Surgical Anatomy & Approaches MCQs

During open reduction and internal fixation of a proximal humerus fracture, a deltopectoral approach is utilized. Which two nerves supply the muscles that form the internervous plane for this approach?

A 32-year-old man sustains a displaced 3-part proximal humerus fracture after a high-speed motorcycle accident. An axillary nerve injury is suspected. Which clinical finding is the most reliable indicator of axillary nerve dysfunction?

During an open reduction and internal fixation of a proximal humerus fracture using an extended deltopectoral approach, which nerve is at greatest risk of iatrogenic injury when mobilizing the inferior capsule and placing retractors inferior to the humeral head?

A 35-year-old man sustains a closed midshaft humerus fracture. Initial emergency department examination reveals normal distal neurovascular function. Following the application of a coaptation splint and closed reduction, the patient is unable to actively extend his wrist or fingers. What is the most appropriate next step in management?

During a classic posterior approach to the shoulder for internal fixation of a scapular neck fracture, the internervous plane is developed. Which of the following nerves is at greatest risk of injury during overzealous medial retraction of the superior muscle in this interval?

Following a traumatic anterior shoulder dislocation, a 65-year-old patient develops numbness over the lateral aspect of the shoulder and an inability to actively abduct the arm past 15 degrees. Which peripheral nerve is most likely injured?

A 35-year-old man sustains a closed midshaft humerus fracture. Upon presentation in the emergency department, his radial nerve function is intact. He undergoes a closed reduction and splinting. Post-reduction examination reveals a new-onset complete loss of wrist extension and thumb extension. What is the most appropriate next step in management?

A 58-year-old female sustains a displaced two-part surgical neck fracture of the proximal humerus. She complains of numbness over the lateral aspect of her shoulder. Which nerve is most likely injured, and what is its correct anatomic relationship in the shoulder?

When performing an anterolateral approach (deltoid split) for plating a proximal humerus fracture, how far distal to the lateral edge of the acromion is it generally safe to split the deltoid before placing the axillary nerve at significant risk?

A 65-year-old female sustains a closed, highly displaced proximal humerus fracture after a fall. Following closed reduction and splinting, she is noted to have decreased sensation over the lateral aspect of her shoulder and is unable to actively contract her deltoid. Injury to which of the following nerves is most likely responsible for these findings?

During a deltopectoral approach for open reduction and internal fixation of a proximal humerus fracture, the cephalic vein is identified. Which of the following correctly describes the internervous plane utilized in this surgical approach?

A surgeon utilizes the standard deltopectoral approach for a total shoulder arthroplasty. To safely access the anterior shoulder joint, the internervous plane developed relies on the innervation of the deltoid and pectoralis major muscles. Which of the following represents the correct internervous plane?

The anterior (Smith-Petersen) surgical approach to the hip is favored in certain procedures because it utilizes a true internervous plane. This plane is located between muscles innervated by which of the following nerve pairs?

During an anterior intrapelvic (modified Stoppa) approach to the acetabulum, brisk arterial bleeding is encountered near the superior pubic ramus. This bleeding most likely originates from an anomalous anastomosis between the obturator vessels and which of the following?

During the classic ilioinguinal approach to the pelvis, the middle window is accessed to treat anterior column fractures. Which structures define the medial and lateral borders of this middle window?

A surgeon is performing a posterior approach to the humerus. To identify the radial nerve, she explores the triangular interval. This interval is bounded by the long head of the triceps, the teres major, and which of the following structures?

During a volar approach to the proximal radius (Henry approach), the radial nerve is at risk when exposing the proximal third of the shaft. To safely mobilize the supinator muscle and protect the posterior interosseous nerve, the forearm should be placed in what position?

A patient suffers a traction injury to the upper trunk of the brachial plexus (Erb's palsy). Which of the following nerves branches directly from the roots of the brachial plexus and may remain intact depending on the exact level of the lesion?

A 35-year-old man undergoes a deltopectoral approach for open reduction and internal fixation of a proximal humerus fracture. During the procedure, a vessel passing through the quadrangular space with the axillary nerve is inadvertently injured. Which of the following arteries is most likely affected?

During an anterior (Smith-Petersen) approach to the hip for an open reduction of a developmental dysplasia of the hip, the surgeon utilizes a true internervous plane. This superficial plane is developed between muscles innervated by which two nerves?