Nerve & Tendon MCQs

A 5-year-old boy is brought in after sustaining a lateral condyle fracture of the humerus. It is displaced by 4 mm on initial radiographs but the parents refuse surgery. Six months later, the fracture goes on to nonunion. If left untreated, what is the most likely long-term neurologic complication?

Following a severe crush injury to the forearm, a patient suffers a Sunderland fourth-degree nerve injury to the median nerve. Which of the following accurately describes the precise histological status of the nerve architecture?

In a patient undergoing an ulnar nerve transposition for cubital tunnel syndrome, the surgeon releases the retinacular band spanning the two heads of the flexor carpi ulnaris. This structure, known as Osborne's ligament, connects which two bony landmarks?

During surgical release of de Quervain's tenosynovitis, the surgeon must carefully identify and release the first dorsal extensor compartment. To prevent painful neuroma formation, which nerve must be protected as it courses directly over this compartment?

When decompressing the ulnar nerve at the elbow for cubital tunnel syndrome, the surgeon must trace its course into the forearm. The ulnar nerve enters the forearm by passing between the two heads of which muscle?

A 40-year-old mother of a newborn undergoes surgical release for refractory De Quervain's tenosynovitis. Which tendons are released, and what is the most common anatomical variation that can lead to surgical failure if unrecognized?

During an in situ ulnar nerve decompression at the elbow, the surgeon releases the roof of the cubital tunnel. The primary fascial structure forming this roof (Osborne's ligament) connects which of the following bony landmarks?

A 35-year-old typist complains of proximal anterior forearm pain and paresthesias in the radial three-and-a-half digits. Examination shows reproduction of symptoms with resisted forearm pronation and elbow flexion. Compression of the median nerve by the lacertus fibrosus is suspected. From which muscle does the lacertus fibrosus originate?

Which of the following describes the most common configuration of a Martin-Gruber anastomosis?

During trigger finger release of the ring finger, the A1 pulley is transected. Which pulleys are considered mechanically critical to prevent bowstringing of the flexor tendons and must be preserved?

A cyclist presents with numbness in the ring and small fingers along with weakness in finger abduction and adduction. Sensory examination reveals normal sensation over the dorso-ulnar aspect of the hand. Where is the most likely site of compression?

During a medial epicondylectomy for severe cubital tunnel syndrome, the surgeon releases the compressive structures overlying the ulnar nerve. Which of the following forms the primary roof of the cubital tunnel?

A patient suffers a severe forearm crush injury and subsequently demonstrates an inability to make the 'OK' sign, exhibiting extended distal interphalangeal joints of the thumb and index finger. This specific nerve palsy represents denervation to which muscle group?

A 21-year-old collegiate baseball pitcher elects to undergo ulnar collateral ligament (UCL) reconstruction after failing conservative management. Which nerve must be carefully protected, and potentially transposed, during this procedure?

A 45-year-old man undergoes a single-incision anterior approach for an acute distal biceps tendon repair. During the drilling of the posterior radial cortex for a cortical button, which nerve is at the greatest risk of injury?

A 20-year-old collegiate baseball pitcher reports medial elbow pain during the late cocking and early acceleration phases of throwing. Examination reveals a positive moving valgus stress test and distinct paresthesias in the ring and small fingers. MRI confirms a full-thickness ulnar collateral ligament (UCL) tear. What is the recommended surgical management?

A 7-year-old boy presents with progressive valgus deformity of his left elbow and paresthesias in his ring and small fingers. He sustained an elbow fracture at age 3 that was treated nonoperatively. Radiographs show a nonunion of the lateral condyle. Which of the following is the most likely cause of his current neurologic symptoms?

A 5-year-old boy sustains a completely displaced, extension-type supracondylar humerus fracture. He is unable to flex the IP joint of his thumb and the DIP joint of his index finger. Which of the following nerve structures is most likely injured?

A 6-year-old boy presents with a displaced lateral condyle fracture of the humerus (Milch Type II). Open reduction and internal fixation is performed. Which of the following long-term complications is most characteristic if this fracture initially went unrecognized and progressed to nonunion?

A 6-year-old boy falls from monkey bars and sustains an extension-type supracondylar humerus fracture. Radiographs show posteromedial displacement of the distal fragment. Which nerve is at the highest risk of injury from the proximal metaphyseal spike?