CHT Prep Questions and Answers 100% Pass
Steindler procedure Correct Ans-Flexor pronator muscle tendon transfer to promote elbow
flexion. due to c5c6 brachial plexus injury.
C6 quad. What tendon transfer may be used to restore elbow extension Correct Ans-Biceps
to tricep tendon transfer. Still have brachialis and supinators so bicep can be spared.
Space of poireir Correct Ans-Weakness from the absence of ligamentous support between
capitate and lunate articulation. Bolar extrinsic ligaments for a V, lunate is able to dislocate w
high velocity injury
Extensor lag test Correct Ans-Tests supraspinatus and infraspinatus. ER to near full then
abd to 20deg, release if lag then supraspinatus tear
Drop arm test Correct Ans-Tests infraspinatus, ER near full then abd to 90 deg, release if
lag then tear in infraspinatus
Flexor digitorum profundus Correct Ans-Small/ring : Ulnar nerve innervated.
Flexor pollicis brevis Correct Ans-Deep head innervated by ulnar nerve
Oblique retinacular ligament Correct Ans-Landsmeer's ligament, originates volar aspect of
pp, inserts on extensor tendon dorsal axis of DIPJ, helps w PIP flex w DIP ext
, CHT Prep Questions and Answers 100% Pass
If contracted in extension DIP is unable to flex contributes to boutonniere def
Swan neck deformity Correct Ans-
Boutonnière deformity Correct Ans-
Lacertus Fibrosus Correct Ans-Bicepital apneurosis. Tendon from bicep brachii, tighten w
pronation. Active flexion w pronation may contribute to compression of median nerve at LF
Hook of hamate fracture Correct Ans-Ulnar side pain w extension, ulnar deviation and
flexion of small ring finger. Pain distal to pisiform. Commonly neg on xray. Common w racket
sports, golf, baseball, using hand to close lids. Use ulnar gutter splint. Orif or excision
Common flexor origin muscles Correct Ans-Pronator teres, flexor carpi radialis/ulnaris,
flexor digitorum superficialis, palmaris longus
Arcade of Froshe Correct Ans-Common impingement site for PIN (radial tunnel stndrome)
Fibrous band that arises as a semi circular structure from tip of medial aspect of lateral epi.
Located at proximal edge of supinator
Cubital tunnel Correct Ans-Roof is formed by acruate ligament of osborne and investing
fascia of FCU Roof slacks w extension and tightens in flexion
, CHT Prep Questions and Answers 100% Pass
Ulnar nerve Correct Ans-1site of compression: as pierces medial intermuscular spetum at
level of coracobrachialis mm. Nerve passes thru acrade of struthers to formally enter cubital
tunnel.
High ulnar N injury w intrinsic loss n 2ndary loss of 4 n 5 th FDP loss of 60-80% of grasp occurs
Cubital tunnel syndrome: numbness in 4/5th digits, intrinsic weakness (1st webspace 1st
dorsal int) and ulnar side pain
Median nerve Correct Ans-Enters forearm thru anticubital fossa innervating pronator
teres, FCRL palmaris Longus, FDS,. Nerve bifurcates giving rise to anterior interosseous nerve
innervating flexor pollicis longus n flexor digitorum profundus(2/3) index n long. And pronator
quadratus. Terminal ain is carpal sensory branch. Main brach enters hand thru carpal tunnel
innervating Abd PB, OP, FPB, lumbricle 1/2 index middle
Carpal tunnel: nocturnal pain
Pronator syndrome: no muscle weakness. Pain n parathesia in forearm, thumb, index
Splint in neutral wrist w 2deg flexion and 3 def ulnar dev
Lumbricles occupy carpal tunnel w finger flexion, mcpj block at 20-40 deg will decrease
pressure of lumbricle sin carpal tummel and and decrease FDP excursion
AIN syndrome: no parathesia only motor. Pain proximal volar forearm. Dif w fine motor
Radial Nerve Correct Ans-Tricep, anconeus, brachradialis, ECRL. Then EVRB. Bifurcates into
sensory and PIN: supinator, ED,EDM, ECU, Abd PL, EPL, EPB, EI. Compression: arcade of froshe
, CHT Prep Questions and Answers 100% Pass
covering supinator compression of PIN. Sensory nerve compression as it exits fascia adjacent
to brachiradialis tendon
Horners syndrome Correct Ans-Occurs w loss of sympathetic ganglionic function after
avulsion of T1 nerve root and is recognized by meiosis(papillary constriction),
endophthalmas(insert orbit), ptosis(droppy eye lid), anhydrosis (dry eye) due to distuption of
sympathetic outflow from and to the head and neck from sympathetic ganglion of T1 level
Poland syndrome Correct Ans-Aplsia of pec mj, brachydactyly, syndactyly of digits and
hypoplasia of hand.
Aperts syndrome Correct Ans-Craniofacial deform n complex syndactyly hand n feet
VACTERL syndrome Correct Ans-Congenital malformation involving radial deficiency and
other anomalies.
Posterior interosseus nerve Correct Ans-Radial nerve innervates flexor carpi radi longus
then bifurcates at level of FCRL becoming PIN and sensory nerve. Innervation: ECRB, ECU EDC
EIP EPL EDM APL EPB, LOSS OF FUNCTION: radial wrist ext and inability to extend MCP &
retropulse thumb.
PIN patient will present motor abnormalities. No sensory innervation however provides
proprioception to wrist, runs along 4th dorsal compartment terminally
Resisted supination increase pain
Steindler procedure Correct Ans-Flexor pronator muscle tendon transfer to promote elbow
flexion. due to c5c6 brachial plexus injury.
C6 quad. What tendon transfer may be used to restore elbow extension Correct Ans-Biceps
to tricep tendon transfer. Still have brachialis and supinators so bicep can be spared.
Space of poireir Correct Ans-Weakness from the absence of ligamentous support between
capitate and lunate articulation. Bolar extrinsic ligaments for a V, lunate is able to dislocate w
high velocity injury
Extensor lag test Correct Ans-Tests supraspinatus and infraspinatus. ER to near full then
abd to 20deg, release if lag then supraspinatus tear
Drop arm test Correct Ans-Tests infraspinatus, ER near full then abd to 90 deg, release if
lag then tear in infraspinatus
Flexor digitorum profundus Correct Ans-Small/ring : Ulnar nerve innervated.
Flexor pollicis brevis Correct Ans-Deep head innervated by ulnar nerve
Oblique retinacular ligament Correct Ans-Landsmeer's ligament, originates volar aspect of
pp, inserts on extensor tendon dorsal axis of DIPJ, helps w PIP flex w DIP ext
, CHT Prep Questions and Answers 100% Pass
If contracted in extension DIP is unable to flex contributes to boutonniere def
Swan neck deformity Correct Ans-
Boutonnière deformity Correct Ans-
Lacertus Fibrosus Correct Ans-Bicepital apneurosis. Tendon from bicep brachii, tighten w
pronation. Active flexion w pronation may contribute to compression of median nerve at LF
Hook of hamate fracture Correct Ans-Ulnar side pain w extension, ulnar deviation and
flexion of small ring finger. Pain distal to pisiform. Commonly neg on xray. Common w racket
sports, golf, baseball, using hand to close lids. Use ulnar gutter splint. Orif or excision
Common flexor origin muscles Correct Ans-Pronator teres, flexor carpi radialis/ulnaris,
flexor digitorum superficialis, palmaris longus
Arcade of Froshe Correct Ans-Common impingement site for PIN (radial tunnel stndrome)
Fibrous band that arises as a semi circular structure from tip of medial aspect of lateral epi.
Located at proximal edge of supinator
Cubital tunnel Correct Ans-Roof is formed by acruate ligament of osborne and investing
fascia of FCU Roof slacks w extension and tightens in flexion
, CHT Prep Questions and Answers 100% Pass
Ulnar nerve Correct Ans-1site of compression: as pierces medial intermuscular spetum at
level of coracobrachialis mm. Nerve passes thru acrade of struthers to formally enter cubital
tunnel.
High ulnar N injury w intrinsic loss n 2ndary loss of 4 n 5 th FDP loss of 60-80% of grasp occurs
Cubital tunnel syndrome: numbness in 4/5th digits, intrinsic weakness (1st webspace 1st
dorsal int) and ulnar side pain
Median nerve Correct Ans-Enters forearm thru anticubital fossa innervating pronator
teres, FCRL palmaris Longus, FDS,. Nerve bifurcates giving rise to anterior interosseous nerve
innervating flexor pollicis longus n flexor digitorum profundus(2/3) index n long. And pronator
quadratus. Terminal ain is carpal sensory branch. Main brach enters hand thru carpal tunnel
innervating Abd PB, OP, FPB, lumbricle 1/2 index middle
Carpal tunnel: nocturnal pain
Pronator syndrome: no muscle weakness. Pain n parathesia in forearm, thumb, index
Splint in neutral wrist w 2deg flexion and 3 def ulnar dev
Lumbricles occupy carpal tunnel w finger flexion, mcpj block at 20-40 deg will decrease
pressure of lumbricle sin carpal tummel and and decrease FDP excursion
AIN syndrome: no parathesia only motor. Pain proximal volar forearm. Dif w fine motor
Radial Nerve Correct Ans-Tricep, anconeus, brachradialis, ECRL. Then EVRB. Bifurcates into
sensory and PIN: supinator, ED,EDM, ECU, Abd PL, EPL, EPB, EI. Compression: arcade of froshe
, CHT Prep Questions and Answers 100% Pass
covering supinator compression of PIN. Sensory nerve compression as it exits fascia adjacent
to brachiradialis tendon
Horners syndrome Correct Ans-Occurs w loss of sympathetic ganglionic function after
avulsion of T1 nerve root and is recognized by meiosis(papillary constriction),
endophthalmas(insert orbit), ptosis(droppy eye lid), anhydrosis (dry eye) due to distuption of
sympathetic outflow from and to the head and neck from sympathetic ganglion of T1 level
Poland syndrome Correct Ans-Aplsia of pec mj, brachydactyly, syndactyly of digits and
hypoplasia of hand.
Aperts syndrome Correct Ans-Craniofacial deform n complex syndactyly hand n feet
VACTERL syndrome Correct Ans-Congenital malformation involving radial deficiency and
other anomalies.
Posterior interosseus nerve Correct Ans-Radial nerve innervates flexor carpi radi longus
then bifurcates at level of FCRL becoming PIN and sensory nerve. Innervation: ECRB, ECU EDC
EIP EPL EDM APL EPB, LOSS OF FUNCTION: radial wrist ext and inability to extend MCP &
retropulse thumb.
PIN patient will present motor abnormalities. No sensory innervation however provides
proprioception to wrist, runs along 4th dorsal compartment terminally
Resisted supination increase pain
