-
Question 1
Correct
-
Which of the following ligaments supports the head of the talus?
Your Answer: Spring ligament
Explanation:The spring-ligament complex is a significant medial arch stabilizer.
The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 2
Correct
-
A 55 year old man presents to ED complaining of leg weakness. Your colleague has examined the patient and suspects femoral nerve palsy. Which of the following clinical features would you LEAST expect to see on examination of this patient:
Your Answer: Weakness of hip extension
Explanation:Damage to the femoral nerve results in weakness of hip flexion and knee extension and loss of sensation over the anterior thigh and the anteromedial knee, medial leg and medial foot.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 3
Correct
-
Superficial fibular nerve palsy results in which of the following clinical features:
Your Answer: Loss of eversion of the foot
Explanation:Damage to the superficial fibular nerve results in loss of eversion of the foot and loss of sensation over the lower anterolateral leg and the dorsum of the foot.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 4
Incorrect
-
A 42-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip adduction, but normal hip flexion.
Which of the following muscles was most likely injured in this case?Your Answer: Psoas major
Correct Answer: Pectineus
Explanation:The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.
The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 5
Incorrect
-
Damage to this nerve affects the flexor digitorum longus.
Your Answer: Obturator nerve
Correct Answer: Tibial nerve
Explanation:Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 6
Correct
-
A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus longus.
Peroneus longus receives its innervation from which of the following nerves? Select ONE answer only.Your Answer: Superficial peroneal nerve
Explanation:Peroneus brevis is innervated by the superficial peroneal nerve.
Peroneus longus is innervated by the superficial peroneal nerve.
Peroneus tertius is innervated by the deep peroneal nerve. -
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 7
Incorrect
-
Regarding an avulsion fracture, a sudden contraction of which muscle may lead to fracture of the head of the fibula?
Your Answer: Semitendinosus
Correct Answer: Biceps femoris
Explanation:Avulsion fractures of the fibular head are rare and are so-called the arcuate signal. The “arcuate signal” is used to describe an avulsed bone fragment related to the insertion site of the tendon of the biceps femoris associated with the arcuate complex, which consists of the fabellofibular, popliteofibular, and arcuate ligaments. Such lesions are typically observed in direct trauma to the knee with excessive varus and internal rotation forces or indirect trauma with the same direction of the force.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 8
Incorrect
-
A patient suffers an injury to the nerve that innervates gluteus medius.
The gluteus medius muscle is innervated by which of the following nerves? Select ONE answer only.Your Answer: Inferior gluteal nerve
Correct Answer: Superior gluteal nerve
Explanation:Gluteus minimus is innervated by the superior gluteal nerve.
Gluteus medius is innervated by the superior gluteal nerve.
Gluteus maximus is innervated by the inferior gluteal nerve. -
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 9
Correct
-
A 77 year old lady presents to ED with her left leg shortened and externally rotated following slipping and falling on a wet bathroom floor. There is an intracapsular fracture of the neck of femur seen on imaging studies. She is at risk of avascular necrosis of the head of femur.
This is caused by lack of blood supply from which of these arteries?
Your Answer: Medial circumflex artery
Explanation:The primary blood supply to the head of the femur is from branches of the medial femoral circumflex artery.
The superior and inferior gluteal arteries supply the hip joint but not the head of femur.
The lateral circumflex artery anastomoses with the medial femoral circumflex artery and assists in supplying the head of femur.
The obturator artery is an important source of blood supply in children up to about 8 years. It gives rise to the artery of the head of femur which runs in the ligamentum teres and is insufficient to supply the head of femur in adults.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 10
Incorrect
-
Which of the following clinical features would you NOT expect to see in a tibial nerve palsy:
Your Answer: Weakened inversion of the foot
Correct Answer: Weakened eversion of the foot
Explanation:Damage to the tibial nerve results in loss of plantarflexion of the ankle and weakness of inversion of the foot resulting in a shuffling gait, clawing of the toes and loss of sensation in its cutaneous distribution.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 11
Correct
-
A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.
In which of the following nerves is the gluteus maximus muscle innervated by?Your Answer: Inferior gluteal nerve
Explanation:The gluteal muscles are a group of muscles that make up the buttock area. These muscles include: gluteus maximus, gluteus medius. and gluteus minimus.
The gluteus maximus is the most superficial as well as largest of the three muscles and makes up most of the shape and form of the buttock and hip area. It is a thick, fleshy muscle with a quadrangular shape. It is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect.
The innervation of the gluteus maximus muscle is from the inferior gluteal nerve. -
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 12
Correct
-
Which of the following nerves innervates the gastrocnemius muscle?
Your Answer: Tibial nerve
Explanation:The gastrocnemius is innervated by the anterior rami of S1 and S2 spinal nerves, carried by the tibial nerve into the posterior compartment of the leg.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 13
Correct
-
A 25-year-old athlete suffers an injury to the nerve that innervates the gluteus minimus muscle.
Which of the following nerves innervates the gluteus minimus muscle?Your Answer: Superior gluteal nerve
Explanation:Gluteus minimus is the smallest muscle of the glutei. It is located just beneath the gluteus medius muscle. Gluteus minimus predominantly acts as a hip stabilizer and abductor of the hip.
The superior gluteal nerve innervates the gluteus minimus. -
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 14
Correct
-
Which of the following nerves is most important for eversion of the foot:
Your Answer: Superficial fibular nerve
Explanation:Eversion of the foot is primarily produced by the fibularis longus and fibularis brevis, both innervated by the superficial fibular nerve. The fibularis tertius, innervated by the deep fibular nerve, also assists in this action.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 15
Incorrect
-
A foot drop is a sign of damage to which of the following nerves?
Your Answer: Tibial nerve
Correct Answer: Deep fibular nerve
Explanation:The deep fibular nerve was previously referred to as the anterior tibial nerve.
It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 16
Correct
-
A 30-year-old rugby player suffers from an anterior cruciate ligament tear while pivoting to attempt to run around another player. An MRI was performed and showed that his injury caused two other structures in the knee joint to be injured.
Which of the following structures is most likely also injured?Your Answer: Medial meniscus
Explanation:The O’Donoghue unhappy triad or terrible triad often occurs in contact and non-contact sports, such as basketball, football, or rugby, when there is a lateral force applied to the knee while the foot is fixated on the ground. This produces an abduction-external rotation mechanism of injury.
The O’Donoghue unhappy triad comprises three types of soft tissue injury that frequently tend to occur simultaneously in knee injuries. O’Donoghue described the injuries as: anterior cruciate ligament tear, medial collateral ligament injury, and medial meniscal tear (lateral compartment bone bruise).
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 17
Correct
-
Which of the following muscles inserts into the patella?
Your Answer: The quadriceps femoris complex
Explanation:The quadriceps femoris muscle translates to “four-headed muscle” from Latin. It bears this name because it consists of four individual muscles; rectus femoris, vastus medialis, vastus lateralis, and vastus intermedius. Out of all four muscles, only the rectus femoris crosses both the hip and knee joints. The others cross only the knee joint. These muscles differ in their origin, but share a common quadriceps femoris tendon which inserts into the patella. The function of the quadriceps femoris muscle is to extend the leg at the knee joint and to flex the thigh at the hip joint.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 18
Correct
-
Aside from the inability to extend the leg above the knee, which of the following clinical symptoms should you anticipate seeing in a patient who had a pelvic and right leg injury as well as femoral nerve damage?
Your Answer: Loss of sensation over the anterior thigh
Explanation:The femoral nerve runs down the front of the leg from the pelvis. It gives the front of the thigh and a portion of the lower leg sensation.
Extension of the leg at the knee joint, flexion of the thigh at the hip are produced by muscles that is primarily innervated by the femoral nerve.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 19
Incorrect
-
A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:
Your Answer: Tibial and superficial fibular nerve
Correct Answer: Tibial and deep fibular nerve
Explanation:Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
-
Question 20
Correct
-
Which of the following nerves has been damaged when a patient presents with a foot drop?
Your Answer: Common peroneal nerve
Explanation:The common peroneal nerve often referred to as the common fibular nerve, is a major nerve that innervates the lower extremity. It is one of the two major branches off the sciatic nerve and receives fibres from the posterior divisions of L4 through S2 nerve roots. The common peroneal nerve separates from the sciatic nerve in the distal posterior thigh proximal to the popliteal fossa. After branching off of the sciatic nerve, it continues down the thigh, running posteroinferior to the biceps femoris muscle, and crosses laterally to the head of the lateral gastrocnemius muscle through the posterior intermuscular septum. The nerve then curves around the fibular neck before dividing into two branches, the superficial peroneal nerve (SPN) and the deep peroneal nerve (DPN). The common peroneal nerve does not have any motor innervation before dividing; however, it provides sensory innervation to the lateral leg via the lateral sural nerve.
The superficial peroneal nerve innervates the lateral compartment of the leg, and the deep peroneal nerve innervates the anterior compartment of the leg and the dorsum of the foot. These two nerves are essential in the eversion of the foot and dorsiflexion of the foot, respectively. The superficial and deep peroneal nerves provide both motor and sensory innervation.
The most common presentation with common peroneal nerve injury or palsy is acute foot drop, although symptoms may be progressive and can include sensory loss or pain. Weakness in foot eversion may occur if the superficial peroneal nerve component is involved.
-
This question is part of the following fields:
- Anatomy
- Lower Limb
-
SESSION STATS - PERFORMANCE PER SPECIALTY
