1. General Principles & Basic Science MCQs

A surgeon is performing an extensive deltopectoral approach. To mobilize the pectoralis major, they note its neurovascular supply. The medial pectoral nerve is named for its origin from the medial cord of the brachial plexus. How does it typically enter the pectoralis major relative to the pectoralis minor?

When performing an extensile lateral approach to the humerus, the radial nerve must be identified and protected. At approximately what distance proximal to the radiocapitellar joint does the radial nerve pierce the lateral intermuscular septum?

Which of the following best describes the most common anatomical variant of the sciatic nerve in relation to the piriformis muscle?

During a Smith-Petersen (anterior) approach to the hip, the deep internervous plane lies between the rectus femoris and the gluteus medius. What is the motor innervation to the muscle forming the medial border of this deep plane?

In a standard deltopectoral approach to the shoulder, the conjoined tendon is often retracted medially. At approximately what distance distal to the coracoid process does the musculocutaneous nerve typically enter the coracobrachialis?

A 55-year-old woman presents with the inability to extend her fingers and thumb at the metacarpophalangeal joints. Wrist extension is preserved but deviates radially. Electromyography confirms an entrapment neuropathy. Which of the following is the most likely site of compression?

During a deltopectoral approach to the shoulder, the coracoid process may be osteotomized for better exposure. Which nerve is most at risk if the conjoint tendon is forcefully retracted medially?

During a flatfoot reconstruction, the spring ligament is identified and reefed. Which of the following accurately describes the anatomic attachments of the superomedial calcaneonavicular (spring) ligament?

During a surgical approach to the proximal radius, the surgeon identifies the posterior interosseous nerve (PIN). The PIN passes between the two heads of which muscle?

A surgeon is performing a surgical dislocation of the hip. To protect the main blood supply to the femoral head, the medial circumflex femoral artery (MCFA) must be protected. The deep branch of the MCFA passes between which two muscles?

A patient with a traction injury to the lower trunk of the brachial plexus will demonstrate deficits in muscles supplied by which two cords?

During an ilioinguinal approach to the acetabulum, massive bleeding is encountered near the superior pubic ramus. This is most likely due to injury to the "corona mortis," which is an anastomosis between which two vascular systems?

A patient with an axillary nerve injury following a proximal humerus fracture will most likely show denervation in the deltoid and which other muscle?

During a distal femoral osteotomy, retractors are placed medially. Which nerve is at greatest risk of injury as it exits the adductor canal?

When performing an anterolateral approach to the distal humerus, the radial nerve is at risk. Between which two muscles is the radial nerve located as it crosses the lateral intermuscular septum in the distal third of the arm?

During an ilioinguinal approach for an anterior column acetabular fracture, significant hemorrhage occurs superior to the superior pubic ramus. This bleeding is most likely from an anastomosis (corona mortis) between which two vascular systems?

A patient develops weak shoulder abduction and external rotation following a posterior fracture-dislocation of the proximal humerus. The injured nerve exits the axilla through a space bounded superiorly by which structure?

A patient has deep gluteal pain radiating down the posterior thigh. The sciatic nerve normally exits the greater sciatic foramen inferior to the piriformis muscle. In a common anatomical variant, a portion of the nerve pierces the piriformis. Which portion typically pierces the muscle?

During placement of an L4 pedicle screw, a lateral breach occurs. Which of the following nerve roots is at greatest risk for direct injury from the misdirected screw?

During an anterior ilioinguinal approach for an acetabular fracture, significant hemorrhage is encountered posterior to the superior pubic ramus. This bleeding is most likely originating from an anastomosis between which two vascular systems?