Surgical Anatomy & Approaches MCQs

An isolated fracture of the fibular shaft is approached surgically. The surgeon utilizes the internervous plane between the lateral and superficial posterior compartments of the leg. Which two muscles define this specific surgical interval?

A 45-year-old man sustains a proximal humerus fracture and subsequently demonstrates weakness in shoulder abduction and diminished sensation over the lateral deltoid. The affected nerve exits the axilla through the quadrangular space. Which of the following defines the superior border of this anatomic space?

A surgeon is performing an open reduction internal fixation of an acetabular fracture via the ilioinguinal approach. If a Smith-Petersen extension is utilized, the superficial internervous plane lies between muscles innervated by which two nerves?

While performing an ilioinguinal approach for a transverse acetabular fracture, life-threatening hemorrhage occurs near the superior pubic ramus. This bleeding is most likely originating from the corona mortis, which represents an anastomosis between which two vascular systems?

A 45-year-old mechanic presents with an inability to actively extend his fingers and thumb at the metacarpophalangeal joints. Wrist extension is preserved but exhibits a strong radial deviation. Sensation in the upper extremity is fully intact. Which of the following anatomical structures is the most likely site of neural compression?

A 28-year-old male is evaluated in the emergency department following a direct blow to the lateral aspect of his shoulder. He has weakness in shoulder abduction and decreased sensation over the lateral deltoid. Through which anatomical space does the injured nerve exit the axilla?

A 30-year-old man sustains a penetrating stab wound to the axilla. Physical examination demonstrates profound weakness in elbow flexion and decreased sensation along the lateral aspect of the forearm. From which portion of the brachial plexus does the injured nerve originate?

An orthopaedic surgeon uses the Smith-Petersen (anterior) approach for a pelvic osteotomy. This approach exploits an internervous plane between the sartorius and the tensor fasciae latae. Which of the following nerves innervates the sartorius?

A lateral transpsoas approach (LLIF) is utilized for interbody fusion at L4-L5. Postoperatively, the patient experiences quadriceps weakness and anterior thigh numbness. Which structure within the psoas major muscle was most likely injured?

A surgeon utilizes the Smith-Petersen (direct anterior) approach for a total hip arthroplasty. To prevent denervation of the surrounding musculature, the dissection utilizes a true internervous plane. Which two nerves supply the muscles defining this superficial interval?

A patient sustains a spiral fracture of the distal third of the humerus (Holstein-Lewis fracture). They present with wrist drop and loss of finger extension. The nerve involved is at greatest risk of tethering as it passes through which anatomical structure?

Following a traumatic anterior shoulder dislocation, a patient complains of numbness over the lateral aspect of the shoulder. The injured nerve exits the axilla through the quadrangular space. Which of the following muscles forms the inferior border of this space?

Piriformis syndrome occurs due to compression of the sciatic nerve by the piriformis muscle. In the most common anatomical configuration, what is the relationship of the sciatic nerve to the piriformis muscle as it exits the greater sciatic foramen?

A 24-year-old male undergoes a Latarjet procedure for recurrent anterior shoulder instability with severe glenoid bone loss. Postoperatively, he demonstrates profound weakness in elbow flexion and decreased sensation over the lateral aspect of his forearm. Which nerve was most likely injured during the surgical approach?

When comparing the tibial inlay technique to the transtibial technique for Posterior Cruciate Ligament (PCL) reconstruction, what is the primary biomechanical advantage of the tibial inlay approach?

During a massive rotator cuff repair, the surgeon opts to perform an open subpectoral biceps tenodesis. If retractor placement and dissection drift too far medial to the short head of the biceps/coracobrachialis, which nerve is at greatest risk of iatrogenic injury?

A 35-year-old man presents with anterior shoulder pain and internal rotation weakness following a fall onto an outstretched hand. The examiner notes a positive belly-press test. Which of the following nerves innervates the primary muscle evaluated by this specific test?

A 6-year-old boy falls on an outstretched hand and sustains an extension-type supracondylar humerus fracture, which is displaced posteromedially. Which nerve is most commonly at risk with this specific displacement pattern?

A 28-year-old woman sustains a posterior hip dislocation during a high-speed collision. After closed reduction, she exhibits a foot drop and decreased sensation over the dorsum of her foot. Which portion of the sciatic nerve is most vulnerable in this injury, and what specific area of sensory loss is most diagnostic for its isolated injury?

A 28-year-old unrestrained driver is involved in a motor vehicle collision. In the emergency department, his right lower extremity is shortened, adducted, and internally rotated. He is unable to dorsiflex his right foot or extend his toes. What is the most likely direction of his hip dislocation and the specific injured nerve branch?