Menu

5. Sports Medicine MCQs

Practice Set 297 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 5921

Topic: Shoulder & Hip Sports

A volleyball player presents with isolated weakness in external rotation of the shoulder but normal abduction initiation. MRI shows a paralabral cyst. Where is the cyst most likely located?

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

Correct Answer & Explanation

. Suprascapular notch

Explanation

Entrapment of the suprascapular nerve at the spinoglenoid notch affects only the motor branch to the infraspinatus, causing isolated external rotation weakness. Entrapment at the suprascapular notch would also affect the supraspinatus.

Question 5922

Topic: Knee Sports

The popliteofibular ligament is a primary stabilizer against external rotation of the tibia. It originates from the popliteus tendon and attaches to which anatomical structure?

. Gerdy's tubercle
. Fibular styloid
. Lateral tibial plateau
. Anterior fibular head
. Tibial tubercle

Correct Answer & Explanation

. Gerdy's tubercle

Explanation

The popliteofibular ligament arises from the popliteus musculotendinous junction and inserts on the posteromedial aspect of the fibular styloid. It is a crucial isometric component of the posterolateral corner of the knee.

Question 5923

Topic: Shoulder & Hip Sports

A 35-year-old male presents with posterior shoulder pain and numbness over the lateral deltoid. An MRI reveals a space-occupying lesion in the quadrilateral space. Which of the following structures form the superior and inferior borders of this space, respectively?

. Teres minor and Teres major
. Teres major and Teres minor
. Supraspinatus and Infraspinatus
. Teres minor and Latissimus dorsi
. Subscapularis and Teres major

Correct Answer & Explanation

. Teres minor and Teres major

Explanation

The quadrilateral space is bounded superiorly by the teres minor, inferiorly by the teres major, medially by the long head of the triceps, and laterally by the humeral shaft. It transmits the axillary nerve and posterior circumflex humeral vessels.

Question 5924

Topic: Shoulder & Hip Sports

During a Latarjet procedure for recurrent anterior shoulder instability, the conjoined tendon is retracted medially. The musculocutaneous nerve typically penetrates the coracobrachialis at what average distance distal to the tip of the coracoid process?

. 1 to 2 cm
. 3 to 8 cm
. 9 to 12 cm
. 13 to 15 cm
. 15 to 20 cm

Correct Answer & Explanation

. 1 to 2 cm

Explanation

The musculocutaneous nerve enters the medial aspect of the coracobrachialis roughly 3 to 8 cm (average 5 cm) distal to the tip of the coracoid process. Vigorous distal or medial retraction of the conjoined tendon can cause severe neuropraxia.

Question 5925

Topic: Shoulder & Hip Sports

A professional volleyball player presents with insidious onset, painless weakness of shoulder external rotation. MRI reveals a paralabral cyst located in the spinoglenoid notch. Which muscle exhibits denervation atrophy?

. Supraspinatus
. Infraspinatus
. Teres minor
. Subscapularis
. Deltoid

Correct Answer & Explanation

. Supraspinatus

Explanation

The suprascapular nerve innervates the supraspinatus before passing through the spinoglenoid notch to innervate the infraspinatus. Compression at the spinoglenoid notch spares the supraspinatus but causes isolated infraspinatus denervation.

Question 5926

Topic: Shoulder & Hip Sports

A 28-year-old volleyball player presents with isolated weakness in external rotation of the shoulder without any deficit in abduction. At which of the following anatomical locations is the involved nerve compression most likely occurring?

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

Correct Answer & Explanation

. Quadrangular space

Explanation

Compression of the suprascapular nerve at the spinoglenoid notch affects only the infraspinatus muscle, leading to isolated external rotation weakness. Compression at the suprascapular notch would affect both the supraspinatus (abduction) and infraspinatus (external rotation).

Question 5927

Topic: Knee Sports

During a posterolateral approach to the knee for ligamentous reconstruction, the surgeon identifies the structures of the posterolateral corner. What is the correct anatomical relationship of the popliteus tendon footprint on the lateral femoral condyle relative to the lateral collateral ligament (LCL) origin?

. Proximal and anterior
. Proximal and posterior
. Distal and anterior
. Distal and posterior
. Directly superficial

Correct Answer & Explanation

. Proximal and anterior

Explanation

On the lateral femoral condyle, the popliteus tendon inserts in the popliteal sulcus, which is located distal and anterior to the origin of the lateral collateral ligament. This relationship is critical during anatomical posterolateral corner (PLC) reconstructions.

Question 5928

Topic: 5. Sports Medicine
When comparing arthroscopic lavage and knee debridement to placebo in patients with chronic symptomatic osteoarthritis, what outcome has been demonstrated?
. Reliable and durable pain relief
. No significant benefit for chronic osteoarthritis
. Up to 75% pain relief for 2 months, then variable response
. Three-month measurable pain relief, followed by recurrence

Correct Answer & Explanation

. No significant benefit for chronic osteoarthritis

Explanation

Excluding a diagnosis of meniscal tear, loose body, or mechanical derangement, when knee osteoarthritis of indeterminate cause is treated with arthroscopic lavage and debridement, no discernable benefit has been found to offset the risk of surgery. Effects of arthroscopy have not been clinically significant in the vast majority of patient-oriented outcomes measures for pain and function at multiple time points between 1 week and 2 years after surgery.

Question 5929

Topic: Knee Sports

A 48-year-old woman had an 8-month history of spontaneous onset of left medial knee pain. She was otherwise healthy with an unremarkable past medical history. Prior to the onset of knee pain, she jogged,played tennis, and golfed regularly. She wished to remain active. Examination showed a fit woman witha BMI of 26, a stable left knee with full range of motion, and some mild medial joint line tenderness.Radiograph results were normal. An MRI scan showed diffuse grade 3 and a focal area of grade 4 chondromalacia on the medial femoral condyle. The medial meniscus had a degenerative signal but no tear. The remainder of the knee showed no additional pathology. What is the most appropriate initial treatment?

. Lateral heal wedge
. Low-impact aerobic exercises
. Glucosamine 1500 mg/day and chondroitin sulfate 800 mg/day
. Arthroscopic debridement and microfracture of the focal area of grade 4 chondromalacia to reduce risk for progression

Correct Answer & Explanation

. Lateral heal wedge

Explanation

This patient has early medial compartmental osteoarthritis of her knee. According to the 2008 AAOS Clinical Practice Guideline, Treatment of Osteoarthritis of the Knee (Non-Arthroplasty), there is Level 1 evidence and an โ€œAโ€ recommendation for the use of low-impact aerobic exercises. The guideline also has โ€œAโ€ recommendations with Level 1 evidence indicating that glucosamine and chondroitin should not be prescribed and that arthroscopic debridement not be performed in the absence of symptoms of a meniscal tear or loose body. Lateral heal wedge is not appropriate; the AAOS guideline provides a โ€œBโ€ recommendation with Level 2 evidence indicating that a lateral heal wedge not be prescribed.---

Question 5930

Topic: Knee Sports

The anterior cruciate ligament (ACL) consists of two bundles: the anteromedial (AM) and posterolateral (PL). When the knee is extended, which statement best describes the tension of these bundles?

. Both bundles are equally tense.
. Both bundles are lax.
. The PL bundle is tense and the AM bundle is lax.
. The AM bundle is tense and the PL bundle is lax.
. The PL bundle tension varies with rotation but not flexion/extension.

Correct Answer & Explanation

. Both bundles are equally tense.

Explanation

In knee extension, the posterolateral (PL) bundle is tense, whereas the anteromedial (AM) bundle is relatively lax. Conversely, in knee flexion, the AM bundle becomes tense and the PL bundle becomes lax. The PL bundle is primarily responsible for rotational stability, which is most critical near extension.

Question 5931

Topic: Knee Sports
In a patient with recurrent patellar instability, reconstruction of the MPFL is planned. Where is the normal anatomic femoral attachment of the MPFL located?
. Anterior to the medial epicondyle and distal to the adductor tubercle
. Posterior to the medial epicondyle and proximal to the adductor tubercle
. Between the adductor tubercle proximally and medial epicondyle distally, and posterior to both
. Just distal to the medial epicondyle
. Anterior to the adductor tubercle

Correct Answer & Explanation

. Between the adductor tubercle proximally and medial epicondyle distally, and posterior to both

Explanation

Schรถttle's point identifies the radiographic femoral footprint of the MPFL. Anatomically, it is located in a saddle between the adductor tubercle proximally and the medial epicondyle distally, and slightly posterior to both.

Question 5932

Topic: Knee Sports

A 45-year-old female presents with acute posterior knee pain and a 'pop' while squatting. MRI reveals a medial meniscus posterior root tear. Which of the following biomechanical consequences is most likely if left untreated?

. Decreased contact pressure in the medial compartment
. Loss of hoop stresses equivalent to a total meniscectomy
. Increased anterior tibial translation
. Varus thrust during swing phase
. Isolated patellofemoral osteoarthritis

Correct Answer & Explanation

. Decreased contact pressure in the medial compartment

Explanation

A meniscal root tear disrupts the circumferential hoop stresses of the meniscus, causing it to extrude. Biomechanically, this is equivalent to a total meniscectomy, leading to significantly increased contact pressures and rapid cartilage degeneration in the involved compartment.

Question 5933

Topic: Knee Sports

A patient undergoes reconstruction of the posterolateral corner (PLC) of the knee. The reconstruction includes the fibular collateral ligament (FCL), popliteus tendon (PT), and popliteofibular ligament (PFL). What is the primary restraint to varus opening at 30 degrees of knee flexion?

. Popliteus tendon
. Popliteofibular ligament
. Fibular collateral ligament
. Iliotibial band
. Biceps femoris tendon

Correct Answer & Explanation

. Popliteus tendon

Explanation

The fibular collateral ligament (FCL, or LCL) is the primary restraint to varus stress at all angles of knee flexion, but it is clinically tested and most isolated at 30 degrees of flexion. The PT and PFL are primary restraints to external rotation.

Question 5934

Topic: Shoulder & Hip Sports

An Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA) lesion differs from a classic Bankart lesion in which of the following ways?

. The ALPSA lesion involves an avulsion of the greater tuberosity.
. In an ALPSA lesion, the anterior labrum remains attached to the periosteum and displaces medially and inferiorly.
. A classic Bankart lesion includes a fracture of the anterior glenoid rim.
. ALPSA lesions only occur with posterior shoulder dislocations.
. ALPSA lesions do not require surgical repair due to their high spontaneous healing rate.

Correct Answer & Explanation

. The ALPSA lesion involves an avulsion of the greater tuberosity.

Explanation

An ALPSA lesion involves the anterior labrum being stripped from the glenoid margin but remaining attached to the intact periosteum of the scapula. It typically rolls medially and inferiorly down the glenoid neck. A classic Bankart lesion is a complete avulsion of the labrum and capsule without intact periosteum.

Question 5935

Topic: General Sports & Tendon

A water skier sustains a forced hyperflexion injury of the hip with an extended knee. MRI shows a complete proximal hamstring avulsion with 4 cm of retraction. Which of the following nerves is at greatest risk of injury during surgical repair?

. Superior gluteal nerve
. Inferior gluteal nerve
. Sciatic nerve
. Pudendal nerve
. Obturator nerve

Correct Answer & Explanation

. Superior gluteal nerve

Explanation

The sciatic nerve lies immediately lateral to the ischial tuberosity and the proximal hamstring origin. It is at significant risk of injury or tethering during repair of a retracted proximal hamstring avulsion.

Question 5936

Topic: Knee Sports

In a 14-year-old male with an osteochondritis dissecans (OCD) lesion of the knee, which radiographic location is most classic for this condition?

. Lateral aspect of the medial femoral condyle
. Medial aspect of the medial femoral condyle
. Medial aspect of the lateral femoral condyle
. Central trochlea
. Inferior pole of the patella

Correct Answer & Explanation

. Lateral aspect of the medial femoral condyle

Explanation

The classic and most common location for an OCD lesion of the knee is the lateral aspect of the medial femoral condyle (LAME - Lateral Aspect Medial Epicondyle/condyle).

Question 5937

Topic: Shoulder & Hip Sports

A 22-year-old hockey player presents with groin pain worsened by hip flexion and internal rotation. Radiographs reveal a cam-type deformity. What anatomical location on the proximal femur is most commonly associated with a cam lesion?

. Anteromedial head-neck junction
. Anterolateral head-neck junction
. Posteromedial head-neck junction
. Posterolateral head-neck junction
. Greater trochanter

Correct Answer & Explanation

. Anteromedial head-neck junction

Explanation

Cam impingement is typically caused by an aspherical femoral head with decreased offset, most commonly located at the anterolateral head-neck junction. This causes abutment against the anterosuperior acetabular rim during flexion and internal rotation.

Question 5938

Topic: Shoulder & Hip Sports
During arthroscopic evaluation of a shoulder, the surgeon identifies a tear of the superior third of the subscapularis tendon. According to the Fox/Romeo classification, what type of tear does this represent?
. Type I
. Type II
. Type III
. Type IV
. Type V

Correct Answer & Explanation

. Type II

Explanation

In the Fox/Romeo classification of subscapularis tears: Type I is a partial thickness tear, Type II is a full-thickness tear of the upper 25% (or upper third), Type III is a full-thickness tear of the upper 50%, Type IV is a full-thickness tear involving the entire tendon with the humeral head centered, and Type V is a complete tear with anterior subluxation of the humeral head.

Question 5939

Topic: Knee Sports
A patient sustains a KD-III knee dislocation (ACL, PCL, and PMC/MCL torn, PLC intact). Following acute reduction, vascular examination reveals diminished distal pulses. An ABI is calculated at 0.7. What is the most appropriate next step in management?
. Observation and repeat ABI in 4 hours
. CT angiography
. Immediate exploration by vascular surgery
. Application of a spanning external fixator
. Emergent MRI of the knee

Correct Answer & Explanation

. CT angiography

Explanation

In the setting of a knee dislocation, an Ankle-Brachial Index (ABI) less than 0.9 is highly suspicious for a vascular injury (specifically the popliteal artery). The next best step is a CT angiogram or standard angiogram to delineate the injury, unless the limb is frankly ischemic with hard signs (absent pulses, expanding hematoma, pulsatile bleeding), which would warrant immediate surgical exploration.

Question 5940

Topic: Shoulder & Hip Sports

The supraspinatus and infraspinatus tendons insert on the greater tuberosity. Which of the following accurately describes the anatomy of the supraspinatus footprint?

. It is broad anteriorly and tapers posteriorly, inserting on the superior facet.
. It is broad posteriorly and tapers anteriorly, inserting on the middle facet.
. It inserts primarily on the lesser tuberosity.
. It has a larger footprint area than the infraspinatus.
. It inserts exclusively on the inferior facet of the greater tuberosity.

Correct Answer & Explanation

. It is broad anteriorly and tapers posteriorly, inserting on the superior facet.

Explanation

The supraspinatus tendon footprint is described as triangular, being broader anteriorly and tapering posteriorly, and inserts on the superior facet of the greater tuberosity. The infraspinatus has a much larger footprint overall, covering the middle facet and sweeping anteriorly to cover part of the superior facet.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page