Practice Set 43 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.
In a patient presenting with cubital tunnel syndrome, which of the following represents the most common anatomic site of ulnar nerve compression?
. Arcade of Struthers
A 25-year-old basketball player presents unable to actively extend the distal interphalangeal (DIP) joint of his right ring finger after a jamming injury. Radiographs reveal no fractures. What is the most appropriate initial management?
. Surgical repair of the terminal extensor tendon
A surgeon is performing an open elbow contracture release via an extensile lateral column approach (Kocher). During the release of the anterior capsule to improve elbow extension, which nerve is at the greatest risk of iatrogenic injury and must be meticulously protected?
. Radial nerve
A 55-year-old male undergoes a single-incision anterior repair for an acute distal biceps tendon rupture. Postoperatively, he exhibits an expected neurologic deficit. Which nerve is at greatest risk of stretch injury during the superficial dissection and lateral retractor placement of this approach?
. Posterior interosseous nerve
A patient undergoes an ulnar nerve transposition for severe cubital tunnel syndrome. During the approach, the nerve must be carefully mobilized from its native groove. Which fascial structure forms the direct roof of the cubital tunnel and must be released?
. Osborne's ligament
A volar approach is chosen for open reduction and internal fixation of a scaphoid waist fracture with a humpback deformity. Which interval is utilized to access the scaphoid?
. Between the flexor carpi radialis (FCR) and the radial artery
A 12-year-old boy sustains an elbow dislocation. After closed reduction in the emergency department, a post-reduction radiograph shows the ulnohumeral joint is concentrically reduced, but there is a displaced medial epicondyle fracture. What is an absolute indication for open reduction and internal fixation of this fracture?
. Displacement > 2 mm
A patient presents with intrinsic hand weakness, clawing of the ring and small fingers, and numbness in the ulnar half of the ring finger. Froment's sign is positive. The examiner suspects compressive ulnar neuropathy. Which of the following anatomical structures is NOT a recognized site of ulnar nerve compression at or around the elbow?
. Arcade of Struthers
A surgeon is performing a release of the first dorsal extensor compartment for recalcitrant De Quervain's tenosynovitis. Incomplete release is a known cause of persistent postoperative symptoms. Which of the following anatomic variations within the first compartment is most commonly responsible for this failure?
. An aberrant superficial branch of the radial nerve piercing the extensor retinaculum
When evaluating a patient with an ulnar nerve injury, the 'ulnar paradox' refers to which of the following clinical phenomena?
. A proximal (high) injury results in more severe digital clawing than a distal injury
During Ulnar Collateral Ligament (UCL) reconstruction using the docking technique, which structure is at greatest risk of iatrogenic injury during the splitting of the flexor pronator mass and exposure of the sublime tubercle?
. Median nerve
A 40-year-old male sustains an acute distal biceps tendon rupture while lifting a heavy object. He undergoes surgical repair utilizing a single-incision anterior approach. Which nerve is most at risk of injury during this specific surgical approach?
. Median nerve
During a Tommy John procedure (Ulnar Collateral Ligament reconstruction) using a modified Jobe technique with submuscular ulnar nerve transposition in a 20-year-old collegiate pitcher, what fascial structure must be released distally to prevent postoperative ulnar nerve compression?
. Arcade of Struthers
A 45-year-old male presents with severe cubital tunnel syndrome that has failed conservative management. During an in situ ulnar nerve decompression, which of the following structures forms the anatomic roof of the cubital tunnel and must be released?
. Struthers ligament
A 55-year-old male presents with numbness in his small and ring fingers and intrinsic muscle weakness. Electrodiagnostic studies confirm severe ulnar neuropathy at the elbow. During an open surgical release, which structure forms the primary roof of the cubital tunnel?
. Struthers ligament
A 6-year-old boy presents to the emergency department after a fall off monkey bars. Radiographs reveal a widely displaced, extension-type supracondylar humerus fracture. On examination, he is unable to actively flex the interphalangeal joint of his thumb and the distal interphalangeal joint of his index finger. Which nerve is injured?
. Anterior interosseous nerve (AIN)
. Zone I
A 6-year-old girl falls off monkey bars and sustains a significantly displaced extension-type supracondylar humerus fracture. On examination, she is unable to flex the interphalangeal joint of her thumb and the distal interphalangeal joint of her index finger. Which nerve is most likely injured?
. Radial nerve
A patient presents with Anterior Interosseous Nerve (AIN) syndrome. On physical examination, they are unable to form an "OK" sign. Which of the following muscles is definitively spared in an isolated AIN palsy?
. Flexor pollicis longus
A 22-year-old rugby player presents with an inability to flex the distal interphalangeal (DIP) joint of his ring finger. Ultrasound confirms the flexor digitorum profundus (FDP) tendon has retracted into the palm. What is the maximum recommended time frame for primary repair to avoid myotendinous contracture?
. 24 hours