Hand Therapy Practice Questions 1-5 ANSWERS

1. Correct Answer: A. Radial notch of the ulna and capetellum of the humerus 
The radial head articulates with the radial notch of the ulna, secured by the annular ligament, creating the proximal radioulnar joint. It also attaches at the capetellum, which lies medial to the lateral epicondyle at the distal end of the humerus. 


Reference: Rehabilitation of the Hand and Upper Extremity, 6th edition. (Chapter 3)
2.  Correct Answer: A. FPB

The flexor pollicis brevis muscle flexes the metacarpal phalangeal joint of the thumb and has a superficial as well as a deep head.  The superficial head is innervated by the median nerve while the deep head is often innervated by the ulnar nerve.

The Abductor pollicis brevis and flexor pollicis longus are both innervated by the median nerve. The abductor pollicis longus is innervated by the radial nerve.

Reference: A Walk Through the Anatomy of the Hand and Forearm, Daniel C. Riordan MD. Journal of Hand Therapy, April-June 1995, pgs. 68-78

3.   Correct Answer: B. Median

Inability to make the “ok” sign results from anterior interosseous nerve (AIN) palsy. The AIN is a branch of the median nerve which innervates the flexor policis longus,  the index flexor digitorum profundus, and pronator quadratus.

Reference: Rehabilitation of the Hand and Upper Extremity, 6th edition. (Chap 149)
4. Correct Answer: D. Fracture of the radial head with dislocation of the DRUJ

      An Essex Lopresti fracture involves fracture of the radial head, rupture of the interosseous membrane of the forearm, and DRUJ dislocation. It occurs as a result of high energy trauma.

      A Monteggia fracture involves a radial head dislocation with a proximal ulna fracture (Answer A.).  Galeazzi fracture is a distal radius fracture with DRUJ dislocation (Answer B.). Barton's fracture is an intraarticular distal radius fracture with radiocarpal dislocation (Answer C.).

Reference: The Forearm Complex: Anatomy, Biomechanics, and Clinical Considerations. LeStayo and Lee, Journal of Hand Therapy April-June 2006 p.138-143

5. Correct Answer: B. Keinbock’s disease

Keinbock’s disease is avascular necrosis of the lunate and presents with the symptoms listed above. Preiser’s disease is avascular necrosis of the scaphoid.  Vaughn Jackson syndrome is rupture of Extensor digiti minimi, and tendons of the extensor digitorum communis.  It can be found in patients with severe rheumatoid arthritis. Vaughn Jackson syndrome begins with the extensor tendons of the small and ring fingers and progresses radially.  Caput ulna is end stage destruction of the distal radio-ulnar joint in patients with rheumatoid arthritis. It can be associated with Vaughn Jackson syndrome as extensor tendons rupture from rubbing on the subluxed head of the ulna.



Reference: Hand Secrets, 3rd edition, p. 11

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