Nerve & Tendon MCQs

A 40-year-old carpenter presents with 6 months of persistent numbness in his small and ring fingers, and subjective clumsiness in his right hand. Examination shows a positive Tinel's sign at the cubital tunnel, weak pinch strength, and a positive Froment's sign. Electrodiagnostic studies confirm severe ulnar neuropathy at the elbow with active denervation in the first dorsal interosseous muscle. Notably, his right elbow demonstrates a 15-degree cubitus valgus deformity from a malunited pediatric supracondylar fracture. What is the most appropriate surgical intervention?

A 45-year-old avid cyclist complains of numbness and tingling in his right ring and small fingers, along with weakness in gripping. Examination reveals clawing of the small and ring fingers, a positive Froment's sign, but normal sensation over the dorso-ulnar aspect of the hand. Where is the most likely site of ulnar nerve compression?

A 50-year-old man presents with persistent ulnar neuropathy 14 months after undergoing an in situ cubital tunnel release. He reports progressive intrinsic weakness. Dynamic ultrasound reveals the ulnar nerve is encased in thick scar tissue and subluxates over the medial epicondyle during elbow flexion. What is the most appropriate surgical intervention?

A 48-year-old man presents with severe recurrence of right ulnar neuropathy symptoms 18 months after an in situ ulnar nerve decompression at the cubital tunnel. Electrodiagnostic studies confirm a conduction block at the elbow. Intraoperatively, the ulnar nerve is found to be encased in thick perineural scar tissue within the postcondylar groove. What is the most appropriate management for this revision procedure?

A 40-year-old avid cyclist presents with intrinsic muscle weakness in his right hand. He reports numbness on the volar aspect of his small finger and the ulnar half of his ring finger. Sensation on the dorsum of his right hand is completely normal. Tinel's sign is positive at the wrist but negative at the cubital tunnel. Compression of the ulnar nerve is most likely occurring at which anatomical location?

A 48-year-old carpenter complains of numbness and tingling in his small and ring fingers of the right hand. He also notes weakness in grip strength. Examination reveals a positive Froment's sign and intrinsic muscle wasting. Electrodiagnostic studies confirm severe ulnar neuropathy at the elbow. Which of the following clinical or anatomic findings is an absolute indication for an anterior transposition of the ulnar nerve rather than a simple in situ decompression?

A 40-year-old male felt a pop in his antecubital fossa while lifting a heavy box. An MRI confirms a complete avulsion of the distal biceps tendon from the radial tuberosity. He elects to undergo surgical repair using a single-incision anterior approach. Which of the following neurological complications is most frequently encountered with this specific surgical approach?

A 50-year-old male carpenter presents with a 6-month history of numbness and tingling in his ring and small fingers, accompanied by grip weakness. Nerve conduction studies confirm compression of the ulnar nerve across the elbow. During a surgical in situ decompression, the nerve is traced from proximal to distal. Which of the following structures is the most common site of ulnar nerve compression in this region?

A 52-year-old man presents with chronic numbness and tingling in his small and ring fingers. Physical examination reveals a positive Tinel's sign over the cubital tunnel and weak interosseous muscles. Nerve conduction studies confirm severe ulnar neuropathy at the elbow. During surgical decompression, the surgeon must evaluate all potential sites of ulnar nerve entrapment. From proximal to distal, which of the following represents the most proximal potential site of compression?

A 55-year-old male undergoes surgery for severe cubital tunnel syndrome. During the planned in situ decompression, the ulnar nerve is observed to subluxate completely anterior to the medial epicondyle during passive elbow flexion. What is the most appropriate next step in surgical management?

A 42-year-old avid cyclist presents with intrinsic muscle weakness and numbness in the small and ring fingers of his right hand. Examination shows clawing of the ring and small fingers, a positive Froment sign, and normal sensation over the dorsal ulnar aspect of the hand. Where is the most likely location of ulnar nerve compression?

During surgical decompression of the cubital tunnel for ulnar nerve entrapment, the surgeon must be aware of potential anatomical variations. Which structure is considered the primary static constraint forming the roof of the cubital tunnel?

During surgical exploration of the posteromedial elbow, the surgeon must identify the various components of the medial epicondyle's muscle attachment. Which muscle's tendon is the most posterior attachment to the medial epicondyle, making it vulnerable during posterior approaches?

During surgical exposure of the medial epicondyle for ulnar nerve transposition, the surgeon identifies various muscle attachments. Which of the following muscles does not originate from the common flexor tendon of the medial epicondyle?

A patient presents with insidious onset of pain and paresthesias in the dorsoradial forearm, exacerbated by repetitive pronation and supination. Examination reveals tenderness over the supinator muscle. Which nerve is most commonly entrapped in the 'radial tunnel' in this scenario?

A 50-year-old female presents with weakness in extending her fingers and thumb at the metacarpophalangeal joints. She has no sensory deficits, and wrist extension results in radial deviation. She is diagnosed with Posterior Interosseous Nerve (PIN) syndrome. During surgical decompression, the surgeon meticulously explores the radial tunnel. Which of the following is considered the most common site of PIN compression?

A 34-year-old carpenter sustains a penetrating injury to the proximal volar forearm. He subsequently demonstrates an inability to flex the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. Which of the following muscles is also typically denervated in this specific nerve injury pattern?

A 34-year-old mechanic sustains a severe laceration to the medial aspect of the elbow, resulting in complete transection of the ulnar nerve. However, clinical examination reveals preserved motor function of the first dorsal interosseous and adductor pollicis muscles, despite complete loss of sensation in the small finger. Which of the following anatomical anomalies best explains these findings?

A 28-year-old competitive cyclist presents with isolated weakness in pinching (adductor pollicis) and finger abduction/adduction, but reports normal sensation in the little and ring fingers. A ganglion cyst is suspected to be compressing the deep motor branch of the ulnar nerve. Where does this branch typically course immediately after bifurcating from the main ulnar nerve in Guyon's canal?

During an anterior (Henry) approach to the radius for internal fixation of a midshaft fracture, the surgeon develops the interval between the brachioradialis and flexor carpi radialis. To expose the proximal radius, the supinator muscle must be elevated. What nerve must be protected, and how is it anatomically safeguarded during this specific step?