1. General Principles & Basic Science MCQs

A patient undergoes ORIF of a midshaft clavicle fracture using a superiorly applied pre-contoured locking plate. Postoperatively, the patient notes numbness over the anterior chest wall just inferior to the incision. Which nerve was likely injured during the surgical approach?

A 28-year-old competitive weightlifter feels a "pop" in his anterior axilla while performing a heavy bench press. Examination reveals loss of the anterior axillary fold and weakness in internal rotation. If surgical repair is indicated, which anatomical footprint should be targeted?

When utilizing an anterolateral acromial approach (deltoid-splitting) for open reduction and internal fixation of a proximal humerus fracture, which anatomical landmark best predicts the location of the axillary nerve?

An 18-year-old rugby player sustains a direct blow to the medial aspect of his clavicle. He presents in distress, complaining of shortness of breath and difficulty swallowing. His arm is supported across his chest. What is the BEST initial imaging modality, and what is the definitive management if closed reduction is unsuccessful?

A 35-year-old active male with constitutional varus alignment undergoes a medial opening-wedge high tibial osteotomy (HTO) for isolated medial compartment osteoarthritis. Which of the following is a known biomechanical consequence in the sagittal plane associated with this procedure?

A 28-year-old weightlifter feels a sharp pop in his anterior axilla while bench pressing. Examination reveals weakness in internal rotation and an asymmetric axillary fold. MRI confirms an isolated rupture of the sternal head of the pectoralis major. Where does the sternal head anatomically insert on the humerus relative to the clavicular head?

A 28-year-old male bodybuilder feels a pop in his anterior axilla while bench-pressing heavy weights. Exam reveals loss of the anterior axillary fold and weakness in internal rotation. Which specific anatomical segment is most commonly ruptured in this injury?

A 45-year-old female sustains an acute medial meniscus posterior root tear. Biomechanically, this injury is most equivalent to which of the following?

A 32-year-old bodybuilder feels a pop in his anterior axillary fold while performing a heavy bench press. He is diagnosed with a complete pectoralis major rupture. Which of the following best describes the anatomic location where this injury most commonly occurs?

During surgical exposure for a mid-diaphyseal radial shaft fracture via the Henry (anterior) approach, which neurovascular structure is most directly at risk and requires careful identification and protection?

A surgeon plans an open reduction and internal fixation of a proximal third radial shaft fracture utilizing the Thompson approach. This surgical exposure develops an internervous plane between which two muscles?

When performing the Thompson (dorsal) approach to the proximal radius, the surgeon develops the interval between which two muscles?

During ORIF of a proximal radius fracture utilizing the volar Henry approach, the surgeon must identify and protect the radial artery and the superficial radial nerve. In the proximal third of the forearm, the posterior interosseous nerve (PIN) is protected by keeping the forearm in which position?

A 35-year-old male undergoes open reduction and internal fixation (ORIF) of a displaced two-part surgical neck fracture of the humerus via a deltopectoral approach. Post-operatively, the patient complains of numbness and weakness in his shoulder. On examination, he has difficulty initiating abduction and has sensory loss over the lateral aspect of his deltoid. Which of the following nerves was most likely injured during the surgical procedure or due to the initial trauma?

A 68-year-old female with severe osteoporosis presents with a comminuted Neer four-part proximal humerus fracture. She is scheduled for surgical management. During pre-operative planning, the surgeon emphasizes the critical importance of achieving and maintaining medial calcar support during fixation. What is the primary biomechanical reason for this emphasis?

A 55-year-old male is undergoing open reduction and internal fixation of a displaced three-part proximal humerus fracture via a deltopectoral approach. The surgical team has positioned the patient as shown in the image below. During the approach, the surgeon identifies the cephalic vein in the deltopectoral groove. Which of the following statements accurately describes the management of the cephalic vein and the anatomical plane it defines?

During the surgical approach for a severely comminuted proximal humerus fracture, the surgeon utilizes the deltopectoral interval. Which of the following accurately describes the primary neural supply to the muscles forming this true internervous plane?

A 68-year-old female undergoes open reduction and internal fixation (ORIF) with a locked compression plate for a 3-part proximal humerus fracture. Postoperatively, she develops profound weakness in external rotation and a loss of contour over the lateral shoulder. Injury to which of the following nerves is the most likely cause?

Which of the following vascular structures provides the primary blood supply to the humeral head, replacing previous historical anatomical beliefs?

A 22-year-old female presents after an MVC with anterior cord syndrome following a flexion teardrop fracture. Which of the following sensory or motor modalities will most likely remain intact on her physical examination?