Hand: palmar fascia: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Hand: palmar fascia

Sample item

A 58-year-old man has a firm nodule in the palm and a gradually worsening flexion deformity of the ring and little fingers that he cannot straighten. Flexor tendons glide normally. Which structure is primarily affected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Palmar aponeurosis

Dupuytren contracture is a progressive fibrosis and shortening of the palmar aponeurosis, the triangular fascial sheet in the palm. It usually begins as a nodule and cord, most commonly affecting the ring and little fingers, and is more common in men of northern European descent and in alcoholic liver disease or diabetes. The tendons themselves are normal.

Option by option

  • A. Fibrous flexor sheath of the finger

    Fibrous sheath disease causes a trigger finger rather than a fixed palmar cord.

  • B. Flexor retinaculum

    The flexor retinaculum forms the roof of the carpal tunnel and is not the site of this disease.

  • C. Extensor expansion

    The extensor expansion lies on the dorsum and does not cause palmar nodules.

  • D. Palmar aponeurosis (correct)

    Correct. Thickening and contracture of the palmar aponeurosis cause the fixed flexion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Palmar aponeurosis. Dupuytren contracture is a progressive fibrosis and shortening of the palmar aponeurosis, the triangular fascial sheet in the palm.

Why is "Fibrous flexor sheath of the finger" not the answer?

Fibrous sheath disease causes a trigger finger rather than a fixed palmar cord.

Why is "Flexor retinaculum" not the answer?

The flexor retinaculum forms the roof of the carpal tunnel and is not the site of this disease.

Why is "Extensor expansion" not the answer?

The extensor expansion lies on the dorsum and does not cause palmar nodules.

What concept does this question test?

It tests Hand: palmar fascia in Anatomy. It usually begins as a nodule and cord, most commonly affecting the ring and little fingers, and is more common in men of northern European descent and in alcoholic liver disease or diabetes. The tendons themselves are normal.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hand: palmar fascia?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.