Surgical Anatomy & Approaches MCQs

An orthopedic surgeon is performing a direct anterior approach (DAA) to the hip. This approach utilizes the Smith-Petersen internervous plane. During the superficial dissection, which nerve is at greatest risk of iatrogenic injury, and between which two muscles is the interval developed?

A 38-year-old male is involved in a high-speed motor vehicle collision and sustains a Pipkin IV fracture-dislocation. Which of the following surgical approaches is most appropriate to adequately address both components of this specific injury pattern?

During an ilioinguinal approach for an anterior column acetabulum fracture, massive bleeding is encountered near the superior pubic ramus. What vascular structure is most likely injured?

A surgeon is performing an open reduction and internal fixation of a proximal humerus fracture via a deltopectoral approach. To facilitate plate placement, the deltoid insertion is partially released. Which nerve is most at risk of injury when dissecting on the deep surface of the deltoid muscle, 5-7 cm distal to the lateral acromial edge?

A 29-year-old unrestrained driver is involved in a motor vehicle collision. Radiographs demonstrate a posterior hip dislocation. Post-reduction, he exhibits a foot drop and inability to extend his great toe, with decreased sensation over the dorsum of the foot. Which specific neural structure is most likely injured?

A 22-year-old motorcyclist sustains a traumatic brachial plexus injury. Clinical examination shows complete paralysis of the C5 and C6 myotomes. Sensory examination reveals anesthesia in the C5 and C6 dermatomes, yet Sensory Nerve Action Potentials (SNAPs) for the median and radial nerves are preserved. What is the anatomical location of this nerve injury?

A patient with a chronic, isolated, traumatic avulsion of the axillary nerve with complete deltoid atrophy is scheduled for a nerve transfer 5 months post-injury. Which of the following is the most highly successful donor nerve for restoring deltoid function in this setting?

A 22-year-old male presents with a complete C5-C6 root avulsion following a motorcycle accident. An Oberlin transfer is planned to restore elbow flexion. Which of the following describes the correct neurological transfer performed in this procedure?

A 32-year-old man presents with a high radial nerve palsy following a humeral shaft fracture. A tendon transfer is planned to restore thumb extension. Which of the following is the most commonly used donor tendon to restore function to the extensor pollicis longus (EPL)?

A 60-year-old man presents with chronic sacral pain and bowel/bladder dysfunction. Imaging shows a large, destructive, midline mass in the sacrum. Biopsy reveals physaliferous cells in a myxoid background. What is the most appropriate surgical approach for definitive treatment?

A structural tricortical bone graft is harvested from the anterior iliac crest to reconstruct a scaphoid nonunion. Postoperatively, the patient reports significant numbness and a burning sensation over the anterolateral aspect of his thigh. Which nerve was most likely injured during the graft harvest?

During the surgical management of an anterior pelvic ring injury via an ilioinguinal approach, the surgeon encounters significant hemorrhage over the superior pubic ramus. This is most likely originating from the corona mortis, an anastomotic vascular connection typically linking which two vessel systems?

The direct anterior approach (DAA) to the hip is popular for its theoretical advantage of utilizing a true internervous and intermuscular plane. The superficial surgical interval in the DAA is between muscles supplied by which two nerves?

During an ilioinguinal approach for a transverse acetabular fracture, significant arterial hemorrhage occurs near the superior pubic ramus. The bleeding is most likely originating from an anastomosis between which two vessels?

The direct anterior (Smith-Petersen) approach for total hip arthroplasty utilizes a true internervous plane between which of the following muscle groups?

What is the most common neurologic complication following a reverse total shoulder arthroplasty (RSA) for rotator cuff arthropathy, and what is its most common mechanism?

A 40-year-old laborer undergoes an open subpectoral biceps tenodesis. Postoperatively, he presents with profound weakness in wrist extension, finger extension, and numbness over the dorsal web space of the hand. Which of the following technical errors most likely occurred during the procedure?

A 24-year-old rugby player undergoes an open Latarjet procedure for recurrent anterior shoulder instability associated with 25% glenoid bone loss. In the recovery room, he exhibits marked weakness in elbow flexion and forearm supination. Which nerve was most likely injured during the procedure, and what is its normal anatomic relationship to the transferred coracoid?

Which of the following nerve injuries is most likely to occur due to excessive medial retraction of the conjoined tendon during the deltopectoral approach for a total shoulder arthroplasty?