Surgical Anatomy & Approaches MCQs

During a deltopectoral approach for a total shoulder arthroplasty, the cephalic vein is identified. Which of the following correctly describes its anatomical relationship and the recommended method of retraction during this approach?

During an ilioinguinal approach for an anterior column acetabular fracture, the surgeon encounters massive, pulsatile hemorrhage while exposing the superior pubic ramus. This bleeding most likely originates from an anomalous vascular connection (corona mortis) bridging which two vascular systems?

A 28-year-old hockey player undergoes hip arthroscopy for a symptomatic CAM-type femoroacetabular impingement and a focal anterosuperior labral tear. The anterolateral (AL) portal is established first under fluoroscopic guidance. To safely establish the mid-anterior (MAP) portal, the surgeon must remain lateral to the sagittal plane of the anterior superior iliac spine (ASIS). Deviating medial to this plane primarily increases the risk of injury to which of the following structures?

During an open subpectoral biceps tenodesis, the surgeon creates a cortical window in the bicipital groove just distal to the transverse humeral ligament. However, due to extensive fraying of the long head of the biceps tendon, the incision and deep dissection are extended further distally along the humeral shaft. If medial retractors are placed too aggressively deep to the conjoined tendon and biceps muscle belly during this distal extension, which neurovascular structure is at greatest risk of iatrogenic injury?

During an open subpectoral biceps tenodesis, the conjoint tendon is retracted medially to optimize exposure of the bicipital groove and pectoralis major tendon. Overzealous medial retraction of the conjoint tendon is most likely to result in injury to which of the following nerves?

A 19-year-old collegiate wrestler sustains an anterior shoulder dislocation. After successful closed reduction, he complains of numbness over the lateral deltoid and demonstrates weakness with shoulder abduction. Electromyography (EMG) confirms an isolated neurapraxia. What is the expected anatomic distance of the affected nerve from the inferior border of the glenoid at the 6 o'clock position?

A 26-year-old male ice hockey player presents with deep anterior groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate an alpha angle of 65 degrees and no crossover sign. Arthroscopy is planned. During hip arthroscopy, establishing the anterior portal places which of the following structures at greatest risk?

A 55-year-old manual laborer undergoes an arthroscopic rotator cuff repair with an open subpectoral biceps tenodesis. What nerve is at greatest risk of iatrogenic injury if medial retractors are placed too aggressively during the subpectoral exposure?

During an ulnar collateral ligament (UCL) reconstruction using the docking technique, a muscle-splitting approach through the flexor pronator mass is utilized. Which nerve is most at risk of iatrogenic injury during this specific surgical approach?

The Smith-Petersen (direct anterior) approach is frequently utilized for THA and pelvic procedures.

Which two muscles define the true superficial internervous plane of this surgical approach?

A 60-year-old man undergoes a total hip arthroplasty via a direct anterior approach using the primary inter-nervous plane between the tensor fasciae latae and the sartorius. Postoperatively, he complains of numbness and a burning sensation over the anterolateral aspect of his operative thigh. Which nerve was most likely injured during the surgical exposure, and what are its corresponding nerve roots?

A 55-year-old woman undergoes a primary right total hip arthroplasty via a direct anterior approach. Postoperatively, she reports a burning sensation and numbness over the anterolateral aspect of her right thigh. Motor function of her lower extremity is completely intact. During the surgical approach, which of the following internervous planes was utilized, and which nerve is most likely injured?

A surgeon is performing a primary total hip arthroplasty using a direct anterior approach.

The internervous plane utilized is between the tensor fasciae latae and the sartorius superficially. During the exposure, care must be taken to avoid a nerve that typically crosses the surgical field. Injury to this structure will most likely result in:

During a total hip arthroplasty utilizing the direct anterior (Smith-Petersen) approach, the internervous plane is developed between the tensor fasciae latae (TFL) and the sartorius. Which of the following nerves is at greatest risk of iatrogenic injury during the superficial dissection and subsequent retractor placement?

The direct anterior approach (Smith-Petersen) to the hip is frequently utilized in primary total hip arthroplasty to exploit a true internervous plane. Which of the following best describes the superficial internervous plane utilized in this approach?

A surgeon is performing a primary total hip arthroplasty utilizing the direct anterior approach (Smith-Petersen). Development of the superficial internervous plane is required for initial exposure. Which two muscles define this superficial plane, and what are their respective innervations?

During a direct anterior approach for total hip arthroplasty, the surgeon dissects through an internervous plane. Which two nerves supply the muscles that form the superficial boundary of this interval?

During a direct anterior approach to the hip, which internervous plane is utilized?

The direct anterior (Smith-Petersen) approach to the hip is popular for total hip arthroplasty because it exploits a true internervous plane. Which two muscles define the superficial interval of this approach?