A 34-year-old female presents to the emergency room after

falling in the bathroom. She complains of wrist pain and

numbness in her right palm. Based on her symptoms. you
suspect that she has dislocated the lunate bone in the wrist.
Identify the lunate bone on the X-ray below.
a) A
b) B
c) C
d) D
e) E
A 53-year-old Caucasian male presents to your office with a
dull ache in his shoulder that interferes with his sleep. Local
tenderness is present just below the acromion. Active
abduction of the right arm into an overhead position is
accompanied by severe pain. A tendon of which of the
following muscles is most likely inflamed in this patient?
a) Biceps brachii
b) Supraspinatus
c) Levator scapulae
d) Serratus anterior
e) Deltoid

An 11-year-old boy presents to the ER after a basketball injury
caused acute right shoulder pain. Imaging studies suggest
clavicular dislocation at the acromioclavicular joint. Which of
the following acts to prevent the dislocation described in this
patient?
a) Sternoclavicular ligament
b) Costoclavicular ligament
c) Acromioclavicular ligament
d) Coracoclavicular ligament
e) Levator scapulae muscle
A 46-year-old gardener presents to your office with knee pain. He
reports that he spends hours on his knees several times per week while
gardening. Which of the following bursae do you most expect to be
affected in this patient?
a) Suprapatellar bursa
b) Prepatellar bursa
c) Anserine bursa
d) Semimembranous (popliteal) bursa
e) Gastrocnemius bursa

A 53-year-old male complains of a strange feeling in his right hand.
On physical examination, there is loss of sensation over the 5th digit.
Which of the following nerves has most likely been injured?
a) Ulnar
b) Median
c) Radial
d) Musculocutaneous
e) Axillary

A 45-year-old Caucasian female presents to your office with numbness
of the right palm. Alter taking a detailed history and doing a physical
examination you suspect a median nerve lesion at the wrist. Before
reaching the wrist the median nerve courses between the:
a) Biceps and coracobrachialis muscles
b) Flexor carpi ulnaris and flexor digitorum profundus
c) Flexor digitorum superficialis and flexor digitorum profundus
d) Olecranon and the medial epicondyle of the humerus
e) Supinator muscle and the head of the radius

A patient presents to the emergency room with weak wrist extension.
On physical examination, sensation to the arm is intact. The affected
nerve was most likely injured at which of the following locations?
a) Carpal tunnel
b) Hook of the hamate
c) Surgical neck of the humerus
d) Head of the radius
e) Coracobrachialis

A 52-year-old golfer presents to your office with right shoulder pain
that has started to interfere with his daily activities, such as getting
dressed. Imaging studies suggest calcification of the supraspinatus
tendon. Which of the following is most likely to provoke pain in this
patient?
a) Flexion of the humerus
b) Extension of the humerus
c) Adduction of the humerus
d) Abduction of the humerus
e) Medial rotation of the humerus

A 24-year-old male complains of clumsiness of his right arm. The
patient is asked to face a wall and push against it with both hands.
Abnormal prominence of the right inferior scapular angle is observed
during the maneuver. Which of the following muscles is most likely
denervated in this patient?
a) Serratus anterior
b) Latissimus dorsi
c) Deltoid
d) Rhomboid major
e) Teres major

A 34-year-old male presents to the emergency room complaining of
severe right shoulder pain after falling from a tree. X-ray reveals a
fracture in the middle third of the right clavicle. The medial end of the
fractured clavicle is displaced upward due to traction by the:
a) Rhomboid muscles
b) Sternocleidomastoid muscle
c) Pectoralis minor muscle
d) Serratus anterior muscle
e) Subclavius muscle
f) Sternoclavicular ligaments

A young athlete presents to your office after sustaining an injury to the
right upper extremity. Physical examination reveals weak right forearm
flexion and an absent biceps reflex. Given these findings, sensation loss
in which of the following areas is most likely to be found in this patient?
a) Posterior arm
b) Posterior forearm
c) Lateral forearm
d) Medial forearm
e) Thenar eminence

A 56-year-old male with advanced bladder carcinoma suffers from
compression of a nerve that passes through the obturator foramen.
Which of the following functions would be most affected in this
patient?
a) Abduction of the thigh
b) Adduction of the thigh
c) Flexion of the thigh
d) Extension of the thigh
e) Extension of the leg

A 54 year-old alcoholic who has been sober for 6 months falls of the
wagon and imbibes a large amount of isopropyl alcohol. After an unknown
period of time she is found by her neighbor and brought into the emergency
room. The patient eventually arouses but is troubled by a persistent right
foot drop. Prolonged compression of what nerve most likely accounts for her
symptoms?
a) Common peroneal
b) Femoral
c) Tibial
d) Radial
e) Pudendal
f) Lateral sural cutaneous

A patient presents to your office with right leg numbness. When he
walks, you notice that he lifts his right foot higher than he does his left,
and that his right foot slaps to the ground with each step. On
neurologic exam, you also ascertain that he is unable to evert the right
foot. Which of the following nerves has most likely been injured?
a) Tibial
b) Common peroneal
c) Superficial peroneal
d) Sural
e) Obturator

A 34-year-old male has difficulty walking after sustaining a traumatic
injury to his right leg. Physical examination reveals a right foot that is
dorsiflexed and everted. The patient is unable to stand on his tiptoes.
What is the most likely area of sensory loss in this patient?
a) Anterior thigh
b) Medial leg
c) Medial foot
d) Dorsal foot
e) Plantar foot

A 43-year-old Caucasian female presents to your office with back pain after
dragging a heavy box. She describes pain in the right posterior thigh and
posterior calf shooting down to the foot. Physical examination reveals
symmetric knee reflexes, but the ankle jerk reflex is slightly diminished on
the right. Which of the following nerve roots is most likely affected in this
patient?
a) L2
b) L3
c) L4
d) L5
e) S1

A 23-year-old female is examined by an obstetrician in the delivery
room. Starling intravaginally, he injects lidocaine solution near the tip
of the ischial spine. Which of the following nerves is most likely blocked
by the injection?
a) Genitofemoral
b) Iliohypogastric
c) Lateral femoral cutaneous
d) Obturator
e) Pudendal
f) Inferior gluteal

A 43-year-old male presents to your office with difficulty walking. On
gait examination you note that he leans to the right side while walking.
When he is asked to stand on his left foot, his right hip tilts significantly
downward. Which of the following nerves is most likely injured in this
patient?
a) Superior gluteal
b) Inferior gluteal
c) Obturator
d) Femoral
e) Sciatic

A 17-year-old football player comes to the ER hopping on his right foot.
An X-ray of the left leg shows a fracture of the neck of the fibula. Which
of the following findings do you most expect on physical examination?
a) Loss of plantarflexion of the left foot
b) Weakened inversion of the left foot
c) Loss of sensation on the sole of the left foot
d) Loss of sensation on the medial aspect of the left leg
e) Loss of sensation on the dorsum of the left foot
A 7-year-old male has a right leg cast alter a bicycle accident. After
wearing the cast for some time he complains of pain and numbness of
the dorsum of his right foot and cannot dorsiflex his right ankle. Which
of the following is the most likely site of nerve compression in this
patient?
a) Popliteal fossa
b) Fibular head
c) Lateral compartment of the leg
d) Anterior compartment of the leg
e) Medial malleolus

A 53-year-old Caucasian male comes to the ER with severe low back
pain of sudden onset. Pinprick in the perianal area does not cause rapid
contraction of the anal sphincter in this patient. This finding indicates
involvement of which of the following nerve roots?
a) T12
b) L2
c) L4
d) L5
e) S1
f) S4

A 43-year-old male received a deep intramuscular injection
two days ago and now presents with difficulty walking. You
note that his right hip drops every time he raises his right foot.
At which location did this patient most likely receive his
injection?
a) Superomedial quadrant of the buttock
b) Superolateral quadrant of the buttock
c) Inferomedial quadrant of the buttock
d) Inferolateral quadrant of the buttock
e) Posterior thigh