Surgical Anatomy & Approaches MCQs

During a Smith-Petersen approach to the hip, the internervous plane is developed to access the anterior joint capsule. This plane is defined by muscles innervated by which of the following pairs of nerves?

During an ilioinguinal approach for open reduction of an anterior column acetabular fracture, severe hemorrhage is encountered upon dissection just posterior to the superior pubic ramus. This bleeding is most likely originating from an anastomotic connection between which two vascular systems?

During a lateral deltoid-splitting approach for fixation of a proximal humerus fracture, the axillary nerve is at risk of iatrogenic injury. Approximately how far distal to the lateral edge of the acromion does the axillary nerve typically course on the deep surface of the deltoid?

Anatomical variations in the relationship between the sciatic nerve and the piriformis muscle can theoretically contribute to piriformis syndrome. In the most common normal anatomical arrangement, how does the sciatic nerve traverse the greater sciatic foramen relative to the piriformis?

During a lateral transpsoas approach (LLIF) to the lumbar spine at the L4-L5 disc space, the surgeon must carefully navigate the lumbar plexus to avoid neurologic injury. Which nerve pierces the anterior surface of the psoas major muscle and is highly vulnerable during initial psoas muscle splitting and retraction?

A 28-year-old overhead athlete presents with chronic posterior shoulder pain and teres minor atrophy. MRI confirms nerve compression within the quadrilateral space. Which of the following structures defines the superior boundary of this anatomic space?

During an ilioinguinal approach for an anterior column acetabular fracture, massive hemorrhage occurs posterior to the superior pubic ramus. This is most likely due to an iatrogenic injury to the corona mortis, which represents an anastomosis between the obturator vessels and branches of which artery?

A patient presents with an inability to extend the metacarpophalangeal joints of the fingers following a surgical approach to the proximal radius. The most likely injured nerve typically enters the supinator muscle beneath a dense fibrous arch. What is the proper anatomical name of this arch?

To avoid iatrogenic injury to the axillary nerve during a lateral deltoid-splitting approach to the proximal humerus, the split should not extend beyond what distance distal to the lateral edge of the acromion?

The Smith-Petersen approach to the hip utilizes a superficial internervous plane between which of the following muscle pairs?

A surgeon is performing a surgical exposure of the hip via the anterior (Smith-Petersen) approach. Which of the following represents the correct internervous plane for the superficial dissection?

A 32-year-old bodybuilder complains of vague posterior shoulder pain and numbness over the lateral aspect of his shoulder. MRI reveals a paralabral cyst compressing structures within the quadrangular space. Which of the following muscles forms the superior border of this space?

A surgeon is planning an extensile posterolateral approach to the tibia to plate a complex tibial plateau fracture. Which internervous plane is predominantly utilized in this approach?

The standard deltopectoral approach to the shoulder utilizes a true internervous plane. This interval is developed between muscles innervated by which of the following combinations of nerves?

During an anterior intrapelvic (modified Stoppa) approach for acetabular fracture fixation, significant hemorrhage occurs while dissecting over the superior pubic ramus. This is likely due to an injury to the corona mortis, an anastomosis connecting the obturator vessels with which of the following systems?

Following a severe motorcycle crash, a patient presents with paralysis of the latissimus dorsi, deltoid, and all extensor muscles of the arm, forearm, and hand. Sensation is preserved over the lateral aspect of the forearm. The lesion is most accurately localized to which structure of the brachial plexus?

A 25-year-old sustains a displaced fracture of the surgical neck of the humerus. On examination, weakness in shoulder abduction and external rotation is noted. The injured nerve exits the axilla through a space that is bordered superiorly by which of the following muscles?

A trauma patient undergoes open reduction and internal fixation of an anterior pelvic ring fracture via an ilioinguinal approach. The surgeon identifies substantial bleeding from a vascular anastomosis coursing over the superior pubic ramus. This structure primarily connects which two vessel systems?

A patient sustains a midshaft femur fracture. During an anterolateral approach, the surgeon utilizes the interval between the rectus femoris and the vastus lateralis. Which of the following nerves innervates the muscle that is retracted medially?

A surgeon uses a single-incision anterior approach to repair an acute distal biceps tendon rupture. During dissection, a cutaneous nerve is identified and protected to avoid lateral forearm numbness. This nerve is the terminal sensory branch of which parent nerve?