5. Sports Medicine MCQs

A surgeon is performing an open posterior stabilization for recurrent posterior shoulder instability. The classic posterior approach to the shoulder utilizes an internervous plane between which of the following two muscles?

During the physical examination of a 19-year-old male with suspected posterior shoulder instability, the examiner places the patient's arm in 90 degrees of abduction and internal rotation. The examiner then applies an axial load to the humerus while horizontally adducting the arm. A sudden clunk is felt as the humeral head subluxates posteriorly. As the arm is returned to the starting position, a second clunk is felt. This clinical test is known as the:

A 28-year-old male presents to the clinic with a history of recurrent posterior shoulder subluxations. To best evaluate for the presence of a reverse Hill-Sachs lesion on plain radiography, which of the following views is most appropriate?

A 22-year-old collegiate offensive lineman presents with a history of recurrent posterior shoulder instability. He has not had any frank dislocations but experiences pain and a sensation of subluxation when his arm is forward flexed, adducted, and internally rotated during blocking maneuvers. He is prescribed a comprehensive physical therapy program. Which of the following muscles should be the primary focus of strengthening to dynamically stabilize the glenohumeral joint against posterior translation?

A 19-year-old male weightlifter complains of vague posterior shoulder pain that worsens during the descent phase of the bench press. You suspect underlying posterior shoulder instability and a possible labral tear. Which of the following physical examination maneuvers is most specific for detecting a posteroinferior labral tear?

A 40-year-old male presents with a locked posterior shoulder dislocation that occurred 3 weeks ago following an electrical shock. Computed tomography (CT) imaging reveals an anteromedial humeral head defect involving 35% of the articular surface. Which of the following is the most appropriate surgical management to prevent recurrent instability?

A surgeon is performing an open posterior bone block procedure for a patient with recurrent posterior shoulder instability and significant posterior glenoid bone loss. The surgical approach involves an incision over the posterior shoulder. To safely access the posterior joint capsule, the surgeon must develop an internervous plane. Which of the following describes the correct internervous plane for the classic posterior approach to the shoulder?

A physical therapist is designing a rehabilitation protocol for a patient with posterior shoulder instability. The protocol heavily focuses on the infraspinatus muscle. In addition to providing external rotation, what is the primary biomechanical function of the infraspinatus during active shoulder elevation?

Posterior shoulder instability is relatively uncommon compared to anterior instability, accounting for roughly 2-10% of all shoulder instabilities. Which of the following patient populations has the highest risk for developing recurrent microtraumatic posterior shoulder instability?

A 24-year-old offensive lineman presents with recurrent posterior shoulder instability. He is undergoing a nonoperative rehabilitation program. Which of the following muscles acts as the primary dynamic posterior stabilizer of the glenohumeral joint and should be the primary focus of his strengthening program?

A 32-year-old male presents to the emergency department with severe right shoulder pain and an inability to externally rotate his arm after a generalized tonic-clonic seizure. Radiographs reveal a posterior shoulder dislocation. Which of the following best explains the mechanism of this specific injury pattern during a seizure?

A 21-year-old collegiate weightlifter complains of deep posterior shoulder pain with bench pressing. On examination, the patient is seated with the arm abducted to 90 degrees and internally rotated. The examiner applies an axial load to the humerus while horizontally adducting the arm, which produces a sudden clunk and pain. Which of the following is the most likely diagnosis?

A 28-year-old male presents with recurrent posterior shoulder instability. Magnetic resonance arthrography (MRA) demonstrates an incomplete and concealed avulsion of the posteroinferior labrum. The articular cartilage is intact, and there is no retroversion of the glenoid. Which of the following eponyms best describes this lesion?

A 26-year-old male requires an open posterior stabilization for refractory posterior shoulder instability. The surgeon utilizes a classic posterior approach to the shoulder. Which of the following describes the correct internervous plane utilized in this approach?

A 40-year-old male presents with a locked posterior shoulder dislocation that occurred 3 weeks ago. A CT scan reveals an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 35% of the articular surface. Which of the following is the most appropriate surgical management for this bony defect?

The primary muscle targeted in the conservative management of recurrent posterior shoulder instability is innervated by a nerve that passes through which of the following anatomic structures?

A 19-year-old collegiate swimmer is diagnosed with recurrent posterior shoulder subluxation. She is prescribed a physical therapy program. In addition to strengthening the infraspinatus and posterior deltoid, she is advised to avoid positions that place the posterior capsule under maximal stress. Which of the following positions should she avoid?

A 22-year-old male with recurrent posterior shoulder instability undergoes advanced imaging. Which of the following anatomic variants of the glenoid is most strongly associated with an increased risk of posterior shoulder instability?