7. Hand and Wrist MCQs

A patient undergoes an in-situ decompression of the ulnar nerve at the elbow. The surgeon identifies and releases a distinct fascial band that bridges the humeral and ulnar heads of the flexor carpi ulnaris (FCU). This anatomic structure is known as:

A patient sustained a deep laceration to the thenar eminence, resulting in an inability to oppose the thumb despite intact sensation. The injured nerve branch typically takes which of the following paths relative to the transverse carpal ligament to innervate the thenar musculature?

A patient sustains a laceration to the volar wrist, dividing the ulnar nerve distal to the takeoff of the dorsal ulnar cutaneous branch. Which of the following physical examination findings is most likely to be observed?

During an open reduction and internal fixation of a distal humerus shaft fracture via an anterolateral approach, the surgeon identifies a supracondylar process. An anomalous fibrous band extending from this process to the medial epicondyle can compress which of the following structures?

While performing an open reduction and internal fixation of a distal radius fracture via a dorsal approach, the surgeon elevates the third extensor compartment. Which of the following tendons is contained within this compartment?

A rock climber experiences a sudden "pop" in his middle finger while aggressively pulling on a crimp hold. He subsequently demonstrates visible bowstringing of the flexor tendons over the proximal phalanx. Complete rupture of which of the following flexor tendon pulleys is the primary cause of this bowstringing?

A 45-year-old mechanic with severe cubital tunnel syndrome undergoes surgical decompression. The ulnar nerve is compressed as it passes between the two heads of the flexor carpi ulnaris. The thick fascial band bridging these two heads is known anatomically as:

A 65-year-old patient treated non-operatively for a distal radius fracture presents 8 weeks later with a sudden inability to actively extend the interphalangeal joint of the thumb. The involved tendon typically travels through which extensor compartment of the wrist?

During a Henry (volar) approach to the proximal radius for plate fixation of a fracture, the surgeon heavily supinates the forearm while exposing the radial shaft. What is the primary anatomic rationale for this maneuver?

A 27-year-old rock climber presents with a closed rupture of the A2 pulley in the ring finger. To plan surgical reconstruction, the surgeon reviews the local anatomy. The A2 pulley is anatomically attached directly to which of the following skeletal structures?

A patient undergoes surgical decompression of the ulnar nerve in Guyon's canal. Which of the following structures forms the primary floor of this anatomic canal?

A 45-year-old mechanic presents with an inability to extend his metacarpophalangeal joints following a proximal radius fracture. Sensation in the hand is completely normal. The injured nerve most commonly becomes entrapped at which of the following anatomic structures?

In flexor tendon repairs of the hand (Zone II), preserving the pulley system is crucial to prevent bowstringing. Which of the following pulleys is considered most biomechanically critical and originates directly from the periosteum of the proximal phalanx?

A surgeon is performing a volar (Henry) approach to the proximal radius for plate fixation. The internervous plane for this exposure lies between muscles supplied by which of the following nerve pairs?

A 32-year-old female presents with severe pain over the radial styloid, exacerbated by grasping and ulnar deviation of the wrist. Non-operative management fails, and surgical release is planned. To prevent a highly morbid postoperative complication characterized by painful neuromas, the surgeon must protect a specific nerve. This at-risk nerve characteristically courses superficial to the roof of which extensor compartment?

A 32-year-old construction worker presents with a deep space infection of the hand following a penetrating injury. The surgical team plans an incision to drain the midpalmar space. The midpalmar space is anatomically separated from the thenar space by which of the following structures?

Following closed reduction and percutaneous pinning of a severely displaced supracondylar humerus fracture, a 6-year-old boy is noted to be unable to make an 'OK' sign, instead demonstrating a flat pinch mechanism. Which muscle's weakness is primarily responsible for this physical finding, and what is its innervation?

A patient presents with a deep space infection of the hand localized strictly to the thenar space. Which of the following structures forms the ulnar border of the thenar space, separating it from the midpalmar space?

A 32-year-old female presents with pain and swelling over the dorsal aspect of her wrist, specifically at the level of Lister's tubercle. During surgical release for tenosynovitis, the tendon passing directly ulnar to Lister's tubercle is identified. This tendon belongs to which extensor compartment of the wrist?

A 45-year-old cyclist complains of numbness in his ring and small fingers along with weakness in finger abduction. Compression of the ulnar nerve in Guyon's canal is diagnosed. Which of the following structures forms the floor of Guyon's canal?