Upper limb and brachial plexus: trigger finger: 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: trigger finger

Sample item

A 55-year-old diabetic woman has a ring finger that locks in flexion in the morning and snaps open with a click. A tender nodule is felt in the palm over the metacarpal head. Which structure constricts the flexor tendon?

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

The answer and the reasoning

B. A1 annular pulley

Trigger finger is stenosing tenosynovitis in which a thickened flexor tendon catches at the A1 pulley at the level of the metacarpal head. It is more frequent in diabetics and the ring finger and thumb are commonly involved.

Option by option

  • A. Transverse carpal ligament

    The transverse carpal ligament is at the wrist and relates to carpal tunnel syndrome.

  • B. A1 annular pulley (correct)

    Correct. The A1 pulley over the metacarpal head catches the thickened tendon.

  • C. A2 annular pulley

    The A2 pulley lies over the proximal phalanx, not at the metacarpal head.

  • D. Cruciform pulley over the middle phalanx

    Cruciform pulleys lie over the phalanges and are not the usual site of triggering.

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 B, A1 annular pulley. Trigger finger is stenosing tenosynovitis in which a thickened flexor tendon catches at the A1 pulley at the level of the metacarpal head.

Why is "Transverse carpal ligament" not the answer?

The transverse carpal ligament is at the wrist and relates to carpal tunnel syndrome.

Why is "A2 annular pulley" not the answer?

The A2 pulley lies over the proximal phalanx, not at the metacarpal head.

Why is "Cruciform pulley over the middle phalanx" not the answer?

Cruciform pulleys lie over the phalanges and are not the usual site of triggering.

What concept does this question test?

It tests Upper limb and brachial plexus: trigger finger in Anatomy. It is more frequent in diabetics and the ring finger and thumb are commonly involved.

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 Upper limb and brachial plexus: trigger finger?

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.