7. Hand and Wrist MCQs

The roof of the cubital tunnel, which can become tightened and compress the ulnar nerve during elbow flexion, is formed by which structure?

The flexor digitorum superficialis (FDS) tendon bifurcates at the level of the proximal phalanx to allow the flexor digitorum profundus (FDP) tendon to pass through. What is the anatomic term for this bifurcation structure?

Displaced scaphoid waist fractures have a high rate of avascular necrosis due to retrograde blood flow. What artery provides the primary blood supply to the proximal pole of the scaphoid?

During an in situ ulnar nerve decompression at the cubital tunnel, the first branch of the ulnar nerve identified just distal to the medial epicondyle provides motor innervation to which muscle?

During a dorsal approach to the wrist, the extensor pollicis longus (EPL) is released from its compartment and retracted radially. Around which bony landmark does the EPL normally pivot to change its mechanical line of pull?

In reconstructive hand surgery, preserving or reconstructing certain flexor pulleys is essential to prevent bowstringing of the flexor tendons. Which two annular pulleys are considered biomechanically most critical?

A 45-year-old male presents with an inability to actively extend his metacarpophalangeal joints, but wrist extension is preserved with radial deviation. A compressive neuropathy is suspected. The structure most likely responsible for compression is located between which two muscle parts?

A surgeon performs an open carpal tunnel release. To avoid iatrogenic injury to the recurrent motor branch of the median nerve, its anatomical variations must be understood. According to the Lanz classification, what is the most common anatomical path of the recurrent motor branch?

Following an open reduction and internal fixation of a distal radius fracture via a standard volar approach, a patient cannot actively flex the interphalangeal joint of the thumb. Which tendon was most likely injured?

When repairing a distal biceps tendon rupture via a two-incision technique, what structure is at highest risk of iatrogenic injury during the deep posterolateral muscle-splitting exposure?

A displaced fracture of the medial epicondyle of the humerus often compromises the ulnar nerve. The ulnar nerve enters the anterior forearm by passing between the two heads of which muscle?

A patient requires a surgical release for De Quervain's tenosynovitis. Which two tendons are located within the targeted first dorsal compartment of the wrist?

A patient sustains a complete sharp laceration of the ulnar nerve at the level of the pisiform. Despite this, they surprisingly maintain normal strength in the deep head of the flexor pollicis brevis and the adductor pollicis. Which of the following anatomical variants best explains this?

A 35-year-old male presents with vague anterior elbow pain and numbness in the radial three and a half digits. Radiographs demonstrate a bony spur projecting from the anteromedial aspect of the distal humerus. Compression at this specific level involves which of the following structures?

A patient undergoes ORIF of a scaphoid fracture via a volar approach. The surgeon must open the wrist capsule while preserving the critical volar radiocarpal ligaments. Which of the following ligaments is the primary stabilizer preventing volar dislocation of the lunate?

A 45-year-old woman complains of proximal volar forearm pain and paresthesias in the radial three and a half digits. Electrodiagnostic testing confirms a high median nerve compression. Which of the following anatomical structures is most likely responsible for this specific entrapment syndrome?

Surgical treatment of a recalcitrant trigger finger involves incising the A1 pulley. During flexor tendon exploration, which of the following combinations of pulleys are the most critical biomechanical stabilizers that must be preserved to prevent significant tendon bowstringing?

Surgical release for De Quervain's tenosynovitis requires incising the extensor retinaculum over the first dorsal extensor compartment. Which of the following sensory nerves is at greatest risk of iatrogenic injury or neuroma formation during this superficial dissection?

A 21-year-old collegiate baseball pitcher presents with medial elbow pain and decreased pitching velocity. MRI confirms a full-thickness tear of the anterior band of the ulnar collateral ligament (UCL).

During surgical reconstruction of the UCL utilizing the modern docking technique, how is the ulnar nerve typically managed?

A 21-year-old collegiate baseball pitcher presents with medial elbow pain and decreased pitching velocity. MRI confirms a full-thickness tear of the anterior bundle of the ulnar collateral ligament (UCL). He undergoes a UCL reconstruction utilizing a palmaris longus autograft via the modified Jobe technique. During the exposure and preparation of the medial epicondyle for the humeral tunnels, what structure is at greatest risk of iatrogenic injury and must be meticulously protected?