Surgical Anatomy & Approaches MCQs

A 28-year-old overhead athlete presents with posterior shoulder pain and deltoid weakness. MRI reveals a paralabral cyst compressing a nerve within the quadrangular space. Which vascular structure runs alongside the affected nerve in this space?

During a posterior triceps-splitting approach to the humerus, the radial nerve is identified. In relation to the posterior humerus, at what approximate distance from the lateral epicondyle does the radial nerve typically cross the posterior midshaft?

A 45-year-old patient presents with a displaced acetabular fracture requiring surgical fixation via an ilioinguinal approach. During the dissection, severe hemorrhage is encountered posterior to the superior pubic ramus. Which of the following anatomic variants is the most likely source of the bleeding?

A patient is scheduled for an extreme lateral interbody fusion (XLIF) at L4-L5. The trans-psoas approach places specific nerves of the lumbar plexus at risk. Which nerve lies most anteriorly on the surface of the psoas major muscle and is highly vulnerable during initial psoas dilation?

A 30-year-old patient with intractable piriformis syndrome is undergoing surgical release. The surgeon considers the anatomic variations of the sciatic nerve in relation to the piriformis muscle. What is the most common anatomical variation (Beaton and Anson Type B) of the sciatic nerve?

During a volar approach to the forearm (Henry approach) for a middle-third radius fracture, the surgeon develops the internervous plane. Between which two muscles is the proximal interval of the Henry approach classically developed?

When performing a posterior approach to the humerus for internal fixation, the radial nerve must be identified and protected. At approximately what distance proximal to the lateral epicondyle does the radial nerve cross the lateral intermuscular septum from posterior to anterior?

An orthopedic surgeon utilizes the anterior (Smith-Petersen) approach for a core decompression of the hip. This approach utilizes a true internervous plane. Which two nerves supply the muscles that form the superficial boundary of this plane?

During a volar approach to the proximal radius (Henry approach), the surgeon dissects between the brachioradialis and the pronator teres. Which of the following describes the innervation of these two muscles respectively?

A 45-year-old construction worker with chronic anterior shoulder pain undergoes an open subpectoral biceps tenodesis.

During the surgical approach, retractors are placed deep to the short head of the biceps and coracobrachialis (conjoined tendon). Which nerve is at greatest risk of injury with overly aggressive medial retraction in this specific area?

When performing a direct anterior approach to the hip for total hip arthroplasty, the internervous plane utilized is between the tensor fasciae latae (TFL) and the sartorius superficially. Which two nerves supply these muscles respectively?

Which surgical approach to the hip is most frequently associated with the risk of iatrogenic injury to the superior gluteal nerve?

A direct anterior approach to the hip utilizes an internervous and intermuscular plane. Which of the following accurately describes this superficial interval?

A surgeon is performing a total hip arthroplasty via the direct anterior (Smith-Petersen) approach. This approach exploits the internervous plane between which two muscle groups?

A 29-year-old recreational tennis player presents with vague, poorly localized shoulder pain and paresthesias over the lateral deltoid. MRI reveals isolated denervation atrophy of the teres minor. Which vascular structure is most likely compressed along with the involved nerve in this syndrome?

A 26-year-old professional baseball pitcher presents with vague posterior shoulder pain and numbness over the lateral deltoid. MRI reveals isolated atrophy of the teres minor. Compression of the involved nerve is most likely occurring in a space bounded medially by which of the following structures?

A 29-year-old male competitive tennis player complains of vague posterior shoulder pain and numbness over the lateral deltoid after overhead activities. MRI of the shoulder reveals isolated fatty atrophy of the teres minor muscle. Which of the following structures are most likely being compressed?

In the management of proximal biceps tendon pathology, a surgeon elects to perform an open subpectoral biceps tenodesis instead of an arthroscopic suprapectoral tenodesis. What is the primary theoretical advantage of a subpectoral tenodesis?

A 45-year-old female is 6 months post-ORIF for a proximal humerus fracture. She complains of severe shoulder stiffness. Radiographs show a healed fracture with implants in good position, and no intra-articular screw penetration. She has failed conservative management and is scheduled for an arthroscopic capsular release. Which nerve must be most carefully protected when releasing the inferior capsule (closest to the 6 o'clock position)?

A 30-year-old male falls from a ladder and sustains an intra-articular distal radius fracture. The surgeon opts for a volar surgical approach utilizing the modified Henry interval. After retracting the flexor carpi radialis (FCR) ulnarly, which structure forms the floor of the approach and must be incised to directly expose the pronator quadratus?