This is Part 1 of the Hand
Surgery Fundamentals
Comprehensive Test Bank.
PART 1 of 5
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Hand Anatomy and Examination (Questions 1-10)
Chapter 2: Flexor Tendon Injuries (Questions 11-20)
Chapter 3: Extensor Tendon Injuries (Questions 21-30)
Chapter 4: Nerve Injuries and Compression (Questions 31-40)
Chapter 5: Hand Fractures and Dislocations (Questions 41-50)
CHAPTER 1: HAND ANATOMY AND EXAMINATION
Q1. A 35-year-old man has a laceration at the volar wrist that spares the median nerve but divides
the structure passing through the carpal tunnel superficial to the flexor tendons. Which structure is
most likely injured?
A. Palmaris longus tendon
B. Flexor carpi radialis tendon
C. Flexor digitorum superficialis tendon
D. Flexor pollicis longus tendon
Correct Answer: Palmaris longus tendon ✅
Rationale: The correct answer is the palmaris longus tendon. The palmaris longus is superficial
to the flexor retinaculum and lies in the midline of the volar wrist, making it the structure at risk in a
,superficial volar wrist laceration. Option B is wrong because the flexor carpi radialis lies radial to the
palmaris longus and is not within the carpal tunnel. Option C is wrong because the flexor digitorum
superficialis lies deep to the flexor retinaculum. Option D is wrong because the flexor pollicis longus
lies deep within the carpal tunnel. The governing concept is that surface anatomy of the volar wrist
guides identification of injured structures.
Q2. A 28-year-old woman cannot flex the distal interphalangeal joint of the index finger. Which
structure is most likely injured?
A. Flexor digitorum profundus tendon
B. Flexor digitorum superficialis tendon
C. Extensor digitorum communis tendon
D. Lumbrical muscle
Correct Answer: Flexor digitorum profundus tendon ✅
Rationale: The correct answer is the flexor digitorum profundus tendon. The flexor digitorum
profundus inserts on the distal phalanx and is the sole flexor of the distal interphalangeal joint.
Option B is wrong because the flexor digitorum superficialis inserts on the middle phalanx and flexes
the proximal interphalangeal joint. Option C is wrong because the extensor digitorum communis
extends the finger. Option D is wrong because the lumbricals flex the metacarpophalangeal joints
and extend the interphalangeal joints. The governing concept is that tendon function can be localized
by testing specific joints.
Q3. A 32-year-old man cannot flex the proximal interphalangeal joint while the distal interphalangeal
joint is held extended. Which structure is most likely injured?
A. Flexor digitorum superficialis tendon
B. Flexor digitorum profundus tendon
C. Extensor digitorum communis tendon
D. Lumbrical muscle
Correct Answer: Flexor digitorum superficialis tendon ✅
,Rationale: The correct answer is the flexor digitorum superficialis tendon. Isolating the
superficialis by holding the other fingers extended and the distal interphalangeal joint extended tests
its function at the proximal interphalangeal joint. Option B is wrong because the profundus is tested
by blocking the proximal interphalangeal joint and asking the patient to flex the distal
interphalangeal joint. Option C is wrong because the extensor digitorum communis extends the
finger. Option D is wrong because the lumbricals flex the metacarpophalangeal joints. The governing
concept is that isolated tendon testing distinguishes superficialis from profundus injury.
Q4. A 40-year-old woman has numbness in the thumb, index, middle, and radial half of the ring
finger. Which nerve is most likely affected?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Posterior interosseous nerve
Correct Answer: Median nerve ✅
Rationale: The correct answer is the median nerve. The median nerve supplies sensation to
the thumb, index, middle, and radial half of the ring finger. Option B is wrong because the ulnar
nerve supplies the little finger and ulnar half of the ring finger. Option C is wrong because the radial
nerve supplies the dorsal radial hand. Option D is wrong because the posterior interosseous nerve is
purely motor. The governing concept is that sensory distribution identifies the affected nerve.
Q5. A 45-year-old man has numbness in the little finger and ulnar half of the ring finger. Which nerve
is most likely affected?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Anterior interosseous nerve
Correct Answer: Ulnar nerve ✅
, Rationale: The correct answer is the ulnar nerve. The ulnar nerve supplies sensation to the
little finger and ulnar half of the ring finger. Option B is wrong because the median nerve supplies the
thumb, index, middle, and radial half of the ring finger. Option C is wrong because the radial nerve
supplies the dorsal radial hand. Option D is wrong because the anterior interosseous nerve is purely
motor. The governing concept is that sensory distribution identifies the affected nerve.
Q6. A 38-year-old woman has weakness of thumb opposition. Which nerve is most likely affected?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Posterior interosseous nerve
Correct Answer: Median nerve ✅
Rationale: The correct answer is the median nerve. The median nerve supplies the thenar
muscles including the opponens pollicis. Option B is wrong because the ulnar nerve supplies most
intrinsic hand muscles but not thumb opposition. Option C is wrong because the radial nerve
supplies wrist extensors. Option D is wrong because the posterior interosseous nerve supplies finger
extensors. The governing concept is that motor testing identifies the affected nerve.
Q7. A 42-year-old man has weakness of finger abduction. Which nerve is most likely affected?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Anterior interosseous nerve
Correct Answer: Ulnar nerve ✅
Rationale: The correct answer is the ulnar nerve. The ulnar nerve supplies the dorsal
interossei, which abduct the fingers. Option B is wrong because the median nerve does not supply
the interossei. Option C is wrong because the radial nerve supplies wrist and finger extensors. Option
Surgery Fundamentals
Comprehensive Test Bank.
PART 1 of 5
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Hand Anatomy and Examination (Questions 1-10)
Chapter 2: Flexor Tendon Injuries (Questions 11-20)
Chapter 3: Extensor Tendon Injuries (Questions 21-30)
Chapter 4: Nerve Injuries and Compression (Questions 31-40)
Chapter 5: Hand Fractures and Dislocations (Questions 41-50)
CHAPTER 1: HAND ANATOMY AND EXAMINATION
Q1. A 35-year-old man has a laceration at the volar wrist that spares the median nerve but divides
the structure passing through the carpal tunnel superficial to the flexor tendons. Which structure is
most likely injured?
A. Palmaris longus tendon
B. Flexor carpi radialis tendon
C. Flexor digitorum superficialis tendon
D. Flexor pollicis longus tendon
Correct Answer: Palmaris longus tendon ✅
Rationale: The correct answer is the palmaris longus tendon. The palmaris longus is superficial
to the flexor retinaculum and lies in the midline of the volar wrist, making it the structure at risk in a
,superficial volar wrist laceration. Option B is wrong because the flexor carpi radialis lies radial to the
palmaris longus and is not within the carpal tunnel. Option C is wrong because the flexor digitorum
superficialis lies deep to the flexor retinaculum. Option D is wrong because the flexor pollicis longus
lies deep within the carpal tunnel. The governing concept is that surface anatomy of the volar wrist
guides identification of injured structures.
Q2. A 28-year-old woman cannot flex the distal interphalangeal joint of the index finger. Which
structure is most likely injured?
A. Flexor digitorum profundus tendon
B. Flexor digitorum superficialis tendon
C. Extensor digitorum communis tendon
D. Lumbrical muscle
Correct Answer: Flexor digitorum profundus tendon ✅
Rationale: The correct answer is the flexor digitorum profundus tendon. The flexor digitorum
profundus inserts on the distal phalanx and is the sole flexor of the distal interphalangeal joint.
Option B is wrong because the flexor digitorum superficialis inserts on the middle phalanx and flexes
the proximal interphalangeal joint. Option C is wrong because the extensor digitorum communis
extends the finger. Option D is wrong because the lumbricals flex the metacarpophalangeal joints
and extend the interphalangeal joints. The governing concept is that tendon function can be localized
by testing specific joints.
Q3. A 32-year-old man cannot flex the proximal interphalangeal joint while the distal interphalangeal
joint is held extended. Which structure is most likely injured?
A. Flexor digitorum superficialis tendon
B. Flexor digitorum profundus tendon
C. Extensor digitorum communis tendon
D. Lumbrical muscle
Correct Answer: Flexor digitorum superficialis tendon ✅
,Rationale: The correct answer is the flexor digitorum superficialis tendon. Isolating the
superficialis by holding the other fingers extended and the distal interphalangeal joint extended tests
its function at the proximal interphalangeal joint. Option B is wrong because the profundus is tested
by blocking the proximal interphalangeal joint and asking the patient to flex the distal
interphalangeal joint. Option C is wrong because the extensor digitorum communis extends the
finger. Option D is wrong because the lumbricals flex the metacarpophalangeal joints. The governing
concept is that isolated tendon testing distinguishes superficialis from profundus injury.
Q4. A 40-year-old woman has numbness in the thumb, index, middle, and radial half of the ring
finger. Which nerve is most likely affected?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Posterior interosseous nerve
Correct Answer: Median nerve ✅
Rationale: The correct answer is the median nerve. The median nerve supplies sensation to
the thumb, index, middle, and radial half of the ring finger. Option B is wrong because the ulnar
nerve supplies the little finger and ulnar half of the ring finger. Option C is wrong because the radial
nerve supplies the dorsal radial hand. Option D is wrong because the posterior interosseous nerve is
purely motor. The governing concept is that sensory distribution identifies the affected nerve.
Q5. A 45-year-old man has numbness in the little finger and ulnar half of the ring finger. Which nerve
is most likely affected?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Anterior interosseous nerve
Correct Answer: Ulnar nerve ✅
, Rationale: The correct answer is the ulnar nerve. The ulnar nerve supplies sensation to the
little finger and ulnar half of the ring finger. Option B is wrong because the median nerve supplies the
thumb, index, middle, and radial half of the ring finger. Option C is wrong because the radial nerve
supplies the dorsal radial hand. Option D is wrong because the anterior interosseous nerve is purely
motor. The governing concept is that sensory distribution identifies the affected nerve.
Q6. A 38-year-old woman has weakness of thumb opposition. Which nerve is most likely affected?
A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Posterior interosseous nerve
Correct Answer: Median nerve ✅
Rationale: The correct answer is the median nerve. The median nerve supplies the thenar
muscles including the opponens pollicis. Option B is wrong because the ulnar nerve supplies most
intrinsic hand muscles but not thumb opposition. Option C is wrong because the radial nerve
supplies wrist extensors. Option D is wrong because the posterior interosseous nerve supplies finger
extensors. The governing concept is that motor testing identifies the affected nerve.
Q7. A 42-year-old man has weakness of finger abduction. Which nerve is most likely affected?
A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Anterior interosseous nerve
Correct Answer: Ulnar nerve ✅
Rationale: The correct answer is the ulnar nerve. The ulnar nerve supplies the dorsal
interossei, which abduct the fingers. Option B is wrong because the median nerve does not supply
the interossei. Option C is wrong because the radial nerve supplies wrist and finger extensors. Option
