Anatomy Board Review MCQs (Set 4): Peripheral Nerve & Musculoskeletal Systems | AAOS ABOS OITE

Portions of which of the following normal structures help compose the spiral cord seen in Dupuytren's contracture?

Figure 43 shows an arthroscopic view of the posteromedial compartment of a patient's left knee using a 70-degree arthroscope placed through the intercondylar notch. The arrow is pointing to what structure?

Which of the following statements best describes the location of the nerve that is at risk in a direct posterior approach to the Achilles tendon?

A 46-year-old woman has bilateral groin pain, with more severe pain on the left side than on the right side. Figures 44a and 44b show a radiograph and a T1-weighted MRI scan. What is the most likely diagnosis?

Figures 45a through 45c show the radiograph, CT scan, and MRI scan of a 15-year-old boy who has lateral ankle pain. What is the most likely diagnosis?

A 5-year-old girl has had a low-grade fever, right hip and buttock pain, and a right-sided limp for the past 5 days. Examination shows diffuse tenderness and extreme pain on range of motion of the hip. Laboratory studies show a peripheral WBC count of 13,500/mm3 and an erythrocyte sedimentation rate of 55 mm/h. A radiograph is shown in Figure 46a, and an axial postgadolinium T1-weighted MRI scan with fat suppression and an axial T2-weighted fast spin echo MRI scan are shown in Figures 46b and 46c. What is the most likely diagnosis?

The palmar cutaneous branch of the median nerve (PCBMN) originates from the

The blood supply to the anterior cruciate ligament is primarily derived from what artery?

Figures 47a and 47b show the CT scans of a patient who reports persistent pain in the sinus tarsi following a fall. The avulsion fracture fragment remains attached to what ligament?

Figure 48 shows an MRI scan of the knee. The arrow is pointing to what structure?

In Figure 49, line AB connects the anterior arch of C1 to the posterior margin of the foramen magnum. Line CD connects the anterior margin of the foramen magnum to the posterior arch of C1. What is the normal ratio of displacement from CD to AB (Power's ratio)?

Figure 50 shows the AP radiograph of an asymptomatic 82-year-old woman who underwent total hip arthroplasty 16 years ago. What is the most likely diagnosis?

The MRI findings shown in Figure 51 would most likely create which of the following signs and symptoms?

Figure 52 shows the MRI scan of a 28-year-old baseball pitcher. Examination will most likely reveal which of the following findings?

A 23-year-old man has had heel pain and fullness for the past several months. He reports that initially the pain was present only with activity, but more recently the pain has become constant. Figures 53a through 53d show a radiograph, a bone scan, and T2-weighted and gadolinium MRI scans. What is the most likely diagnosis?

A 77-year-old woman who underwent total knee arthroplasty 16 years ago now reports pain, swelling, and notable crepitation with range of motion. AP, lateral, and Merchant radiographs are shown in Figures 54a through 54c. What is the most likely diagnosis?

A 65-year-old woman who works as a florist has had pain in her right elbow for the past 6 months after lifting a flowerpot. MRI scans are shown in Figures 55a and 55b. The area of increased signal intensity seen in Figure 55b most likely represents which of the following findings?

The carpal tunnel canal is narrowest (smallest cross-sectional area) at what level?

When harvesting iliac crest bone graft during a posterior spinal decompression and fusion, injury to which of the following nerves may result in painful neuromas or numbness over the skin of the buttocks?

The injury seen in the CT scan shown in Figure 56 is related to or associated with injury to which of the following structures?

A 3-year-old girl has had wrist pain, a fever, and has refused to move her right wrist for the past 10 days. She has an oral temperature of 102 degrees F (38.7 degree C). Laboratory studies show an erythrocyte sedimentation rate of 50 mm/h, a WBC count of 11,000/mm3, and a left shift. AP and lateral radiographs are shown in Figures 57a and 57b. What is the most likely diagnosis?

Which of the following is considered the preferred approach to resect a lesion in the posterior one third of the proximal humerus?

The main blood supply to the lateral two thirds of the talar body is provided by the

When performing an arthroscopic subacromial decompression, bleeding can be encountered when dividing the coracoacromial ligament because of injury to what artery?

Following its exit from the sciatic notch, the sciatic nerve passes between what two muscles?

What structure does the radial nerve pierce as it passes from the posterior to the anterior compartment of the arm?

A patient presents with weakness in thumb interphalangeal joint flexion and index finger distal interphalangeal joint flexion, but normal hand sensation. Entrapment of the involved nerve most commonly occurs at which of the following sites?

During a minimally invasive repair of an acute Achilles tendon rupture, the sural nerve is at greatest risk of iatrogenic injury at what location relative to the calcaneal tuberosity?

A 24-year-old overhead athlete presents with posterior shoulder pain and isolated weakness of external rotation, with normal strength in abduction. An MRI reveals an isolated paralabral cyst in the spinoglenoid notch. Which of the following nerves is directly compressed?

Which of the following best describes the boundaries of the quadrangular space of the shoulder?

During an anterior (Smith-Petersen) approach to the hip, an internervous plane is utilized to expose the joint. This superficial plane lies between muscles supplied by which of the following pairs of nerves?

When performing a lateral approach to the fibula for open reduction and internal fixation of an ankle fracture, identifying the superficial peroneal nerve is critical. Where does this nerve typically pierce the deep crural fascia to become subcutaneous?

A patient with severe cubital tunnel syndrome is undergoing an in situ ulnar nerve decompression. The floor of the cubital tunnel is formed by which of the following structures?

A 35-year-old man sustains a midshaft humerus fracture. During open reduction and internal fixation via a posterior approach, the radial nerve is identified. At what approximate distance from the lateral epicondyle does the radial nerve typically pierce the lateral intermuscular septum to enter the anterior compartment of the arm?

A patient presents with weakness in pinching the thumb and index finger, noting an inability to make an 'OK' sign. Electromyography confirms a compressive neuropathy of the anterior interosseous nerve (AIN). Which of the following anatomical structures is the most common cause of this specific nerve compression?

During a posterior approach to the shoulder for a glenoid fracture, the surgeon enters the quadrangular space. Which of the following structures form the superior and inferior borders of this space, respectively?

A 28-year-old volleyball player presents with isolated weakness of external rotation in the dominant shoulder. MRI shows an isolated paralabral cyst. Compression of the suprascapular nerve at the spinoglenoid notch will result in denervation of which of the following muscles?

A surgeon is performing an open release of the tarsal tunnel. Based on the anatomical arrangement of structures passing posterior to the medial malleolus, what structure lies immediately posterior to the flexor digitorum longus (FDL) tendon?

A 45-year-old mechanic complains of a deep aching pain in the dorsal proximal forearm and an inability to extend the fingers at the MCP joints. Wrist extension is preserved but deviates radially. Where is the most likely site of nerve compression?

A common anatomical variant involves a communicating neural branch between the median nerve and the ulnar nerve in the forearm. What is the name of this anomaly and what type of nerve fibers does it predominantly carry?

During surgical decompression of the ulnar nerve at the elbow (cubital tunnel release), the floor of the cubital tunnel is visualized. Which of the following structures primarily forms the floor of the cubital tunnel?

During a Smith-Petersen (anterior) approach to the hip, there is a risk of injury to the lateral femoral cutaneous nerve (LFCN). To minimize this risk, the surgeon should remember that the LFCN typically enters the thigh by passing beneath the inguinal ligament at what specific location?

When creating an anterolateral portal during ankle arthroscopy, the superficial peroneal nerve is at risk. At what approximate level does this nerve typically pierce the crural fascia to become subcutaneous in the leg?

A patient suffers a traumatic dislocation of the knee resulting in injury to the common peroneal nerve. If the deep peroneal branch fails to recover, the patient will exhibit weakness in dorsiflexion and sensory loss over which specific area?

Tarsal tunnel syndrome can lead to entrapment of the terminal branches of the tibial nerve. The medial plantar nerve innervates which of the following groups of intrinsic foot muscles?

Compression of the ulnar nerve in Guyon's canal can present with mixed sensory and motor deficits or isolated deficits depending on the zone of compression. A ganglion cyst in Zone 2 of Guyon's canal will produce which of the following clinical pictures?

In a patient undergoing a posterior approach to the hip, the sciatic nerve is identified. In approximately what percentage of the population does the common peroneal division of the sciatic nerve pierce directly through the piriformis muscle belly?

A patient presents with aching pain in the proximal volar forearm and paresthesias in the thumb, index, and middle fingers. Symptoms worsen with resisted pronation. Examination reveals no weakness of the flexor pollicis longus. An anomalous ligament extending from a supracondylar process to the medial epicondyle is suspected. What structures are compressed by this ligament?

During an extended deltopectoral approach to the shoulder, the axillary nerve is at risk as it crosses the deep surface of the deltoid. Approximately how far distal to the lateral edge of the acromion does the axillary nerve typically run?

Thoracic outlet syndrome commonly involves compression within the interscalene triangle. Which of the following structures pass through the interscalene triangle?

During harvest of the semitendinosus and gracilis tendons for ACL reconstruction, the saphenous nerve is at risk. The saphenous nerve exits the adductor (Hunter's) canal by penetrating the vastoadductor membrane. Which artery accompanies it as it exits?

A patient presents with shoulder weakness after a superficial lymph node biopsy in the posterior triangle of the neck. Examination shows a prominent medial border of the scapula with lateral translation and an inability to abduct the arm past 90 degrees. Which nerve was most likely injured?

A surgeon exploring the posterior humerus identifies a neurovascular bundle passing through the triangular interval. Which structures are found within this anatomical space?

During a lateral approach to the distal humerus, the radial nerve is identified crossing the lateral intermuscular septum. At what average distance proximal to the lateral epicondyle does the radial nerve pierce the lateral intermuscular septum?

A 28-year-old overhead athlete presents with poorly localized posterior shoulder pain and deltoid weakness. MRI reveals a paralabral cyst in the quadrilateral space. Which of the following structures forms the superior border of this anatomic space?

Compression of the suprascapular nerve at the spinoglenoid notch will result in isolated weakness of which of the following muscles?

A patient presents with volar forearm pain and paresthesias in the thumb, index, and middle fingers. Symptoms are exacerbated by resisted forearm pronation with the elbow extended. Which of the following structures is the most likely site of median nerve compression?

A cyclist presents with intrinsic muscle weakness of the right hand but intact sensation over the volar hypothenar eminence and the dorsal ulnar aspect of the hand. In which zone of Guyon's canal is the ulnar nerve most likely compressed?

A 45-year-old runner with chronic heel pain undergoes surgical release. The surgeon targets the first branch of the lateral plantar nerve. This nerve courses between which two muscles?

During a minimally invasive Achilles tendon repair, the sural nerve is at greatest risk of iatrogenic injury at which location relative to the Achilles tendon?

During a direct lateral (Hardinge) approach to the hip, proximal splitting of the gluteus medius is limited to prevent injury to the superior gluteal nerve. What is the generally accepted maximum safe distance for splitting the gluteus medius proximal to the tip of the greater trochanter?

A patient develops inability to extend the fingers at the MCP joints following a proximal radius fracture. Wrist extension is maintained but with radial deviation. The injured nerve typically enters the supinator muscle beneath which of the following structures?

During an anterior (Smith-Petersen) approach to the hip, an internervous plane is utilized. The nerve at greatest risk during superficial dissection crosses the sartorius muscle. What is the sensory distribution of this nerve?

A patient sustains an obturator nerve injury during pelvic lymph node dissection. Which of the following muscles will maintain partial function because of its dual innervation?

Inside the tarsal tunnel, the tibial nerve bifurcates into the medial and lateral plantar nerves. Which of the following statements correctly describes the anatomical relationship of the neurovascular structures beneath the flexor retinaculum from anterior to posterior?

A patient suffers a high-energy motorcycle collision and sustains a traction injury to the brachial plexus affecting the posterior cord. Which of the following movements will be most severely impaired?

In anatomical variations of the relationship between the sciatic nerve and the piriformis muscle, the most common variant (Beaton and Anson type B) involves which of the following arrangements?

During a Latarjet procedure, the conjoined tendon is retracted to expose the anterior glenoid. The musculocutaneous nerve must be protected. At what average distance distal to the coracoid process does this nerve enter the coracobrachialis muscle?

A patient presents with an inability to form an OK sign with their thumb and index finger after a supracondylar humerus fracture. Sensation in the hand is completely normal. What is the most likely injured nerve and its primary origin?

A surgeon is performing an extensive deltopectoral approach. To mobilize the pectoralis major, they note its neurovascular supply. The medial pectoral nerve is named for its origin from the medial cord of the brachial plexus. How does it typically enter the pectoralis major relative to the pectoralis minor?

During an in situ ulnar nerve decompression at the cubital tunnel, several distinct anatomic structures can cause compression. Which of the following structures forms the roof of the cubital tunnel?

When performing an extensile lateral approach to the humerus, the radial nerve must be identified and protected. At approximately what distance proximal to the radiocapitellar joint does the radial nerve pierce the lateral intermuscular septum?

A 25-year-old athlete develops isolated weakness in external rotation of the shoulder after a direct blow to the posterior axilla. MRI reveals a mass in the quadrilateral space. What are the borders of the space where the axillary nerve is most likely compressed?

A 34-year-old male develops a compartment syndrome of the anterior leg following a tibia fracture. If left untreated, which of the following sensory deficits is most likely to be present due to nerve ischemia in this specific compartment?

A 22-year-old collegiate volleyball player presents with isolated weakness of the infraspinatus without supraspinatus involvement. Entrapment of the suprascapular nerve is suspected. At what anatomical location does this isolated compression typically occur?

During a direct lateral approach to the distal fibula for an ORIF, the superficial peroneal nerve must be protected. Where does this nerve typically penetrate the crural fascia to become subcutaneous?

Which of the following best describes the most common anatomical variant of the sciatic nerve in relation to the piriformis muscle?

When performing a posterolateral approach to the ankle for a posterior malleolus fracture, the sural nerve is at risk. What vascular structure normally accompanies the sural nerve in this region?

During a medial approach to the foot, the branches of the posterior tibial nerve must be identified. The medial plantar nerve provides motor innervation to which of the following muscles?

During an anterior approach to the proximal radius (Henry approach), the posterior interosseous nerve (PIN) is at risk. What structure represents the most common site of PIN compression in radial tunnel syndrome?

During a Smith-Petersen (anterior) approach to the hip, the deep internervous plane lies between the rectus femoris and the gluteus medius. What is the motor innervation to the muscle forming the medial border of this deep plane?

A 45-year-old patient presents with lateral winging of the scapula and inability to shrug the shoulder following a lymph node biopsy in the posterior triangle of the neck. Which of the following muscles has most likely been denervated?

In a standard deltopectoral approach to the shoulder, the conjoined tendon is often retracted medially. At approximately what distance distal to the coracoid process does the musculocutaneous nerve typically enter the coracobrachialis?

A patient is unable to flex the IP joint of the thumb and the DIP joint of the index finger following a forearm laceration. Sensation is perfectly intact in the hand. Which of the following muscles is typically SPARED if the injured nerve is the anterior interosseous nerve (AIN)?

A 50-year-old runner presents with chronic heel pain refractory to conservative management. Entrapment of the first branch of the lateral plantar nerve (Baxter's nerve) is suspected. Which muscle is predominantly innervated by this specific nerve branch?

A 45-year-old mechanic presents with numbness in the small finger and weakness in grip strength. Nonoperative management has failed, and an in situ decompression of the ulnar nerve is planned. During the approach, the roof of the cubital tunnel must be divided. Which of the following structures constitutes the primary roof of this tunnel?

A 55-year-old woman presents with the inability to extend her fingers and thumb at the metacarpophalangeal joints. Wrist extension is preserved but deviates radially. Electromyography confirms an entrapment neuropathy. Which of the following is the most likely site of compression?

A 32-year-old marathon runner presents with chronic, recalcitrant medial heel pain that radiates into the plantar aspect of the foot. A diagnostic injection relieves the pain, suggesting entrapment of the first branch of the lateral plantar nerve. This nerve normally courses between which two structures?

A 28-year-old overhead athlete is diagnosed with quadrilateral space syndrome, presenting with vague posterior shoulder pain and isolated atrophy of the teres minor. The structures forming the borders of this anatomical space are the:

A 35-year-old volleyball player is found to have a large paralabral ganglion cyst extending into the spinoglenoid notch. Physical examination is most likely to demonstrate which of the following isolated findings?

During an extensile lateral approach for a comminuted calcaneus fracture, the surgeon must carefully identify and protect a nerve that provides sensation to the lateral border of the foot. What is the normal anatomical course of this nerve at the level of the ankle?

In a direct anterior approach to the hip, careful deep dissection is required. In a different scenario where an adductor tenotomy and obturator nerve block are performed for spasticity, the surgeon isolates the anterior and posterior divisions of the obturator nerve. These divisions are anatomically separated by which of the following muscles?

A patient sustains a midshaft fibula fracture and subsequently develops a compartment syndrome requiring fasciotomies. The surgeon must be mindful of the superficial peroneal nerve as it exits the deep fascia to become subcutaneous. At what approximate level does this transition normally occur?

A patient presents with an inability to make an 'OK' sign, demonstrating loss of flexion at the thumb interphalangeal joint and index finger distal interphalangeal joint. Sensation in the hand is completely normal. Which of the following is LEAST likely to be the anatomical site of neural compression in this syndrome?