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5. Sports Medicine MCQs

Practice Set 229 of 360

This practice set contains high-yield board review questions covering key concepts in 5. Sports Medicine. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 4561

Topic: Shoulder & Hip Sports

A patient undergoes arthroscopic shoulder repair for a superior labrum anterior-posterior (SLAP) tear. Which structure constitutes the primary anatomical landmark for the superior labrum and provides an anchor for the long head of the biceps tendon?

. Glenoid rim
. Supraglenoid tubercle
. Coracoid process
. Infraglenoid tubercle
. Greater tuberosity

Correct Answer & Explanation

. Glenoid rim

Explanation

The superior aspect of the glenoid labrum, where SLAP tears occur, is intimately associated with the origin of the long head of the biceps brachii tendon. The biceps tendon typically originates from the supraglenoid tubercle and then blends into the superior labrum. The supraglenoid tubercle is thus the primary anatomical landmark for the superior labrum and the biceps anchor. The glenoid rim is the periphery of the socket. The coracoid process is a separate bony projection. The infraglenoid tubercle is the origin for the long head of the triceps. The greater tuberosity is for rotator cuff insertions.

Question 4562

Topic: Shoulder & Hip Sports

A patient presents with shoulder pain and weakness, particularly with external rotation. MRI reveals a tear in the teres minor muscle. The teres minor is innervated by a branch of which nerve, as it passes through a specific anatomical space?

. Suprascapular nerve
. Upper subscapular nerve
. Lower subscapular nerve
. Axillary nerve
. Musculocutaneous nerve

Correct Answer & Explanation

. Suprascapular nerve

Explanation

The teres minor muscle is one of the four rotator cuff muscles and is primarily involved in external rotation and adduction of the shoulder. It is innervated by a branch of the axillary nerve. The axillary nerve also innervates the deltoid muscle and provides sensory innervation to the 'regimental badge' area. It passes through the quadrangular space along with the posterior circumflex humeral artery. The suprascapular nerve innervates supraspinatus and infraspinatus. Upper and lower subscapular nerves innervate the subscapularis and teres major respectively. Musculocutaneous nerve innervates biceps, coracobrachialis, and brachialis.

Question 4563

Topic: Knee Sports

Regarding the anatomy of the knee, which structure forms the most posterior boundary of the intercondylar notch of the femur?

. Anterior cruciate ligament (ACL) insertion
. Posterior cruciate ligament (PCL) insertion
. Medial femoral condyle
. Lateral femoral condyle
. Blumensaat's line

Correct Answer & Explanation

. Anterior cruciate ligament (ACL) insertion

Explanation

The intercondylar notch of the femur is bounded anteriorly by the intercondylar line (Blumensaat's line radiographically), laterally by the medial surface of the lateral femoral condyle, medially by the lateral surface of the medial femoral condyle, and posteriorly by the posterior cruciate ligament (PCL) insertion footprint. The PCL originates from the anterior part of the lateral surface of the medial femoral condyle, but its main bulk is posterior. The ACL inserts into the posteromedial aspect of the lateral femoral condyle, which is more anterior within the notch than the PCL insertion. Therefore, the PCL insertion forms the most posterior boundary.

Question 4564

Topic: 5. Sports Medicine

During arthroscopic examination of the knee, the surgeon identifies a structure located between the lateral meniscus and the posterior cruciate ligament (PCL). This structure, when present, can be a confounding factor in diagnosing meniscal pathology. Which ligament is being described?

. Ligament of Humphry (anterior meniscofemoral)
. Ligament of Wrisberg (posterior meniscofemoral)
. Coronary ligament
. Transverse meniscal ligament
. Popliteofibular ligament

Correct Answer & Explanation

. Ligament of Humphry (anterior meniscofemoral)

Explanation

The ligament of Wrisberg (posterior meniscofemoral ligament) is an accessory ligament of the lateral meniscus that runs posterior to the posterior cruciate ligament (PCL) to attach to the medial femoral condyle. The ligament of Humphry (anterior meniscofemoral ligament) runs anterior to the PCL. Both ligaments connect the posterior horn of the lateral meniscus to the medial femoral condyle and can be confused with bucket-handle meniscal tears or loose bodies during arthroscopy. The question specifically mentionsbetween the lateral meniscus and PCL, with Wrisberg being posterior to PCL, and Humphry anterior. The Wrisberg is often more prominent. Given the specific context, Wrisberg is a common confounding factor when seen posteriorly. Coronary ligaments connect the meniscus to the tibia. Transverse meniscal ligament connects anterior horns. Popliteofibular ligament connects the fibular head to the popliteus tendon.

Question 4565

Topic: Knee Sports

Which anatomical structure of the knee provides the primary static restraint to posterior translation of the tibia relative to the femur?

. Anterior cruciate ligament (ACL)
. Posterior cruciate ligament (PCL)
. Medial collateral ligament (MCL)
. Lateral collateral ligament (LCL)
. Menisci

Correct Answer & Explanation

. Anterior cruciate ligament (ACL)

Explanation

The posterior cruciate ligament (PCL) is the primary static restraint to posterior translation of the tibia relative to the femur. It is a strong ligament that originates from the lateral surface of the medial femoral condyle and inserts into the posterior intercondylar area of the tibia. The anterior cruciate ligament (ACL) primarily resists anterior translation. The MCL and LCL are collateral ligaments, providing valgus and varus stability, respectively. The menisci provide load distribution and secondary stability but are not the primary static restraint to AP translation.

Question 4566

Topic: 5. Sports Medicine

A 22-year-old athlete sustains a posterolateral corner (PLC) injury of the knee requiring surgical reconstruction. To correctly place the femoral tunnel for the fibular collateral ligament (FCL) anatomically, the surgeon must identify its footprint. Where is the femoral attachment of the FCL located in relation to the lateral epicondyle?

. Slightly proximal and posterior
. Slightly proximal and anterior
. Slightly distal and posterior
. Slightly distal and anterior
. Directly over the apex of the epicondyle

Correct Answer & Explanation

. Slightly proximal and posterior

Explanation

Anatomical studies by LaPrade et al. demonstrate that the femoral attachment of the fibular collateral ligament (FCL) is situated in a small depression located approximately 1.4 mm proximal and 3.1 mm posterior to the lateral epicondyle. The popliteus tendon attaches in a sulcus approximately 18.5 mm anterior and distal to the FCL attachment.

Question 4567

Topic: Knee Sports

During reconstruction of the posterolateral corner (PLC) of the knee, achieving anatomic femoral tunnel placement is critical for restoring biomechanics. Relative to the lateral epicondyle, where does the popliteus tendon insert on the femur?

. Proximal and posterior
. Proximal and anterior
. Distal and posterior
. Distal and anterior
. Directly over the lateral epicondyle

Correct Answer & Explanation

. Proximal and posterior

Explanation

The popliteus tendon inserts into the popliteal sulcus on the lateral femoral condyle. Anatomically, this insertion site is located approximately 18.5 mm anterior and distal to the fibular collateral ligament (FCL) origin, which lies slightly proximal and posterior to the lateral epicondyle.

Question 4568

Topic: Knee Sports

A 28-year-old female undergoes arthroscopic reconstruction of a torn posterior cruciate ligament (PCL). While preparing the tibial footprint, the surgeon must exercise extreme caution to avoid catastrophic vascular injury. At the level of the PCL tibial insertion, the popliteal artery is anatomically separated from the posterior joint capsule by which of the following?

. Popliteus muscle belly
. Oblique popliteal ligament
. A thin layer of fat only
. Medial head of the gastrocnemius
. Plantaris muscle tendon

Correct Answer & Explanation

. Popliteus muscle belly

Explanation

At the level of the PCL insertion on the posterior aspect of the proximal tibia (the PCL facet), the popliteal artery lies directly posterior to the joint capsule, separated only by a very thin layer of fat. This intimate relationship makes the popliteal artery highly vulnerable to injury during PCL reconstruction and posterior meniscal repair.

Question 4569

Topic: Shoulder & Hip Sports

A 28-year-old male undergoes surgical hip dislocation for the treatment of severe femoroacetabular impingement. To safely dislocate the hip while preserving the primary blood supply to the femoral head, a trochanteric flip osteotomy is performed. During the approach, the main branch of the medial femoral circumflex artery (MFCA) must be protected. This critical vessel is consistently found coursing between which two structures before it pierces the hip capsule?

. Piriformis and superior gemellus
. Obturator internus and inferior gemellus
. Quadratus femoris and obturator externus
. Pectineus and iliopsoas
. Gluteus medius and minimus

Correct Answer & Explanation

. Piriformis and superior gemellus

Explanation

The deep branch of the medial femoral circumflex artery (MFCA) is the primary blood supply to the femoral head. It courses anterior to the quadratus femoris and posterior to the obturator externus muscle. Recognizing this anatomic relationship is critical during posterior and surgical dislocation approaches to the hip to avoid iatrogenic avascular necrosis. The tendon of the obturator externus protects the deep branch of the MFCA during surgical dislocation.

Question 4570

Topic: Knee Sports

A 22-year-old collegiate football player sustains a multi-ligament knee injury. An MRI demonstrates a complete rupture of the posterolateral corner (PLC) structures. During surgical reconstruction, the surgeon isolates the fibular head to accurately recreate the insertions of the lateral collateral ligament (LCL) and the popliteofibular ligament (PFL). What is the normal anatomical relationship of the LCL footprint relative to the PFL footprint on the fibula?

. LCL inserts anterolateral to the PFL.
. LCL inserts posteromedial to the PFL.
. LCL inserts directly inferior to the PFL.
. LCL inserts anteromedial to the PFL.
. The LCL and PFL share an identical, conjoined footprint.

Correct Answer & Explanation

. LCL inserts anterolateral to the PFL.

Explanation

On the fibular head, the lateral collateral ligament (LCL) inserts on the anterolateral aspect. The popliteofibular ligament (PFL) inserts on the posteromedial aspect of the fibular styloid. Accurate recognition of these distinct footprints is essential for anatomical reconstruction of the posterolateral corner (PLC) of the knee.

Question 4571

Topic: Knee Sports

A 24-year-old professional soccer player sustains a multi-ligamentous knee injury, including a complete tear of the posterolateral corner (PLC). During surgical reconstruction, the surgeon must anatomically restore the femoral attachment of the fibular collateral ligament (FCL). What is the anatomical location of the FCL femoral footprint relative to the popliteus tendon footprint?

. Proximal and posterior
. Distal and anterior
. Proximal and anterior
. Distal and posterior
. Directly medial and distal

Correct Answer & Explanation

. Proximal and posterior

Explanation

On the lateral femoral condyle, the popliteus tendon inserts anteriorly and distally within the popliteal sulcus. The femoral footprint of the Fibular Collateral Ligament (FCL) is situated proximal and posterior to the popliteus tendon attachment (averaging 18.5 mm away). Proper identification of this relationship is critical for anatomical PLC reconstruction to restore proper biomechanics and avoid graft isometry mismatch.

Question 4572

Topic: Knee Sports

In the reconstruction of the posterolateral corner (PLC) of the knee, understanding precise anatomical insertions is crucial. The popliteofibular ligament, a primary static stabilizer against external rotation, originates from the popliteus musculotendinous junction and inserts onto which of the following areas?

. Anterior aspect of the lateral tibial condyle
. Anterolateral aspect of the fibular head
. Posteromedial aspect of the fibular styloid
. Lateral epicondyle of the femur
. Gerdy's tubercle

Correct Answer & Explanation

. Anterior aspect of the lateral tibial condyle

Explanation

The posterolateral corner (PLC) of the knee primarily consists of the lateral collateral ligament (LCL), popliteus tendon, and the popliteofibular ligament. The popliteofibular ligament is a critical stabilizer against posterior translation, varus angulation, and external rotation of the tibia. It originates from the popliteus complex and inserts anatomically on the posteromedial aspect of the fibular styloid (tip of the fibular head).

Question 4573

Topic: 5. Sports Medicine

A 28-year-old overhead athlete presents with insidious onset of posterior shoulder pain and weakness in external rotation. An MRI reveals isolated atrophy of the teres minor muscle, raising suspicion for neurovascular compression within the quadrilateral space. Which of the following correctly describes the anatomical borders of this space?

. Superior: Teres major; Inferior: Teres minor; Medial: Long head of triceps; Lateral: Humeral shaft
. Superior: Teres minor; Inferior: Teres major; Medial: Long head of triceps; Lateral: Surgical neck of the humerus
. Superior: Teres minor; Inferior: Teres major; Medial: Surgical neck of the humerus; Lateral: Long head of triceps
. Superior: Infraspinatus; Inferior: Teres minor; Medial: Lateral head of triceps; Lateral: Surgical neck of the humerus
. Superior: Subscapularis; Inferior: Teres major; Medial: Long head of triceps; Lateral: Coracobrachialis

Correct Answer & Explanation

. Superior: Teres major; Inferior: Teres minor; Medial: Long head of triceps; Lateral: Humeral shaft

Explanation

Quadrilateral space syndrome involves compression of the axillary nerve and posterior circumflex humeral artery. The borders of the quadrilateral space are the teres minor (superiorly), teres major (inferiorly), long head of the triceps (medially), and the surgical neck of the humerus (laterally). Compression here often leads to isolated teres minor atrophy, as the branch to the deltoid frequently escapes compression depending on the exact site of the lesion.

Question 4574

Topic: Knee Sports

During a reconstruction of the posterolateral corner (PLC) of the knee, the surgeon must identify the anatomic footprints of the structures involved. Where is the normal femoral attachment of the popliteus tendon located relative to the lateral collateral ligament (LCL) origin?

. Proximal and posterior
. Proximal and anterior
. Distal and anterior
. Distal and posterior
. Directly medial

Correct Answer & Explanation

. Proximal and posterior

Explanation

The femoral attachment of the popliteus tendon is located distal and anterior to the femoral attachment of the lateral collateral ligament (LCL) on the lateral femoral condyle. The popliteus attaches in the popliteal sulcus, whereas the LCL attaches slightly proximal and posterior to the lateral epicondyle.

Question 4575

Topic: Knee Sports

A 24-year-old football player sustains a multi-ligamentous knee injury including the posterolateral corner (PLC). Surgical reconstruction is planned. During dissection, the surgeon identifies the popliteofibular ligament. Which of the following best describes the anatomical origin and insertion of this critical structure?

. Originates from the lateral femoral epicondyle and inserts on the fibular styloid
. Originates from the popliteus musculotendinous junction and inserts on the posteromedial aspect of the fibular head
. Originates from the lateral meniscus and inserts on the fibular head
. Originates from the posterior tibia and inserts on the anterior fibular head
. Originates from the iliotibial band and inserts on the posterolateral tibia (Gerdy's tubercle)

Correct Answer & Explanation

. Originates from the lateral femoral epicondyle and inserts on the fibular styloid

Explanation

The popliteofibular ligament (PFL) is a key static stabilizer of the posterolateral corner of the knee, resisting posterior translation, varus angulation, and external rotation. It originates from the popliteus musculotendinous junction and courses distally and laterally to insert on the posteromedial aspect of the fibular head (fibular styloid). The lateral collateral ligament (LCL) originates from the lateral femoral epicondyle and inserts on the fibular head. Gerdy's tubercle is the insertion site for the iliotibial band.

Question 4576

Topic: Knee Sports

A 22-year-old athlete is undergoing surgical reconstruction of the posterolateral corner (PLC) of the knee. The surgeon is isolating the structures attaching to the fibula. What is the precise anatomical insertion of the popliteofibular ligament?

. Anterior aspect of the fibular head
. Posteromedial aspect of the fibular styloid process
. Anteromedial aspect of the fibular styloid process
. Lateral epicondyle of the femur
. Posterior horn of the lateral meniscus

Correct Answer & Explanation

. Anterior aspect of the fibular head

Explanation

The popliteofibular ligament (PFL) is a crucial static stabilizer of the posterolateral corner of the knee, resisting external rotation and posterior translation. It originates from the musculotendinous junction of the popliteus and inserts onto the posteromedial aspect of the fibular styloid process. The fibular collateral ligament (LCL) inserts slightly more anterior and lateral on the fibular head.

Question 4577

Topic: Shoulder & Hip Sports

A 28-year-old overhead athlete presents with chronic posterior shoulder pain. Physical examination reveals isolated weakness in external rotation with the arm at the side, but normal shoulder abduction strength. MRI demonstrates a paralabral cyst causing nerve compression. At which of the following anatomical locations is the cyst most likely situated?

. Suprascapular notch
. Quadrilateral space
. Triangular interval
. Spinoglenoid notch
. Spiral groove

Correct Answer & Explanation

. Suprascapular notch

Explanation

The patient has isolated weakness of the infraspinatus (external rotation) with sparing of the supraspinatus (abduction). The suprascapular nerve innervates both muscles but passes through two distinct notches. Compression at the suprascapular notch affects both the supraspinatus and infraspinatus. Compression at the spinoglenoid notch (distal to the supraspinatus motor branches) results in isolated denervation of the infraspinatus. Paralabral cysts associated with posterior SLAP tears frequently track to the spinoglenoid notch.

Question 4578

Topic: Shoulder & Hip Sports

A 28-year-old overhead athlete presents with poorly localized posterior shoulder pain and paresthesias over the lateral deltoid. MRI reveals isolated atrophy of the teres minor. Compression of the involved nerve typically occurs within a space bounded by which of the following anatomic structures?

. Teres minor (superior), teres major (inferior), long head of triceps (medial), humerus (lateral)
. Teres minor (superior), teres major (inferior), long head of triceps (lateral)
. Teres major (superior), lateral head of triceps (lateral), long head of triceps (medial)
. Subscapularis (anterior), supraspinatus (superior), infraspinatus (posterior)
. Coracoid (superior), pectoralis minor (anterior), upper ribs (medial)

Correct Answer & Explanation

. Teres minor (superior), teres major (inferior), long head of triceps (medial), humerus (lateral)

Explanation

The patient is presenting with Quadrilateral Space Syndrome, causing compression of the axillary nerve and posterior humeral circumflex artery. The axillary nerve innervates the teres minor and deltoid, and compression leads to teres minor atrophy (best seen on MRI) and lateral arm paresthesias. The quadrilateral space is bounded superiorly by the teres minor (or subscapularis anteriorly), inferiorly by the teres major, medially by the long head of the triceps, and laterally by the surgical neck of the humerus. The triangular space (Option B) contains the circumflex scapular artery. The triangular interval (Option C) contains the radial nerve and profunda brachii artery.

Question 4579

Topic: Shoulder & Hip Sports

During a Latarjet procedure for recurrent anterior shoulder instability, the conjoined tendon is identified and retracted medially to access the subscapularis. At what average distance distal to the tip of the coracoid process does the musculocutaneous nerve penetrate the coracobrachialis muscle, placing it at risk during vigorous distal or medial retraction?

. 1 to 3 cm
. 5 to 8 cm
. 10 to 12 cm
. 12 to 15 cm
. Greater than 15 cm

Correct Answer & Explanation

. 1 to 3 cm

Explanation

The musculocutaneous nerve typically enters the coracobrachialis muscle at an average distance of 5 to 8 cm (approx. 5.6 cm) distal to the tip of the coracoid process. Knowledge of this distance is critical during anterior shoulder surgery, such as the Latarjet procedure, to avoid neurapraxia or structural injury to the nerve during medial and distal retraction of the conjoined tendon.

Question 4580

Topic: Knee Sports

A 24-year-old professional soccer player sustains a posterolateral corner (PLC) injury of the knee. Surgical reconstruction is planned. During anatomical reconstruction of the PLC, precise tunnel placement on the lateral femoral condyle is critical. What is the correct anatomical relationship of the fibular collateral ligament (FCL) and the popliteus tendon (PT) femoral attachments?

. The PT attaches proximal and posterior to the FCL attachment.
. The PT attaches distal and anterior to the FCL attachment.
. The PT attaches directly posterior to the FCL attachment.
. The FCL attaches distal and anterior to the PT attachment.
. The FCL and PT share a conjoined origin on the lateral epicondyle.

Correct Answer & Explanation

. The PT attaches proximal and posterior to the FCL attachment.

Explanation

The femoral attachment of the popliteus tendon is located an average of 18.5 mm anterior and distal (inferior) to the fibular collateral ligament (FCL/LCL) attachment on the lateral femoral condyle. Recognizing this spatial relationship is essential for anatomic PLC reconstruction to restore proper knee kinematics and stability.

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