Nerve & Tendon MCQs

A 24-year-old male sustained a C6-C7 brachial plexus root avulsion injury 6 months ago. He has absent finger and thumb extension but maintains strong elbow flexion, shoulder abduction, active wrist flexion, and intact median nerve intrinsic function. A nerve transfer is planned to restore thumb and finger extension. Which of the following is the most appropriate nerve transfer for this purpose?

A 45-year-old cyclist reports numbness and tingling strictly isolated to the volar aspect of his right small finger and the volar-ulnar half of his ring finger. Sensation over the dorso-ulnar aspect of his hand is perfectly normal. He also exhibits intrinsic muscle weakness (positive Wartenberg sign and Froment sign). Where is the most likely site of compression?

During an exploration of a Zone II flexor tendon injury, the anatomical relationship of the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) is evaluated. At what anatomical level does the FDS tendon bifurcate to allow the FDP tendon to pass superficially?

During the physical examination of a patient with severe cubital tunnel syndrome, the examiner observes that the patient's small finger rests in a persistently abducted position. This finding (Wartenberg's sign) is caused by the unopposed action of which muscle?

During a nerve conduction study for suspected carpal tunnel syndrome, the neurologist identifies a Martin-Gruber anastomosis. This anatomic variant involves a neural communication in the forearm transferring fibers from the:

A 45-year-old carpenter complains of numbness in his ring and small fingers, and progressive hand weakness. Examination shows intrinsic muscle wasting, a positive Froment's sign, and a positive Tinel's sign at the elbow. Which of the following anatomical structures is the most common site of compression for this pathology?

A 35-year-old avid cyclist complains of numbness in his ring and small fingers, and weakness with finger abduction. However, he has completely normal sensation over the dorso-ulnar aspect of his hand. Examination reveals a positive Froment's sign. Where is the most likely anatomic site of neural compression?

A patient with advanced rheumatoid arthritis presents with a classic swan neck deformity of the ring finger. This specific deformity is morphologically defined by which of the following joint positions?

A 6-year-old girl sustains a widely displaced extension-type supracondylar humerus fracture. Upon reduction and pinning, she is unable to flex her thumb interphalangeal joint or index finger distal interphalangeal joint. Which nerve is most likely injured?

A patient sustains a closed midshaft humerus fracture and presents with a complete radial nerve palsy. An EMG performed at 4 weeks shows fibrillation potentials in the brachioradialis and no voluntary motor unit action potentials. However, clinical recovery is noted at 12 weeks. According to the Seddon classification, what was the most likely initial nerve injury?

A 52-year-old female presents with night-time awakening due to numbness in her thumb, index, and long fingers. On nerve conduction studies (NCS), what is the earliest electrodiagnostic finding characteristic of carpal tunnel syndrome?

Stenosing tenosynovitis (Trigger Finger) is characterized by painful catching or locking of the digit during flexion and extension. The pathology is primarily caused by thickening and constriction at the level of which pulley?

A patient sustains a severe laceration to the ulnar nerve at the level of the medial epicondyle. Upon examination, the patient has completely preserved function of the first dorsal interosseous muscle and adductor pollicis, despite profound ulnar sensory loss in the hand. What anatomical variant best explains this clinical picture?

A 45-year-old carpenter presents with progressive numbness in his ring and small fingers, accompanied by grip weakness. Examination reveals a positive Froment's sign and a positive Tinel's sign at the elbow. Compression of the ulnar nerve at the cubital tunnel is diagnosed. Which anatomic structure forms the roof of the cubital tunnel?

During a physical examination of the hand, a patient is asked to tightly hold a piece of paper between their thumb and lateral aspect of the index finger (key pinch). The examiner pulls the paper away, and the patient's thumb interphalangeal (IP) joint noticeably flexes. This is a positive Froment's sign. Which muscle is compensating, and what is its innervation?

A 25-year-old rugby player injures his ring finger while grabbing an opponent's jersey. He cannot actively flex the distal interphalangeal (DIP) joint. If radiographs show a small bony avulsion retracted to the A4 pulley, what is the optimal timeframe for surgical repair to prevent fixed retraction and muscle belly shortening?

A 30-year-old carpenter sustains a zone II laceration of the flexor digitorum profundus (FDP). During repair, the surgeon chooses a 4-strand core suture over a 2-strand core suture. What is the primary biomechanical advantage of increasing the number of strands crossing the repair site in the context of an early active motion rehabilitation protocol?

A 22-year-old rugby player presents with an inability to actively flex the distal interphalangeal (DIP) joint of his right ring finger. MRI confirms an avulsion of the flexor digitorum profundus (FDP) tendon with complete retraction into the palm. What is the optimal time frame for surgical repair to prevent permanent muscle contracture and preserve the remaining blood supply?