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Orthopedic Prometric MCQs - Chapter 3 Part 1

Orthopedic Prometric MCQs - Chapter 3 Part 45

25 Apr 2026 20 min read 1 Views
Orthopedic Prometric MCQs - Chapter 3 Part 45

Welcome to Chapter 3 Part 45 of our comprehensive Orthopedic Prometric Exam Simulator. This interactive test features 20 high-yield multiple-choice questions designed to help you prepare for the Saudi Prometric (SCFHS), DHA, HAAD, SLE, and OMSB orthopedic surgery exams.

Use the Study Mode to view detailed explanations instantly, or switch to Exam Mode to test your speed and accuracy under simulated testing conditions.

Prometric Exam Simulator


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Question 1

To avoid injury associated with repetitive internal impingement, the pitchers long humeral axis must be in which position during the late cocking phase of throwing:





Explanation

Hyperangulation during the late cocking phase of throwing can result in impingement of the greater tuberosity on the posterosuperior glenoid rim leading to labral or rotator cuff lesions. Positioning of the humeral axis parallel to the plane of the scapula is recommended to avoid injury associated with internal impingement.

Question 2

Which of the following factors is related to recurrence after primary anterior shoulder dislocation:





Explanation

The only known factor that statistically correlates with recurrence of anterior shoulder instability is patient age at the time of initial dislocation. A recent study demonstrated that patients having an initial dislocation during the third decade have more than a 60% chance of redislocating. The type of sport practiced, type of nonoperative treatment, and patient gender do not influence recurrence rate.

Question 3

Use of functional knee bracing after anterior cruciate ligament (AC L) reconstruction will most likely result in which of the following scenarios:





Explanation

Two-year follow-up has failed to show any differences in range of motion, stability, function, strength, pain, or atrophy in patients who were braced after AC L reconstruction vs. patients who were treated without a brace. The only difference between the two groups is that the braced group has better knee function in the early postoperative period, despite having more quadriceps atrophy.

Question 4

The stabilizing ligamentous pulley of the long head of the biceps at the shoulder is composed of fibers from all of the following structures except:





Explanation

The stabilizing ligamentous pulley system of the long head of the biceps at the shoulder is a coalescence of the coracohumeral ligament and superior glenohumeral ligament. It also receives fiber contributions from the supraspinatus and subscapularis tendons.

Question 5

Which of the following is the principal function of the biceps during throwing:





Explanation

The function of the biceps at the shoulder is controversial, especially in the throwing athlete. The biceps may act as a secondary shoulder stabilizer, weak shoulder flexor, arm decelerator, or weak depressor of the humeral head. However, it is widely agreed upon that the biceps principal function during throwing is elbow flexion.

Question 6

Which of the following arteries provides the main vascular supply to the humeral head:





Explanation

The ascending branch of the anterior humeral circumflex artery provides the main vascular supply to the humeral head. Disruption of this blood supply can result in osteonecrosis of the humeral head.

Question 7

When assessing patient outcomes after rotator cuff repair, which of the following is not related to poor functional outcome:





Explanation

A large outcome study of more than 600 rotator cuff repairs demonstrated that workmanâ s compensation, revision surgery, male gender, and age younger than 55 years at the time of repair are factors contributing to poor functional outcome and decreased workability following rotator cuff repair.

Question 8

When using open measurement as the standard, which of the following is the most reliable instrument to measure rotator cuff tear size:





Explanation

Of the modalities listed, arthroscopy most closely estimates the actual size of a rotator cuff tear. Magnetic resonance imaging and ultrasound are similar in their ability to determine rotator cuff tear size. Computed tomography (without arthrography) is poor in evaluation of the rotator cuff. A detailed clinical examination is helpful in determining which tendons are torn, however elucidation of the specific size of the tear on physical examination is unlikely.

Question 9

When biomechanically comparing reconstruction of the anterior band of the medial collateral ligament of the elbow to the intact ligament, the reconstructed ligament behaves nearly identical to the intact ligament when subjected to valgus stress at all of the following degrees of elbow flexion except:





Explanation

Mullen and associates biomechanically compared reconstruction of the medial collateral ligament of the elbow to the intact ligament at 30°, 60°, 90°, and 120° of elbow flexion. They identified a significant difference in displacement with an applied valgus load at 120° of elbow flexion, leading them to conclude that medial collateral ligament reconstruction is a biomechanically sound procedure.

Question 10

Which of the following is the most commonly reported cause of nontraumatic humeral head osteonecrosis:





Explanation

Corticosteroid therapy is the most commonly reported cause of osteonecrosis of the humeral head. Other risk factors include alcohol abuse, hemoglobinopathies, Gaucherâ s disease, dysbarism, connective tissue disorders, arteritis, vasculitis, hypercoagulability, prior radiation, pregnancy, and pancreatitis.

Question 11

The microfracture technique for articular cartilage lesions is most successful for which chondral lesions:





Explanation

The inventors of the microfracture technique described a 70% to 80% success rate after microfracture of lesions smaller than 2 cm in diameter. The technique involves maintenance of some subchondral bone integrity and is indicated for full thickness chondral lesions. Lesions involving both the tibia and femur have resulted in less satisfactory outcomes.

Question 12

The results of anteromedial tibial tubercle transfer for patellar malalignment are best when patellar lesions are located:





Explanation

A study revealed that results after tibial tubercle anteromedialization are best if patellar lesions are located distally or laterally. The results were poor when the lesions were located proximally or on the medial facet.

Question 13

The following structures are found in the superficial layer of the posterolateral corner:





Explanation

An anatomic study described three distinct layers that compose the posterolateral corner of the knee. Layer one includes the biceps tendon, the iliotibial tract, the prepatellar bursa, and peroneal nerve. Layer two includes the quadriceps retinaculum and patellofemoral ligaments. Layer three, the deepest layer, includes the lateral part of the joint capsule, the popliteus tendon passing through the hiatus, the fibular collateral ligament, the fabellofibular ligament, arcuate complex, and popliteofibular ligament.

Question 14

The following structures are found in the second, or middle layer, of the posterolateral corner:





Explanation

An anatomic study described three distinct layers that compose the posterolateral corner of the knee. Layer one includes the biceps tendon, the iliotibial tract, the prepatellar bursa, and peroneal nerve. Layer two includes the quadriceps retinaculum and patellofemoral ligaments. Layer three, the deepest layer, includes the lateral part of the joint capsule, the popliteus tendon passing through the hiatus, the fibular collateral ligament, the fabellofibular ligament, arcuate complex, and popliteofibular ligament.

Question 15

The following structures are found in the deep layer of the posterolateral corner:





Explanation

An anatomic study described three distinct layers that compose the posterolateral corner of the knee. Layer one includes the biceps tendon, the iliotibial tract, the prepatellar bursa, and peroneal nerve. Layer two includes the quadriceps retinaculum and patellofemoral ligaments. Layer three, the deepest layer, includes the lateral part of the joint capsule, the popliteus tendon passing through the hiatus, the fibular collateral ligament, the fabellofibular ligament, arcuate complex, and popliteofibular ligament.

Question 16

Sectioning the posterolateral structures alone affects lateral tibial plateau translation with:





Explanation

Biomechanical studies show that sectioning the posterolateral structures alone results in increases in posterior translation of the lateral tibial plateau primarily at 30° of knee flexion.

Question 17

Sectioning the posterolateral structures and posterior cruciate ligament results in:





Explanation

Biomechanical studies show that sectioning the posterolateral structures and posterior cruciate ligament results in increases in posterior translation of the medial and lateral tibial plateaus at 30° and 90° of knee flexion.

Question 18

The maximal restraint to varus stress provided by the posterolateral structures of the knee is at what degree of knee flexion:





Explanation

Biomechanical studies show that sectioning the posterolateral structures results in increases in varus rotation of the knee from 0º to 30° of knee flexion, with maximal increase observed at 30°.

Question 19

The reverse pivot shift is most useful for diagnosing which of the following knee injuries:





Explanation

The reverse pivot shift is positive if there is a palpable shift or jerk as the lateral tibial plateau reduces while bringing the knee from 90° of flexion to full extension with the foot in external rotation. This is indicative of posterolateral corner knee injury but has been reported to be positive in 11% to 35% of normal asymptomatic patients.

Question 20

When using the tibial external rotation test on a patient, increased external rotation at 30° but not at 90° of knee flexion is indicative of:





Explanation

The tibial external rotation test is performed at 30° and 90° of knee flexion. The degree of foot external rotation with regard to the femur is evaluated. Increased external rotation at 30 ° is consistent with an isolated posterolateral corner injury. Increased external rotation at 30° and 90° is consistent with a combined posterolateral and posterior cruciate ligament injury.

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Dr. Mohammed Hutaif
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Prof. Dr. Mohammed Hutaif
Consultant Orthopedic & Spine Surgeon
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