Surgical Anatomy & Approaches MCQs

During the deltopectoral approach to the shoulder, the conjoint tendon is commonly retracted medially to gain exposure to the subscapularis and anterior glenohumeral joint. Over-retraction of this structure places which of the following nerves at highest risk of injury?

The Watson-Jones (anterolateral) approach to the hip utilizes the interval between the tensor fasciae latae and the gluteus medius. Why is this considered an internervous plane by some authors, but technically an intranervous plane by purists?

During an ilioinguinal approach for an anterior column acetabular fracture, the surgeon must carefully identify and ligate the 'corona mortis' to prevent life-threatening hemorrhage. This vascular structure represents an anastomosis between which two systems?

Following a crush injury to the forearm, a patient shows loss of radial nerve function. According to Sunderland's classification, a second-degree nerve injury directly corresponds to which of the following descriptions?

Following a closed humeral shaft fracture, a patient demonstrates a complete radial nerve palsy. Electromyography at 4 weeks reveals fibrillation potentials in the brachioradialis, but imaging shows the nerve sheath remains macroscopically intact. According to Seddon's classification, what is this nerve injury?

A 25-year-old male sustains a closed, isolated midshaft humerus fracture and is treated non-operatively with a functional fracture brace. At his 12-week follow-up, the fracture is radiographically healing, but he demonstrates an inability to actively extend his wrist or digits. Finger flexion and intrinsic function are normal. What is the most appropriate next step in management?

A 35-year-old male sustains a closed mid-shaft humerus fracture and is noted to have a radial nerve palsy on initial presentation. He is managed non-operatively in a functional brace. At 12 weeks, there is no clinical or electromyographic (EMG) evidence of nerve recovery. What is the most appropriate next step in management?

A 30-year-old sustains a closed midshaft humerus fracture with an immediate complete radial nerve palsy. At what time point after the injury will electromyography (EMG) first show fibrillation potentials in the brachioradialis muscle?

During a Smith-Petersen (anterior) approach to the hip, the superficial internervous plane is developed between the sartorius and the tensor fasciae latae. Which nerves supply these two muscles, respectively?

During an ilioinguinal approach for an acetabular fracture, severe hemorrhage occurs over the superior pubic ramus. This bleeding is most likely originating from an anastomosis between the obturator vessels and which of the following?

During a standard anterior (Smith-Petersen) approach to the hip, the internervous plane lies between muscles innervated by which of the following pairs of nerves?

A patient with a closed humeral shaft fracture develops a radial nerve palsy. An EMG at 3 weeks shows fibrillation potentials in the brachioradialis but no voluntary motor unit action potentials. This indicates at least what degree of nerve injury according to Sunderland's classification?

A patient sustains a closed midshaft humerus fracture and is noted to have a complete radial nerve palsy immediately post-injury. If the nerve injury is classified as an axonotmesis (Sunderland second-degree), which of the following structures remains intact, facilitating optimal regeneration?

Following a severe crush injury resulting in neurotmesis of the radial nerve, the nerve segment distal to the injury undergoes Wallerian degeneration. This cellular process typically begins within what timeframe following the injury?

A 5-year-old boy sustains a completely displaced extension-type supracondylar humerus fracture. On examination, he is unable to make an 'A-OK' sign. Which nerve is most likely injured?

During the Smith-Petersen (anterior) approach to the hip, an internervous plane is utilized to protect dynamic stabilizers. Which of the following defines the superficial internervous plane of this approach?

Following a closed midshaft humerus fracture, a patient demonstrates a profound radial nerve palsy. An electromyogram (EMG) performed at 4 weeks demonstrates abundant fibrillation potentials but no voluntary motor unit action potentials. What is the minimum grade of nerve injury sustained according to Seddon's classification?

A 30-year-old male sustains a closed midshaft humerus fracture and presents concurrently with an isolated wrist drop. Initial observation is elected. At 12 weeks post-injury, there is no clinical or electromyographic (EMG) evidence of radial nerve recovery. What is the most appropriate next step in management?

Following a closed humerus fracture, a patient exhibits a radial nerve palsy. According to Sunderland's classification, a third-degree nerve injury is characterized by disruption of the axon, myelin, and which of the following connective tissue structures?

A 6-year-old boy falls from a swing and sustains an extension-type supracondylar humerus fracture. Radiographs show that the distal fracture fragment is displaced posterolaterally. Based on this specific displacement pattern, which nerve is at the highest risk of injury from the proximal fracture fragment?