Correct answer  B.  Ulnar wrist extension & ulnar deviation  After innervating the extensor carpi radialis brevis (ECRB) and extensor carpi radialis longus (ECRL) at the elbow, the radial nerve divides into the posterior interroseous nerve (PIN) and the superficial branch of the radial nerve. The PIN provides motor function to the following muscles, in order proximal to distal: Supinator, extensor carpi ulnaris, extensor digitorum communis, extensor digiti minimi, abductor policis longus, extensor policis longus, extensor policis brevis, extensor indicis. The pronator is innervated by the median nerve therefore answer (A) pronation, is incorrect.   Reference:    Rehabilitation of the Hand and Upper Extremity, 6 th  edition.   Chapter 3: Anatomy and Kinesiology of the Elbow 

Which muscles are flexors of the Metacarpophalangeal (MCP) joints? Lumbricals Dorsal and Palmar Interossei Flexor digitorum superficialis (FDS) All of the above are flexors of the MCP joints

Correct Answer: D.  All are flexors of the metacarpophalangeal (MCP) joints. The four lumbricals (Answer A.) originate in the palm from the flexor digitorum profundus (FDP) tendons.  They pass volar to the axis of rotation at the MCP joints and insert onto the extensor mechanism permitting both MCP flexion and IP extension.   The palmar interossei adduct ("PAD") the index, ring, and small fingers towards the middle finger. The dorsal interossei abduct ("DAB") the index, middle, and ring fingers.  The middle finger has two dorsal interossei to allow it to abduct to both sides.  Both the palmar interossei and dorsal interossei originate from the metacarpal shafts and pass volar to MCP axis of rotation.  They then insert onto the central and lateral bands of the extensor mechanism.  Thus they contribute also contribute to MCP flexion as well as IP extension. The flexor digitorum superficialis (FDS) has two heads with one originating at t

21. A patient that you are seeing for treatment of a distal radius fracture presents to clinic with a flexed posture of the middle finger, swelling, diffuse tenderness over the volar aspect of the entire digit, and severe pain with any attempt at passive extension.  The patient states she was trimming her rose bushes yesterday and woke up this morning with the symptoms.  Based on your exam what condition may be suspected?  A.  Trigger finger B.  Herpetic Whitlow C.  Infectious tenosynovitis  D.  Gout

Correct Answer: C. Infectious tenosynovitis  The patient is experiencing all four signs of Kanavel which indicate acute infectious/pyogenic flexor tenosynovitis.  Not all four signs need to be present for diagnosis. Infectious tenosynovitis can occur with penetrating trauma from an animal bite or foreign body (In this case a thorn from a rose bush).   The patient should be referred to her surgeon for urgent medical intervention.  Left untreated, infectious tenosynovitis can lead to tendon necrosis and rupture.   Stenosing tenosynovitis or trigger finger (Answer A.) is a non urgent medical condition that causes catching or locking of a digit with active flexion.  In this condition repetitive use or systemic illness such as diabetes causes swelling of the flexor tendon and prevents normal tendon glide under a flexor pulley (typically the A-1 pulley).  Herpetic Whitlow (Answer B.) is a finger tip infection caused by the Herpes virus.  This infection can be found more commonl

16.   A patient presents to your clinic with moderately severe carpal tunnel syndrome. His electromyography (EMG) examination also showed moderately severe ulnar mononeuropathy localized at the cubital tunnel.   However,   he is not experiencing typical signs or symptoms of cubital tunnel syndrome. What would explain this? A.    Riche Canneau Anastomosis B.    Martin Gruber Anastomosis C.    Marinacci Anastomosis D.    Beretinni Anastomosis 17.   What complication is possible following a volar proximal interphalangeal (PIP) dislocation and what early treatment is essential? A. Swan neck deformity; figure 8 splint; active flexion B. Boutonnière deformity; PIP extension splint; oblique retinacular ligament (ORL) stretching C. Mallet finger; distal interphalangeal (DIP) hyperextension splint; range of motion  (ROM) to unaffected joints. D.  Metacarpal phalangeal (MCP) flexion contracture; Finger cast; no ROM advised 18.   What range of motion