CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
!@#$%%%%%
Ulnar nerve - order of innervation - (ANSWERS)FCU - FDP (ring & small) - medial cutaneous
branch - ADM - ODM - FDM - ulnar lumbricals - palmar & dorsal interossei%%%%%%
- FPB (deep) -
adductor pollicis
Radial nerve - order of innervation - (ANSWERS)Triceps - anconeus - BR - ECRL - ECRB (1/2 RN
& 1/2 PIN) - PIN: supinator - EDC - EDM - ECU - APL - EPL - EPB - EIP
Median nerve - order of innervation - (ANSWERS)PT - FCR - PL - FDS (index thru small) - AIN:
FDP (index & middle) - FPL - PQ; palmar cutaneous branch - under flexor retinaculum: APB - OP
- FPB (superficial) - radial lumbricals
Order of sensory return - (ANSWERS)Pain and Temperature
30 Hz Vibration
Moving Touch
Constant Touch
256 Hz Vibration
Touch Localization
Two Point Discrimination
Stereognosis
Steindler procedure - (ANSWERS)Flexor pronator muscle-tendon transfer to promote elbow
flexion s/p C5/C6 BPI.
"Steindler.. Which way to the beach?"
Quadrangular space - (ANSWERS)Axillary nerve and posterior circumflex humeral artery
Quadrigia phenomenon - (ANSWERS)Flexion contracture of involved digit as well as limited
flexion of adjacent digits; results if FDP advanced >1cm during repair (limits proximal excursion
of other FDP tendons)
Egawa's Sign - (ANSWERS)Ability to flex the LF, but cannot RD/UD; interosseous paralysis (UN
out)
(Egawa has road rage )
Guyon's canal - (ANSWERS)Contains UN and UA; borders of canal are hook of hamate &
pisiform
*common UN pathology with cyclists
,CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
Anatomical snuffbox - (ANSWERS)Borders are EPL dorsally & APL/EPB volarly;!@#$%%%%%
can palpate the
scaphoid %%%%%%
*radial artery passes through here
DISI deformity - (ANSWERS)S-L injury - lunate extends Dorsally with the triquetrum; dorsal S-L
ligament is the strongest and vital for normal kinematics
VISI deformity - (ANSWERS)L-T injury - lunate flexes Volarly with the scaphoid
PIP flexion contractures: structures involved - (ANSWERS)Check rein ligaments, volar plate,
collateral ligament
Extensor tendon compartments - (ANSWERS)1. APL/EPB
2. ECRL/ECRB
3. EPL
4. EDC/EIP
5. EDM (5th digit)
6. ECU
Acute compartment syndrome: causes & symptoms - (ANSWERS)Causes: crush,
thermal/electrical burns
Symptoms: pain, paresthesias, paralysis, pulselessness (4 p's)
Often intrinsic minus hand
Increasing pressure = necrosis
Martin-Gruber anastomosis - (ANSWERS)MN/UN connection in the FA; intrinsic muscles can
be innervated by MN in case of UN injury
- RF/SF FDP out
Riche-Cannieu anastomosis - (ANSWERS)Occurs in palm - communicating branch between
deep branch of UN and recurrent branch of MN in thenar eminence
Berretini anastomosis - (ANSWERS)Connection between UN/MN common digital nerves
"Bear claw - rawr"
Medial collateral ligament (MCL): anterior oblique bundle - (ANSWERS)Medial epicondyle to
coronoid
,CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
!@#$%%%%%
Greatest constraint to valgus when elbow at 30-90 degrees %%%%%%
Injured in baseball pitchers
Medial collateral ligament (MCL): posterior oblique bundle - (ANSWERS)Medial epicondyle to
coronoid (below AOL)
Greatest constraint to valgus with elbow flexion > 90 degrees
Medial collateral ligament (MCL): transverse bundle - (ANSWERS)Below AOL and POL;
functionally insignificant to valgus restraint
Bouvier test - (ANSWERS)Tests if PIPJ and extensor mechanism is working
Place MP in slight flexion and see if IP's extend
Adson's Test - (ANSWERS)Monitor pt's radial pulse with arm extended; pt. Asked to breathe in
and tilt head towards ipsilateral arm
(+) Test = severely DEC/absent radial pulse
*indicates compression between anterior & middle scalene of the neurovascular bundle
Finochietto-Bunnel Test - (ANSWERS)Checks intrinsic tightness - MP hyperextended: PIPJ
tighter than with MP flexed
Brachial artery - (ANSWERS)The major vessel in the upper extremity that supplies blood to the
arm; splits into the radial and ulnar arteries at the antecubital fossa
Signs of arterial insufficiency - (ANSWERS)Color (pale; worsened by elevation of extremity;
dusky red when extremity is lowered)
Temperature (cool, blood flow blocked to extremity)
Pulse (decreased or absent)
Edema (absent or mild)
Skin changes (thin, shiny skin; decreased hair growth; thickened nails)
Pain (increased)
, CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
!@#$%%%%%
%%%%%%
Cleland's ligament - (ANSWERS)Originated from flexor tendon sheath, passes DORSAL to
neurovascular bundle, inserts into skin
*prevents rotary movement of the skin around the fingers with grasp
Grayson's ligament - (ANSWERS)Originated from flexor tendon sheath, passes VOLAR to
neurovascular bundle, inserts into skin
*prevents rotary movement of the skin around the fingers with grasp
*may contribute to Dupuytren's PIP contractures
Scaphoid fracture - (ANSWERS)MOI: axial load to hyperextended and radially deviated wrist
Waist: 65%
Proximal pole: 25% (more avascular)
Distal pole: 10% (more common in kids)
Preiser's disease - (ANSWERS)AVN of the scaphoid, resulting from a fracture or repeated
trauma
Cubital fossa - boundaries - (ANSWERS)SUPERIOR: imaginary line through epicondyles
LATERAL: Brachioradialis muscle
MEDIAL: Pronator teres muscle
Signs of venous insufficiency - (ANSWERS)Cyanosis (blue tint caused by reduced amounts of
hemoglobin)
Abnormal capillary refill
Snapping lateral bands - (ANSWERS)Pain and snapping at lateral PIPJ with flexion
TRL loosens - solution: oval 8 splint
Transverse retinacular ligament (TRL) - (ANSWERS)Connects lateral bands (LB) to ORL;
restrains the LB's from dorsal subluxation - guides LB's volarly with flexion
Lacertus fibrosus (aka: bicipital aponeurosis) - (ANSWERS)Fibrous band originating from
biceps aponeurosis; active flexion with pronation may contribute to compression of MN
CORRECT Answers
!@#$%%%%%
Ulnar nerve - order of innervation - (ANSWERS)FCU - FDP (ring & small) - medial cutaneous
branch - ADM - ODM - FDM - ulnar lumbricals - palmar & dorsal interossei%%%%%%
- FPB (deep) -
adductor pollicis
Radial nerve - order of innervation - (ANSWERS)Triceps - anconeus - BR - ECRL - ECRB (1/2 RN
& 1/2 PIN) - PIN: supinator - EDC - EDM - ECU - APL - EPL - EPB - EIP
Median nerve - order of innervation - (ANSWERS)PT - FCR - PL - FDS (index thru small) - AIN:
FDP (index & middle) - FPL - PQ; palmar cutaneous branch - under flexor retinaculum: APB - OP
- FPB (superficial) - radial lumbricals
Order of sensory return - (ANSWERS)Pain and Temperature
30 Hz Vibration
Moving Touch
Constant Touch
256 Hz Vibration
Touch Localization
Two Point Discrimination
Stereognosis
Steindler procedure - (ANSWERS)Flexor pronator muscle-tendon transfer to promote elbow
flexion s/p C5/C6 BPI.
"Steindler.. Which way to the beach?"
Quadrangular space - (ANSWERS)Axillary nerve and posterior circumflex humeral artery
Quadrigia phenomenon - (ANSWERS)Flexion contracture of involved digit as well as limited
flexion of adjacent digits; results if FDP advanced >1cm during repair (limits proximal excursion
of other FDP tendons)
Egawa's Sign - (ANSWERS)Ability to flex the LF, but cannot RD/UD; interosseous paralysis (UN
out)
(Egawa has road rage )
Guyon's canal - (ANSWERS)Contains UN and UA; borders of canal are hook of hamate &
pisiform
*common UN pathology with cyclists
,CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
Anatomical snuffbox - (ANSWERS)Borders are EPL dorsally & APL/EPB volarly;!@#$%%%%%
can palpate the
scaphoid %%%%%%
*radial artery passes through here
DISI deformity - (ANSWERS)S-L injury - lunate extends Dorsally with the triquetrum; dorsal S-L
ligament is the strongest and vital for normal kinematics
VISI deformity - (ANSWERS)L-T injury - lunate flexes Volarly with the scaphoid
PIP flexion contractures: structures involved - (ANSWERS)Check rein ligaments, volar plate,
collateral ligament
Extensor tendon compartments - (ANSWERS)1. APL/EPB
2. ECRL/ECRB
3. EPL
4. EDC/EIP
5. EDM (5th digit)
6. ECU
Acute compartment syndrome: causes & symptoms - (ANSWERS)Causes: crush,
thermal/electrical burns
Symptoms: pain, paresthesias, paralysis, pulselessness (4 p's)
Often intrinsic minus hand
Increasing pressure = necrosis
Martin-Gruber anastomosis - (ANSWERS)MN/UN connection in the FA; intrinsic muscles can
be innervated by MN in case of UN injury
- RF/SF FDP out
Riche-Cannieu anastomosis - (ANSWERS)Occurs in palm - communicating branch between
deep branch of UN and recurrent branch of MN in thenar eminence
Berretini anastomosis - (ANSWERS)Connection between UN/MN common digital nerves
"Bear claw - rawr"
Medial collateral ligament (MCL): anterior oblique bundle - (ANSWERS)Medial epicondyle to
coronoid
,CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
!@#$%%%%%
Greatest constraint to valgus when elbow at 30-90 degrees %%%%%%
Injured in baseball pitchers
Medial collateral ligament (MCL): posterior oblique bundle - (ANSWERS)Medial epicondyle to
coronoid (below AOL)
Greatest constraint to valgus with elbow flexion > 90 degrees
Medial collateral ligament (MCL): transverse bundle - (ANSWERS)Below AOL and POL;
functionally insignificant to valgus restraint
Bouvier test - (ANSWERS)Tests if PIPJ and extensor mechanism is working
Place MP in slight flexion and see if IP's extend
Adson's Test - (ANSWERS)Monitor pt's radial pulse with arm extended; pt. Asked to breathe in
and tilt head towards ipsilateral arm
(+) Test = severely DEC/absent radial pulse
*indicates compression between anterior & middle scalene of the neurovascular bundle
Finochietto-Bunnel Test - (ANSWERS)Checks intrinsic tightness - MP hyperextended: PIPJ
tighter than with MP flexed
Brachial artery - (ANSWERS)The major vessel in the upper extremity that supplies blood to the
arm; splits into the radial and ulnar arteries at the antecubital fossa
Signs of arterial insufficiency - (ANSWERS)Color (pale; worsened by elevation of extremity;
dusky red when extremity is lowered)
Temperature (cool, blood flow blocked to extremity)
Pulse (decreased or absent)
Edema (absent or mild)
Skin changes (thin, shiny skin; decreased hair growth; thickened nails)
Pain (increased)
, CHT Exam Megan UPDATED ACTUAL Exam Questions and
CORRECT Answers
!@#$%%%%%
%%%%%%
Cleland's ligament - (ANSWERS)Originated from flexor tendon sheath, passes DORSAL to
neurovascular bundle, inserts into skin
*prevents rotary movement of the skin around the fingers with grasp
Grayson's ligament - (ANSWERS)Originated from flexor tendon sheath, passes VOLAR to
neurovascular bundle, inserts into skin
*prevents rotary movement of the skin around the fingers with grasp
*may contribute to Dupuytren's PIP contractures
Scaphoid fracture - (ANSWERS)MOI: axial load to hyperextended and radially deviated wrist
Waist: 65%
Proximal pole: 25% (more avascular)
Distal pole: 10% (more common in kids)
Preiser's disease - (ANSWERS)AVN of the scaphoid, resulting from a fracture or repeated
trauma
Cubital fossa - boundaries - (ANSWERS)SUPERIOR: imaginary line through epicondyles
LATERAL: Brachioradialis muscle
MEDIAL: Pronator teres muscle
Signs of venous insufficiency - (ANSWERS)Cyanosis (blue tint caused by reduced amounts of
hemoglobin)
Abnormal capillary refill
Snapping lateral bands - (ANSWERS)Pain and snapping at lateral PIPJ with flexion
TRL loosens - solution: oval 8 splint
Transverse retinacular ligament (TRL) - (ANSWERS)Connects lateral bands (LB) to ORL;
restrains the LB's from dorsal subluxation - guides LB's volarly with flexion
Lacertus fibrosus (aka: bicipital aponeurosis) - (ANSWERS)Fibrous band originating from
biceps aponeurosis; active flexion with pronation may contribute to compression of MN
