National Physical Therapy Examination (NPTE) Practice Exam

A rock climber with a bowstring injury likely injured which structures?

1. The Cruciform pulleys

2. The Annular pulleys

3. Lumbrical muscles

4. Wrist extensors crossing the elbow

The correct answer is: The Annular pulleys

A bowstring injury in the context of a rock climber typically involves the structures that help in stabilizing the flexor tendons as they pass over the joints of the fingers. The annular pulleys are critical in maintaining the proper position of these tendons against the phalanges during movement, particularly gripping, which is essential in climbing. When a bowstring injury occurs, it implies that there has been damage or dysfunction to these pulleys, leading to a situation where the tendon can "bowstring" away from the phalanx rather than staying in close contact as it should. This condition can significantly impair the climber's ability to grip and manipulate holds, which is crucial for performance in climbing activities. The cruciform pulleys, while important, do not typically experience injury in the same context as annular pulleys in bowstring cases specifically related to climbing. The lumbrical muscles play a role in finger flexion and extension but are not directly involved in this type of injury. Similarly, while wrist extensors are essential for overall wrist function, they are not specifically implicated in a bowstring injury scenario. Understanding the role of the annular pulleys emphasizes the importance of tendon stability and function in activities that require hand grip strength,