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DFT-18/09/2025-ANATOMY D4

Total questions: 20

Worksheet time: 15mins

Name
Class
Date
1.

A 34-year-old carpenter presents with a three-week history of weakness in his dominant right hand. He struggles to pick up nails and cannot make an "OK" sign, noting his thumb and index finger form a "pinch" grip instead of a circle. There are no sensory deficits. Electromyography confirms an isolated neuropathy of the anterior interosseous nerve. Besides the flexor pollicis longus and the lateral half of the flexor digitorum profundus, which muscle, identified in the deep distal forearm, is also denervated?

a)

Pronator Quadratus

b)

Pronator Teres

c)

Flexor Carpi Ulnaris


d)

 Brachioradialis

2.

A 52-year-old avid tennis player presents with insidious-onset pain over the medial aspect of his left elbow, worsened by his forehand stroke. Examination reveals marked tenderness just distal to the medial epicondyle. The pain is exacerbated on resisted wrist flexion and forearm pronation. This presentation is classic for medial epicondylitis, which involves inflammation of the common flexor tendon. Which of the following muscles originates from the lateral supracondylar ridge and forms the lateral boundary of the cubital fossa, making it anatomically distinct from the group of muscles implicated in this pathology?


a)

 Brachioradialis


b)

 Pronator Teres

c)

Flexor Carpi Radialis

d)

Palmaris Longus


3.

A 45-year-old carpenter presents with acute, deep pain in his proximal forearm after a day of extensively using a manual screwdriver. He reports a sudden inability to make a perfect "O" sign with his thumb and index finger. Examination reveals weakness in flexion of the distal interphalangeal (DIP) joint of the index finger and the interphalangeal (IP) joint of the thumb. Sensation over the entire hand is normal. Which of the following is the most likely diagnosis explaining this specific motor deficit?

a)

Anterior interosseous nerve (AIN) syndrome


b)

Pronator teres syndrome

c)

Ulnar nerve entrapment at the cubital tunnel

d)

C8 radiculopathy

4.

A 30-year-old patient sustains a deep laceration to the volar wrist, positioned anatomically between the palmaris longus and flexor carpi ulnaris tendons. Neurological assessment reveals an inability to abduct or adduct the fingers and sensory loss over the medial one-and-a-half digits.

Based on the most probable nerve injury, which muscle's function would be completely spared?


a)

 First lumbrical


b)

Third palmar interosseous

c)

Abductor digiti minimi

d)

Adductor pollicis

5.

From a purely anatomical and functional standpoint, which statement most accurately describes the intrinsic interosseous muscles of the hand?

a)

The four bipennate dorsal interossei are primarily responsible for finger abduction (DAB), while the three unipennate palmar interossei execute adduction (PAD).

b)

The four unipennate dorsal interossei abduct the digits, whereas the three bipennate palmar interossei adduct them.

c)

 All seven interossei are bipennate, innervated by the median nerve, and primarily function to extend the interphalangeal joints.


d)

There are three dorsal interossei and four palmar interossei, all of which are innervated by the radial nerve and function to flex the metacarpophalangeal joints.


6.

During a radical mastectomy procedure for breast carcinoma, the surgeon must carefully preserve the arterial supply to the serratus anterior muscle to prevent its iatrogenic paralysis and subsequent "winging" of the scapula. Which vessel, originating from the second part of the axillary artery, is paramount to preserve for this purpose?


a)

Lateral thoracic artery

b)

Thoracoacromial artery

c)

Subscapular artery

d)

Dorsal scapular artery

7.

A 22-year-old rugby player sustains a forceful abduction and external rotation injury to his right arm, resulting in an anterior glenohumeral dislocation. Post-reduction, he exhibits marked deltoid weakness and hypoesthesia over the "regimental badge" area. An urgent angiogram is performed due to an expanding axillary hematoma, which reveals a pseudoaneurysm. Which artery, arising from the third part of the axillary artery, is most likely compromised?

a)

Posterior circumflex humeral artery

b)

Subscapular artery

c)

Thoracoacromial artery

d)

Superior thoracic artery

8.

A 24-year-old motorcyclist is brought to the emergency department after being thrown from his vehicle, landing forcefully on the point of his right shoulder. This mechanism caused extreme lateral flexion of his neck to the contralateral side. On examination, his right upper limb is held in adduction and internal rotation, with the elbow extended and forearm pronated. He also reports sensory loss over the "regimental badge" area. Which neurological structure is most likely compromised at its origin?

a)

Superior trunk

b)

Posterior cord

c)

Medial cord


d)

Radial nerve in the spiral groove

9.

A 35-year-old rock climber loses his grip and momentarily hangs by his right arm from a ledge before being rescued. In the following days, he develops weakness in his right hand, specifically with finger abduction and adduction. He also notes a loss of sensation along the medial border of his forearm and hand. On physical examination, a mild drooping of his right eyelid is observed. Which component of the brachial plexus is most likely injured?

a)

Inferior trunk (C8, T1)


b)

Lateral cord (C5, C6, C7)

c)

 Musculocutaneous nerve

d)

 Suprascapular nerve

10.

A 28-year-old male presents to the trauma center after a high-speed motorcycle collision where he was thrown from his vehicle, landing forcefully on the point of his right shoulder and neck. Physical examination reveals his right arm is held in adduction and internal rotation, with the elbow extended and the forearm pronated. He demonstrates a significant loss of shoulder abduction and elbow flexion. Sensation is diminished over the regimental badge area. Which single neurological structure is most likely injured?


a)

Superior trunk

b)

Posterior cord

c)

 Musculocutaneous nerve


d)

C8 and T1 nerve roots

11.

The convergence of the C5 and C6 ventral rami to form the superior trunk of the brachial plexus is a critical anatomical landmark susceptible to stretch injuries, as depicted in the diagram. This specific location is eponymously known as:


a)

 Erb's point

b)

Point of Zinn

c)

McBurney's point

d)

Kiesselbach's plexus

12.

The anatomical structure responsible for transmitting the preganglionic sympathetic fibers that are disrupted in Klumpke's paralysis, leading to Horner's syndrome, is the:

a)

White ramus communicans of the T1 spinal nerve.

b)

Gray ramus communicans of the T1 spinal nerve.

c)

Recurrent meningeal branch of the C8 spinal nerve.

d)

Ansa cervicalis within the carotid sheath.

13.

A 62-year-old male with a 45-pack-year smoking history presents with a new onset of left-sided shoulder pain radiating down the medial aspect of his arm, accompanied by the ocular findings seen in the image. He also reports unintentional weight loss and a persistent cough. On examination, weakness is noted in the intrinsic muscles of the left hand. Neurological examination is otherwise unremarkable. Where is the most probable location of the lesion causing this constellation of symptoms?


a)

Pulmonary apex

b)

Cavernous sinus


c)

Dorsolateral pontine tegmentum


d)

Ipsilateral oculomotor nuclear complex


14.

The median nerve is classically formed by the confluence of two roots originating from the brachial plexus. A penetrating injury selectively transecting only the medial root of the median nerve in the axilla would most likely spare motor and sensory functions primarily derived from which of the following spinal cord segments?


a)

C5, C6, C7


b)

 C8, T1

c)

C7, C8, T1


d)

C5, T1


15.

A 45-year-old professional cyclist presents with a two-month history of numbness in his right little finger and the ulnar half of his ring finger, along with progressive weakness in his hand grip. He denies any sensory loss on the dorsum of his hand. Examination reveals significant atrophy of the hypothenar eminence and interosseous muscles. Froment's sign is positive. Sensation over the dorsal ulnar aspect of the hand is notably intact. Based on these findings, where is the most likely site of ulnar nerve compression?


a)

Guyon's canal

b)

Cubital tunnel at the elbow

c)

Medial cord of the brachial plexus

d)

Carpal tunnel

16.

The anatomical space known as Guyon's canal is a fibro-osseous tunnel at the wrist, critical in the pathogenesis of ulnar neuropathy. An intricate understanding of its boundaries is essential for diagnosis and surgical planning. Which of the following structures constitutes the floor of this canal?

a)

Transverse carpal ligament and pisohamate ligament.

b)

Volar carpal ligament.

c)

Tendons of flexor digitorum profundus.

d)

Extensor retinaculum.

17.

A 42-year-old construction worker presents to the emergency department after a heavy object fell on his arm. Radiographs confirm a displaced, oblique fracture of the mid-shaft of the humerus. Neurological examination reveals an inability to extend the wrist and digits, with sensory loss over the dorsum of the hand. However, elbow extension strength is 5/5. Which muscle's function is most likely preserved due to its innervation proximal to the site of injury?

a)

Triceps brachii (long head)

b)

Brachioradialis

c)

Extensor carpi radialis longus

d)

Flexor carpi ulnaris


18.

Which of the following eponymous syndromes is characterized by the entrapment of a purely sensory terminal branch of the radial nerve, often caused by external compression at the wrist?


a)

Wartenberg's syndrome

b)

Kiloh-Nevin syndrome

c)

Froment-Rauber syndrome

d)

 Berger's paresthesia


19.

A 45-year-old patient develops "cheiralgia paresthetica" (Wartenberg's syndrome) secondary to a tightly worn wristband. This condition involves compression of the superficial radial nerve, causing sensory deficits over the dorsolateral hand. Anatomically, this nerve becomes vulnerable as it emerges from deep to superficial by piercing the fascia between the tendons of which two muscles?


a)

Brachioradialis and Extensor Carpi Radialis Longus.

b)

Extensor Pollicis Longus and Extensor Pollicis Brevis.

c)

Abductor Pollicis Longus and Extensor Pollicis Brevis.

d)

 Flexor Carpi Radialis and Palmaris Longus.


20.

A 28-year-old male is brought to the emergency department following a motorcycle accident where his knee forcefully struck the dashboard, resulting in a posterior dislocation. Following closed reduction, the foot is cool and pale, with non-palpable dorsalis pedis and posterior tibial pulses. An emergent angiogram is planned. Which arterial structure is most likely compromised at its point of bifurcation?


a)

Popliteal artery, bifurcating into the anterior and posterior tibial arteries

b)

Femoral artery, transitioning at the adductor hiatus to give rise to genicular branches

c)

Profunda femoris artery, just distal to its origin from the common femoral artery

d)

External iliac artery, immediately proximal to the inguinal ligament