Upper limb and brachial plexus: median nerve high lesion: 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 · Upper limb and brachial plexus: median nerve high lesion

Sample item

A man with a deep elbow laceration is asked to make a fist. His index and middle fingers stay extended, his thumb cannot oppose, and he has numbness over the lateral three and a half digits. Which lesion is most likely?

AMusculocutaneous nerve in the armBRadial nerve in the spiral grooveCUlnar nerve at the wristDMedian nerve at the elbow

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

The answer and the reasoning

D. Median nerve at the elbow

A high median nerve lesion paralyses flexor digitorum superficialis and the lateral half of flexor digitorum profundus, so the index and middle fingers do not flex. Thumb opposition is lost and there is lateral palmar sensory loss, giving the benediction posture.

Option by option

A. Musculocutaneous nerve in the arm
A musculocutaneous lesion weakens elbow flexion and gives lateral forearm numbness, with intact finger flexion.
B. Radial nerve in the spiral groove
A radial lesion causes wrist drop and does not impair finger flexion or lateral palm sensation.
C. Ulnar nerve at the wrist
A wrist ulnar lesion gives clawing of ring and little fingers and spares flexion of the index and middle.
D. Median nerve at the elbow (correct)
Correct. Index and middle fingers fail to flex, with loss of opposition and lateral digit sensation.

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.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Median nerve at the elbow. A high median nerve lesion paralyses flexor digitorum superficialis and the lateral half of flexor digitorum profundus, so the index and middle fingers do not flex.

Why is "Musculocutaneous nerve in the arm" not the answer?

A musculocutaneous lesion weakens elbow flexion and gives lateral forearm numbness, with intact finger flexion.

Why is "Radial nerve in the spiral groove" not the answer?

A radial lesion causes wrist drop and does not impair finger flexion or lateral palm sensation.

Why is "Ulnar nerve at the wrist" not the answer?

A wrist ulnar lesion gives clawing of ring and little fingers and spares flexion of the index and middle.

What concept does this question test?

It tests Upper limb and brachial plexus: median nerve high lesion in Anatomy. Thumb opposition is lost and there is lateral palmar sensory loss, giving the benediction posture.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Upper limb and brachial plexus: median nerve high lesion?

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.