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R Thomson 109 o Trauma, radiation, infiltration, inflammation o Pancoast syndrome o Cervical rib fi Peripheral nerve lesions o Median and ulnar nerve lesions o Peripheral motor neuropathy fi Myopathy o Dystrophia myotonica (forearms are extra affected than the arms) o Distal myopathy fi Trophic problems o Atrophy o Ischemia o Shoulder hand syndrome o Arthritis of hand or wrist * Rarely diabetes, lead poisoning or a carcinoma-related neuropathy may show an identical twine lesion Adapted from: Talley N. Women with advanced immunosuppression could have severe mucocutaneous ulcerations involving massive areas of the perineum. Morphine could also be given frst-move metabolism in the intestinal wall and liver, resulting in low epidurally at 10% and intrathecally at 1% of the parenteral oral bioavailability. 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