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Upper Extremity Injury Assessment Flashcards

6 cards from real NATA-BOC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A wrestler experiences a forced abduction of the thumb during a match. There is pain and instability at the MCP joint of the thumb with valgus stress. Which injury is most likely?

    Answer: Gamekeeper's thumb (UCL injury of the thumb)

    Gamekeeper's thumb (also called skier's thumb) involves injury to the ulnar collateral ligament (UCL) of the thumb MCP joint. Forced abduction of the thumb stretches or tears the UCL, resulting in pain and instability with valgus stress.

  2. During evaluation of a shoulder, the athletic trainer asks the patient to lift their hand off their lower back. The patient cannot perform this motion. Which muscle is being tested?

    Answer: Subscapularis

    The lift-off test (Gerber test) specifically evaluates the subscapularis muscle. The patient places the dorsum of their hand on the lower back and attempts to lift it off against resistance. Inability to do so indicates subscapularis insufficiency.

  3. An athlete reports chronic wrist pain on the radial side that worsens with thumb and wrist movement. The Finkelstein test is positive. What condition does this indicate?

    Answer: De Quervain tenosynovitis

    A positive Finkelstein test (pain at the radial styloid with ulnar deviation of the wrist while the thumb is tucked in the fist) is the hallmark finding for De Quervain tenosynovitis, which involves the abductor pollicis longus and extensor pollicis brevis tendons.

  4. When assessing a patient with suspected thoracic outlet syndrome, which provocative test involves having the patient abduct the shoulders to 90 degrees and repeatedly open and close the fists for 3 minutes?

    Answer: Roos test (Elevated Arm Stress Test)

    The Roos test (EAST — Elevated Arm Stress Test) involves holding the arms in a position of 90 degrees abduction and external rotation while repeatedly opening and closing the fists for 3 minutes. Reproduction of symptoms (numbness, tingling, heaviness) constitutes a positive test.

  5. A softball player is hit on the dorsum of the hand by a pitched ball. She has pain and swelling over the 5th metacarpal with an obvious angular deformity. What is the most likely injury?

    Answer: Boxer's fracture

    A Boxer's fracture is a fracture of the neck of the 5th metacarpal with palmar angulation of the distal fragment. Direct trauma to the dorsum of the hand is a common mechanism, along with punching.

  6. An athletic trainer notices a patient has difficulty with precision grip (thumb to fingertip pinch). Which nerve is most likely affected?

    Answer: Median nerve (anterior interosseous branch)

    The anterior interosseous nerve (a branch of the median nerve) innervates the flexor pollicis longus, pronator quadratus, and the lateral half of the flexor digitorum profundus. Injury affects precision pinch because the thumb IP and index finger DIP cannot flex properly.