shoulder&ligaments

[Miracoli]

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Q1
A 47-year-old female tennis professional is informed by her physician that she has a rotator cuff injury that will require surgery. Her physician explains that over the years of play a shoulder ligament has gradually caused severe damage to the underlying muscle. To which of the following ligaments is the physician most likely referring?
A. Acromioclavicular ligament
B. Coracohumeral ligament
C. Transverse scapular ligament
D. Glenohumeral ligament
E. Coracoacromial ligament

 

[acciddropping]

I think it's the extensor muscle - not sure which ligament though. Probably D?

 

[Miracoli]

Q2
A 34-year-old female skier was taken by ambulance to the hospital after she struck a tree on the ski slope. Imaging gives evidence of a shoulder separation. Which of the following typically occurs in this kind of injury?
A. Displacement of the head of the humerus from the glenoid cavity
B. Partial or complete tearing of the coracoclavicular ligament
C. Partial or complete tearing of the coracoacromial ligament
D. Rupture of the transverse scapular ligament
E. Disruption of the glenoid labrum

Q3
A 55 yrs old woman falls in the shower and hurts her shoulder. She shows up in the ER with her arm close to held close her body, but rotated outward as if she were going to shake hands. She is in pain and will not move the arm from that position. There is numbness in the small area of her shoulder, over the deltoid muscle. Which ligament is most likely injured in this pt?

Q4
When the shoulder is dislocated, most commonly the humerus tends to move in the
A. lateral direction
B. posterior inferior direction
C. anterior inferior direction
D. medial direction

Q5
An 11-year-old boy presents to the ER after a basketball injury caused acute right shoulder pain. Imaging studies suggest clavicular dislocation at the acromioclavicular joint. Which of the following acts to prevent the dislocation described in this patient?
A. Sternoclavicular ligament
B. Costoclavicular ligament
C. Acromioclavicular ligament
D. Coracoclavicular ligament
E. Levator scapulae muscle

 

[thehundredthone]

Q1
E. Coracoacromial ligament

Most rotator cuff injuries involve the supraspinatus muscle, which passes under the coracoacromial ligament.

Q2
A 34-year-old female skier was taken by ambulance to the hospital after she struck a tree on the ski slope. Imaging gives evidence of a shoulder separation. Which of the following typically occurs in this kind of injury?
B. Partial or complete tearing of the coracoclavicular ligament

Shoulder separation is also called acromioclavicular separation. Technically this should be the answer, but from the choices mentioned, the coracoclavicular ligament can also be involved. Remember, it is the clavicle and scapula that are separated.

Q3
A 55 yrs old woman falls in the shower and hurts her shoulder. She shows up in the ER with her arm close to held close her body, but rotated outward as if she were going to shake hands. She is in pain and will not move the arm from that position. There is numbness in the small area of her shoulder, over the deltoid muscle. Which ligament is most likely injured in this pt?

Typical anterior shoulder dislocation. Glenohumeral ligament is affected.

Q4
When the shoulder is dislocated, most commonly the humerus tends to move in the
C. anterior inferior direction

This is pretty basic stuff.

Q5
An 11-year-old boy presents to the ER after a basketball injury caused acute right shoulder pain. Imaging studies suggest clavicular dislocation at the acromioclavicular joint. Which of the following acts to prevent the dislocation described in this patient?
C. Acromioclavicular ligament

I wonder. Although technically the coracoclavicular ligament can also be involved, the main structure preventing such dislocation is the acromioclavicular.

I don't know if you asked these because you had doubts or they were just for other people to attempt, because these are pretty basic questions. If the latter is the case, let me know so that I can delete the explanations.

 

[conan31]

I don't think they are pretty basic questions, Kaplan videos and books don't even speak about this ligament, where you can find them? In an ultra-super-specialist book of ortopedic maybe. I don't think this knowledge is required for step1!

 

[thehundredthone]

I don't think they are pretty basic questions, Kaplan videos and books don't even speak about this ligament, where you can find them? In an ultra-super-specialist book of ortopedic maybe. I don't think this knowledge is required for step1!

Barring maybe the acromioclavicular separation (which you are highly unlikely to see on your exam), the rest are basic questions. The most common type of shoulder dislocation, the direction of this dislocation, the ligament affected in this dislocation; and the most commonly injured rotator cuff muscle are all high yield facts, because the USMLE pretty much tests only shoulder dislocation and rotator cuff injuries when it comes to the shoulder.

Which ligament are you talking about? Most of my answers are from the orthopaedics I learned in medical school and the rest is from what I read through the course of Step 1 prep.

 

[conan31]

I think that, about shoulder, they can ask about : teres minor, supraspinatus, subscapularis, infraspinatus, serratus anterior, and their innervation, but i haven't ever read a question about ligaments! Aren't they too specific for step1?

I didn't find ligaments even in the Kaplan prep for step1