9. Shoulder and Elbow MCQs

During a deltopectoral approach to the shoulder, the cephalic vein is identified. Which of the following is the most appropriate management of the cephalic vein to preserve its primary venous drainage?

A patient presents with winging of the scapula and an inability to elevate the shoulder above 90 degrees following a diagnostic lymph node biopsy in the posterior cervical triangle. Injury to which of the following nerves is the most likely cause?

A patient exhibits marked lateral winging of the scapula following a lymph node biopsy in the posterior triangle of the neck. The patient struggles to abduct the shoulder past 90 degrees. Which nerve was most likely injured?

During a Bankart repair, the surgeon must address the essential capsulolabral lesion. Which of the following structures serves as the primary static restraint to anterior translation of the humeral head when the shoulder is positioned in 90 degrees of abduction and maximal external rotation?

During a standard deltopectoral approach to the shoulder, the cephalic vein is identified in the interval. To optimally preserve its venous drainage, what is the standard recommended handling of this structure?

A patient sustains an injury resulting in medial winging of the scapula. Which nerve is injured, and what are its correct nerve root origins?

A 22-year-old collegiate baseball pitcher presents with vague dominant shoulder pain. Examination reveals glenohumeral internal rotation of 20 degrees and external rotation of 125 degrees. Total arc of motion is symmetric to the non-throwing shoulder. Nonoperative management for this specific deficit should prioritize stretching of which anatomical structure?

A 28-year-old bodybuilder feels a tearing sensation in his anterior shoulder while performing a heavy bench press. Examination reveals a loss of the anterior axillary fold and weakness in internal rotation. If surgical repair is planned, the sternal head of the pectoralis major must be recognized to insert on the humerus at what position relative to the clavicular head?

A 22-year-old baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Examination shows 130 degrees of external rotation and 20 degrees of internal rotation. The contralateral non-dominant shoulder has 100 degrees of external rotation and 50 degrees of internal rotation. What is the most appropriate initial treatment?

A 65-year-old female presents with pseudoparalysis of the shoulder, severe glenohumeral osteoarthritis, and a massive, retracted, irreparable rotator cuff tear. Her deltoid function is completely intact. What is the most reliable surgical option to restore function and relieve pain?

A 60-year-old man undergoes arthroscopic evaluation for an irreparable rotator cuff tear and undergoes a biceps tenotomy. Compared to a biceps tenodesis, tenotomy is associated with a higher rate of which of the following?

A 72-year-old female presents with severe shoulder pseudoparalysis. Radiographs show advanced glenohumeral osteoarthritis with superior migration of the humeral head abutting the acromion. What is the most appropriate surgical intervention?

A 50-year-old female with poorly controlled diabetes presents with severe shoulder stiffness and night pain. Passive and active external rotation are equally and severely restricted. What is the primary pathophysiologic hallmark of her condition?

An 8-year-old boy is evaluated for a cosmetic deformity of his elbow three years after sustaining a supracondylar humerus fracture that was treated nonoperatively. He has full range of motion and normal neurology. What is the most common long-term deformity following this injury, and what is its primary functional consequence?

A 9-year-old boy healed from a supracondylar humerus fracture sustained at age 5 but developed a prominent cubitus varus deformity. Which of the following statements regarding cubitus varus following supracondylar humerus fractures is true?

A 7-year-old child presents with a Bado type I Monteggia fracture-dislocation (ulnar shaft fracture with anterior radial head dislocation). Closed reduction of the ulna is performed, but the radial head remains subluxated. What is the most critical technical factor to ensure stable reduction of the radial head?

A 5-year-old girl falls on her outstretched hand and sustains a displaced lateral condyle fracture of the humerus. Radiographs show 4 mm of displacement. If this fracture progresses to a symptomatic nonunion, which of the following long-term complications is most characteristic?

A 45-year-old woman falls on an outstretched hand and sustains an elbow injury. Imaging confirms a posterior elbow dislocation, a type II coronoid fracture, and a comminuted radial head fracture (the "terrible triad"). During surgical reconstruction, what is the standard recommended sequence of repair?

During surgical reconstruction for a 'terrible triad' injury of the elbow, what is the recommended sequence of repair to best restore elbow stability?

A 45-year-old man presents to the emergency department with severe left shoulder pain following a generalized tonic-clonic seizure. On examination, his arm is locked in internal rotation, and he has 0 degrees of external rotation. Radiographs demonstrate a 'lightbulb' sign on the AP view. A CT scan reveals an anteromedial humeral head impaction fracture involving 30% of the articular surface. Which of the following is the most appropriate surgical treatment?