1. General Principles & Basic Science MCQs

During an anterior intrapelvic (modified Stoppa) approach for a complex acetabular fracture involving the anterior column, the surgeon dissects along the posterior aspect of the superior pubic ramus. Brisk, pulsatile bleeding is encountered from an anomalous anastomotic vessel. This structure, classically known as the corona mortis, represents a potentially fatal communication between which two major vascular networks?

A 35-year-old man undergoes an ilioinguinal approach for an anterior column acetabular fracture. During the surgical exposure along the superior pubic ramus, severe bleeding is encountered from an injured vascular anastomosis. This structure represents an anastomosis between which of the following vascular systems?

A 28-year-old man sustains a closed anterior shoulder dislocation. After a successful closed reduction, he has persistent numbness over the lateral aspect of the shoulder and weakness in shoulder abduction. The nerve injured in this patient passes through a defined anatomic space in the posterior shoulder. Which of the following forms the inferior border of this space?

A 45-year-old man sustains a closed midshaft humerus fracture. Upon presentation, he is unable to extend his wrist or fingers and has numbness over the dorsal first web space. The nerve responsible for this deficit pierces the lateral intermuscular septum of the arm to cross from the posterior to the anterior compartment. At approximately what distance proximal to the lateral epicondyle does this nerve pierce the septum?

A 45-year-old male undergoes an open reduction and internal fixation for a proximal humerus fracture via a standard deltopectoral approach. To properly develop the internervous plane, the surgeon identifies the cephalic vein. Which of the following nerve pairs innervates the muscles that define the boundaries of this specific surgical interval?

A surgeon is performing an anterior approach to the hip (Smith-Petersen) for an uncemented total hip arthroplasty in a 65-year-old patient. The approach requires careful dissection through both a superficial and a deep internervous plane. Which of the following correctly identifies the muscles and corresponding innervations of the superficial internervous plane?

A 50-year-old man requires an excision of a symptomatic plantar fibromatosis. The surgeon utilizes a medial approach to the midfoot. Deep dissection reveals a critical intersection of tendons known as the Master Knot of Henry. Which of the following accurately describes the relationship of structures at this location?

During an ilioinguinal approach to the pelvis for acetabular fracture fixation, significant hemorrhage occurs while dissecting over the superior pubic ramus. The bleeding is most likely from an anomalous anastomotic vessel connecting the external iliac system to the internal iliac system. This vessel, known as the 'corona mortis,' typically connects which of the following?

During surgical exploration for a complex flexor tendon laceration in Zone II of the index finger, a surgeon plans to vent portions of the flexor sheath to facilitate tendon glide. To prevent bowstringing of the flexor tendons, which of the following annular pulleys are considered the most biomechanically critical to preserve?

A 28-year-old male bodybuilder presents with right posterior shoulder pain, as well as distinct weakness in shoulder abduction and external rotation. An MRI of the shoulder reveals an isolated paralabral cyst compressing the structures within the quadrangular space. Which of the following neurovascular structures are most likely being compressed?

A surgeon is utilizing the anterior (Smith-Petersen) approach to the hip for an open reduction of a displaced femoral neck fracture. Which of the following best describes the deep internervous plane of this surgical approach?

A 35-year-old man requires open reduction and internal fixation of a middle-third humeral shaft fracture via a posterior approach. The surgeon must identify and protect the radial nerve as it passes through the intermuscular septum. At what average distance proximal to the lateral epicondyle does the radial nerve pierce the lateral intermuscular septum?

During an ilioinguinal approach to the pelvis for an anterior column acetabular fracture, severe hemorrhage is encountered superior to the superior pubic ramus while dissecting near the posterior aspect of the symphysis pubis. This bleeding is most likely originating from an anastomosis between which two vascular systems?

A surgeon is plating a proximal radius fracture utilizing the volar (Henry) approach to the forearm. In the proximal portion of the incision, what is the primary internervous plane being developed?

A 60-year-old man is undergoing an open reduction and internal fixation of a proximal humerus fracture using a minimally invasive deltoid-splitting approach. To avoid injury to the axillary nerve, the surgeon must be aware of its location. The axillary nerve typically crosses the humerus at what distance distal to the lateral edge of the acromion?

During an anterior approach (Smith-Petersen) to the hip for a core decompression, the superficial internervous plane is developed between the sartorius and the tensor fasciae latae. What is the deep internervous plane utilized in this surgical approach?

A 45-year-old man undergoes open reduction and internal fixation of a diaphyseal radius fracture via a volar (Henry) approach. The surgeon begins the exposure in the proximal forearm. Which of the following describes the correct internervous plane for the proximal third of this approach?

A 35-year-old male undergoes a modified Stoppa approach for a displaced acetabular fracture involving the anterior column. During the dissection along the pelvic brim, the surgeon carefully ligates a vascular structure known as the 'corona mortis'. This structure represents an anastomotic connection between which two vascular systems?

During surgical exploration for a compressive neuropathy in the proximal forearm, the radial nerve is identified. The superficial branch of the radial nerve and the deep branch (posterior interosseous nerve, PIN) are visualized at their bifurcation. The PIN classically passes beneath the arcade of Frohse and dives between the two heads of which muscle?

A 45-year-old man is undergoing an open reduction and internal fixation of an anterior column acetabular fracture via an ilioinguinal approach. During the deep dissection near the posterior aspect of the superior pubic ramus, brisk arterial bleeding is suddenly encountered. Which of the following vascular anastomoses was most likely injured in this location?