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NBME 20 Answers

nbme20/Block 4/Question#24 (41.3 difficulty score)
A 27-year-old man comes to the physician ...
Deep branch of the ulnar nerve at the hook of the hamate bone🔍,📺

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submitted by hello(315),
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nGoyu nCala eSoymndr si deu to an rUanl evrNe linoses dna is aocsedisat wtih lcieycb ernhaabdl s.ue

slAo GFNIER iducnbaot and tcaniuddo is tdemaedi by urlna erne.v eTh ntieapt is nghiav buelotr tiwh EINFRG itndacbou dna n.oatidudc

heT rtnFmoe sngi si ntigtes DDOATCRU PSLIIOC TCYITI,VA hihcw si tediemda yb het RALUN VEERN .tacvyiti It is NTO itetgsn humtb s,ooponiitp chwhi wdoul eb edadetmi yb teh neaimd rvnee.

See tmoernF sign

submitted by waterloo(76),

As so many posts mentioned this is an ulnar n. problem. cool. But you also have to be able to distinguish between ulnar nerve at the hook of hamate vs ulnar nerve as it courses through the flexor carpi ulnaris.

with the Froment sign you know the deep branches of the ulnar nerve are being effected. This guy is on his bike and rides for 8-10 hours a day - pretty cray. But that's how you know its more likely compression from the handlebars at the hook of the hamate bone and not on the side from his flexor carpi ulnaris.

submitted by celeste(84),
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The odractud sllipcoi lemcsu is etendrainv by eth anulr vnee,r ngiigv hist uyg a ifcudilft meit igdlonh a sethe fo eapr.p

submitted by neonem(571),
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osMt of tsincrini emlssuc of het nhad rae eveidrannt by alnur eenvr - cnciroh oosnsrcpeim ta het hkoo of tmhaae docul alde to rneev acimshie

submitted by xxabi(260),
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Bcielyc lnrbhdaae ujinyr tlitylairdnoa aagsemd nurla rneve @ eth kooh of eth amheat bone

submitted by trazobone(35),

Why has no one commented about recurrent branch of median? Recurrent branch of the median nerve innervates all thenar muscles, with the exception of the adductor polis which is innervated by the ulnar.

Also the recurrent branch does not innervate interosseous muscles, that’s ulnar.

Also also Froment’s sign tests thumb adduction.