Module 7 - Hand Injuries

Hand Injuries



Question 1 - The median nerve is responsible for:

Wrist extension
Thumb opposition
Finger abduction
Finger adduction

Question 2 - The autonomous sensory zone of the radial nerve is

The volar first web space of the hand
The dorsum first web space of the hand
The dorsum first web space of the foot
The index finger tip

Question 3 - A Zone 2 flexor tendon laceration occurs:

In the distal forearm
In the carpal tunnel
Between the sublimes insertion and the proximal end of the flexor sheath
Distal to the insertion of the sublimes tendon on the middle phalanx

Question 4 - How many extensor compartments are there to the hand?

4
5
6
7

Question 5 - The following are Kanavel’s sign for tenosynovitis EXCEPT:

Fusiform swelling
Finger held in flexion
Tenderness along tendon sheath
Pain on passive extension
Pain on passive flexion

Question 6 - How do you test the flexor digitorum superficialis?

Hold all other fingers in extension and flex DIP of chosen finger
Hold all other fingers in extention and flex MCP of chosen finger
Hold all other fingers in flexion and extend PIP of chosen finger
Hold all other fingers in extension and flex PIP of chosen finger

Question 7 - How can the radial nerve motor function be tested?

Wrist and MCP extension
Flexion of PIP/DIP joints
Abduction of little finger
Flexion of MCP joint only

Question 8 - Which of following traverse the carpal tunnel?

Ulnar nerve
Flexor carpi radialis
Flexor pollicis longus tendon
Palmaris longus

Question 9 - What tendons are involved in deQuervain tenosynovitis?

Extensor pollicis longus and extensor pollicis brevis
Abductor pollicis longus and extensor pollicis brevis
Flexor pollicis brevis and adductor pollicis
Extensor carpi radialis and adductor pollicis

Question 10 - What is cut open in a carpal tunnel release?

Transverse carpal ligament
Nattatory ligament
Flexor tendon sheath
Median nerve

Question 11 - Which of the following may lead to acute carpal tunnel syndrome?

Fracture of proximal ulna
Fracture of distal radius
Dislocation of hamate
Proximal fracture of Scaphoid
Fracture of 5th metacarpal base

Question 12 - A 25-year-old medical student is on the dance floor at a bar when someone spills a drink on their new shirt. On the way to the bathroom to clean their shirt they punch open the door. The next morning they wake up with a sore and swollen hand along the ulnar aspect. X ray reveals a closed intra-articular fracture of the 5th metacarpal with 30 degrees of angulation and no rotation. Which of the following is the CORRECT treatment?

Do nothing. There is no scissoring of the little finger and the fracture will heal by itself
Immobilize in brace for 3-4 wks
Closed reduction and K-wire fixation
Open reduction and plate fixation
Their career as a surgeon is over

Question 13 - Which of the following is NOT a structure within the carpal tunnel?

Median nerve
Flexor pollicis longus
Flexor digitorum profundus
Flexor digitorum superficialis
Flexor pollicis brevis

Question 14 - Mallet finger deformity is caused by:

Fracture of the distal middle phalanx
Fracture of the proximal middle phalanx
Rupture of the extensor tendon at the DIP
Rupture of the flexor tendon at the DIP
Rheumatoid arthritis

Question 15 - A 67-year-old male with longstanding history of osteoarthritis presents to the plastic Surgery Clinic for follow-up after a carpal tunnel release. He is noted to have nodules at the DIP which he says have been there for a number of years. These are most likely to be:

Osteophytes
Heberden’s Nodes
Bouchard’s Nodes
Subchondral cysts

Question 16 - Which of the following statements about the median nerve is FALSE?

It provides sensation to the volar aspect of the 1st, 2nd, 3rd and half of the 4th fingers
It provides motor to flexor digitorum profundus of the index and long finger
It is responsible for the innervation of the interossei muscles of the hand
It passes within the carpal tunnel
It provides motor to the thenar muscles

Question 17 - You see a gentleman with marked flexion of the right index finger DIP joint, subsequent to a laceration sustained opening the lid on a can of condensed milk. This sounds like a case of:

De Quervain’s Tenosynovitis
Laceration of the extensor tendon
A Boutonniere deformity
Dupuyten’s disease

Question 18 - What pulley is affected in trigger finger?

A1
A3
A4
C1
C2

Question 19 - A 16-year-old male has sustained an injury in a hockey game with a skate slash to the lower forearm. On exam he has decreased sensation over the thumb, index and long fingers, decreased flexion at the wrist and is unable to flex the IP joint of the thumb. What has he likely cut?

Median nerve, flexor pollicis brevis, flexor carpi radialis
Median nerve, flexor pollicis longus, flexor carpi radialis
Radial nerve, flexor pollicis longus, flexor carpi radialis
Median nerve, flexor pollicis longus, flexor carpi ulnaris

Question 20 - Which of the following is the preferred donor site for tendon grafts?

Palmaris longus tendon
Flexor carpi ulnaris tendon
Achilles tendon
Peroneus longus tendon
Biceps brachii tendon

Question 21 - A finger in which the PIP is flexed and the PIP is extended:

Boutonniere deformity
Mallet finger deformity
Swan neck deformity
A flexor tendon rupture

Question 22 - Inflammation of the synovium causing size discrepancy between the tendon and sheath pulley resulting in locking of the digits in flexion or extension would lead to the diagnosis of:

Mallet finger
Stenosing tenosynovitis
Ganglion cyst
De Quervain’s Tenosynovitis

Question 23 - A patient is unable to flex his/her fingertip while the associated PIP joint is stabilized in extension. This suggests a problem with which one of the following muscles?

Flexor digitorum profundus
Flexor digitorum superficialis
Extensor digitorum communis
Flexor carpi radialis

Question 24 - What type of injury is sustained in a typical “jersey finger” injury?

Laceration of the extensor tendon at the DIP joint
Forced extension of a flexed DIP joint
Valgus force on the thumb MCP joint
Fracture of the distal phalynx

Question 25 - Gamekeeper’s thumb is:

An avulsion fracture of the distal phalanx of the thumb
Synonymous with trigger thumb
An avulsion injury of the ulnar collateral ligament of the thumb
Dislocation of the IP joint of the thumb