7. Hand and Wrist MCQs

The ulnar nerve enters the hand through Guyon's canal, where it is susceptible to compression. What anatomical structures form the floor (dorsal boundary) of Guyon's canal?

During surgical exploration of the anterior elbow for a suspected neurovascular injury, the contents of the cubital fossa are assessed. From lateral to medial, what is the normal sequence of the primary structures crossing the elbow joint within this fossa?

A patient experiences a severe traction injury to the brachial plexus. An electromyogram (EMG) reveals intact function of the musculocutaneous and median nerves, but complete denervation of the latissimus dorsi. The thoracodorsal nerve, which innervates the latissimus dorsi, arises as a direct branch of which cord of the brachial plexus?

The annular flexor pulleys of the digits are critical to hand function. Injury to the A2 and A4 pulleys typically results in bowstringing and substantial loss of flexor tendon excursion. From which underlying structures do the A2 and A4 pulleys anatomically originate?

A cyclist presents with weakness in finger adduction and abduction but intact sensation over the hypothenar eminence and volar ulnar digits. An MRI shows a ganglion cyst compressing the ulnar nerve in Zone 2 of Guyon's canal. Which of the following describes the contents of Zone 2?

When performing a fasciectomy for Dupuytren's contracture, the digital neurovascular bundle must be carefully dissected and protected. Which of the following describes the anatomical relationship of Cleland's and Grayson's ligaments to the neurovascular bundle?

During an in situ ulnar nerve decompression at the elbow, the surgeon divides Osborne's ligament. This structure anatomically represents the:

When performing a dorsal approach to the distal radius, Lister's tubercle is identified as a key anatomical landmark that serves as a pulley for the tendon of the third extensor compartment. Which two compartments does Lister's tubercle anatomically separate?

The lumbrical muscles of the hand are unique because they originate from tendons and insert onto tendons. Which of the following accurately describes the anatomy of the lumbrical muscles?

When approaching the cubital fossa to repair a ruptured distal biceps tendon, understanding the mediolateral arrangement of the deep structures is essential. From medial to lateral, what is the correct order of structures within the cubital fossa?

Avascular necrosis (AVN) is a common complication of proximal pole scaphoid fractures due to its retrograde intraosseous blood supply. The dominant arterial supply to the proximal 80% of the scaphoid enters the bone at which specific anatomical location?

The space of Poirier is an area of inherent weakness in the volar wrist capsule, often implicated in perilunate dislocations. This space is anatomically defined as the interval between which two carpal ligaments?

To prevent bowstringing of the flexor tendons in the digits, the flexor pulley system must be maintained. Which annular pulleys are considered the most critical to preserve during surgery?

Which of the following intrinsic muscles of the hand is strictly innervated by the median nerve?

During an open carpal tunnel release, the transverse carpal ligament is divided. The standard recurrent motor branch of the median nerve takes off from the median nerve at what anatomic landmark?

During a volar (Henry) approach to the distal radius, the pronator quadratus must be elevated. To preserve its blood supply and allow for anatomical repair over a volar plate, from which border should it be detached?

A 6-year-old girl sustains a severely displaced extension-type supracondylar humerus fracture. Upon examination in the emergency department, she is unable to flex the interphalangeal joint of her thumb and the distal interphalangeal joint of her index finger. Which nerve is most likely injured?

A 4-year-old child sustains a displaced lateral condyle fracture of the humerus that is left untreated. Years later, the patient develops a progressive deformity and neurological symptoms. What is the most likely late neurological complication?

A 5-year-old girl is treated non-operatively for a lateral condyle fracture of the humerus that was displaced 3 mm. She subsequently develops a symptomatic nonunion. Which of the following long-term complications is most directly associated with this condition?

A 5-year-old boy sustains a minimally displaced lateral condyle fracture of the humerus. Which of the following is the most likely long-term complication if this fracture goes on to nonunion?