Approaches Orthopedic B Review | Dr Hutaif General Orth -...

(SAE08AN.50) What complication is more likely following excessive medial retraction of the anterior covering structures during the anterolateral (Watson-Jones) approach to the hip?
1. Numbness over the anterolateral thigh
2. Ischemia to the leg
3. Quadriceps weakness
4. Abductor insufficiency
5. Foot drop
PREFERRED RESPONSE 3
(SAE08OS.3) During the medial parapatellar approach to the knee, most of the arterial supply to the patella is divided. What artery is at risk if a lateral retinacular release is performed?
1. Anterior tibial recurrent
2. Lateral superior genicular
3. Lateral inferior genicular
4. Descending genicular
5. Medial superior genicular PREFERRED RESPONSE 2
(SAE09SN.98) During a left-sided transforaminal lumbar interbody fusion at the L4-5 level, the surgeon notes a significant amount of bleeding that cannot be controlled while using a pituitary rongeur. What anatomic structure has been injured?
1. Aorta
2. Common iliac artery
3. Common iliac vein
4. External iliac artery
5. External iliac vein PREFERRED RESPONSE 2
(OBQ13.202) After arthroscopic shoulder surgery a 45-year-old male develops pain, weakness and decreased sensation over the lateral arm and shoulder. If this injury was due to portal placement, which of the following portals would be the most likely site of injury?
1. Lateral superior portal
2. Posterior superior portal
3. Anterior portal
4. Posterior inferior portal
5. Nevasier (supraspinatus) portal PREFERRED RESPONSE 4
(SAE11AN.90) During an anterior retroperitoneal approach to the L4-5 disk, the iliac vessels must be mobilized. The dissection is carried out along the lateral edge of the vessels so they can be retracted medially across the midline. What structure that tethers the common iliac vein must be identified and taken down for safe and adequate mobilization?
1. Ureter
2. Genitofemoral nerve
3. Internal femoral artery
4. Iliolumbar vein
5. Central sacral vein PREFERRED RESPONSE 4
(OBQ13.207) What intermuscular plane is most commonly used in the anterior approach to the ankle?
1. Between the tendons of extensor digitorum
2. Between extensor hallucis longus and extensor digitorum longus
3. Between tibialis anterior and extensor hallucis longus
4. Between extensor digitorum longus and extensor digitorum brevis
5. Between peroneus tertius and peroneus brevis PREFERRED RESPONSE 2
(SAE08AN.27) The posterior approach to the proximal radius uses what intermuscular interval?
1. Extensor carpi radialis brevis and extensor digitorum communis
2. Extensor carpi radialis longus and extensor digitorum communis
3. Extensor digitorum communis and extensor pollicis brevis
4. Brachioradialis and flexor carpi radialis
5. Anconeus and extensor carpi ulnaris PREFERRED RESPONSE 1
(SAE09FA.41) During a posterior approach to the right Achilles tendon, the surgeon encounters a nerve running with the small saphenous vein as shown in Figure 22. This nerve innervates what part of the foot?

1. Posterior heel
2. Plantar-lateral foot
3. Plantar-medial foot
4. Dorso-lateral foot
5. Dorso-medial foot
   PREFERRED RESPONSE 4
   (SAE10HK.84) The anterior approach to the hip (iliofemoral or Smith-Peterson) puts which of the following anatomic structures at greatest risk?
6. Femoral artery
7. Femoral nerve
8. Lateral femoral cutaneous nerve
9. Medial femoral circumflex artery
10. Obturator artery
    PREFERRED RESPONSE 3
    (SBQ12SP.36) What is the most common type of cause and type of peripheral nerve injury detected by electrophysiologic monitoring during anterior cervical spine surgery? Review Topic
11. Brachial plexopathy following shoulder taping and application of countertraction
12. Brachial plexopathy on neck extension for surgical access
13. Spinal cord injury on neck extension for surgical access
14. Ulnar neuropathy due to tightly wrapped or malpositioned upper extremities
15. Cerebral hypoperfusion due to elevation of the head of the bed PREFERRED RESPONSE 1
    (SBQ12TR.83) A 45-year-old male sustains the fracture seen in Figure A. He is scheduled for open reduction and internal fixation using the Smith-Peterson approach. After dissection through the superficial intermuscular plane, a moderate amount of bleeding is noted in the surgical field. What vessel was likely injured?
    

1. Ascending branch of the lateral femoral circumflex artery
2. Medial femoral circumflex artery
3. Obturator artery
4. Superficial external pudendal artery
5. Femoral vein
   PREFERRED RESPONSE 1
   (SAE11AN.26) Figure 26 shows an axial T1-weighted MRI scan of the foot of a 13-year-old boy. The three-pronged structure indicated by the arrow shows which of the following?
   

1. Insertion of the peroneus longus tendon
2. Insertion of the posterior tibial tendon
3. Flexor digitorum longus tendons
4. Inferior calcaneonavicular (spring) ligament
5. Branches of the posterior tibial artery PREFERRED RESPONSE 4
   (SAE11UE.89) What is the interval used during an anterior approach (Henry) for a distal radius shaft fracture?
6. Flexor digitorum superficialis-flexor carpis ulnaris
7. Flexor carpi radialis-flexor digitorum superficialis
8. Brachioradialis-flexor carpi radialis
9. Flexor pollicis longus-flexor digitorum profundus
10. Flexor pollicis longus-flexor carpi radialis PREFERRED RESPONSE 3
    (SAE11AN.62) A 41-year-old man has a severe posttraumatic elbow contracture. The surgeon chooses to approach laterally. This exposure to the anterior elbow capsule exploits what anatomic interval?
11. Anconeus and anterior surface of the humerus
12. Brachioradialis and extensor carpi radialis longus
13. Brachioradialis and brachialis
14. Extensor carpi radialis longus and extensor carpi radialis brevis
15. Brachioradialis/extensor carpi radialis longus and anterior surface of the humerus PREFERRED RESPONSE 5
    (SAE08AN.58) What structure is most at risk for injury from a retractor against the tracheoesophageal junction during an anterior approach to the cervical spine?
16. Esophagus
17. Trachea
18. Superior laryngeal nerve
19. Recurrent laryngeal nerve
20. Sympathetic chain
    PREFERRED RESPONSE 4
    (SAE09SN.80) Which of the following statements about hoarseness due to vocal cord paralysis after anterior cervical diskectomy and fusion is most accurate?
21. Vocal cord paralysis is three times as likely with a right-sided approach as compared to a left-sided approach.
22. Vocal cord paralysis is twice as likely with a right-sided approach as compared to a left-sided approach.
23. Vocal cord paralysis is equally likely with either a right-sided or a left-sided approach.
24. Vocal cord paralysis is three times as likely with a left-sided approach as compared to a right-sided approach.
25. Vocal cord paralysis is twice as likely with a left-sided approach as compared to a right-sided approach.
    PREFERRED RESPONSE 3
    (SAE12FA.97) With respect to the clinical photograph shown in Figure 97, what artery provides the most blood supply to the area of the planned incision?
    

1. Lateral tarsal
2. Lateral calcaneal
3. Lateral malleolar
4. Common peroneal
5. Artery of the tarsal sinus PREFERRED RESPONSE 2
   (SAE11AN.59) During a posterolateral exposure of the knee, the fascial intervals between the iliotibial band and the biceps femoris tendon are incised. What vascular structure is at most risk during this exposure?
6. Peroneal artery
7. Lateral sural artery
8. Superior lateral genicular artery
9. Inferior lateral genicular artery
10. Posterior tibial recurrent artery PREFERRED RESPONSE 4
    (SAE08AN.54) Which of the following best describes the relationship of the median nerve to the flexor carpi radialis tendon just proximal to the carpal canal?
11. Median nerve is volar and ulnar
12. Median nerve is radial and volar
13. Median nerve is dorsal and ulnar
14. Median nerve is dorsal and radial
15. Median nerve is volar and radial PREFERRED RESPONSE 3
    (SAE08AN.93) When harvesting an iliac crest bone graft from the posterior approach, what anatomic structure is at greatest risk for injury if a Cobb elevator is directed too caudal?
16. Sciatic nerve
17. Cluneal nerves
18. Inferior gluteal artery
19. Superior gluteal artery
20. Sacroiliac joint
    PREFERRED RESPONSE 4
    (SAE11AN.70) Figure 70 shows the arthroscopic view of a right knee from an inferolateral viewing portal. The probe is touching what anatomic structure?
    

1. Posterior cruciate ligament, anterolateral bundle
2. Posterior cruciate ligament, posterolateral bundle
3. Posterior cruciate ligament, anteromedial bundle
4. Posterior cruciate ligament, posteromedial bundle
5. Posterior meniscofemoral ligament PREFERRED RESPONSE 1
   (SAE11UE.18) During the Kocher approach to repair a radial head fracture, care must be taken not to release what posterior structure lying under the anconeus that may be inadvertently injured during this common lateral approach to the elbow?
6. Ulnar nerve
7. Annular ligament
8. Anterior band of the medial collateral ligament
9. Lateral ulnar collateral ligament
10. Arcade of Struthers PREFERRED RESPONSE 4
    (SAE09SN.27) Which of the following palpable bony landmarks is correctly matched with its corresponding vertebral level?
11. Angle of the mandible and the C2-C3 interspace
12. Hyoid bone and C6
13. Carotid tubercle and C6
14. Superior portion of the thyroid cartilage and the C3 vertebral body
15. Cricoid cartilage and C7-T1 PREFERRED RESPONSE 3
    (SAE11AN.76) What anatomic structure is marked with an asterisk in Figure 76a in the posterior arthroscopic view of a left shoulder subacromial space and with the arrow in the sagittal oblique MRI scan in Figure 76b?
    

1. Coracoacromial ligament
2. Coracohumeral ligament
3. Conoid ligament
4. Trapezoid ligament
5. Acromioclavicular ligament
   PREFERRED RESPONSE 1
   (SAE09SN.75) What structure is most at risk with anterior penetration of C1 lateral mass screws?
6. Vertebral artery
7. External carotid artery
8. Internal carotid artery
9. Pharynx
10. Glossopharyngeal nerve
    PREFERRED RESPONSE 3
    (SAE11AN.72) The radial forearm free flap has a vascular pedicle that passes between which of the following muscles?
11. Flexor carpi radialis and brachioradialis
12. Flexor carpi radialis and pronator teres
13. Brachioradialis and pronator teres
14. Brachioradialis and abductor pollicis longus
15. Brachioradialis and palmaris longus PREFERRED RESPONSE 1
    (OBQ14.124) A urologist has requested the operative report for a 41-year-old male that underwent L5-S1 anterior lumbar interbody fusion using bone morphogenetic protein-2 augmentation. Which of the following urological complications occurs most commonly after this surgery?
16. Erectile dysfunction
17. Recurrent urinary tract infections
18. Retrograde ejaculation
19. Testicular atrophy
20. Penile numbness
    PREFERRED RESPONSE 3
    (SAE09SN.47) What nerve is most likely to be injured during the anterior exposure of C2-3?
21. Facial
22. Superior laryngeal
23. Vagus
24. Hypoglossal
25. Phrenic
    PREFERRED RESPONSE 4
    (SAE12TR.67) What approach should be chosen for the injury seen in Figure 67? Review Topic
    

1. Stoppa
2. Hardinge
3. Ilioinguinal
4. Watson Jones
5. Kocher-Langenbeck
   PREFERRED RESPONSE 5
   (SBQ12TR.4) Which of the following statements about the lateral femoral cutaneous nerve is true?
6. Innervates the medial aspect of the proximal thigh
7. Originates from the dorsal roots of L4-L5
8. Course runs medial to the femoral artery
9. Courses along the medial border of the psoas muscle
10. Courses under the inguinal ligament PREFERRED RESPONSE 5
    (SAE11AN.50) When planning the incision for an anterior approach to the cervical spine, what external landmark is easily palpable that would correspond most closely to the C6 vertebral level?
11. Upper border of the thyroid cartilage
12. Cricoid cartilage
13. Hyoid bone
14. Lower border of the thyroid cartilage
15. Carotid tubercle
    PREFERRED RESPONSE 2
    (SAE08AN.1) During a retroperitoneal approach to the L4-5 disk, what structure must be ligated to safely mobilize the common iliac vessels toward the midline from laterally and gain exposure?
16. Obturator vein
17. Iliolumbar vein
18. External iliac vein
19. Middle sacral artery
20. Hypogastric artery
    PREFERRED RESPONSE 2
    (OBQ14.26) A 28-year-old football player sustained a displaced posterior glenoid fossa fracture. He elects to undergo open reduction and internal fixation using a posterior approach to the shoulder. What intermuscular interval should be used to expose the posterior glenoid?
21. Deltoid and Teres minor
22. Teres minor and Infraspinatus
23. Supraspinatus and Infraspinatus
24. Deltoid and Supraspinatus
25. Teres minor and Teres major PREFERRED RESPONSE 2
    (SAE11AN.99) While performing a medial approach to the hip, the superficial dissection takes place between the gracilis and the adductor longus muscles. The deeper dissection takes place between what two muscles?
26. Adductor longus and adductor brevis
27. Adductor longus and pectineus
28. Adductor brevis and adductor magnus
29. Adductor magnus and semimembranosus
30. Pectineus and iliopsoas PREFERRED RESPONSE 3
    (SAE09SN.84) A 55-year-old woman undergoes an anterior cervical diskectomy and fusion at C5-C6 through a left-sided approach. One year later, she requires an anterior cervical diskectomy and fusion on another level. Which of the following is considered a contraindication to performing a right-sided approach for the revision procedure? Review Topic
31. Revision surgery caudad to C6
32. Persistent left cervical radiculopathy
33. History of a left-sided Horner’s syndrome
34. Transient dysphagia following the initial anterior cervical procedure
35. Nonfunctional left vocal cord PREFERRED RESPONSE 5
    (SAE09SN.89) What muscle is most often encountered during surgical approaches to C5-6?
36. Omohyoid
37. Cricohyoid
38. Splenius capitus
39. Thyrohyoid
40. Posterior digastrics
    PREFERRED RESPONSE 1
    (SAE07SM.87) The use of knee arthroscopy following total knee arthroplasty is most effective in treating which of the following conditions?
41. Patellar clunk syndrome
42. Septic arthritis
43. Nonspecific pain
44. Improper tracking of the patellar component
45. Synovitis secondary to polyethylene wear PREFERRED RESPONSE 1
    (SAE11OS.142) A 72-year-old man has a severe limp 9 months after undergoing a total hip arthroplasty. He has no pain. He had an anterolateral approach and the incision healed well without prolonged antibiotics or drainage. His legs feel equal when he stands, but he ambulates with a severe Trendelenburg limp and is unable to actively abduct his hip against gravity. What is the most likely cause of his problem?
46. Component loosening
47. Component impingement
48. Foraminal stenosis at L3-4
49. Detached gluteus medius tendon
50. Neuropathy of the superior gluteal nerve PREFERRED RESPONSE 4
    (SAE12TR.83) The vessel that is exposed crossing the interval used for an anterior approach to the hip between the tensor fascia lata and the sartorius muscle is a branch of what artery?
51. Deep femoral artery (profunda)
52. Superficial femoral artery
53. Superior gluteal artery
54. Descending recurrent femoral artery
55. External iliac
    PREFERRED RESPONSE 1
    (SAE09FA.94) When performing a gastrocnemius recession, what structure should be protected?
56. Tibial nerve
57. Sural artery
58. Plantaris
59. Posterior tibial artery
60. Sural nerve
    PREFERRED RESPONSE 5