5 Damage to which a Inability to extend the forearm and hand b Inability to brea

Question

5 Damage to which a Inability to extend the forearm and hand b Inability to breathe C inability to feel the skin over the anterolateral thigh d Inability to dorsiflex the foot spinal nerve(s) might produce the following physical findings? 6 Marta is an editor and tingling in her anterior and lateral hands and weakness in the muscles of her forearm t nerve is likely involved in her problem, and what do you think has happened? Explain her symptoms she spends a great deal of time typing on her computer. She begins to feel numbness and hat flex her hand. what 7 The herbal supplement bitter orange, also known as synephrine, mimics the effects of the neurotransmitters of the SNS on the heart and blood vessels serving the abdominal viscera and skin. What effect do you think this would have on blood pressure? Considering this, do you think this drug should be given to people with hypertension (high blood pressure)?

Explanation / Answer

5. Question: Damage to which spinal nerves might produce the following physical findings:

a. Inability to extend the forearm and hand: Radial Nerve

Explanation: Radial nerve innervates the muscles of posterior arm, forearm, hand, thumbs and first two fingers. Hence, its damage results in anability to extend the forearm and hand

b. Inability to breathe: Intercostal nerve and Phrenic nerve

Explanation: Intercostal nerve serves the muscles of rib cage. While phrenic innervates the diaphragm. Damage to these nerves results in inability to breathe

c. Inability to feel the skin over the anterolateral region: Sural Nerve (Dermatome)

Dermatome is region of skin supplied by spinal nerves, damage to dermatomes causes inability to feel the skin over the antero lateral region

d. Inability to dorsiflex the foot: Tibial nerve

Explanation: It innervates the muscles of posterior area of leg and foot. Damage of this nerve leads to shuffled gait and inability to dorsiflex the foot

6. In the given condition median nerve is the most likely nerve which would have been affected and resulted in the symptoms. Median nerve supplies the muscles of forearm, muscles of hand.

In the given case, as the subject is an editor she should have damaged her Carpal tunnel due to long typing exercises by profession, which caused excessive pressure on the median nerve due to narrowing of the carpal tunnel or inflammation of ligament and tendons compressing the median nerve.

Damage of the median nerve resulted in numbness, tingling in her anterior and lateral hands, weakness in the muscles of her forearm as these areas are innervated by Median Nerve

7. Synephrine is an adrenergic drug (sympathomimetic drug) which causes vasoconstriction in blood vessels (alpha1 and alpha 2), tachycardia, increased contractility(Beta1 receptor). So, there is increase in cardiac output which ultimately increases the blood pressure both by vasoconstrition (increase in Periphereal vascular resistance) and increased cardiac output

Even though there is vasodilatin of blood vessels partly by Beta 2 receptors the effect is moderate and there is only increase in blood pressure. Hence, it should not be given to the patients with hypertension and it is contraindicated in such patients

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