9. Shoulder and Elbow MCQs

A 35-year-old patient presents with a history of recurrent anterior shoulder dislocations. During your examination, you perform the Apprehension Test. Which of the following describes a positive test?

During the examination of a patient with suspected shoulder dislocation, you note a sulcus sign. What does this finding MOST commonly indicate?

Following reduction of an anterior shoulder dislocation, a patient complains of persistent weakness in active shoulder abduction. Sensation over the lateral aspect of the deltoid is intact. Which of the following is the MOST likely cause of this isolated weakness?

A 22-year-old male presents with his first-time anterior shoulder dislocation. During the initial assessment, which of the following is a critical component of the examination PRIOR to any reduction attempts?

You are examining a patient with a suspected posterior shoulder dislocation. Which maneuver is most likely to confirm your suspicion on physical exam?

A 19-year-old college football player sustains a first-time anterior shoulder dislocation during a game. It is successfully reduced in the emergency department. Which of the following factors is the single greatest predictor of recurrent glenohumeral instability in this patient?

A 28-year-old construction worker falls from a height and sustains an inferior shoulder dislocation. On clinical presentation, his arm is hyperabducted, and his hand is resting behind his head.

Which of the following vascular injuries is most commonly associated with this specific dislocation pattern?

Biomechanical studies have demonstrated that different bands of the glenohumeral ligaments act as primary restraints in varying shoulder positions. In which position is the anterior band of the inferior glenohumeral ligament (IGHL) the primary restraint to anterior humeral translation?

A 29-year-old competitive weightlifter presents with acute right shoulder pain and loss of the anterior axillary fold after attempting a heavy bench press. MRI confirms a complete pectoralis major rupture. Regarding the anatomy of the pectoralis major insertion, where does the sternocostal head attach relative to the clavicular head?

A 55-year-old female presents with lateral scapular winging three weeks after undergoing a lymph node biopsy in the posterior triangle of her neck. She has difficulty elevating her arm above 90 degrees. Which nerve was most likely injured during the procedure?

A 30-year-old male sustains a severe hyperabduction injury to his shoulder. He presents to the trauma bay with his arm locked in an overhead position. Which complication is disproportionately associated with this specific type of shoulder dislocation compared to anterior dislocations?

Which of the following muscles is most directly affected by the nerve most commonly injured during an anterior shoulder dislocation?

A 55-year-old female presents with an insidious onset of progressive global shoulder stiffness and poorly localized pain over the past 4 months. She has profound restriction of active and passive external rotation. Which of the following systemic conditions is most strongly associated with the development and refractoriness of this disorder?

A 74-year-old female sustains a complex 3-part proximal humerus fracture involving the surgical neck and greater tuberosity. Which of the following patient or radiographic factors most strongly supports the decision to perform a primary reverse total shoulder arthroplasty (RTSA) instead of open reduction internal fixation (ORIF)?

A 65-year-old male presents with worsening left shoulder pain. Radiographs demonstrate severe primary glenohumeral osteoarthritis. A preoperative CT scan classifies the glenoid as a Walch B2 type. Which of the following morphological features characterizes a Walch B2 glenoid?

A 74-year-old female presents with pseudoparalysis of the right shoulder and severe pain. Radiographs reveal an acromiohumeral interval of 3 mm and severe "bone-on-bone" arthritic changes. MRI confirms a massive, retracted rotator cuff tear with grade 4 fatty infiltration of the supraspinatus and infraspinatus. What is the most appropriate surgical intervention?

A 48-year-old female with insulin-dependent diabetes presents with a 4-month history of insidious onset right shoulder stiffness and pain. Radiographs are normal. Which physical examination finding is the hallmark diagnostic sign of adhesive capsulitis?

A 19-year-old male presents with a history of recurrent posterior shoulder subluxations during basketball. He reports a feeling of the shoulder 'slipping out' when he reaches across his body or attempts a chest pass. Physical examination reveals a positive Kim test. Which of the following best describes the Kim test and its significance?

A 38-year-old male presents with recurrent posterior shoulder instability. He reports that his shoulder dislocates when he falls onto an outstretched hand with his arm in a specific position. Which combination of arm positions places maximal stress on the posterior capsule and labrum, predisposing to posterior glenohumeral instability?

A 40-year-old male presents to the emergency department after a cycling accident, complaining of severe right shoulder pain. Physical examination reveals a prominent distal clavicle. To accurately assess the acromioclavicular joint and rule out a Rockwood Type IV injury, which radiographic views are most critical, and what specific modification is recommended for optimal visualization of the AC joint itself?