Saturday, March 17, 2007

VizD Answer 3/17/2007

Despite many close entries, there was NO WINNER for this week's VizD.

Therefore, the pot doubles to $10


Recap:

A 44-year-old man presents to your Emergency Department complaining of left hand weakness for one day. You ask him to perform various movements that are seen in the video below. (click on play)

1. What is the injured nerve?
2. Name three motor movements that are affected by damage to this nerve
3. Name three conditions that can lead to a bilateral neuropathy of the affected nerve seen in the video


Answers
1. Radial nerve
2. Wrist extension, Thumb extension, Thumb abduction, Finger extension
3. Childbirth, Lead poisoning, Viral infection

For a nice read, check out The Origin of Saturday Night Palsy by Robert Spinner, MD
Neurosurgery. 51(3):737-41; discussion 741, 2002 Sep.

ABSTRACT
The term Saturday night palsy has become synonymous with radial nerve compression in the arm resulting from direct pressure against a firm object. It typically follows deep sleep on the arm, often after alcohol intoxication. The commonly accepted origin of the phrase is the association of Saturday night with carousing. We offer an alternate explanation: we think that the term Saturday night palsy was introduced mistakenly as a simplification of saturnine palsy (much like the way the word palsy was shortened from paralysis). Saturnine palsy, which is a relatively common complication of lead poisoning, has the same clinical presentation of radial nerve compression, and Saturday night palsy even sounds like saturnine palsy. Moreover, Saturday, lead, carousing, and alcohol are associated with each other through their connection to Saturn, the Roman god of agriculture, which encourages the association of the two syndromes with one another.
The next VizD will be posted on Monday March 19th

VizD
is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.