Menu

Nerve & Tendon MCQs

Practice Set 26 of 53

This practice set contains high-yield board review questions covering key concepts in Nerve & Tendon. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 501

Topic: Nerve & Tendon

A 22-year-old man undergoes a Latarjet procedure for recurrent anterior instability with 25% glenoid bone loss. Postoperatively, he exhibits weakness in elbow flexion and numbness over the lateral aspect of the forearm. Which nerve was most likely injured during the procedure?

. Median nerve
. Radial nerve
. Musculocutaneous nerve
. Ulnar nerve
. Suprascapular nerve

Correct Answer & Explanation

. Median nerve

Explanation

The musculocutaneous nerve is at high risk during the Latarjet procedure, particularly during aggressive medial retraction of the conjoint tendon. Injury results in weakness of the biceps and brachialis, as well as sensory deficits in the distribution of the lateral antebrachial cutaneous nerve.

Question 502

Topic: Nerve & Tendon

The ulnar nerve is compressed at the elbow in a 45-year-old patient. During surgical release of the cubital tunnel, the surgeon must divide the fascial roof of the tunnel. What structure forms this roof?

. Medial collateral ligament
. Osborne's ligament
. Struthers' arcade
. Lacertus fibrosus
. Deep fascia of the flexor carpi radialis

Correct Answer & Explanation

. Medial collateral ligament

Explanation

The roof of the cubital tunnel is formed by Osborne's ligament, a fascial band connecting the two heads of the flexor carpi ulnaris. The floor is formed by the medial collateral ligament and joint capsule.

Question 503

Topic: Nerve & Tendon

A patient exhibits an inability to make an "OK" sign, demonstrating weakness in flexing the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. Which muscle is typically NOT innervated by the affected nerve?

. Flexor pollicis longus
. Pronator quadratus
. Flexor digitorum profundus to the index finger
. Flexor digitorum profundus to the middle finger
. Flexor digitorum superficialis

Correct Answer & Explanation

. Flexor pollicis longus

Explanation

The anterior interosseous nerve (AIN) innervates the flexor pollicis longus, pronator quadratus, and the radial half of the flexor digitorum profundus. The flexor digitorum superficialis is innervated by the main branch of the median nerve, not the AIN.

Question 504

Topic: Nerve & Tendon

A 28-year-old carpenter suffers a deep laceration to the base of his thenar eminence. He subsequently presents with an inability to perform palmar abduction of the thumb, but thumb interphalangeal joint flexion is preserved. Which of the following muscles is paralyzed due to this isolated nerve injury?

. Adductor pollicis
. Flexor pollicis longus
. Abductor pollicis longus
. First dorsal interosseous
. Abductor pollicis brevis

Correct Answer & Explanation

. Adductor pollicis

Explanation

The recurrent motor branch of the median nerve supplies the thenar muscles: abductor pollicis brevis, opponens pollicis, and the superficial head of the flexor pollicis brevis. Palmar abduction is the primary function of the abductor pollicis brevis.

Question 505

Topic: Nerve & Tendon

A 48-year-old mechanic undergoes an in situ decompression of the ulnar nerve for advanced cubital tunnel syndrome. During the release, the primary compressive fascial structure forming the roof of the cubital tunnel between the medial epicondyle and the olecranon must be divided. This structure is known as:

. Arcade of Struthers
. Ligament of Struthers
. Lacertus fibrosus
. Osborne's ligament
. Medial intermuscular septum

Correct Answer & Explanation

. Arcade of Struthers

Explanation

Osborne's ligament (or the cubital tunnel retinaculum) forms the roof of the cubital tunnel, bridging the two heads of the flexor carpi ulnaris from the medial epicondyle to the olecranon. Division of this ligament is the key step in in situ ulnar nerve decompression.

Question 506

Topic: Nerve & Tendon

A 30-year-old man presents with an inability to cross his fingers and numbness over the volar aspect of his small finger following a deep laceration to his proximal medial forearm. Which cord of the brachial plexus gives rise to the nerve injured in this scenario?

. Lateral cord
. Posterior cord
. Medial cord
. Lateral and Medial cords
. Posterior and Medial cords

Correct Answer & Explanation

. Lateral cord

Explanation

The patient has an ulnar nerve injury, evidenced by intrinsic muscle weakness and small finger numbness. The ulnar nerve is a terminal branch of the medial cord of the brachial plexus (C8, T1).

Question 507

Topic: Nerve & Tendon

A patient has isolated weakness in flexing the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. There is no sensory loss. Compression of the involved nerve most commonly occurs at which of the following anatomical structures?

. Ligament of Struthers
. Arcade of Frohse
. Tendinous edge of the deep head of the pronator teres
. Cubital tunnel
. Guyon's canal

Correct Answer & Explanation

. Ligament of Struthers

Explanation

The anterior interosseous nerve (AIN) is a purely motor nerve innervating the FPL, FDP to the index/long fingers, and pronator quadratus. It is most commonly entrapped by the tendinous edge of the deep head of the pronator teres or the FDS arcade.

Question 508

Topic: Nerve & Tendon

Which of the following structures is innervated by the anterior interosseous nerve (AIN)?

. Flexor carpi radialis
. Flexor digitorum superficialis
. Ulnar half of flexor digitorum profundus
. Radial half of flexor digitorum profundus
. Palmaris longus

Correct Answer & Explanation

. Flexor carpi radialis

Explanation

The AIN is a motor branch of the median nerve that innervates the flexor pollicis longus, the pronator quadratus, and the radial half (index and middle fingers) of the flexor digitorum profundus.

Question 509

Topic: Nerve & Tendon

Which of the following statements accurately describes the Martin-Gruber anastomosis?

. Sensory branches crossing from the ulnar nerve to the median nerve in the hand.
. Motor branches crossing from the median nerve to the ulnar nerve in the forearm.
. Motor branches crossing from the ulnar nerve to the median nerve in the forearm.
. A vascular connection between the radial and ulnar arteries in the deep palmar arch.
. A neural connection between the musculocutaneous and median nerves in the arm.

Correct Answer & Explanation

. Sensory branches crossing from the ulnar nerve to the median nerve in the hand.

Explanation

The Martin-Gruber anastomosis is a common anatomical variant involving a motor nerve connection passing from the median nerve to the ulnar nerve in the proximal forearm. It can cause confusing electromyographic findings in nerve entrapments.

Question 510

Topic: Nerve & Tendon

The anterior interosseous nerve (AIN) is a purely motor branch that courses through the volar forearm. Which of the following muscles is NOT innervated by the AIN?

. Flexor digitorum superficialis
. Flexor pollicis longus
. Pronator quadratus
. Flexor digitorum profundus to the index finger
. Flexor digitorum profundus to the middle finger

Correct Answer & Explanation

. Flexor digitorum superficialis

Explanation

The flexor digitorum superficialis is innervated directly by the main trunk of the median nerve. The AIN innervates the flexor pollicis longus, pronator quadratus, and the radial half of the flexor digitorum profundus.

Question 511

Topic: Nerve & Tendon

The Martin-Gruber anastomosis most commonly involves a transfer of motor nerve fibers from the:

. Median nerve to the ulnar nerve in the forearm
. Ulnar nerve to the median nerve in the forearm
. Median nerve to the ulnar nerve in the hand
. Ulnar nerve to the median nerve in the hand
. Radial nerve to the median nerve in the forearm

Correct Answer & Explanation

. Median nerve to the ulnar nerve in the forearm

Explanation

The Martin-Gruber anastomosis is a normal anatomical variant present in up to 25% of individuals. It involves motor fibers crossing from the median nerve (or AIN) to the ulnar nerve in the proximal forearm.

Question 512

Topic: Nerve & Tendon

Which of the following structures forms the roof of the cubital tunnel?

. Osborne's ligament
. Struthers ligament
. Lacertus fibrosus
. Arcade of Frohse
. Transverse carpal ligament

Correct Answer & Explanation

. Osborne's ligament

Explanation

Osborne's ligament (the cubital tunnel retinaculum) spans between the medial epicondyle and the olecranon, forming the roof of the cubital tunnel. Thickening of this ligament is a common cause of ulnar nerve compression at the elbow.

Question 513

Topic: Nerve & Tendon

During surgical release of De Quervain's tenosynovitis, the surgeon must identify and protect branches of which of the following nerves to avoid painful neuroma formation?

. Superficial branch of the radial nerve
. Lateral antebrachial cutaneous nerve
. Palmar cutaneous branch of the median nerve
. Posterior interosseous nerve
. Dorsal sensory branch of the ulnar nerve

Correct Answer & Explanation

. Superficial branch of the radial nerve

Explanation

The superficial branch of the radial nerve courses over the first dorsal compartment. It is highly susceptible to injury during surgical release for De Quervain's tenosynovitis.

Question 514

Topic: Nerve & Tendon

During an ulnar nerve transposition, the medial intermuscular septum is excised to prevent compression of the nerve. What structure is most at risk of injury when excising this septum?

. Ulnar nerve
. Median nerve
. Ulnar collateral ligament
. Medial antebrachial cutaneous nerve
. Brachial artery

Correct Answer & Explanation

. Ulnar nerve

Explanation

The medial antebrachial cutaneous (MABC) nerve travels closely with the basilic vein and crosses the medial intermuscular septum. Excision of the septum during ulnar nerve transposition places the MABC nerve at significant risk.

Question 515

Topic: Nerve & Tendon

The lumbrical muscles of the hand originate from the tendons of the flexor digitorum profundus. Which nerve typically innervates the first and second lumbricals?

. Deep branch of the ulnar nerve
. Superficial branch of the ulnar nerve
. Median nerve
. Anterior interosseous nerve
. Posterior interosseous nerve

Correct Answer & Explanation

. Deep branch of the ulnar nerve

Explanation

The first and second lumbricals are unipennate muscles typically innervated by the median nerve. The third and fourth lumbricals are innervated by the deep branch of the ulnar nerve.

Question 516

Topic: Nerve & Tendon

The floor of the cubital tunnel is formed by which of the following structures?

. Osborne's ligament
. Medial collateral ligament
. Arcade of Struthers
. Flexor carpi ulnaris aponeurosis
. Brachialis muscle

Correct Answer & Explanation

. Osborne's ligament

Explanation

The floor of the cubital tunnel is formed by the medial collateral ligament (specifically the anterior and posterior bundles) and the joint capsule. The roof is formed by Osborne's ligament and the FCU aponeurosis.

Question 517

Topic: Nerve & Tendon



Based on a normal cross-section of the forearm (as seen in Figure 6), the anterior interosseous nerve (AIN) courses distally along the interosseous membrane. Which of the following muscles is NOT innervated by the AIN?

. Flexor pollicis longus
. Pronator quadratus
. Flexor digitorum profundus to the index finger
. Flexor digitorum superficialis
. Flexor digitorum profundus to the middle finger

Correct Answer & Explanation

. Flexor pollicis longus

Explanation

The anterior interosseous nerve (AIN) innervates the flexor pollicis longus, pronator quadratus, and the radial half of the flexor digitorum profundus. The flexor digitorum superficialis is innervated by the main trunk of the median nerve.

Question 518

Topic: Nerve & Tendon

A patient presents with a deep penetrating injury to the palm and demonstrates an inability to forcefully cross the index and middle fingers. Which of the following nerves is most likely injured?

. Median nerve
. Anterior interosseous nerve
. Posterior interosseous nerve
. Ulnar nerve
. Radial nerve

Correct Answer & Explanation

. Median nerve

Explanation

Crossing the index and middle fingers requires the function of the dorsal and volar interossei muscles, which are responsible for digit abduction and adduction. These intrinsic muscles are innervated by the deep motor branch of the ulnar nerve.

Question 519

Topic: Nerve & Tendon

Compression of the posterior interosseous nerve (PIN) most commonly occurs at the Arcade of Frohse. This arcade is formed by the proximal aponeurotic edge of which muscle?

. Brachioradialis
. Extensor carpi radialis brevis
. Supinator
. Pronator teres
. Extensor digitorum communis

Correct Answer & Explanation

. Brachioradialis

Explanation

The Arcade of Frohse is a fibrous arch formed by the proximal border of the superficial head of the supinator muscle. It is the most common site of PIN entrapment in radial tunnel syndrome.

Question 520

Topic: Nerve & Tendon

A patient sustains a deep laceration to the palm, severing the deep branch of the ulnar nerve. Which of the following functional deficits is most likely to be observed?

. Inability to flex the interphalangeal joint of the thumb
. Loss of sensation over the volar aspect of the index finger
. Inability to abduct the index finger
. Inability to flex the distal interphalangeal joints of the ring and small fingers
. Loss of opposition of the thumb

Correct Answer & Explanation

. Inability to flex the interphalangeal joint of the thumb

Explanation

The deep branch of the ulnar nerve is purely motor. It supplies the interossei, including the first dorsal interosseous, whose primary function is abduction of the index finger.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page