Shoulder: subscapularis: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anatomy · Shoulder: subscapularis

Sample item

A 58-year-old man cannot lift the back of his hand away from his lumbar spine when the hand is placed behind him (positive lift-off test). Which muscle is weak and where does it insert on the humerus?

AInfraspinatus, into the middle facet of the greater tubercleBSubscapularis, into the lesser tubercleCSupraspinatus, into the superior facet of the greater tubercleDTeres minor, into the inferior facet of the greater tubercle

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Subscapularis, into the lesser tubercle

Subscapularis is the powerful internal rotator of the rotator cuff and is the only cuff muscle attached to the lesser tubercle. The lift-off test checks its ability to rotate the arm internally against resistance. The other cuff muscles attach to the greater tubercle and rotate externally or abduct.

Option by option

A. Infraspinatus, into the middle facet of the greater tubercle
Infraspinatus is an external rotator and is tested with resisted external rotation.
B. Subscapularis, into the lesser tubercle (correct)
Correct. Subscapularis is tested by lift-off and inserts on the lesser tubercle.
C. Supraspinatus, into the superior facet of the greater tubercle
Supraspinatus initiates abduction and is tested with the empty can position.
D. Teres minor, into the inferior facet of the greater tubercle
Teres minor is an external rotator and is tested with the hornblower sign.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Subscapularis, into the lesser tubercle. Subscapularis is the powerful internal rotator of the rotator cuff and is the only cuff muscle attached to the lesser tubercle.

Why is "Infraspinatus, into the middle facet of the greater tubercle" not the answer?

Infraspinatus is an external rotator and is tested with resisted external rotation.

Why is "Supraspinatus, into the superior facet of the greater tubercle" not the answer?

Supraspinatus initiates abduction and is tested with the empty can position.

Why is "Teres minor, into the inferior facet of the greater tubercle" not the answer?

Teres minor is an external rotator and is tested with the hornblower sign.

What concept does this question test?

It tests Shoulder: subscapularis in Anatomy. The lift-off test checks its ability to rotate the arm internally against resistance. The other cuff muscles attach to the greater tubercle and rotate externally or abduct.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Shoulder: subscapularis?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.