and 5th digits are flexed while 1,2,3 are extended.

There are 2 ways to look at it.
Median nerve lesion will impair the flexion of the 1,2,3 fingers - so when someone makes a fist he will be able only to flex the 4,5 fingers as they are innervated by flexor digitorum superficials and profundus which receive fibers from both the median and ulnar nerve but the fibers working on 4,5 fingers mainly get the fibers from the ulnar nerve.

Ulnar nerve lesion : as you know the ulnar nerve innervates the 2 medial (ulnar) lumbrical muscles which are working on the 4 and 5 fingers. the lumbricles are responsible for flexion at MCP and extension of PIP and DIP hence if they are not working the opposite will happen the the PIP and DIP will be flexed giving us the claw finger appearance.

So you can see that both have the similar appearance when you are trying to make fist with the median or on normal appearance when you have ulnar lesion.

Hope it was understandable.
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Old 06-22-2012
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Pope's blessing, two possibilities:

1- The hand is trying to flex (make a fist), with an inability to flex 1st and 2nd and 3rd:
Proximal median nerve injury

2- The hand is trying to extend (straighten your fingers), with an inability to extend 4th and 5th:
Distal ulnar nerve lesion.

This is how I remember it, hope it's right, they can get a bit confusing sometimes!
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Old 06-22-2012
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Thanks guys!!
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Old 06-22-2012
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Hey, didn't proximal median nerve injury affect the opposition of the thumb, or is it both?

Quote:
Originally Posted by Renaissance View Post
Pope's blessing, two possibilities:

1- The hand is trying to flex (make a fist), with an inability to flex 1st and 2nd and 3rd:
Proximal median nerve injury

2- The hand is trying to extend (straighten your fingers), with an inability to extend 4th and 5th:
Distal ulnar nerve lesion.

This is how I remember it, hope it's right, they can get a bit confusing sometimes!
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Old 06-25-2012
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Is pope's blessing and claw hand the same thing??
This is getting on my nerves! someone please enlighten me
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Last edited by numbndumb; 06-25-2012 at 01:28 PM.
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Old 06-25-2012
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Default remember the main concept or details too.

Guys by this question i want to ask about one of my problem.
Actually i remember which nerve lesion have which sign like- claw hand or wrist drop but i always forget which extensor or flexor is involved. So should i pay attention for this details too for boards. Thanks
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