Surgical Anatomy & Approaches MCQs

A 30-year-old man sustains a closed midshaft humeral fracture after a fall.

Upon initial clinical examination in the emergency department, he exhibits an inability to actively extend his wrist and metacarpophalangeal joints. Sensation is decreased over the dorsal first web space. What is the most appropriate initial management for this neurological deficit?

A 22-year-old patient with an upper trunk (C5-C6) brachial plexus injury is scheduled for an Oberlin transfer to restore elbow flexion, as his lower trunk function is fully intact. Which of the following best describes the standard surgical technique for an Oberlin transfer?

Which of the following is considered indicative of a scaphoid-lunate ligament tear on posteroanterior radiograph:

A 6-year-old boy sustains a completely displaced, extension-type supracondylar humerus fracture. The distal fragment is displaced posteromedially. Which nerve is most commonly at risk in this specific displacement pattern?

During an ilioinguinal approach to the acetabulum, massive bleeding is encountered near the posterior aspect of the superior pubic ramus. This is most likely due to an injury of the corona mortis, which is an anastomotic vessel connecting the external iliac system to which of the following arteries?

The direct anterior approach to the hip for total hip arthroplasty utilizes a true internervous plane. Which two muscles define this superficial surgical interval?

Which of the following muscles is innervated by the posterior interosseous nerve (PIN)?

A 35-year-old male sustains a comminuted midshaft humerus fracture after a motor vehicle accident. He presents with a complete radial nerve palsy (wrist drop, finger drop, thumb abduction weakness, and dorsoradial hand sensory loss). Given the fracture pattern and the need for stable fixation, the surgeon plans an open reduction and internal fixation via a posterior approach. During the surgical dissection, as depicted in the image below, which of the following statements accurately describes the critical anatomical relationship of the radial nerve in the midshaft humerus?

A 28-year-old male presents with a closed midshaft humerus fracture after a direct blow. On initial examination, he has a complete radial nerve palsy. Radiographs show a simple transverse fracture with minimal displacement. The orthopedic surgeon decides to initially manage the fracture non-operatively with a functional brace. Three months later, there is no clinical or electrophysiological evidence of radial nerve recovery. Based on the case material, what is the MOST appropriate next step in managing the radial nerve palsy?

A surgeon is performing an anterolateral approach to the humerus for plate fixation of a midshaft fracture.

To safely protect the radial nerve during this exposure, the surgeon must understand its anatomical course. At what approximate distance proximal to the lateral epicondyle does the radial nerve typically pierce the lateral intermuscular septum?

A surgeon is performing a posterior approach to the humerus for open reduction and internal fixation of a comminuted midshaft humerus fracture. What is the true internervous plane utilized in the distal aspect of the standard posterior approach?

A 29-year-old male sustains a closed, midshaft oblique humerus fracture after falling from a ladder. Examination in the emergency department reveals absent wrist extension, absent finger extension, and decreased sensation in the first dorsal web space. What is the most appropriate initial management of his nerve injury?

During an extensile posterior approach to the humerus for fracture fixation, identifying and protecting the radial nerve is critical. Based on standard anatomical landmarks, where does the radial nerve predictably cross the posterior aspect of the humerus before piercing the lateral intermuscular septum?

A 68-year-old female presents with a displaced 3-part proximal humerus fracture following a fall. She is scheduled for open reduction and internal fixation via a deltopectoral approach. During the deep dissection, after identifying the cephalic vein and retracting the deltoid laterally and pectoralis major medially, the surgeon proceeds to manage the subscapularis to gain access to the humeral head. Which of the following neurovascular structures is at greatest risk during the inferior aspect of this exposure, particularly when mobilizing the deltoid or performing extensive inferior dissection?

A 60-year-old male presents with a non-union of the mid-shaft humerus, previously treated non-operatively. He is scheduled for revision ORIF via an anterior approach. During the deep dissection, the surgeon identifies the biceps brachii and brachialis muscles. To access the humeral shaft, the surgeon plans to split the brachialis muscle longitudinally in its distal portion. Which nerve is primarily responsible for innervating the brachialis muscle and must be protected during this maneuver?

A 48-year-old male undergoes ORIF of a comminuted humeral shaft fracture via an anterolateral approach. Post-operatively, he develops a new complete radial nerve palsy. The surgeon decides to observe the patient for initial recovery. Based on the case content, what is the typical expected recovery period for most radial nerve palsies following humeral shaft fracture fixation?

During a posterior approach to the humerus for internal fixation of a diaphyseal fracture, the surgeon must identify and protect the radial nerve. On average, at what distance from the relevant bony landmarks does the radial nerve cross the posterior aspect of the humerus in the spiral groove?

A 40-year-old male undergoes open reduction and internal fixation of a humeral shaft fracture via an anterolateral approach. During the distal extension of this approach, which two muscles form the internervous plane?

A surgeon is performing a Kaplan (anterolateral) approach to the elbow for a complex radial head fracture. The internervous plane utilized in this approach lies between which two muscles?

A 42-year-old male is recovering from a humeral shaft fracture complicated by a primary radial nerve palsy. The surgeon monitors him clinically for signs of nerve recovery. Assuming normal progression of reinnervation, which muscle will be the FIRST to exhibit returning motor function?