Nerve injuries: median nerve at the elbow: practice question

A Orthopaedics 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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Orthopaedics · Nerve injuries: median nerve at the elbow

Sample item

A patient asked to make a fist can flex only the ring and little fingers, and the index finger remains straight (pointing finger). Where is the median nerve injured?

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

The answer and the reasoning

C. Proximal to the origin of the anterior interosseous nerve, at or above the elbow

A high median nerve lesion paralyses the flexors of the index and middle fingers, so when making a fist the index finger stays extended and the hand takes the benediction posture. Thenar muscles and the pronator group are also affected.

Option by option

  • A. In Guyon canal

    Guyon canal contains the ulnar nerve.

  • B. At the wrist in the carpal tunnel

    A carpal tunnel lesion spares the forearm flexors.

  • C. Proximal to the origin of the anterior interosseous nerve, at or above the elbow (correct)

    Correct. A high median lesion causes the pointing finger and benediction hand.

  • D. At the spiral groove

    A spiral groove lesion affects the radial nerve.

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.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Proximal to the origin of the anterior interosseous nerve, at or above the elbow. A high median nerve lesion paralyses the flexors of the index and middle fingers, so when making a fist the index finger stays extended and the hand takes the benediction posture.

Why is "In Guyon canal" not the answer?

Guyon canal contains the ulnar nerve.

Why is "At the wrist in the carpal tunnel" not the answer?

A carpal tunnel lesion spares the forearm flexors.

Why is "At the spiral groove" not the answer?

A spiral groove lesion affects the radial nerve.

What concept does this question test?

It tests Nerve injuries: median nerve at the elbow in Orthopaedics. Thenar muscles and the pronator group are also affected.

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 Nerve injuries: median nerve at the elbow?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.