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 5621
Topic: Shoulder & Hip Sports
A patient presents with posterior shoulder pain and selective weakness of external rotation. MRI reveals a large paralabral ganglion cyst isolated to the spinoglenoid notch. Which muscle will exhibit denervation changes?
Correct Answer & Explanation
. Infraspinatus
Explanation
Compression of the suprascapular nerve at the spinoglenoid notch affects only the terminal motor branch to the infraspinatus. Compression at the more proximal suprascapular notch would affect both the supraspinatus and infraspinatus.
Question 5622
Topic: Knee Sports
The meniscofemoral ligaments of the knee are anatomically associated with the posterior cruciate ligament (PCL). What is the specific anatomic course of the ligament of Wrisberg?
Correct Answer & Explanation
. It passes posterior to the PCL
Explanation
The ligament of Wrisberg passes posterior to the posterior cruciate ligament (PCL). The ligament of Humphry passes anterior to the PCL.
Question 5623
Topic: Knee Sports
The anterior cruciate ligament (ACL) consists of two distinct functional bundles. Which bundle provides the primary restraint to anterior tibial translation when the knee is in 90 degrees of flexion?
Correct Answer & Explanation
. Anteromedial bundle
Explanation
The anteromedial (AM) bundle of the ACL tightens in flexion, making it the primary restraint to anterior translation at 90 degrees. The posterolateral (PL) bundle is tightest in extension and provides rotational stability.
Question 5624
Topic: Shoulder & Hip Sports
The rotator interval is a triangular anatomical space in the anterior shoulder. Which of the following sets of structures is contained within this interval?
Correct Answer & Explanation
. Coracohumeral ligament and long head of the biceps tendon
Explanation
The rotator interval is bordered by the supraspinatus superiorly, subscapularis inferiorly, and the coracoid base medially. It contains the long head of the biceps tendon, the coracohumeral ligament, and the superior glenohumeral ligament.
Question 5625
Topic: Knee Sports
During surgical reconstruction of the posterolateral corner of the knee, a surgeon isolates the fibular collateral ligament (FCL). What is the anatomic relationship of the FCL femoral attachment relative to the popliteus tendon femoral attachment?
Correct Answer & Explanation
. Proximal and posterior
Explanation
On the lateral femoral epicondyle, the attachment of the fibular collateral ligament (FCL) is located proximal and posterior to the attachment of the popliteus tendon. Identifying this relationship is crucial for anatomic reconstruction of the posterolateral corner.
Question 5626
Topic: Shoulder & Hip Sports
A 28-year-old weightlifter presents with right shoulder pain and weakness in external rotation. An MRI shows an isolated cyst compressing the nerve in the quadrangular space. Which of the following muscles is most likely denervated?
Correct Answer & Explanation
. Teres minor
Explanation
The axillary nerve passes through the quadrangular space and innervates the deltoid and teres minor. Compression in this space leads to weakness in shoulder abduction and external rotation, along with teres minor denervation.
Question 5627
Topic: Knee Sports
A 22-year-old football player sustains a direct blow to the anteromedial tibia. Clinical examination reveals increased external tibial rotation at 30 degrees of knee flexion but symmetrical rotation at 90 degrees. Which of the following structures is the primary restraint to external tibial rotation at 30 degrees?
Correct Answer & Explanation
. Popliteofibular ligament
Explanation
The popliteofibular ligament (PFL) is a key component of the posterolateral corner. It acts as the primary restraint to external tibial rotation when the knee is flexed to 30 degrees.
Question 5628
Topic: Knee Sports
During a knee reconstruction for a multi-ligamentous injury, the surgeon isolates the primary stabilizer to external tibial rotation at 30 degrees of knee flexion. Which of the following structures is being evaluated?
Correct Answer & Explanation
. Popliteofibular ligament
Explanation
The popliteofibular ligament is a primary stabilizer to external tibial rotation. The fibular collateral ligament (LCL) is the primary restraint to varus stress.
Question 5629
Topic: Shoulder & Hip Sports
A 28-year-old professional volleyball player presents with progressive right shoulder weakness. Examination reveals normal shoulder abduction and internal rotation but weakness in external rotation. Atrophy is noted over the posterior scapula, but the supraspinatus fossa appears normal. Compression of the suprascapular nerve is most likely occurring at which location?
Correct Answer & Explanation
. Spinoglenoid notch
Explanation
Isolated weakness of the infraspinatus with normal supraspinatus function indicates suprascapular nerve compression at the spinoglenoid notch. Compression at the suprascapular notch affects both the supraspinatus and infraspinatus.
Question 5630
Topic: Shoulder & Hip Sports
In planning a surgical dislocation of the hip for femoroacetabular impingement, the surgeon must protect the primary blood supply to the femoral head. Which of the following represents the primary blood supply to the adult femoral head?
Correct Answer & Explanation
. Medial femoral circumflex artery
Explanation
The medial femoral circumflex artery (MFCA) provides the primary blood supply to the adult femoral head via its deep branch and lateral epiphyseal vessels. It must be carefully protected during posterior approaches and surgical dislocations.
Question 5631
Topic: 5. Sports Medicine
A 22-year-old athlete undergoes an arthroscopic medial meniscal repair. Healing is most favorable in the peripheral third of the meniscus. The vascular supply to this region is primarily derived from which of the following?
Correct Answer & Explanation
. Inferior genicular arteries
Explanation
The peripheral 10-30% of the meniscus is vascularized by the perimeniscal capillary plexus, which arises from the medial and lateral inferior genicular arteries. The central avascular portion relies on diffusion from synovial fluid.
Question 5632
Topic: Knee Sports
When evaluating a patient with a suspected posterolateral corner (PLC) knee injury, understanding the femoral attachments is crucial for reconstruction. Where does the fibular collateral ligament (FCL) attach on the lateral femoral condyle relative to the popliteus tendon insertion?
Correct Answer & Explanation
. Proximal and posterior
Explanation
The FCL originates on the lateral femoral condyle proximal and posterior to the popliteus tendon insertion. Recognizing this anatomic relationship is critical for ensuring isometric graft placement during PLC reconstruction.
Question 5633
Topic: Knee Sports
A surgeon is evaluating a patient with recurrent lateral patellar instability and plans to reconstruct the medial patellofemoral ligament (MPFL). Where is the anatomic femoral origin of the MPFL located?
Correct Answer & Explanation
. Between the medial epicondyle and the adductor tubercle
Explanation
The femoral footprint of the MPFL is located in a saddle-like depression situated between the medial epicondyle and the adductor tubercle. Accurate identification of this point (Schรถttle's point) is required to prevent non-isometric graft behavior.
Question 5634
Topic: Knee Sports
Which of the following accurately describes the anatomy and biomechanical properties of the medial meniscus compared to the lateral meniscus?
Correct Answer & Explanation
. It has firmer attachments to the joint capsule
Explanation
The medial meniscus is C-shaped, covers less articular surface area, and has firmer attachments to the deep medial collateral ligament and joint capsule. This decreased mobility makes it more prone to tearing than the O-shaped lateral meniscus.
Question 5635
Topic: Shoulder & Hip Sports
A surgeon is performing an arthroscopic rotator interval closure for shoulder instability. Which of the following structures form the superior and inferior borders of the rotator interval, respectively?
Correct Answer & Explanation
. Supraspinatus and subscapularis
Explanation
The rotator interval is an anatomical space in the anterosuperior shoulder bordered superiorly by the anterior margin of the supraspinatus and inferiorly by the superior margin of the subscapularis. It contains the long head of the biceps tendon and the coracohumeral ligament.
Question 5636
Topic: Knee Sports
A 22-year-old soccer player ruptures her anterior cruciate ligament (ACL). The ACL is composed of two primary bundles. In which position is the anteromedial (AM) bundle of the ACL most taut?
Correct Answer & Explanation
. 90 degrees of flexion
Explanation
The anteromedial (AM) bundle is most taut in flexion (optimally tested at 90 degrees with the anterior drawer test), whereas the posterolateral (PL) bundle is most taut in extension. They are named for their tibial footprint insertions.
Question 5637
Topic: Knee Sports
A 25-year-old professional rugby player undergoes posterolateral corner reconstruction of the knee. The surgeon identifies the popliteofibular ligament (PFL) as a critical structure to reconstruct for rotational stability. What is the correct anatomical origin and insertion of the native PFL?
Correct Answer & Explanation
. Popliteus musculotendinous junction to the posteromedial aspect of the fibular styloid
Explanation
The popliteofibular ligament (PFL) originates from the musculotendinous junction of the popliteus and inserts on the posteromedial aspect of the fibular styloid. It acts as a primary static stabilizer against external tibial rotation in the posterolateral corner of the knee.
Question 5638
Topic: 5. Sports Medicine
A 30-year-old overhead throwing athlete presents with vague posterior shoulder pain. An MRI reveals isolated atrophy of the teres minor. Compression of the axillary nerve within the quadrilateral space is suspected. What are the true anatomical borders of this space?
Correct Answer & Explanation
. Teres minor (superior), teres major (inferior), long head of triceps (medial), surgical neck of humerus (lateral)
Explanation
The quadrilateral space is bordered by the teres minor superiorly, the teres major inferiorly, the long head of the triceps medially, and the surgical neck of the humerus laterally. It transmits the axillary nerve and the posterior circumflex humeral artery.
Question 5639
Topic: Shoulder & Hip Sports
A 28-year-old elite volleyball player presents with painless weakness in shoulder external rotation. Clinical examination demonstrates isolated atrophy of the infraspinatus, with normal bulk and strength of the supraspinatus. Entrapment of the suprascapular nerve is most likely occurring at which anatomical location?
Correct Answer & Explanation
. Spinoglenoid notch
Explanation
The suprascapular nerve innervates the supraspinatus before passing through the spinoglenoid notch to innervate the infraspinatus. Entrapment at the spinoglenoid notch, often due to a paralabral cyst from a SLAP tear, causes isolated infraspinatus atrophy.
Question 5640
Topic: Shoulder & Hip Sports
An orthopedic surgeon is evaluating a volleyball player with an isolated suprascapular nerve entrapment at the spinoglenoid notch. Which of the following physical exam findings is most expected?
Correct Answer & Explanation
. Isolated weakness in external rotation
Explanation
Entrapment at the spinoglenoid notch affects the suprascapular nerve after it has already innervated the supraspinatus. Therefore, it causes isolated denervation and weakness of the infraspinatus (external rotation).
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