Hand: Guyon canal syndrome: 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 · Hand: Guyon canal syndrome

Sample item

A long-distance cyclist has numbness of the little finger and weakness of finger abduction with sensation over the dorsum of the hand preserved. Where is the ulnar nerve compressed?

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

The answer and the reasoning

D. Guyon canal at the wrist

Compression in Guyon canal by handlebar pressure causes motor and sensory loss in the palmar ulnar distribution, sparing the dorsal ulnar sensory branch, which leaves the nerve about 5 cm proximal to the wrist. Cubital tunnel compression affects the dorsal sensation too.

Option by option

  • A. Cubital tunnel at the elbow

    Elbow lesions affect the dorsal ulnar cutaneous branch.

  • B. Arcade of Struthers

    The arcade of Struthers is a proximal arm site, and would affect dorsal sensation.

  • C. Carpal tunnel

    The carpal tunnel contains the median nerve.

  • D. Guyon canal at the wrist (correct)

    Correct. Sparing of the dorsal ulnar sensation localises the lesion to Guyon canal.

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 D, Guyon canal at the wrist. Compression in Guyon canal by handlebar pressure causes motor and sensory loss in the palmar ulnar distribution, sparing the dorsal ulnar sensory branch, which leaves the nerve about 5 cm proximal to the wrist.

Why is "Cubital tunnel at the elbow" not the answer?

Elbow lesions affect the dorsal ulnar cutaneous branch.

Why is "Arcade of Struthers" not the answer?

The arcade of Struthers is a proximal arm site, and would affect dorsal sensation.

Why is "Carpal tunnel" not the answer?

The carpal tunnel contains the median nerve.

What concept does this question test?

It tests Hand: Guyon canal syndrome in Orthopaedics. Cubital tunnel compression affects the dorsal sensation too.

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: Guyon canal syndrome?

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.