The Embryology behind Hand Clues for Congenital Heart defects!

 In the last post a few hand markers were described which signal the presence of congenital heart defects. How come that hands present clues about congenital heart defects?

The answer is relatively simple: the basic structure of both the hands & the heart is developed in the same period of the prenatal development. Below follows an overview of landmark developments in the heart and the hands from week 4 to week 8 after conception.

WEEK 4 AFTER CONCEPTION:

– HEART: A pipe-shaped heart is formed and begins to beat.

– HANDS: – (the hands are not yet formed)

 

 

WEEK 5 AFTER CONCEPTION:

– HEART: A dividing wall is formed in the heart (heartbeat continues in one chamber).

– HANDS: The hands are shaped like paddles.

 

 WEEK 6 AFTER CONCEPTION:

– HEART: The heart has devided into right and left chambers.

– HANDS: Finger soon take shape.

 

 

 WEEK 7 AFTER CONCEPTION:

– HEART: The main structure of the heart is now complete.

– HANDS: Fingers are forming, but are still joined by webs of skin; the ‘volar pads’ become manifest which preceed the formation of the fingerprints – notice: the shape of the ‘volar pads’ correlates with the fingerprint type that is later formed.

 

 WEEK 8 AFTER CONCEPTION:

– HEART: Continues growing.

– HANDS: As the hands develop they have lost their paddle like look. The touch pads of the fingers form and already have fingerprints.

More details are available in the article:
The embryology & the morphogenesis of the hand lines 

40 Common hand characteristics: how many do you have?

40 Common hand characteristics

How to recognize common hand characteristics from uncommon hand characteristics?

The picture above provides a point of reference: it describes 40 typical hand characteristics that can be described as ‘common’: 20 characteristics for the right hand + 20 characteristics for the left hand.

As a matter of fact, there are quite a few other common hand characteristic. However, the combination presented in the picture above illustrates which hand features (e.g. fingerprint types) are found most commonly in which zone of the hand. As you can seen: there are significant differences between the right- and left hand!

The 40 hand characteristics (32 dermatoglyphic + 8 line features ) include :

 • 10 Fingerprints (5 in each hand): on each finger your can find one of the four basis types of fingerprints (whorl, ulnar loop, radial loop or arch);

• 10 Palmar deltas – a.k.a. ‘triradii’ (5 in each hand) : one below each of the 8 fingers + the so-called ‘axial triradius’, which is usually found in the zone near the wrist on the hypothenar (mount of moon);

– 10 Central palmar ridge lines (5 in each hand): starting in the palmar deltas these ridge lines always first progress towards the center of the palm, but they typically exit the palm at specific locations (for example: the ridge line starting in the delta below the pinky finger exits the palm in the right hand typically between the index finger and the middle finger, however in the left hand the same ridge line tends to exit the palm between the middle finger and the ring finger);

– 2 Palmar loops (1 in each hand): in the right hand the palmar loop is typically found between the middle finger and the ring finger, but in the left hand the palmar loop is typically found between the ring finger and the pinky finger;

– 6 Major creases – a.k.a. primary hand lines (3 in each hand): which terminate independently somewhere inside the palm (= the life line, head line & heart line);

– 2 Line connections (1 in each hand): at the starting point of the life line and the head line are typically connected.

More details about these common hand characteristics are available here:
http://www.multiperspectivepalmreading.com/palm-reading-common-hand-characteristics.htm

Now… how many of these characteristics do you have?

NOTICE: Though each of these 40 hand characteristics is quite common, nobody in the world has all these 40 characteristics!

Especially this specific combination of 10 fingerprints is actually extremely rare; because the combination seen in the left hand: one arch combined in the same hand with 2 whorls is extremely rare on itself!

 Combining this extremely rare with e.g. the radial loop + the other specific patterns on the right hand (which is seen in about 1% of all people) makes it quite unlikely that these 10 fingerprints will be observed in any person.

Finally, the anthropometric hand data presented in the picture are taken from e.g. the German BAuA, UK data from the ‘Handbook of normal physical measurements’ + 3 sources which represent large US populations. And these 40 hand characteristics together provide a new helpfull ‘point of reference’ in the perspective of Multi-Perspective Palm Reading. Especially regarding the study of hand characteristics in the so-called ‘phantom pictures’!

Hands signs in Marfan syndrome: thin fingers, long hand shape & hypermobility!

Marfan syndrome is a connective tissue disorder characterised by a tall, slender body featured with long limbs & long thin fingers. The most serious complications are the defects of the heart valves and the aorta, which could lead to an aortic rupture (due to too much stress on the aorta), which is usually fatal. However, many people who have this disorder are not aware of it – partly because Marfan syndrome typically becomes manifest only after the age of 5. But there are hand signs that have a highly reliable diagnostic value!

Marfan syndrome is featured with many typical hand characteristics, however a combination of two specific hands signs related to a long hand shape (hand signs) & hand motorics (joint hypermobility) is often enough to identify the disorder.

THE STEINBERG SIGN (a):

This test is used for the clinical evaluation of Marfan patients.

Procedure:
Instruct the patient to fold his thumb into the closed fist. This test is positive if the thumb tip extends from palm of hand (see figure a).

THE WALKER-MURDOCH SIGN (b):

This test is used for the evaluation of patients with Marfan syndrome.

Procedure:
Instruct the patient to grip his wrist with his opposite hand. If thumb and fifth finger of the hand overlap with each other, this represents a positive Walker-Murdoch sign (see figure b).

 JOINT HYPERMOBILITY

How to check if a person has hypermobility? You can check this easily by doing the 5 tests that are included in the so-called ‘Beighton score‘:  see figure 1.

A ‘Beighton score’ of 4 or above usually indicates hypermobility.

And if a person has the Sternberg sign + Walker-Murdoch sign + hypermobility, the chances are close to 90% that the person has Marfan syndrome.

The presence of other related hand markers such as: skin quality (hyperextensiblity), a simian crease, extra digital transverse creases, or a high positioned axial triradius provide other hand signs which are indicative for a person to have a medical diagnosis for Marfan syndrome.

Marfan hands.

Hands, Minor Physical Anomalies (MPA’s) & Behavior!

The relationship between hands & behavior had already been notice in the early days of the Greek philosopher Aristotle (384 BC – 322 BC) – who e.g. debated the cause-and-effect relationship in the hand’s development and the emergence of the superior human intellect. Later the Roman physician Galen (129 – 199) became known for advocating the view that physical features could reflect inner characteristics of behavior. And more later the concept of the ‘physiognomy’ suggested that deviant behavior could be predicted from certain physical characteristics of the head and hands.

 

During the 2nd half of the 20th century a new development became manifest. The so-called ‘minor physical anomalies’ (MPA’s) became a study object for medical researchers in order to study the cause of various behavior related disorders – featured with a significant role for the most differentiated extremities of the human body: the hands & face.

 

The current state of research indicates that the etiology of these MPA’s is usually associated with two factors: 1 – genetics (sometimes they are described as congenital physical abnormalities), and 2 – insults to the fetal neural development towards the end of the first trimester (due to: infections, lack of oxygen, diseases in the mother & other prenatal traumas).

 

It became also appearant that MPA’s provide an important clue to specific malformation diagnosis, brain pathology and timing of pathology.

 

Hands, MPA’s & behavior disorders:

In the past few decades MPA’s became associated with etiology studies for a wide range of function & behavior related disorders in newborns & school-age children, such as: autism, Down syndrome, hyperactivity, inhibition, learning disabilities, psychoneurotic behavior, schizophrenia, speach- & language problems.

And especially the ‘Waldrop scale‘ (Waldrop & Halverson, 1971) became a popular tool to study the MPA’s in these populations. And various studies have indicated that the MPA’s included in the ‘Waldrop scale’ are much more often seen in certain groups of youngsters. While the average prevalence of items is usually low in controls (1.10-2,32), studies have reported much higher values in various populations, e.g.: Down syndrome (17.04%), schizophrenia (4.83%), Tourette syndrome (5.45%).

 

And the results typically show a much higher occurence of multiple MPA’s among the patients than in the control populations.

 

 

Hand markers in the Waldrop scale: 

 

Interestingly, various items in the Waldrop scale relate to the hands, including: clinodactyly, nail hypoplasia, simian crease, single flexion crease on the 5th finger, Sydney line & unusual length of the fingers.

 

But the studies so far have also indicated that in the Waldrop scale individual items can not serve for reliable diagnosis. And few details are available regarding the possibility that specified combinations of MPA’s (within one body part or multiple body parts) could serve as a reliable diagnostic marker.

 

Other fascinating related reports have been made where hands become a significant specified marker when combined with other body markers. And these can even play a significant role in the explorations & identification of new syndromes.

 

The illustration below represents an example taken from a study where the missing of fingers (oligodactyly) combined with a disorder on the right eye lid, became a marker for a (new) syndrome that relates to chromosome 21qter (associated e.g. with congenital fibrosis of the extraocular muscles – Tukel CFEOM syndrome). Though there were no behavior problems reported for that syndrome, this example does show hand markers can be recognized as clues that relate to problems in the other extremities (in this example the eyes).

 

Read more about the most well-know MPA hand-marker:

The simian line (a.k.a. single palmar transverse crease)

 

In ‘hand diagnostics’ the role Minor Physical Anomalies significant!