7. Hand and Wrist MCQs

When repairing a distal biceps tendon rupture via a two-incision technique, the surgeon must avoid placing retractors forcefully against the radial neck. Which structure is most at risk of injury in this region?

A 25-year-old sustains a laceration over the volar middle phalanx of the index finger, transecting both the FDS and FDP tendons. Regarding the intrinsic hand musculature, the first lumbrical associated with the index finger originates from which of the following structures?

During an ulnar nerve transposition at the elbow, the surgeon must carefully identify and mobilize the first motor branch of the ulnar nerve to prevent tethering. Which muscle does this specific branch typically supply?

A surgeon is performing a complex microvascular reconstruction of the hand. The deep palmar arch is primary formed by the terminal continuation of the radial artery and completes an anastomosis with which of the following vessels?

While performing an open carpal tunnel release, the surgeon notes an aberrant nerve branch piercing directly through the transverse carpal ligament to innervate the thenar musculature. This corresponds to which Lanz classification of the recurrent motor branch of the median nerve?

A competitive cyclist presents with isolated weakness of finger abduction and adduction but normal sensation over the volar hypothenar eminence and small finger. Entrapment of the ulnar nerve is suspected at Guyon's canal. Which zone of Guyon's canal is most likely affected?

A surgeon is performing a complex wrist reconstruction requiring mobilization of the arterial supply. The deep palmar arch provides critical collateral flow to the hand. It is primarily formed by the anastomosis of the deep branch of the ulnar artery with the terminal continuation of which vessel?

A patient presents with weakness in thumb and finger extension but normal wrist extension (with noticeable radial deviation) and no sensory deficits. Entrapment of the involved nerve most commonly occurs at which of the following structures?

An accessory head of the flexor pollicis longus (Ganzer's muscle) is implicated in the compression of a nerve that results in an inability to form a proper "OK" sign. Which of the following muscles is primarily innervated by the affected nerve?

In the setting of a perilunate dislocation, a patient develops profound weakness of the interossei and the lumbricals to the ring and small fingers, alongside decreased sensation over the volar small finger. The affected nerve is most likely compressed in which anatomical zone of Guyon's canal?

During a submuscular ulnar nerve transposition, the surgeon must completely release the fascial roof of the cubital tunnel. After identifying the nerve, the surgeon notes the structures comprising the floor of the cubital tunnel. Which of the following forms the true floor of this anatomical space?

A 65-year-old patient with a history of long-standing rheumatoid arthritis presents with a sudden inability to actively extend the interphalangeal joint of the thumb. The ruptured tendon implicated in this condition normally hooks around which bony prominence at the wrist?

A patient suffers a severe laceration to the volar wrist, resulting in a complete, high ulnar nerve transection. Which of the following best describes the origin and insertion of the functional lumbrical muscles that are spared in this injury?

A 32-year-old cyclist presents with numbness in the small finger and the ulnar half of the ring finger, along with weakness of the intrinsic hand muscles. Compression of the ulnar nerve in Guyon's canal is suspected. What structure forms the floor of this canal?

A 42-year-old mechanic presents with aching pain in the proximal lateral forearm and weakness in finger extension, but maintains normal strong wrist extension. The posterior interosseous nerve (PIN) is most commonly compressed by the proximal tendinous edge of which muscle?

Electromyography of a 35-year-old woman shows an anomalous neural connection in the forearm that carries motor fibers from the median nerve to the ulnar nerve. This normal variant is most likely to confound the clinical assessment of which of the following compressive neuropathies?

A patient presents with progressive weakness in thumb adduction and finger abduction, but has intact sensation over the volar small finger and normal hypothenar muscle strength. A mass is suspected in Guyon's canal. Which anatomic zone is most likely affected?

A patient presents with the inability to form a perfect "OK" sign, resulting in a pinch with extended distal interphalangeal (DIP) and interphalangeal (IP) joints. Which nerve is most likely compressed, and which muscle is consequently affected?

A cyclist presents with numbness in the little finger and weakness of finger abduction. The ulnar nerve is compressed in Guyon's canal. Which of the following structures forms the floor of Guyon's canal?

The ulnar nerve passes through the cubital tunnel at the elbow. The roof of the cubital tunnel is formed by Osborne's ligament, which anatomically spans between which two structures?