Nerve & Tendon MCQs

A 35-year-old cyclist presents with weakness in pinching and crossing his fingers. Physical examination reveals pronounced atrophy of the first dorsal interosseous muscle and weak thumb adduction. Two-point discrimination is 4 mm over both the volar and dorsal aspects of the small finger. Sensation over the hypothenar eminence is intact. A mass compressing the ulnar nerve is suspected. In which zone of Guyon's canal is the lesion most likely located?

Which of the following intrinsic hand muscles is innervated by the median nerve in the majority of individuals?

A patient complains of an inability to form an "OK" sign, resulting in a flat pinch between the thumb and index finger. Sensation is completely intact globally. Which of the following muscles is typically spared in this specific compression syndrome?

A 68-year-old male presents with chronic pain and paresthesias along the medial aspect of his elbow and forearm, extending into his ring and small fingers. He reports weakness in grip strength and difficulty with fine motor movements. Examination reveals a positive Tinel's sign at the cubital tunnel, atrophy of the intrinsic muscles of the hand (e.g., first dorsal interosseous), and impaired two-point discrimination in the small finger. What is the most likely diagnosis?

In a patient presenting with an AC joint dislocation, which nerve is most commonly at risk for injury due to the proximity of the distal clavicle and the forces involved in high-grade dislocations?

A 42-year-old weightlifter undergoes surgical repair of a distal biceps tendon rupture. Comparing the single-incision anterior approach to the two-incision approach, the single-incision technique carries a higher risk of injury to which of the following structures?

A patient with severe carpal tunnel syndrome exhibits weakness in thumb opposition. Which muscle is primarily responsible for this action, and which specific nerve branch innervates it?

A patient suffers a proximal median nerve laceration but retains unexpected intrinsic hand muscle function. This is most likely due to a Martin-Gruber anastomosis. What does this anomaly connect?

During the repair of a complete Zone II flexor tendon laceration in the index finger, preservation of specific pulleys is vital to maintain mechanical advantage and prevent bowstringing. Biomechanically, which pulley is the most critical to preserve or reconstruct?

A 45-year-old female undergoes an open carpal tunnel release. Postoperatively, her paresthesias resolve, but she presents 4 weeks later with a profound inability to palmar abduct her thumb. Which of the following structures was most likely injured iatrogenically during the procedure?

A 50-year-old woman complains of burning pain and numbness over the dorsoradial aspect of her right hand, which worsens when she wears tightly cuffed shirts. Examination reveals a positive Tinel's sign over the distal forearm, approximately 8 cm proximal to the radial styloid. Finkelstein's test is negative. Compression of the involved nerve typically occurs between which two structures during forearm pronation?

Following a neglected central slip rupture, a patient develops a chronic Boutonniere deformity. In the pathogenesis of this established deformity, which anatomical structure becomes attenuated, allowing the lateral bands to subluxate volar to the axis of rotation of the proximal interphalangeal (PIP) joint?

A 38-year-old avid cyclist presents with profound weakness of the interossei and adductor pollicis muscles, resulting in a positive Froment's sign. He has normal sensation over the volar and dorsal aspects of the small finger and the ulnar half of the ring finger. Hypothenar muscle function is also preserved. Based on this isolated clinical presentation, compression of the ulnar nerve is most likely occurring in which zone of Guyon's canal?

In a patient with rheumatoid arthritis, which of the following is the primary initiating anatomic event in the pathogenesis of a classic Type I swan neck deformity?

A 35-year-old woman complains of pain, tingling, and numbness over the dorsoradial aspect of her right hand, worsened by tight watchbands and pronation. Tinel's sign is positive over the radial aspect of the mid-forearm. Motor examination is normal. Which two muscles typically compress the involved nerve in this syndrome?

A 38-year-old female presents with severe, episodic pain in her left index finger, exquisitely sensitive to cold. Physical exam reveals point tenderness over the nail bed. The pain is relieved by inflating a blood pressure cuff on the ipsilateral arm. What is the name of the clinical test described that relieves the patient's pain?