Vascular surgery: cervical rib: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Vascular surgery: cervical rib

Sample item

A young woman has wasting of the small hand muscles and numbness on the medial forearm, aggravated by carrying loads. X-ray shows a cervical rib. Which neural structure is most commonly compressed?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Lower trunk of the brachial plexus (C8 and T1)

Neurogenic thoracic outlet syndrome from a cervical rib or fibrous band compresses the lower trunk (C8, T1), leading to hand weakness and medial arm sensory loss. Arterial compression can cause poststenotic subclavian aneurysm and emboli. Treatment is first rib resection with band excision if symptoms warrant.

Option by option

  • A. Phrenic nerve

    The phrenic nerve is not involved.

  • B. Upper trunk of the brachial plexus

    The upper trunk is not in contact with the rib.

  • C. Lower trunk of the brachial plexus (C8 and T1) (correct)

    Correct. The lower trunk is draped over the rib.

  • D. Radial nerve in the spiral groove

    The radial nerve lies more distally.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Lower trunk of the brachial plexus (C8 and T1). Neurogenic thoracic outlet syndrome from a cervical rib or fibrous band compresses the lower trunk (C8, T1), leading to hand weakness and medial arm sensory loss.

Why is "Phrenic nerve" not the answer?

The phrenic nerve is not involved.

Why is "Upper trunk of the brachial plexus" not the answer?

The upper trunk is not in contact with the rib.

Why is "Radial nerve in the spiral groove" not the answer?

The radial nerve lies more distally.

What concept does this question test?

It tests Vascular surgery: cervical rib in General Surgery. Arterial compression can cause poststenotic subclavian aneurysm and emboli. Treatment is first rib resection with band excision if symptoms warrant.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vascular surgery: cervical rib?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.