1.
AMBRI stands for Atraumatic Multi-directional Bilateral Rehabilitation Inferior Capsular Shift and is most common in young women who are systemically hypermobile. To be considered multidirectional, the instability can be anterior or posterior, but must also be superior.
Correct Answer
B. False
Explanation
The explanation for the correct answer is that the statement provided is false. AMBRI does not stand for Atraumatic Multi-directional Bilateral Rehabilitation Inferior Capsular Shift. The acronym AMBRI actually stands for Atraumatic Multidirectional Shoulder Instability, which is a condition characterized by shoulder instability in multiple directions. It is more common in young women who have systemic hypermobility. The statement also incorrectly states that the instability must be superior, whereas it can be anterior or posterior as well. Therefore, the correct answer is false.
2.
A patient who has instability will always have laxity.
Correct Answer
B. False
Explanation
The statement suggests that all patients with instability will have laxity. However, this is not necessarily true as instability can have various causes and not all of them are related to laxity. Instability can also be caused by muscle weakness, neurological issues, or other factors. Therefore, it is incorrect to assume that all patients with instability will have laxity.
3.
Which of the following is not true regarding the articulating surfaces of the GHJ?
Correct Answer
C. There is 5* retroversion.
Explanation
The given statement "There is 5* retroversion" is not true regarding the articulating surfaces of the GHJ. Retroversion refers to the backward angulation of a bone or joint. In this case, it indicates the backward angulation of the humeral head in relation to the glenoid. However, the correct answer states that there is 5* retroversion, which means that there is a backward angulation of 5 degrees.
4.
What is the most common secondary complication after dislocation?
Correct Answer
A. Recurrent dislocation.
Explanation
The most common secondary complication after dislocation is recurrent dislocation. This refers to the repeated occurrence of the joint being dislocated after the initial dislocation. This can happen due to ligamentous laxity or damage to the structures that stabilize the joint. Recurrent dislocation can lead to chronic instability and may require surgical intervention to address the underlying issue and prevent further dislocations.
5.
The circle concept states that for instability to occur, changes must occur on both sides of the capsule. Therefore, when the humeral head goes anterior, the 1st restraint is the anterior capsule, but plastic deformation must occur on the posterior capsule for true instability to occur.
Correct Answer
A. True
Explanation
The explanation for the given correct answer is that according to the circle concept, both the anterior and posterior capsules need to be affected for true instability to occur. The anterior capsule acts as the first restraint when the humeral head goes anterior, but for true instability, there must also be plastic deformation on the posterior capsule. Therefore, the statement is true.
6.
The SGHL acts to prevent inferior displacement of the humeral head when the arm is abducted to 45*. The coracohumeral ligament behaves much like the SGHL.
Correct Answer
B. False
Explanation
The explanation for the answer "False" is that the statement is incorrect. The coracohumeral ligament does not behave like the SGHL. While the SGHL acts to prevent inferior displacement of the humeral head when the arm is abducted to 45 degrees, the coracohumeral ligament has a different function. It helps to support and stabilize the shoulder joint, but it does not specifically prevent inferior displacement of the humeral head during abduction. Therefore, the statement is false.
7.
SLAP II is the most common type of SLAP lesion and is the only SLAP with the biceps detached.
Correct Answer
A. True
Explanation
SLAP II is indeed the most common type of SLAP lesion, characterized by a tear in the superior labrum that extends into the biceps tendon. In SLAP II, the biceps tendon is completely detached from its attachment on the labrum. This detachment distinguishes SLAP II from other types of SLAP lesions, making the statement true.
8.
If you want to best visualize shoulder instability, which 2 radiograph views are the best?
Correct Answer
B. Scapular AP, Axillary
Explanation
The best way to visualize shoulder instability is by using the Scapular AP and Axillary radiograph views. The Scapular AP view allows for a better assessment of the glenoid and scapular alignment, while the Axillary view provides a clear visualization of the humeral head and glenoid relationship. These two views together provide a comprehensive evaluation of shoulder instability, helping to identify any abnormalities or dislocations in the joint.
9.
A Grade III AC dislocation means that both the AC and CC ligaments are torn. The patient will have slighy ecchymosis and will have a large step-off deformity.
Correct Answer
A. True
Explanation
A Grade III AC dislocation is characterized by the tearing of both the AC (acromioclavicular) and CC (coracoclavicular) ligaments. This means that the joint between the acromion (part of the shoulder blade) and the clavicle (collarbone) is disrupted. As a result, the patient will experience slight bruising (ecchymosis) and a noticeable step-off deformity, where there is a visible and palpable gap between the acromion and clavicle. Therefore, the statement is true.
10.
What is lucatio erecta?
Correct Answer
C. When the humeral head becomes stuck under the glenoid.
11.
Open Bankart Repair is superior to Arthroscopic. Suture Tacks are superior to transglenoid sutures. If the labrum is cut it makes the shoulder 20% more unstable. The shoulder has a negative pressure inside. The cut for a Bankart if made in the deltopectoral region. There are subscap takedown precautions when the cut is vertical.
Correct Answer
A. True
Explanation
The given statement is true. The explanation for this is that Open Bankart Repair, a surgical procedure used to treat recurrent shoulder dislocations, is considered superior to Arthroscopic repair. Suture tacks, which are used to secure the torn labrum back to the glenoid bone, are considered superior to transglenoid sutures. Cutting the labrum can make the shoulder 20% more unstable. The shoulder has a negative pressure inside, which helps to keep the humeral head in place. The cut for a Bankart repair is typically made in the deltopectoral region. Subscapularis takedown precautions are necessary when the cut is vertical to avoid injury to the subscapularis muscle.
12.
All of the following are mechanisms of a dislocation, EXCEPT:
Correct Answer
D. Traction
Explanation
The given answer is "Traction." Traction is not a mechanism of a dislocation. Dislocation refers to the displacement of a bone from its normal position within a joint. The mechanisms of a dislocation include forced flexion, FOOSh (fall on outstretched hand), and AbD/Er (abduction and external rotation). Traction, on the other hand, is a therapeutic technique used to apply tension to a body part to facilitate healing or realignment, but it is not a mechanism that causes a dislocation.
13.
The jerk test tests the intergrity of:
Correct Answer
B. Posterior capsule
Explanation
The jerk test is a diagnostic test used to assess the integrity of the posterior capsule of the shoulder joint. It involves applying a sudden jerk or traction force to the arm while the shoulder is in a specific position. If there is laxity or excessive movement of the humeral head, it indicates a possible injury or instability in the posterior capsule. Therefore, the correct answer is the posterior capsule.
14.
Which of the following statements is NOT TRUE?
Correct Answer
A. A SLAP lesion has better healing potential than a Bankart lesion.
Explanation
The statement "A SLAP lesion has better healing potential than a Bankart lesion" is not true. SLAP (Superior Labrum Anterior to Posterior) lesions involve the tear of the labrum and the biceps tendon attachment at the top of the shoulder joint. These types of injuries are known to have a more complex and challenging healing process compared to Bankart lesions, which involve the tear of the labrum at the front of the shoulder joint. Therefore, Bankart lesions generally have better healing potential than SLAP lesions.
15.
Paralabral ganglion cysts can occur with a TYPE II SLAP lesion. They occur in the suprascapular notch and often affect the Axillary nerve.
Correct Answer
B. False
Explanation
Paralabral ganglion cysts can occur with a TYPE II SLAP lesion, but they do not typically occur in the suprascapular notch or affect the Axillary nerve. Therefore, the statement is false.
16.
When treating AC joint arthrosis, one should try an injection before they try iontophoresis.
Correct Answer
B. False
Explanation
The statement is false because when treating AC joint arthrosis, iontophoresis should be tried before considering an injection. Iontophoresis is a non-invasive treatment that uses electrical currents to deliver medication directly to the affected area, which can help reduce inflammation and pain. Injections, on the other hand, involve injecting medication directly into the joint, which is a more invasive approach and is usually considered if other treatments have not been successful. Therefore, iontophoresis should be attempted before resorting to injections for AC joint arthrosis.
17.
O'Briens is a test for instability.
Correct Answer
B. False
Explanation
The statement "O'Briens is a test for instability" is incorrect. O'Briens is not a test for instability.