1. General Principles & Basic Science MCQs

The anterolateral (Watson-Jones) approach to the hip utilizes a superficial interval between the tensor fasciae latae and the gluteus medius. What is the innervation of these two muscles respectively?

During a deltopectoral approach to the shoulder, the coracoid process may be osteotomized to improve exposure. The surgeon must be careful to avoid placing retractors too distally on the conjoined tendon to prevent injury to which nerve?

When performing the volar (Henry) approach to the proximal radius, the surgeon develops the interval between the pronator teres and the brachioradialis. Which vascular structure must be ligated and divided to fully mobilize the mobile wad laterally?

A patient develops weakness of the deltoid and teres minor following a posterior shoulder dislocation. The injured nerve passes through the quadrangular space. What muscle forms the superior border of this anatomic space?

A hamstring autograft is being harvested for an ACL reconstruction. The surgeon isolates the gracilis and semitendinosus tendons. What is the respective nerve supply to the individual muscles comprising the pes anserinus (Sartorius, Gracilis, Semitendinosus)?

During a lateral transpsoas approach to the lumbar spine (LLIF), the surgeon must navigate the lumbar plexus carefully to avoid neurologic deficit. Which nerve is classically found emerging directly from the anterior surface of the psoas major muscle?

The anterior (Smith-Petersen) approach to the hip exploits a true internervous plane. Which two nerves supply the respective muscles that form the superficial interval of this approach?

During a posterior approach to the hip (Moore or Southern), the short external rotators are tenotomized and reflected posteriorly. Which structure is most at risk if the piriformis is not carefully protected, specifically considering common anatomical variants?

When performing a direct lateral (deltoid-splitting) approach to the proximal humerus for open reduction and internal fixation, what is the maximum safe distance from the tip of the acromion to extend the split without risking denervation of the anterior deltoid?

During a volar (Henry) approach to the proximal radius, the surgeon supinates the forearm to protect the posterior interosseous nerve (PIN). Supination moves the PIN in which direction relative to the anterior surgical exposure?

When performing an anterior approach to the hip (Smith-Petersen), the superficial internervous plane is between the sartorius and tensor fasciae latae (TFL). Which nerve innervates the muscle forming the medial border of this interval?

When placing half-pins for a humeral external fixator from a lateral approach, the radial nerve is at risk. At what location does the radial nerve predictably pierce the lateral intermuscular septum to enter the anterior compartment?

During the placement of pedicle screws at the L4 level, the surgeon breaches the inferior wall of the L4 pedicle. Which nerve root is most directly at risk of injury due to this specific breach?

During an arthroscopic rotator cuff repair, a portal is established posterior to the acromioclavicular joint. If the portal or dissection is extended more than 5 cm inferiorly from the lateral acromion edge, which nerve is at greatest risk of injury?

During an ilioinguinal approach to the acetabulum, severe hemorrhage is encountered while dissecting posterior to the superior pubic ramus. This is most likely due to an unligated vascular anastomosis between which two systems?

A patient undergoes a lateral transpsoas interbody fusion at L4-L5. Postoperatively, they display profound weakness in hip flexion and knee extension, along with anterior thigh numbness. Which nerve was most likely injured?

An isolated fracture of the fibular shaft is approached surgically. The surgeon utilizes the internervous plane between the lateral and superficial posterior compartments of the leg. Which two muscles define this specific surgical interval?

A 45-year-old man sustains a proximal humerus fracture and subsequently demonstrates weakness in shoulder abduction and diminished sensation over the lateral deltoid. The affected nerve exits the axilla through the quadrangular space. Which of the following defines the superior border of this anatomic space?

A surgeon is performing an open reduction internal fixation of an acetabular fracture via the ilioinguinal approach. If a Smith-Petersen extension is utilized, the superficial internervous plane lies between muscles innervated by which two nerves?

While performing an ilioinguinal approach for a transverse acetabular fracture, life-threatening hemorrhage occurs near the superior pubic ramus. This bleeding is most likely originating from the corona mortis, which represents an anastomosis between which two vascular systems?