Question

The patient presented in Part E, case 3, provides you with additional information that x-rays have confirmed that there is narrowing of the intervertebral foramen from C5 – T1 on the right side, which is likely compressing the associated nerve roots. A symptom of nerve root compression is muscle weakness. Is this additional information from the x-ray consistent with the weakness indicated in the case presentation. Provide your rationale.

Case 3: You are working with a carpenter who describes recent challenges in his accuracy in hitting a nail with his hammer using his right hand. After observing your patient performing this activity using a segmental approach to understanding the details of this movement pattern, it appears the ulnar deviation motion of this activity is likely the problem. You observe that rather than straight ulnar deviation, their wrist moves towards wrist flexion preventing an accurate hit  with the hammer on the small nail head.

Answer 1

Ulnar deviation :

It characterised by the abnormal bending of fingers towards little finger due to the swelling and inflammation of metacarpophalangeal joints. Ulna or ulnar bone is a bone in the forearm that extends from elbow to the wrist on the side oppsite to the thumb.Ulnar deviation refers the bending of fingers to the opposite side.

Rationale to the relationship between the weekness and the X- ray report:

* Narrowing of Intervertebral foramen: Stenosis or narrowing of intervertebral foramen may occur due to Osteoarthritis, degenerative disorders of bone, small vertebral column by brth,

Narrowing of Intervertebral fotamen at C5 T1, shows the involvement of the Cervical bone 5 and Thoracic bione 1. Cervical 6 and 7 also included in this process. Due to the narrowing of foramen ,the nerve roots may get compressed causes pain and swelling on the areas,where the nerve is supplied. Nerves  comes through  C5 and C6 ans C7are mainly controls the hand activity. Narrowing aftects wrist flexion and extension, it may cause paralysis of hands and legs. C7 mainly dealing with elbow and some finger extension,and grasp and release of the objects  .and Assistance in a more difficult task also needed in this condition.

As a result of ' stenosis of intervertebral foramen' , nerve roots are getting compressed. In the above case scenario, patient suffering with the weekness of wrist muscles or coordination of eye- hand activity. X-ray report clearly says that the patient suffering with' Narrowing of Intervertebral foramen' at C5 to T1. It clearly indicates the reason for the patient's inability to use wrist to hit the nail properly , as the nerves that supply, forearm, wrists, fingers are coming through C5 to T1 vertebral foramen. The nerve root are getting compressed and the resultant muscle weekness and coordination problems are get manifested.