Surgical Anatomy & Approaches MCQs

A 30-year-old man sustains a midshaft humerus fracture resulting from a motor vehicle collision. Upon examination, he demonstrates a weak wrist extension, an inability to extend his metacarpophalangeal joints, and numbness over the dorsal first web space. Which nerve structure is injured?

A patient sustains a crush injury resulting in a radial nerve palsy. At 4 weeks, clinical examination shows no function, but the nerve is in continuity. Surgical exploration shows intact epineurium and perineurium, but the endoneurium is disrupted. Which of Sunderland's classifications matches this injury?

A patient sustains a closed humerus fracture with a concomitant radial nerve palsy. EMG at 4 weeks shows fibrillation potentials, but ultrasound reveals the nerve remains in continuity with intact perineurium and epineurium. According to Sunderland's classification, what is the grade of this nerve injury?

During an anterior intrapelvic (modified Stoppa) approach for an acetabular fracture, significant arterial hemorrhage occurs near the superior pubic ramus. This is most likely due to an iatrogenic injury of an anastomosis between which two vascular systems?

A patient sustains a closed midshaft humerus fracture and presents with a secondary radial nerve palsy. According to the Seddon classification, if this is an axonotmesis, which of the following histologic structures remains intact?

A patient sustains a closed midshaft humerus fracture and presents with a resultant radial nerve palsy. Which of the following nerve injury types is characterized by intact endoneurium but disrupted axons?

A patient sustains a closed midshaft humerus fracture and presents with a dense radial nerve palsy. After 3 weeks of observation, an electromyography (EMG) study is performed. Which of the following EMG findings is most indicative of active axonal denervation?

A 35-year-old male sustains a midshaft humeral fracture and immediately presents with an inability to extend his wrist or fingers. He undergoes closed management in a Sarmiento brace. At 12 weeks, there is no clinical or electromyographic (EMG) evidence of nerve recovery. What is the most appropriate next step?

A 35-year-old male sustains a spiral fracture of the distal third of the humerus. On presentation, he lacks active wrist and thumb extension. He undergoes closed reduction and splinting. At 12 weeks, there is no clinical or electromyographic (EMG) evidence of radial nerve recovery. What is the most appropriate next step in management?

An 8-year-old child sustains a completely displaced posterolateral supracondylar humerus fracture. Upon examination, which of the following nerves is most at risk of injury due to the direction of the displacement of the proximal fragment?

A patient sustains a closed midshaft humerus fracture and presents with a complete radial nerve palsy. EMGs at 4 weeks show fibrillation potentials but no voluntary motor unit action potentials. However, clinically, the patient regains full function at 12 weeks. According to Seddon's classification, what type of nerve injury did the patient most likely sustain?

A surgeon utilizes the direct anterior approach (Smith-Petersen) for a total hip arthroplasty, exploiting the internervous plane between the sartorius and the tensor fasciae latae (TFL). Which nerve is most at risk during the superficial dissection of this approach?

A 70-year-old woman undergoes a primary total hip arthroplasty via a posterior approach. Postoperatively, she has a profound foot drop and absent sensation over the anterolateral leg and dorsum of the foot. Plantar flexion and foot inversion are completely intact. Which specific nerve branch was most likely injured?

During an arthroscopic Bankart repair, the surgeon places a suture anchor at the 5 o'clock position on the anterior glenoid rim. Which nerve is most at risk of injury if the drill penetrates too deeply at this location?

A patient sustains a closed fracture of the humerus resulting in a radial nerve palsy. According to the Sunderland classification, a 2nd-degree nerve injury (equivalent to Seddon's axonotmesis) is strictly characterized by:

A patient sustains a closed midshaft humerus fracture resulting in a radial nerve palsy. Electromyography (EMG) at 4 weeks shows fibrillation potentials. According to the Sunderland classification, a third-degree peripheral nerve injury is characterized by the disruption of which structures?