Nerve & Tendon MCQs

A 45-year-old man presents with a claw-hand deformity and profound intrinsic muscle weakness. When asked to pinch a piece of paper between his thumb and index finger, his thumb interphalangeal joint strongly flexes (Froment's sign). This sign represents a compensatory mechanism for weakness in which muscle, and what is its primary innervation?

A 45-year-old man presents with chronic lateral elbow pain. He reports deep, aching pain in the proximal forearm that worsens with repetitive pronation and supination. Examination reveals maximal tenderness approximately 4 cm distal to the lateral epicondyle and pain elicited by resisted middle finger extension. What is the most likely diagnosis?

A 50-year-old male with severe cubital tunnel syndrome presents with intrinsic muscle atrophy and clawing of the small and ring fingers. He previously underwent a simple in-situ ulnar nerve release 2 years ago, with initial relief followed by recurrence. What is the most appropriate next surgical step?

A 42-year-old bodybuilder feels a 'pop' in his anterior elbow while doing heavy biceps curls. MRI confirms a complete distal biceps tendon rupture. If a single anterior incision technique is chosen for the repair, which nerve is at the highest risk of iatrogenic injury?

A patient with a severe ulnar nerve transection at the level of the elbow initially presents with weakness of intrinsic hand muscles but minimal clawing of the ring and small fingers. Three months following nerve repair at the elbow, pronounced clawing of these digits develops. This phenomenon is known as:

A 50-year-old diabetic female presents with a locking thumb that is refractory to corticosteroid injections. During surgical release of the A1 pulley, the surgeon must be particularly careful to protect a nerve that courses obliquely over the flexor sheath near the metacarpophalangeal flexion crease. Which nerve is this?

A 40-year-old man undergoes a single-incision anterior approach repair of a distal biceps tendon rupture. What is the most commonly injured neurologic structure associated with this specific surgical approach?

A 42-year-old man feels a pop in his anterior elbow while lifting a heavy object. An MRI confirms a complete avulsion of the distal biceps tendon. He elects to undergo surgical repair via a single-incision anterior approach. What is the most common neurologic complication associated with this specific surgical approach?

A 23-year-old professional baseball pitcher undergoes ulnar collateral ligament (UCL) reconstruction using a palmaris longus autograft. Which nerve is most at risk for injury or entrapment during the harvesting of the graft at the volar wrist?

A patient with severe cubital tunnel syndrome is undergoing an in situ ulnar nerve decompression. The floor of the cubital tunnel is formed by which of the following structures?

A patient presents with weakness in pinching the thumb and index finger, noting an inability to make an 'OK' sign. Electromyography confirms a compressive neuropathy of the anterior interosseous nerve (AIN). Which of the following anatomical structures is the most common cause of this specific nerve compression?

During surgical decompression of the ulnar nerve at the elbow (cubital tunnel release), the floor of the cubital tunnel is visualized. Which of the following structures primarily forms the floor of the cubital tunnel?

Compression of the ulnar nerve in Guyon's canal can present with mixed sensory and motor deficits or isolated deficits depending on the zone of compression. A ganglion cyst in Zone 2 of Guyon's canal will produce which of the following clinical pictures?

A patient presents with aching pain in the proximal volar forearm and paresthesias in the thumb, index, and middle fingers. Symptoms worsen with resisted pronation. Examination reveals no weakness of the flexor pollicis longus. An anomalous ligament extending from a supracondylar process to the medial epicondyle is suspected. What structures are compressed by this ligament?

A cyclist presents with intrinsic muscle weakness of the right hand but intact sensation over the volar hypothenar eminence and the dorsal ulnar aspect of the hand. In which zone of Guyon's canal is the ulnar nerve most likely compressed?

A patient presents with an inability to form an OK sign with their thumb and index finger after a supracondylar humerus fracture. Sensation in the hand is completely normal. What is the most likely injured nerve and its primary origin?

During an in situ ulnar nerve decompression at the cubital tunnel, several distinct anatomic structures can cause compression. Which of the following structures forms the roof of the cubital tunnel?

A 45-year-old mechanic presents with numbness in the small finger and weakness in grip strength. Nonoperative management has failed, and an in situ decompression of the ulnar nerve is planned. During the approach, the roof of the cubital tunnel must be divided. Which of the following structures constitutes the primary roof of this tunnel?