5 OCS/SCS Practice Questions

Below are a sample of the OCS/SCS practice questions that will be released in the shoulder section of our new book coming this fall.

  • This is the 2nd volume for OCS and SCS test takers.
  • Our first OCS book focuses on the spine.
  • Our first SCS book focuses on SCS special topics and on field management.
  • This book emphasizes extremity based questions which are important for both OCS and SCS exam.
  • This book will have practice questions and study guides for reference.
  • Book will be released in November.

Scroll down for 5 practice questions.

Vol_2

OCS Track:

  • For OCS test takers this year we recommend checking out our first OCS specific book.  Find more information about it here.
  • Look for Volume II this November.

 

SCS Track:

  • For SCS test takers we recommend checking out our first SCS specific book.  Find more information here.
  • Look for Volume II this November.

 

On to the questions!

 

  1. A physical therapist (PT) is assessing a 35-year-old patient 5 weeks after large rotator cuff repair, including the subscapularis. The PT performed passive range of motion of the shoulder into 60° of external rotation, 90° of scaption, a passive pectoralis minor stretch, and instructed on scapular clock exercises.  What did the physical therapist do incorrectly?

A. Passive external rotation into 60°

B. Passive pectoralis major stretch

C. Passive scaption to 90°

D. Scapular clock exercises

 

 

2. A hockey player is skating by his bench when he is checked by an opposing player. He falls to the ground clutching his right clavicle.  If the clavicle is fractured in the midshaft and displaced posteriorly, which structure would be most at risk of damage?

A. Subclavian artery

B. Cupula of the lung

C. Internal jugular vein

D. Axillary artery

 

 

3. A 50-year-old male is referred to physical therapy for right shoulder pain secondary to rotator cuff pathology. After 4 weeks of rehabilitation, he did not make any improvements in strength, range of motion or on his QuickDASH score.  Which type of rotator cuff pathology is least likely to succeed with physical therapy?

A. Grade I bursal sided rotator cuff tear

B. Grade I articular sided rotator cuff tear

C. Grade II bursal sided rotator cuff tear

D. Grade II articular sided rotator cuff tear

 

 

4. Which patient with shoulder instability and previous history of dislocation will most likely have another dislocation occur?

A. 18 years old

B. 20 years old

C. 22 yeas old

D. 25 years old

 

 

5. A high school quarterback is holding the football with his arm abducted to 90°, when he is tackled by the opposing team and the crown of the helmet collides with the posterior aspect of his shoulder. What is the primary static restraint to this force?   

A. Superior glenohumeral ligament (SGHL)

B Middle glenohumeral ligament (MGHL)

C. Inferior glenohumeral ligament (IGHL)

D. MGHL and IGHL

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  1. A physical therapist (PT) is assessing a 35-year-old patient 5 weeks after large rotator cuff repair, including the subscapularis. The PT performed passive range of motion of the shoulder into 60° of external rotation, 90° of scaption, a passive pectoralis minor stretch, and instructed on scapular clock exercises.  What did the physical therapist do incorrectly?

A. Passive external rotation into 60°

Answer choice A is the correct option.  Since the subscapularis was repaired, subscapularis precautions are required.  Subscapularis precautions are as follows: No external rotation past 30°, no horizontal adduction, no active internal rotation and no body weight support for 12 weeks.

B. Passive pectoralis major stretch

C. Passive scaption to 90°

D. Scapular clock exercises

Citation: OSU Sports MED Protocol for Large Rotator Cuff Repair (Available for Free):

https://wexnermedical.osu.edu/~/media/Files/WexnerMedical/Patient-Care/Healthcare-Services/Sports-Medicine/Education/Medical-Professionals/RTCLargeMassive.pdf?la=en

 

2. A hockey player is skating by his bench when he is checked by an opposing player. He falls to the ground clutching his right clavicle.  If the clavicle is fractured in the midshaft and displaced posteriorly, which structure would be most at risk of damage?

A. Subclavian artery

B. Cupula of the lung

Midshaft fractures tend to be the most common clavicle fracture, and usually do not result in serious injury.  However, when the fracture is displaced it can affect several different structures.  If displaced posteriorly, the cupula of the lung will be affected and potentially cause a pneumothorax.

C. Internal jugular vein

D. Axillary artery

Citation: Burnham JM, Kim DC, Kamineni S. Midshaft

clavicle fractures: a critical review. Orthopedics. 2016 Sep

19;39(5):e814-21.

 

3. A 50-year-old male is referred to physical therapy for right shoulder pain secondary to rotator cuff pathology. After 4 weeks of rehabilitation, he did not make any improvements in strength, range of motion or on his QuickDASH score.  Which type of rotator cuff pathology is least likely to succeed with physical therapy?

A. Grade I bursal sided rotator cuff tear

B. Grade I articular sided rotator cuff tear

C. Grade II bursal sided rotator cuff tear

Answer choice C is correct.  For this question you need to make note of the grade of the tear and the location.  The higher the grade and bursal sided tears of the rotator cuff are less likely to improve with physical therapy and are more likely to require surgery.  It’s best to search Google Images for the difference between articular and bursal sided rotator cuff tears.  Articular sided rotator cuff tears occur on the undersurface of the rotator cuff (the articular side) as this connects with the articular surface of the humeral head.  Bursal sided tears occur in a top down fashion, and are likely due to some superior bone spur or abnormal acromion causing the tear.

D. Grade II articular sided rotator cuff tear

 

4. Which patient with shoulder instability and previous history of dislocation will most likely have another dislocation occur?

A. 18 years old

Another dislocation is most likely to occur for patients aged under 20 years old.  Dislocation rates have been reported between 66% and 100%.  Recurrent dislocations in patients between the ages of 20 and 40 years old ranges from 13% to 63%, and 0% to 16% for patients over 40 years old.

B. 20 years old

C. 22 yeas old

D. 25 years old

 

5. A high school quarterback is holding the football with his arm abducted to 90°, when he tackled by the opposing team and the crown of the helmet collides with the posterior aspect of his shoulder. What is the primary static restraint to this force?   

A. Superior glenohumeral ligament (SGHL)

B Middle glenohumeral ligament (MGHL)

C. Inferior glenohumeral ligament (IGHL)

The IGHL is the primary static restraint against anterior, posterior and inferior translation when the shoulder is abducted beyond 45°.  SGHL limits anterior and inferior translation of adducted humerus, MGHL prevents excessive translation below 45° of abduction.

D. MGHL and IGHL

 

 

BONUS Question

A volleyball player presents to you with insidious

onset of shoulder pain in their dominant right arm. 

Upon observation, you notice mild atrophy of the

infraspinatus muscle, and 3+ out of 5 strength on

manual muscle testing into right shoulder external

rotation.  What nerve is entrapped and where?

A. C5 and C6 nerve roots, Erb’s points

B. Suprascapular nerve, spinoglenoid notch

C. Quadrilateral syndrome, ganglion cyst

D. Suprascapular neve, suprascapular notch

 

 

 

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BONUS ANSWER

A volleyball player presents to you with insidious

onset of shoulder pain in their dominant right arm. 

Upon observation, you notice mild atrophy of the

infraspinatus muscle, and 3+ out of 5 strength on

manual muscle testing into right shoulder external

rotation.  What nerve is entrapped and where?

A. C5 and C6 nerve roots, Erb’s points

B. Suprascapular nerve, spinoglenoid notch

Symptoms are suggestive of answer choice B.  Cases of nerve entrapment at the spinoglenoid notch of the scapula have been reported either by tension on the nerve or a ganglia.  This can lead to atrophy of the infraspinatus.  For answer choice D, you would suspect atrophy and weakness of supraspinatus and infraspinatus.  Answer C, should be on your differential diagnoses list.  The suprascapular nerve comes off the upper trunk of the brachial plexus (C5 and C6).

C. Quadrilateral syndrome, ganglion cyst

D. Suprascapular neve, suprascapular notch

 

Check out our other Questions of the Month for OCS and SCS prep.

And stay tuned for the release of our second book…..

Vol_2

 

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