1. General Principles & Basic Science MCQs

A patient presents with weakness in flexing the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. Which anomalous structure is most commonly responsible for compressing the nerve involved?

During a Kocher-Langenbeck (posterior) approach to the acetabulum, identifying the sciatic nerve is essential. The nerve classically exits the greater sciatic foramen in what relation to the short external rotators?

During placement of an S1 iliosacral screw for a displaced sacral fracture, an anterior extraosseous screw trajectory risks injuring which neural structure passing over the sacral ala?

Which type of medial collateral ligament (MCL) tear has the lowest intrinsic healing potential and most frequently requires surgical repair if conservative management fails?

A 29-year-old runner presents with a palpable, firm mass along the lateral joint line of the knee. MRI reveals a multiloculated parameniscal cyst. This finding is most strongly associated with which type of meniscal tear?

A 10-year-old girl presents with painless snapping in her lateral knee. MRI reveals a complete discoid lateral meniscus without any evidence of tearing. What is the most appropriate management for this patient?

The posterior oblique ligament (POL) is a key static stabilizer of the posteromedial corner of the knee. The POL is most effective at resisting valgus stress and internal tibial rotation at what degree of knee flexion?

A 40-year-old male undergoes a subtotal medial meniscectomy for an irreparable bucket-handle tear. Biomechanically, the loss of the medial meniscus primarily leads to which of the following alterations in knee joint contact mechanics?

During a traumatic knee dislocation, the popliteal artery is exceptionally vulnerable to traction injury due to its rigid tethering within the popliteal fossa. Proximally, it is tethered by the adductor hiatus. Distally, the artery is tightly anchored by which anatomical structure?

A 30-year-old skier sustains an acute grade III medial collateral ligament (MCL) tear at its tibial insertion. Which of the following factors is most strongly associated with failure of non-operative management for this specific injury pattern?

A 28-year-old skier sustains an isolated grade III medial collateral ligament (MCL) tear. MRI demonstrates an avulsion of the MCL from its distal tibial attachment with the torn end retracted superficial to the pes anserinus. What is the most appropriate treatment?

In performing an arthroscopic repair of a Bankart lesion, the surgeon places suture anchors at the 3, 4, and 5 o'clock positions on the glenoid (in a right shoulder). Which nerve is most at risk if the drill penetrates the anteroinferior glenoid neck too deeply?

A 24-year-old skier sustains an isolated Grade III injury to the medial collateral ligament (MCL). Magnetic resonance imaging reveals an avulsion of the MCL from its tibial insertion with the distal end flipped superficial to the pes anserinus. What is the most appropriate management?

An 18-year-old football player has intense pain and is unable to bear weight on the right knee after being tackled from the front. A posterior knee dislocation is reduced on the field. Because the game took place in a remote location, the patient is not examined in the emergency department until 5 hours after the injury. Examination now shows a grossly swollen knee with moderate ischemia in the lower leg. Posterior tibial and dorsalis pedis pulses are diminished. The best course of action should be to

A 45-year-old woman reports an acute pop in the back of her knee while squatting. MRI reveals a medial meniscus posterior root tear with 3 mm of extrusion. Which of the following biomechanical changes occurs in the knee as a result of this injury?

A 28-year-old competitive weightlifter feels a tearing sensation in his anterior chest while performing a heavy bench press. Examination reveals bruising and loss of the anterior axillary fold. If surgical repair is pursued, the sternal head of the pectoralis major should be reattached in which anatomical relationship to the clavicular head?

A 45-year-old active male feels a 'pop' in the posterior aspect of his knee while performing a deep squat. Subsequent MRI reveals a complete tear of the medial meniscus posterior root. Biomechanically, if left untreated, this injury is most equivalent to which of the following?

A 30-year-old competitive weightlifter feels a tearing sensation in his anterior chest wall while performing a heavy bench press. Examination shows significant axillary ecchymosis and loss of the anterior axillary fold contour. If surgical repair is indicated, which anatomical portion of the pectoralis major tendon is most commonly ruptured in this scenario?

A 45-year-old recreational tennis player feels a sudden "pop" in the posterior aspect of her knee while lunging. MRI reveals a medial meniscus posterior root tear with 4 mm of meniscal extrusion. Which of the following biomechanical consequences is most directly associated with this specific injury?

A 32-year-old competitive weightlifter feels a sharp tear in his anterior chest wall while bench pressing. Examination reveals loss of the anterior axillary fold and ecchymosis. If surgical repair is planned, where is the precise anatomic insertion of the torn structure?