9. Shoulder and Elbow MCQs

In a patient with posterolateral rotatory instability (PLRI) of the elbow, what is the key deficient structure causing this pathology?

A 19-year-old football lineman presents with a stinger (burner) after a direct impact to the neck and shoulder. Symptoms typically resolve within minutes. Which nerve roots are most commonly involved in this traction injury?

A collegiate baseball pitcher presents with chronic medial elbow pain and a decline in pitching velocity. A moving valgus stress test is positive. Which specific ligamentous bundle is the primary restraint to valgus stress of the elbow between 30 and 120 degrees of flexion?

A 40-year-old male feels a sudden pop in his anterior elbow while lifting a heavy box. On examination, what is the most sensitive and specific clinical test for diagnosing a complete distal biceps tendon rupture?

A fourteen-year-old little league pitcher has lateral elbow pain that is worsened by throwing. Plain radiographs demonstrate fragmentation of the capitellum with no evidence of a loose body. A presumptive diagnosis of osteochondritis dissecans of the capitellum has been made. He has undergone rest, followed by physical therapy over the past three months. Now range of motion is from 30 to 120, and pain is present when attempting to throw. The next appropriate step is:

The primary stabilizer of the elbow to valgus stress is:

If a distal biceps tendon avulsion is not repaired or reconstructed, what is the likely result:

Fibrinous degradation in which muscle insertion most commonly characterizes lateral epicondylitis or tennis elbow:

A collegiate tennis player has undergone surgery for recalcitrant tennis elbow (lateral epicondylitis). He now complains of clicking, catching, and "slipping out of joint" of the elbow. Examination reveals a positive "pivot shift" test of the elbow with normal motion. Radiograph examination is normal. The primary stabilizer of the elbow that is damaged in this patient giving rise to his symptoms of posterolateral rotatory instability is:

A 56-year-old competitive triathelete fell off his bicycle and sustained a traumatic anterior shoulder dislocation. The dislocation was reduced in the emergency room. No associated fractures were noted. A magnetic resonance image examination would be judicious in this patient to:

During a diagnostic shoulder arthroscopy, the surgeon notes an absent anterosuperior labrum and a thick, cord-like middle glenohumeral ligament. This anatomic variant, which should not be surgically repaired to the glenoid, is known as:

In the design and biomechanics of a reverse total shoulder arthroplasty (RTSA), moving the center of rotation medially and inferiorly achieves which of the following?

During the late cocking phase of the throwing motion in an elite baseball pitcher, which structure is subjected to the highest tensile forces?

A 45-year-old bodybuilder undergoes a two-incision surgical repair of a distal biceps tendon rupture. Compared to the single-incision anterior approach, the two-incision approach is historically associated with a higher risk of which of the following complications?

A 22-year-old collegiate baseball pitcher presents with shoulder pain and a Glenohumeral Internal Rotation Deficit (GIRD) of 25 degrees compared to his non-throwing shoulder. This deficit is most commonly attributed to contracture of which anatomical structure?

Osteochondritis dissecans of the elbow most commonly occurs at this location:

When examining an individual for suspected posterior instability of the glenohumeral joint, a posteriorly directed force is applied with the arm in this position:

All of the following are reported complications following the surgical treatment of medial epicondylitis except:

A 20-year old female collegiate swimmer has suffered from pain in her right shoulder and inability to compete for the last 9 months. She has been diagnosed with multidirectional instability. Physical therapy for 7 months has failed, and she wishes to swim competitively again. Assuming the diagnosis is correct, the next step should be:

A 24-year-old professional baseball pitcher presents with vague shoulder pain. Physical examination reveals 25 degrees of internal rotation loss and 5 degrees of external rotation gain compared to the non-throwing shoulder. Which of the following anatomic adaptations is most likely responsible for this Glenohumeral Internal Rotation Deficit (GIRD)?