FOREARM AND HAND – Practice Questions

Set 1
Answers can be found at the end of this document
(Note: these questions are meant to be a guide only, and are not all- inclusive
of the material; FOR INTERNAL USE ONLY)

1. When Ned was walking to class, he slipped on a plantain. He braced his

fall with his extended wrist and broke his distal radius. You would expect
the distal fragment to be displaced __ _?

A. Medially
B. Laterally
C. Anteriorly
D. Posteriorly
E. No displacement is likely

2. When pronating your forearm, how do the radius and ulna bones interact?

A. Distal radius rotates over ulna

B. Distal ulna rotates over radius
C. Both bones rotate distally together
D. Neither bones move
E. They fight over who’s better looking

3. Damage to what nerve will cause sensory loss to the dorsal aspect of the
fingertip of the second digit?

A. Radial nerve
B. Median nerve
C. Ulnar nerve
D. Axillary nerve

4. While studying for your next mini, you decide it’s high time you relive
some of your middle-school angst by pulling out a few of your old Toad the
Wet Sprocket albums. “Geeze,” you think, “they just don’t make them like
lead-guitarist Glen Phillips anymore.” A quick web search for his next tour
scars you for life when you discover that he’s had a terrible accident and
severed the ulnar nerve in his left forearm just distal to the elbow. With
your deep understanding of human anatomy, you come to the sad
realization that his classic _ presentation will, amongst
other things, inhibit flexion of the__________ joint(s) of his left hand and
leave the world a little less magical.

A. Ape Hand; CMC of the 1st digit

B. Hand of benediction; IP joints of digits 1-3
C. Claw Hand; DIP of 4th and 5th digits
D. Trigger finger; PIP of the 3rd digit
E. Dupuytren contracture; MCP
 5. A young girl came in with a mid-shaft humerus fracture. Upon
examination you note that she can weakly extend her flexed forearm.
You suspect that the radial nerve is damaged (and you remember
learning that the radial nerve innervates the posterior/extensor
compartment of the forearm) but your findings indicate that some
forearm extension is still possible. What is the reason for this?

A. The brachioradialis muscle aids in extension of the forearm and is

innervated by a different nerve
B. The radial nerve fibers to the long and lateral heads of the triceps
branch off superiorly to mid-shaft of the humerus
C. The musculocutaneous nerve is most likely damaged, and she
cannot flex her forearm. The extension observed was due to
gravity
D. The lateral head of the triceps is not affected since its proximal part is
supplied by the ulnar nerve

6. A baseball player came into your office today because of a “broken

finger”. He said that he was sliding into third, jammed his finger, and
thinks he broke it. Upon observation the index finger of the patient’s
right hand is fully extended except for the distal interphalangeal (DIP)
joint. You recognize this as a hyperflexion of the DIP and believe that
he has snapped the tendon crossing this joint, hindering extension.
What nerve innervates the muscle that allows for extension of this
joint?

A. Brachial nerve
B. Median nerve
C. Ulnar nerve
D. Musculocutaneous nerve
E. Radial nerve

7. An elderly woman was making her way out to her car one winter
morning and slipped on the ice. She fell to the side and was able to catch
herself with her right wrist on an outstretched arm. A neighbor came by
and drove the woman to the hospital. After being seen by the doctor
and having an X-ray taken, it was concluded that she fractured her
scaphoid bone. The doctor was most concerned about the proximal
portion of this bone becoming necrotic as the arterial supply is weak.
What artery directly supplies blood to the scaphoid bone via a distal
entry point?

A. Branch from the superficial palmar arch

B. Ulnar artery
C. Radial artery
D. Brachial artery
8. While walking into the grocery store Steven (a 3-year-old boy) tried to
grab both his parents’ hands to swing between them. He missed his
mother’s hand and his father caught him and was able to pull him up to
keep him from falling on the ground. Steven grabbed his arm in pain
and started to cry. When the parents couldn’t figure out why he was in
so much pain they took him straight to the doctor’s office. A quick X-ray
revealed that the head of the humerus was located in the glenohumeral
joint with no abnormalities, but the radius was not aligned with the ulna
and deviated laterally from its normal position. What is the most likely
injury that caused Steven’s arm pain?

A. Fracture of the radius

B. Subluxation of the radius from the annular ligament
C. Subluxation of the ulna from the annular ligament
D. Anterior dislocation of the humerus
E. Subluxation of the radius from the radial collateral ligament of the elbow

9. A tennis Pro likes to play 18 holes of golf every weekend to relax. One
Monday, he presents to your clinic with severe elbow pain when he
flexes his right wrist and fingers. What condition is most likely in this
patient?

A. Carpal tunnel syndrome

B. Ulnar tunnel syndrome
C. Medial epicondylitis
D. Lateral epicondylitis
E. Nursemaid's elbow

10. A patient presents with anesthesia of the lateral 3½ fingers. Which sign
indicates a lesion of this particular nerve at the elbow rather than at the
wrist?

A. Hand of benediction
B. Swan neck deformity
C. Wrist drop
D. Ape hand
E. Claw hand

11. Your ICM instructor in 3rd semester is Dr. Fitzgerald, who rides his bike
to and from work every day. He tells you about the time he developed
Pronator Syndrome from cycling so much. He shows you how to test for
it by asking the patient to pronate their forearm against your resistance.
A positive result would elicit paresthesia where?

A. Dorsum aspect, lateral 3 ½ fingers

B. Ventral aspect, lateral 3 ½ fingers
C. Dorsal aspect, medial 1 ½ fingers
D. Ventral aspect, medial 1 ½ fingers
E. Skin overlying the pronator teres muscle (upper forearm)
12. What is the main direct arterial supply for the posterior compartment
of the forearm?

A. Posterior Interosseous Artery

B. Radial Artery
C. Brachial Artery
D. Profunda Brachii Artery
E. Ulnar Artery

13. A patient presents to the ED with a medial epicondyle fracture that

occurred during a baseball game. Since you know which nerve may be
affected you expect:

A. Paresthesia in the first 3 digits and ape hand

B. Paresthesia in digits 4 and 5 and claw hand
C. Paresthesia in first 3 digits and claw hand
D. Paresthesia in digits 4 and 5 and ape hand

14. Which carpal bone is most commonly dislocated when falling

on an outstretched hand?

A. Lunate Bone
B. Scaphoid Bone
C. Trapezium Bone
D. Capitate Bone

15. A professional golfer complains of numbness and tingling on the medial

side of his forearm and medial one-third of his palm. What nerve is
implicated and what is the name of the injury?

A. Radial nerve; Colles’ fracture

B. Median nerve; Medial epicondylitis
C. Ulnar nerve; Medial epicondylitis
D. Radial nerve; Smith fracture
E. Ulnar nerve; Lateral epicondylitis

16. After watching one too many Super Man movies a young boy attempts
to fly by jumping off his balcony. The boy bravely jumps off his balcony
but before he can realize that he is unable to fly he hits the ground and
falls backwards onto the posterior side of his right elbow. After
regaining his composure, he goes back inside to contemplate where
he went wrong. Minutes later he realizes he had trouble fully flexing
digits 4 and 5 in his right hand when trying to make a fist. What nerve
may have been damaged in this valiant effort to fly?

A. Median nerve
B. Deep radial nerve
C. Ulnar nerve
D. Superficial radial nerve
E. Posterior interosseous nerve
17. Which of the following muscles is a flexor innervated by the radial nerve?

A. Supinator muscle
B. Flexor carpi radialis muscle
C. Brachioradialis muscle
D. Biceps brachii muscle

18. A 32-year-old body builder began to feel pain and tenderness in his
proximal anterior forearm. In addition, he began to feel hypoesthesia
in his palmar part of his lateral 3 ½ digits, what might have caused
this?

A. Radial nerve
B. Ulnar nerve
C. Musculocutaneous nerve
D. Median nerve
E. Axillary nerve

19. A 16-year-old girl was in the kitchen trying to make a pizza. She was
trying to open the tomato sauce can and accidently stabbed an area
between her abductor pollicis longus tendon and extensor pollicis longus
tendon. She was rushed to the doctor, who said she might suffer from
possible necrosis due to bleeding from a vessel, what vessel was he
referring to?

A. Brachial artery
B. Anterior interosseus artery
C. Radial artery
D. Ulnar artery
E. Cephalic vein

20. A patient comes in with a posterior dislocation of the elbow and inability
to flex their DIP Joints of digits 4 and 5 with hyperextension of the
same metacarpophalangeal joints. i) What nerve do you suspect is
damaged, ii) what muscle causes the presentation, and iii) what is the
name of this presentation?

A. Radial nerve, extensor carpi ulnaris, wrist drop

B. Median nerve, flexor digitorum profundus, ape Hand
C. Median nerve, flexor digitorum superficialis, claw hand
D. Ulnar nerve, flexor digitorum profundus, claw hand
E. Ulnar nerve, flexor carpi ulnaris, claw hand
21. A patient comes into the ER and tells you that he has just finished
playing an intense game of tennis and now is experiencing some severe
pain on their lateral elbow area. Which muscle would least likely be
affected?

A. Extensor carpi radialis longus

B. Extensor carpi radialis brevis
C. Extensor digitorum
D. Extensor digiti minimi
E. Extensor carpi ulnaris

22. All of the following muscles have a common attachment on the

medial epicondyle except:

A. Pronator teres
B. Flexor carpi radialis
C. Flexor carpi ulnaris
D. Flexor digitorum superficialis
E. Flexor digitorum profundus

23. A woman wants to learn more about anatomy. She asks you to name a
muscle in the anterior compartment of her forearm. You reply:

A. Pronator teres
B. Supinator
C. Extensor indicis
D. Brachioradialis
E. Abductor pollicis longus

24. While preforming a delicate surgery within a patient’s anatomical snuff

box, your attending accidentally severs the tendon to the extensor
pollicis brevis and a tendon positioned immediately anterior to this
tendon. What muscle is most likely associated with the cut tendon?

A. Extensor pollicis longus

B. Extensor indicis
C. Abductor pollicis longus
D. Adductor pollicis longus
E. Extensor carpi radialis longus
F. Extensor carpi radialis brevis
25. A patient presents to your clinic complaining of pain in the forearm. He
tells you that while he was lifting weights, he felt a painful, tearing
sensation in his right hand. To test, you immobilize the patients MCP
joints on digits 2-5 and ask him to flex, which he does without a problem.
Next you immobilize his proximal IP joint and have him flex digits 2-5.
During the test you notice that he is unable to flex his index finger at the
distal IP joint. What muscle are you concerned about and what is the
innervation?

A. Palmaris longus - Median nerve

B. Flexor carpi radialis - Median nerve
C. Flexor digitorum superficialis - Median nerve
D. Flexor digitorum profundus - Ulnar nerve
E. Flexor digitorum profundus - Median nerve
F. Flexor carpi ulnaris - Ulnar nerve

26. You return from your first semester in medical school, ripe with new
anatomical knowledge, that you cannot wait to share at the first chance
you get. After you are picked up from the airport, while getting into the
car, you dad knocks his elbow on the car door hitting his "funny bone"
and lets out a scream. He asks you, "why do they call it funny bone if it
hurts so bad?" Excited to share some knowledge you explain that pain
is caused by the compression of the (a) on the (b)

27. Which intrinsic muscle of the hand is not innervated by the median nerve?

A. 1st and 2nd lumbricals

B. Flexor Pollicis brevis
C. Adductor Pollicis
D. Opponens Pollicis

28. The median nerve supplies all of the muscles of the anterior forearm
except two that are supplied by the ulnar nerve. What are they?

29. When a 43-year-old male fell on his hand, he went to the doctor for a
check up. During a sensation test, the doctor noticed that the patient
had lost sensation to the medial half of the 4th digit. The doctor
suspected a carpal bone fracture. What bone was fractured?

30. During the A's improbable win over the Rangers, the shortstop slid into
second base. When he got up, he realized that his finger was swollen
due its impact with the base. He was diagnosed with Mallet finger. How
does this finger present?

A. Extension at DIP and Flexion at PIP

B. Inability to flex at DIP and Extension at PIP
C. Hyperextension at DIP and inability to flex at DIP
D. Hyperflexion at DIP and inability to extend at DIP
E. Inability to extend at DIP and hyperextension at DIP
31. A 101-year-old man is wheeled into the ER by EMS after driving his car
into a tree late last night. He is intoxicated and cannot recall any info.
You notice a huge piece of glass penetrating the posterior aspect of his
forearm. After removing glass and 6 stitches later you determine the
old man is unable to extend his fingers but still has sensation in his arm.
What nerve is most likely damaged?

32. Loss of radial nerve innervation would cause diminished supination of

the hand and forearm. However, one very strong supinator would remain
unaffected and still allow for some supination to occur. Which muscle is
unaffected?

A. Brachialis
B. Supinator
C. Biceps Brachii
D. Flexor Carpi Radialis
E. Brachioradialis

33. While in the anatomy lab reviewing for your upcoming practical, a
fellow student asks for your help identifying a muscle of the anterior
forearm. You notice that the tendon of the muscle in question
passes under the flexor retinaculum with eight other tendons (two
sets of four tendons). Having reviewed forearm anatomy, you
know this muscle is the:

A. Flexor pollicis longus

B. Flexor digitorum profundus
C. Flexor carpi ulnaris
D. Palmaris longus
E. Flexor pollicis brevis

34. While learning how to check radial pulse, a 1st semester medical student
attempts to check Sim Man's pulse by pressing his thumb against Sim
Man's radial artery. The IME instructor alerts the student that digits 2 and
3 should be used by the physician to avoid mistakenly feeling one's own
pulse at this artery. Why?

35. A 5-year-old is brought into the clinic after a fall at the park during
running. On physical exam, a “dinner fork” presentation is found. Which
of the following bones will have a transverse fracture?

A. Humerus
B. Radius
C. Ulnar
D. Metacarpals
36. Identify the muscle that receives innervation by the ulnar nerve AND the
median nerve.

A. Flexor digitorum profundus

B. Flexor digitorum superficialis
C. Extensor digitorum
D. Flexor carpi ulnaris

37. What structure runs through the Guyon's canal?

A. Median nerve
B. Ulnar nerve
C. Radial nerve
D. Radial artery

38. A 62-year-old female presents to the minor emergency clinic with right
wrist pain status post ground level Fall Onto OutStretched Hand
(FOOSH). She has tenderness over the snuff box but there is no
obvious deformity. Pt reports that pain is rated at 3/10. You order a
wrist and hand X-ray; which specific carpal bone are you concerned
about and what is the appropriate plan in the case of a fracture?

A. Hamate; Colles’ splint with pain meds and send home

B. Scaphoid; surgeon referral
C. Triquetrum; Colles’ splint with pain meds and send home
D. Lunate; surgeon referral
E. Scaphoid; Colles’ splint with pain meds and send home
F. Scaphoid; send the patient home

39. The anatomical snuff box is bordered anteriorly by:

A. Adductor pollicis longus and extensor pollicis brevis

B. Abductor pollicis longus and extensor pollicis longus
C. Extensor pollicis longus and extensor pollicis brevis
D. Abductor pollicis longus and abductor pollicis brevis
E. Abductor pollicis longus and extensor pollicis brevis
40. After being hit by a baseball on his elbow by a Red Sox pitcher,
Derek Jeter underwent an x-ray and it was determined that he
fractured his medial epicondyle. What would be his clinical
presentation?

A. Ulnar nerve damage causing numbness and tingling in forearm and

4th and 5th fingers
B. Ulnar nerve damage causing numbness and tingling in forearm
and 1st-4th fingers
C. Radial nerve damage causing numbness and tingling in forearm and
4th and 5th fingers
D. Median nerve damage causing numbness and tingling in forearm and
4th and 5th fingers

41. All of the thenar muscles are innervated by median nerve except which
of the following?

A. Adductor pollicis: ulnar n.

B. Adductor pollicis: radial n.
C. Abductor pollicis: ulnar n.
D. Abductor pollicis: radial n.
 ANSWER KEY & EXPLANATIONS

We have established a new rating system for the practice questions that describes the
level of difficulty of each practice question and the extent of knowledge needed to
answer the questions. The Levels are rated from L1 (the most straightforward) to L4 (the
most complex). The ratings are defined as below:

Level 1 - Fundamental Question- the student should be able to answer this based on
knowledge gained in the lecture, recommended textbook, and associated lab workbook.

Level 2 – Fundamental Integrated Question from one lecture- the student should be able to
answer this question by recognizing two or more individual pieces of anatomical or
anatomical/clinical information from one lecture or its associated lab and relate them to obtain the
answer.

Level 3 – Fundamental integrated question from more than one lecture- the student should
be able to answer this question based on integrating the knowledge gained from more than one
lecture, and /or more than one workbook which may be in different modules e.g. cardio and
respiratory, digestive and renal

Level 4- Honors Level- in order to answer this question, in addition to utilizing the resources
given, the student may need to research external sources to get information needed to answer the
question. The question however will contain significant anatomical and clinical information to
guide the direction of the student’s thinking.

1. D. Posteriorly L2
Colles’ fracture, distal radius fragment moves posteriorly dragging the
hand with it, this distorts the wrist into an overturned ‘dinner fork’ shape.

2. A. Distal radius rotates over ulna L1

Ulna is fixed during pronation/supination, but the distal radius flips
over the ulna in pronation (both bones are parallel during
supination/anatomical position).

3. B. Median nerve L1
Median nerve provides sensory innervation to the distal 3 and half
fingertips on the dorsal side, radial nerve does sensory innervation to
the dorsal lateral aspect of the hand but not fingertips and ulnar does
sensory innervation to the medial aspect of the hand.

4. C. Claw Hand; DIP of 4th and 5th digits L1

The ulnar nerve innervates the flexor carpi ulnaris, the medial half of the
flexor digitorum profundus, and the intrinsic muscles of the hand (minus
the LOAF muscles, which are innervated by the median nerve). The
medial half of the flexor digitorum profundus inserts distally into the
distal phalanges of the 4th and 5th digits, allowing for flexion at the DIP
joints of those fingers.

5. B. The radial nerve fibers to the long and lateral heads of the
triceps branch off superiorly to mid-shaft of the humerus. L2
Only the medial head of triceps would be affected by a mid-shaft
fracture.
6. E. Radial nerve L2
The radial nerve (deep branch) innervates the extensor digitorum
muscle responsible for extension of the fingers. This tendon is often
compromised in such injuries leading to a condition known as Mallet
Finger as described above.

7. C. Radial artery L2
The scaphoid one is located on the lateral aspect of the wrist and its
distal portion is supplied by the radial artery. Branches from the radial
artery supply the proximal portion, but it is not well perfused and
fracturing this bone may lead to necrosis of this proximal portion.

8. B. Subluxation of the radius from the annular ligament L2

This type of injury is most commonly seen in the given scenario. The
head of the radius is pulled free from the annular ligament and deviates
laterally, pinching the ligament. The annular ligament encircles the head
of the radius.

9. C. Medial epicondylitis L2
Golfer’s elbow is from overuse of forearm flexors that share their origin at
the medial epicondyle (common flexor origin), so medial epicondylitis is
the likeliest condition (remember, the movement associated with pain is
the key here, not his occupation!).

10. A. Hand of benediction L1

Median nerve is affected (accounts for sensory deficit). If the lesion is at
the elbow or above, the patient would present with Hand of Benediction; if
the lesion is at the wrist instead, the patient would present with Ape Hand.

11. B. Ventral aspect, lateral 3 ½ fingers L1

Median nerve pierces through the belly of pronator teres m. and may be
compressed by spasms or inflammation of this muscle. This nerve
receives sensation from the palmar (ventral) side of lateral 3 ½ fingers.

12. A. Posterior Interosseous Artery L1

Post comm. Interosseous is a branch of the common interosseous artery
(from Ulnar a.) that pierces the interosseous membrane to go from
anterior to posterior compartment of the forearm.

13. B. Paresthesia in digits 4 and 5 and claw hand L2

The ulnar nerve would be damaged by the medial epicondyle fracture.
The ulnar nerve gives sensation to digits 4 and 5 and allows for flexion of
the DIP and MCP joint for those digits. Without flexion at these locations,
you present with "claw hand". Injury to the ulnar n. also may result in
numbness/tingling over digits 4 and 5.

14. A. Lunate Bone L1

Lunate is the most commonly dislocated and scaphoid is most commonly
broken wrist bone.
15. C. Ulnar nerve; Medial epicondylitis L1
The wear and tear on the tendon on the medial epicondyle also effects
the nerve that travels there. This nerve is the ulnar nerve and it provides
sensation to the medial anterior forearm and medial one-third of the
palm and last two fingers.

16. C. Ulnar nerve L1

The answer is C because the ulnar nerve travels along the medial
epicondyle and if someone falls onto the posterior side of the elbow with
a flexed elbow the ulnar nerve will most likely be damaged.

17. C. Brachioradialis muscle L1

18. D. Median nerve L1

The median nerve runs in between pronator teres causing compression
and loss of sensation. The median nerve also provides sensation to the
3 ½ lateral digits.

19. C. Radial artery L1

The radial artery is located within the snuff box, the anterior border is
abductor pollicis longus tendon and extensor pollicis brevis tendon;
posterior border is extensor pollicis longus tendon; floor is scaphoid bone
and radial artery; roof is superficial branch of radial nerve and cephalic
vein.

20. D. Ulnar nerve, flexor digitorum profundus, claw hand L2

In a posterior dislocation the most common nerve to be injured is the
ulnar nerve. In an ulnar nerve lesion you would expect a claw hand
presentation in which the patient would not be able to make a complete
fist. The loss in the ability to flex the DIP joints of digits 4 and 5 has to do
with The Flexor Digitorum Profundus being supplied by the ulnar nerve for
digits 4 and 5. The Flexor Digitorum Superficialis is in charge of flexing the
PIP joints of digits 2-5 and only receives innervation from the Median
Nerve.

21. A. Extensor carpi radialis longus L2

In tennis elbow there is a tear in the Common Extensor Tendon that
originates at the lateral epicondyle. The one muscle out of the group
that is not part of the common extensor tendon and originates at the
lateral supracondylar ridge is the extensor carpi radialis longus.

22. E. Flexor digitorum profundus L1

The origin for this muscle is below epicondyle on the ulna and the
interosseous membrane.

23. A. Pronator teres L1

The 8 muscles of the anterior compartment of the forearm include:
pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris,
flexor digitorum superficialis, flexor digitorum profundus, flexor pollicus
longus, pronator quadratus.

24. C. Abductor pollicis longus L1

25. E. Flexor digitorum profundus - Median nerve L1
Flexion of the distal IP joint is mainly under the control of the Flexor
digitorum profundus. Remember that this muscle had dual
innervation, digits 2 and 3 are controlled by the Median nerve, while
digits 4 and 5 are controlled by the Ulnar nerve.

26. ulnar nerve, medial epicondyle L2

The ulnar nerve passes posterior to the medial epicondyle,
leaving it precariously exposed and causing pain when
struck.

27. C. Adductor Pollicis L1

C is correct because the adductor pollicis is innervated by the ulnar nerve.
A, B and D are wrong because the thenar muscles and the medial two
lumbricals are innervated by the median nerve.

28. Flexor carpi ulnaris and medial half of flexor digitorum profundus L1
Ulnar nerve supplies flexor carpi ulnaris and medial half (digits 4 and 5) of
flexor digitorum profundus in the anterior forearm.

29. Hamate L2
Losing sensation to the medial 4th digit points towards Ulnar nerve
damage. The Ulnar nerve is damaged when the hamate bone is
fractured.

30. D. Hyperflexion at DIP and inability to extend at DIP L2

Mallet finger is also known as baseball finger. It presents as hyperflexion
at DIP and inability to extend at DIP. Mallet finger is caused by long
extensor tendon avulsion.

31. Deep branch of the radial nerve L1

With a wound to the posterior aspect of the forearm the only nerves that
could possibly be damaged are the Radial nerve and deep branch of the
radial nerve. Because the patient is not presenting with "wrist drop" and
still has sensation to the posterior forearm you can rule out the Radial
nerve. Deep branch injuries present with the inability to extend the
digits as those muscles are all innervated by the deep branch of the
radial nerve.

32. C. Biceps Brachii L1

The biceps brachii is one of the strongest supinators of the arm and
forearm and, as it is innervated by the musculocutaneous nerve, would
be unaffected by radial nerve damage.
Brachioradialis is also innervated by the radial nerve but it is not a
supinator. Flexor carpi radialis is a flexor and is innervated by median
nerve. Supinator, which is innervated by deep radial nerve would be
denervated with a complete loss of radial nerve function.
33. A. Flexor pollicis longus L1
Remember the contents of the carpal tunnel. There is one nerve (Median
N.) as well as three muscles accounting for 9 tendons that pass
through the carpal tunnel.
Flexor Digitorum Superficialis (4 tendons)
Flexor Digitorum Profundus (4 tendons)
Flexor Pollicis Longus (1 tendon)
Having identified the two sets of 4 tendons from the flexor digitorum
muscles, you know the remaining tendon is from the Flexor Pollicis
Longus.
If present, the palmaris longus muscle arises from the medial epicondyle
of the humerus and its tendon passes over the upper part of the flexor
retinaculum before inserting into the palmar aponeurosis.
The flexor carpi ulnaris does not pass through the carpal tunnel on its
way to insert onto the pisiform bone.
The flexor pollicis brevis is an intrinsic muscle of the hand in the thenar
compartment.

34. Princeps pollicis artery L2

The princeps pollicis is a branch of the radial artery that runs along the
sides of the thumb before forming an arch on the palmar surface of the
distal phalanx. Using their thumb to check for a pulse, the student runs
the risk that the pulse he or she is feeling is from the occlusion of their
own artery rather than Sim Man's radial artery. That is why digits 2 and 3
are used instead.

35. B. Radius L1
Complete transverse fracture of distal radius is found during Colles’
fracture. It has a "dinner fork" presentation.

36. A. Flexor digitorum profundus L1

Flexor digitorum profundus receives innervation from median nerve for
the digit 2 & 3 while ulnar nerve provides innervation to digits 4 & 5
through this muscle.

37. B. Ulnar nerve L2

38. B. Scaphoid; surgeon referral L2

If the scaphoid bone is fractured, you are worried about avascular
necrosis which will need to be repaired by a surgeon.

39. E. Abductor pollicis longus and extensor pollicis brevis L1

The anatomical snuffbox is a triangular space on the dorsum of the
hand bounded anteriorly by the Abductor pollicis longus and extensor
pollicis brevis and posteriorly by extensor pollicis longus. The scaphoid
bone forms its floor and the box contains the radial artery.

40. A. Ulnar nerve damage causing numbness and tingling in

forearm and 4th and 5th fingers L1
Damage to Medical epicondyle causes damage to ulnar nerve leading
to sudden severe onset of pain on inside of elbow, numbness and
tingling in forearm and 4th and 5th fingers, and "claw hand"
presentation.
 41. A. Adductor pollicis: ulnar n. L1
Adductor pollicis in the only thenar muscle innervated by the ulnar nerve. Its
function is to adduct the thumb towards the lateral palm.