Surgical Anatomy & Approaches MCQs

A 45-year-old man involved in a fall from a roof sustains a posterior hip dislocation. Post-reduction, he is noted to have a complete sciatic nerve palsy. Based on the typical pattern of sciatic nerve injury in posterior hip dislocations, which focal neurologic deficit is most likely to be permanent or severe?

A 33-year-old male sustains a severe pelvic crush injury resulting in a Denis Zone 3 sacral fracture. Which of the following neurologic complications has the highest incidence in this specific injury zone?

During arthroscopic repair of a Type II SLAP lesion, the surgeon places an anchor in the superior glenoid. If the drill and anchor are placed too far medially and posterosuperiorly, which of the following neurologic structures is at greatest risk of iatrogenic injury?

A 65-year-old woman sustains a 3-part proximal humerus fracture and is managed non-operatively. At her 6-week follow-up, she demonstrates profound weakness in shoulder abduction and reports decreased sensation over the lateral aspect of her shoulder. Injury to which of the following nerves is most likely responsible for her symptoms?

A 38-year-old weightlifter undergoes an anatomic repair of a distal biceps tendon rupture via a single-incision anterior approach. Postoperatively, he notes numbness and paresthesias along the radial and volar aspect of his forearm. Which of the following nerves was most likely injured or subjected to excessive traction during the surgical approach?

A 55-year-old construction worker undergoes an open subpectoral biceps tenodesis for a symptomatic SLAP tear and biceps tendinopathy. Postoperatively, he is noted to have a new-onset neurological deficit with weakness in elbow flexion and numbness over the lateral forearm. Which of the following nerves is at greatest risk of injury during the deep retractor placement for this procedure?

A newborn infant is diagnosed with a brachial plexus birth palsy after a difficult forceps delivery. The child exhibits a shoulder that is internally rotated and adducted, an extended elbow, and a flexed wrist, commonly known as a 'waiter's tip' posture. Which nerve roots are predominantly injured in this classic presentation?

A 45-year-old male bodybuilder undergoes a single-incision anterior approach for the repair of an acute distal biceps tendon rupture. Postoperatively, he complains of numbness, tingling, and paresthesias over the anterolateral aspect of his forearm. Injury to which of the following structures is the most likely cause of his current symptoms?

A 40-year-old bodybuilder feels a sudden 'pop' in his anterior elbow while performing heavy preacher curls. Examination reveals a palpable defect in the distal biceps tendon, weakness in supination, and proximal retraction of the muscle belly. He undergoes a single-incision distal biceps tendon repair using a cortical button and an interference screw. Postoperatively, he notes weakness in extending his thumb and fingers, though wrist extension is preserved with radial deviation. Which nerve is most likely injured, and what is the mechanism?

A 28-year-old man sustained a closed, midshaft humerus fracture and an isolated, complete radial nerve palsy at the time of injury. He was treated in a functional fracture brace. Twelve weeks after the injury, the humerus demonstrates clinical and radiographic evidence of union, but the patient continues to have a complete wrist drop. Electromyography (EMG) shows no evidence of reinnervation of the brachioradialis or extensor carpi radialis longus. What is the most appropriate next step in management?

A 35-year-old man sustains a severe, closed proximal third humeral shaft fracture with extension into the surgical neck. He undergoes open reduction and internal fixation using a long proximal humeral locking plate via a standard deltopectoral approach. During the surgical approach and lateral plate placement, the surgeon must be particularly mindful of avoiding iatrogenic nerve injury. The axillary nerve is most at risk in which of the following anatomic locations?

Which nerve is most commonly injured in fractures of the midshaft humerus?

A 28-year-old male sustains a closed midshaft humerus fracture with an associated radial nerve palsy. If the nerve has undergone Wallerian degeneration but the endoneurial tubes remain completely intact, what is the approximate expected rate of axonal regeneration?

A 32-year-old sustains a closed midshaft humerus fracture. Neurological examination reveals a complete radial nerve palsy. According to the Sunderland classification of nerve injury, which degree corresponds to the disruption of the axon and endoneurium, with preservation of the perineurium and epineurium?

During a direct anterior approach to the hip for a total hip arthroplasty, the surgeon develops the internervous plane between the sartorius and the tensor fasciae latae. Which of the following nerves is at greatest risk of iatrogenic injury during the superficial dissection of this approach?

During a surgical exposure of the anterior shoulder, a retractor is placed inferiorly and inadvertently compresses a nerve structure. Postoperatively, the patient demonstrates isolated weakness in internal rotation of the humerus with completely intact sensation in the upper extremity. Which of the following nerves was most likely injured?

A patient complains of sciatica-like symptoms, particularly pain radiating down the posterior thigh, exacerbated by prolonged sitting and internal rotation of the hip. Examination reveals tenderness in the buttock. Which anatomical variation involving the piriformis muscle and the sciatic nerve is most commonly associated with piriformis syndrome?

Which of the following ligaments is considered the strongest ligament in the human body, preventing hyperextension of the hip joint?

A patient sustains a shoulder injury resulting in weakness of deltoid and teres minor muscles. Sensation over the 'regimental badge' area is diminished. The axillary nerve is implicated. Through which anatomical space does the axillary nerve typically pass?

During total hip arthroplasty, the surgeon is concerned about potential damage to the obturator nerve. This nerve innervates which primary group of muscles?