9. Shoulder and Elbow MCQs

A 70-year-old woman presents with severe right shoulder pain and an inability to raise her arm above the horizontal level for the past 6 months. Examination demonstrates active forward elevation to 70 degrees, but passive forward elevation to 150 degrees. Radiographs reveal advanced glenohumeral osteoarthritis with superior migration of the humeral head articulating with the acromion. What is the most appropriate surgical management?

A 45-year-old man falls on his outstretched hand and sustains a 'terrible triad' injury of the elbow. He undergoes operative management for a posterolateral elbow dislocation, radial head fracture, and a type II coronoid fracture. Which of the following represents the most appropriate sequence of surgical reconstruction for this injury pattern?

A 20-year-old collegiate baseball pitcher feels a pop in his medial elbow during a pitch. MRI confirms a complete distal avulsion of the ulnar collateral ligament (UCL). The primary restraint to valgus stress at the elbow during the late cocking and early acceleration phases of throwing is the:

A 30-year-old male presents with elbow clicking and apprehension when pushing up from a chair. Posterolateral rotatory instability (PLRI) is diagnosed. The primary deficient structure originates on the lateral epicondyle and inserts on which of the following structures?

A patient with rheumatoid arthritis presents with an inability to actively extend their thumb interphalangeal joint. Rupture of the extensor pollicis longus (EPL) tendon is suspected. The EPL tendon normally routes around Lister's tubercle, separating which two dorsal extensor compartments?

A 25-year-old man presents with prominent medial scapular winging when asked to push against a wall, following a heavy traction injury to his shoulder. Electromyography confirms an isolated nerve palsy. From which specific nerve roots does the affected nerve originate?

A 60-year-old patient undergoes a lymph node biopsy in the posterior triangle of the neck and subsequently develops noticeable shoulder drooping and severe weakness with shoulder elevation. The nerve injured during this procedure exits the skull through which of the following foramina?

A 20-year-old collegiate baseball pitcher presents with medial elbow pain. Valgus stress testing reveals joint laxity at 30 degrees of elbow flexion. Which bundle of the ulnar collateral ligament (UCL) complex is the primary restraint to valgus stress at this angle, and what is its distal insertion site?

During a deltopectoral approach to the shoulder, a nerve is encountered piercing the clavipectoral fascia medial to the coracoid process. This nerve primarily innervates which of the following structures?

The distal biceps tendon normally inserts on the radial tuberosity. To maximize supination strength during a surgical repair of a ruptured tendon, it should be reattached to which specific footprint?

A patient presents with shoulder weakness and lateral winging of the scapula following a lymph node biopsy in the posterior triangle of the neck. Which nerve was injured, and which muscle is paralyzed?

A 28-year-old gymnast sustains an elbow dislocation. After closed reduction, she has persistent posterolateral rotatory instability (PLRI). Deficiency of which of the following structures is the primary cause of this instability?

A patient presents with posterolateral rotatory instability (PLRI) of the elbow following a dislocation. This condition is primarily caused by insufficiency of the lateral ulnar collateral ligament (LUCL). Where does the LUCL anatomically insert?

During the proximal portion of the volar (Henry) approach to the forearm, supination of the forearm is performed to protect a major nerve. Which muscle's insertion is stripped and elevated to expose the proximal radius, and what is the anatomical relationship of the at-risk nerve to this muscle?

Posterolateral rotatory instability (PLRI) of the elbow is primarily caused by insufficiency of the lateral ulnar collateral ligament (LUCL). What is the precise insertion of the LUCL?

A patient presents with medial winging of the scapula after a traumatic injury. The injured nerve originates from which of the following roots of the brachial plexus?

A patient presents with winged scapula following a breast lumpectomy and axillary node dissection. The affected nerve innervates which of the following muscles?

The lateral ulnar collateral ligament (LUCL) is the primary stabilizer against posterolateral rotatory instability (PLRI) of the elbow. Where does the LUCL typically insert?

In the evaluation of a patient with scapular winging, physical examination reveals medial prominence of the scapula when pushing against a wall. Injury to which nerve is the most likely cause?

A patient presents with weakness in internal rotation and adduction of the shoulder, specifically lacking the ability to perform latissimus dorsi pull-downs. Which of the following cords of the brachial plexus provides the primary innervation to this muscle?