Part III. Indicate your understanding (characteristics, importance, function, relationships, boundaries and/or contents) of the following. Answer in the space provided. (20 pts)

1.Quandrangular space: Boundaries (6), contents, and significance. (4 pts)

2.Suboccipital triangle: Boundaries (5), contents, and significance. (4 pts)

3.Anatomical snuffbox: Boundaries (6), contents, and significance. (4 pts)

4.Triangular interval: Boundaries (5), contents, and significance. (4 pts)

5.Ulnar groove (of the ulna): Immediate relationships and significance. (4 pts)

Part IV. Answer in the space provided (including the back of the page or the additional pages for each question). (36 pts)

1. A 36 y.o.f. comes to your office with complaints of severe low back pain and episodes of urinary incontinence. She is 22 weeks gestation and had developed low back pain over the last few weeks. Concerned about exposing her fetus to analgesics she sought treatment from an alternative health provider. Since then the pain has been severe, constant, and it to the point that she is having difficulty walking. On exam, she is in obvious distress. Her pelvic exam displayed poor rectal sphincter tone and “saddle anesthesia.” Review the anatomy of the spinal canal. Include boundaries, bones, articulations, ligaments, stability, spaces, contents, vascularization, relationships, and lymphatic drainage. (12 pts)

2. A 55 y.o. female comes to your office with persistent right shoulder pain. She states she had begun a weight-training program recently. After increasing her weight on the military press she noted the next morning that her shoulder was quite painful. She felt she may have slept on it wrong but it has not been improving and she is now having difficulty raising her arm above her head. On physical exam, her "oil can" test is positive on the right side. She has difficulty abducting her right arm above her shoulder. She cannot hold her right arm up when you apply resistance during abduction. Review the anatomy of the rotator cuff. Include bones, muscles, movements, vascularization, innervation, relationships, and lymphatic drainage. (12 pts).

3. A 56 y.o. female presents with complaints of "numb hands" in the morning. She states her hands are numb when she first awakens and will resolve after she shakes her hands for a few seconds. She has awakened, occasionally at night with pain in her hands that, again, improves soon after she awakens and rubs them. Physical exam displays no neurovascular compromise in her upper extremities. There is no thenar or hypothenar atrophy. Her Phalen's and Tinnel's tests are positive. Review the anatomy of the carpal tunnel. Include bones, ligaments, contents, relationships, nerve injury, and lymphatic drainage. (12 pts)

Part III. Indicate your understanding (characteristics, importance, function, relationships, boundaries and/or contents) of the following. Answer in the space provided. (30 pts)

1.Elbow anastomosis. (6 pts)

2.Suboccipital triangle. (6 pts)

3.Posterior cord of the brachial plexus (6 pts)

4.Nerves of the palm of the hand (6 pts)

5.Flexor digitorum profundus (6 pts)

Part IV. Answer in the space provided (including the back of the page or the additional pages for each question). (36 pts)

1. You are a second year resident in orthopedics. At weekly conference, you are asked to: Review the anatomy of the scapular region. Include bones, muscles, movements, vascularization, innervation, relationships, and lymphatic drainage. (12 pts).

2. A 16-yr old male come to the emergency room after a diving accident in the community pool. In your weekly conference in neurosurgery, your attending requests that you present a: Review the anatomy of the spinal canal. Include boundaries, bones, articulations, ligaments, spaces, contents, vascularization, relationships, and lymphatic drainage. (12 pts)

3. A 33-yr old female come to the emergency room with a knife wound in the forearm. In discussing the case at rounds later in the week, you are asked to: Review the anatomy of the extensor region of the forearm and the dorsum of the hand. Include bones, articulations, ligaments, spaces, contents, muscles, movements, independence of movement, limitations of movement, vascularization, innervation, relationships, and lymphatic drainage. (12 pts)

Part III. Indicate your understanding of the following. Answer in the space provided. (18 pts)

1. Define the boundaries, contents, relationships, and importance of the cubital fossa. (6 pts)

2. Define the boundaries, contents, relationships, and importance of the anatomical snuff box. (6 pts)

3. Define the boundaries, contents, relationships, and importance of the carpal tunnel (6 pts)

Part IV. Answer in the space provided (including the back of the page or the additional pages for each question). (36 pts)

1. Review the anatomy and stability of the glenohumeral (shoulder) joint. Include bones, articular sufaces, cavities, capsules, contents, muscles, movements and limitations of movement, vascularization, innervation, relationships, and lymphatic drainage. Include mention of shoulder dislocations and nerve injury. (12 pts).

2. Review the anatomy and stability of the vertebral column and the spinal canal. Include bones, articulations, ligaments, spaces, contents, muscles (omit detailed accounts of transversospinalis muscles), movements and limitations of movement, vascularization, innervation, relationships, and lymphatic drainage. Include mention of the anterior displacement of the L5 vertebra relative to the S1 vertebra in nerve injuries. Include mention of the fascial layers penetrated during lumbar puncture (spinal tap). (12 pts)

3. Review the anatomy of the palm of the hand (omit the carpal tunnel). Include bones, articulations, ligaments, spaces, contents, muscles, movements, independence of movement, limitations of movement, vascularization, innervation, relationships, and lymphatic drainage. Include mention of compression injury to the hamate in nerve injuries. (12 pts)