9. Shoulder and Elbow MCQs

A 24-year-old male sustains an anterior shoulder dislocation during a rugby match. After successful closed reduction, he is noted to have weakness in shoulder abduction and decreased sensation over the lateral aspect of his shoulder. Injury to which of the following nerves is the most likely cause of these findings?

In the standard deltopectoral approach to the shoulder, the cephalic vein is identified within the interval. To minimize bleeding from venous tributaries, the cephalic vein is ideally retracted in which direction?

Posterolateral rotatory instability (PLRI) of the elbow commonly occurs due to insufficiency of the lateral ulnar collateral ligament (LUCL). What is the specific distal insertion site of the LUCL?

A patient with subacromial impingement syndrome is scheduled for an arthroscopic subacromial decompression. The coracoacromial ligament is a key structure in the roof of the subacromial space. Which of the following is true regarding its anatomy?

A patient presents with the inability to flex the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger, but has normal upper extremity sensation. Which of the following muscles will likely also exhibit weakness on examination?

A collegiate baseball pitcher undergoes a Tommy John procedure (ulnar collateral ligament reconstruction). To correctly reconstruct the primary restraint to valgus stress, the graft must be anchored to the anatomical insertion of the anterior bundle of the MCL. What is this ulnar insertion site?

A patient presents with scapular winging and inability to efficiently retract the scapula. EMG reveals a lesion isolated to the dorsal scapular nerve. Which of the following muscles are primarily affected?

A patient sustains a deep penetrating injury immediately anterior to the anterior scalene muscle in the lower neck. Which of the following structures is most likely injured in this specific location?

Which of the following is the primary anatomic footprint for the distal attachment of the lateral ulnar collateral ligament (LUCL)?

An anatomic repair of a distal biceps tendon rupture requires reattachment to its native footprint. Which of the following best describes the normal anatomical insertion of the distal biceps tendon?

A patient develops posterolateral rotatory instability (PLRI) of the elbow following a dislocation. The primary deficient structure originates on the lateral epicondyle and inserts on which of the following structures?

A 32-year-old man presents with chronic elbow instability. Examination reveals apprehension during supination, valgus stress, and axial loading of the elbow. Which structure is most likely deficient, and what is its normal anatomic insertion site?

A 20-year-old collegiate javelin thrower is evaluated for medial elbow pain. The moving valgus stress test is highly positive at 90 degrees of flexion.

Which specific structure is the primary restraint to valgus stress at this angle of elbow flexion?

A 22-year-old collegiate baseball pitcher is diagnosed with a Type II superior labrum anterior and posterior (SLAP) tear. During which phase of throwing does the 'peel-back' mechanism place maximal strain on the biceps anchor?

During ulnar collateral ligament (UCL) reconstruction of the elbow, the graft is typically anchored to the anatomic footprints. The anterior bundle of the UCL originates from the anteroinferior medial epicondyle and inserts onto the:

A 22-year-old baseball pitcher presents with medial elbow pain and decreased velocity. Pain is most severe during the late cocking and early acceleration phases of throwing. Which bundle of the ulnar collateral ligament (UCL) is most likely injured and serves as the primary restraint to valgus stress at 90 degrees of flexion?

A 30-year-old overhead athlete undergoes an arthroscopic Type II SLAP repair. Six months postoperatively, he complains of persistent pain and a significant loss of external rotation. What is the most common iatrogenic cause of this complication?

A 22-year-old baseball pitcher presents with medial elbow pain during the late cocking phase of throwing and a decrease in velocity. Physical examination reveals a positive moving valgus stress test. An MRI arthrogram demonstrates a partial thickness tear of the UCL. Which bundle of the UCL is the primary restraint to valgus stress at 90 degrees of flexion?

A 35-year-old heavy laborer sustains an acute distal biceps tendon rupture. During a single-incision anterior repair using cortical button fixation, the surgeon must be particularly careful to protect which of the following nerves as it pierces the supinator muscle?

A 21-year-old collegiate swimmer complains of anterior shoulder pain. On examination, there is a positive O'Brien's test. During arthroscopy, an anterosuperior labral variant is noted where the labrum is absent from the 1 to 3 o'clock position with a cord-like middle glenohumeral ligament. What is the appropriate management of this anatomic variant?