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Question 1
Incorrect
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Superficial fibular nerve palsy results in which of the following clinical features:
Your Answer: Loss of dorsiflexion of the great toe
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 2
Incorrect
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Which nerve supplies the muscle flexor hallucis longus?
Your Answer: Obturator nerve
Correct Answer: Tibial nerve
Explanation:Flexor hallucis longus is innervated by the tibial nerve, composed of spinal roots L4, L5, S1, S2, and S3.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 3
Incorrect
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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: Superior gluteal nerve
Correct 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
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Question 4
Incorrect
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Which of the following best describes the popliteal artery's course?
Your Answer: Begins at the mid-thigh as a continuation of the femoral artery
Correct Answer: After exiting the popliteal fossa terminates at the lower border of the popliteus muscle
Explanation:The popliteal artery divides into the anterior and posterior tibial arteries at the lower border of the popliteus after exiting the popliteal fossa between the gastrocnemius and popliteus muscles.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 5
Correct
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You are examining the lower limbs of a 54 year old man who presented after falling from a ladder at home. During your neurological assessment you note a weakness of hip flexion. Which of the following nerves is the most important for flexion of the thigh at the hip joint:
Your Answer: Femoral nerve
Explanation:Flexion of the thigh at the hip joint is produced by the sartorius, psoas major, iliacus and pectineus muscles, assisted by the rectus femoris muscle, all innervated by the femoral nerve (except for the psoas major, innervated by the anterior rami of L1 – 3).
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 6
Incorrect
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A 38-year-old woman presented to the emergency room after an incident of slipping and falling onto her back and left hip. Upon physical examination, it was noted that she has pain on hip flexion, but normal hip adduction. Which of the following muscles was most likely injured in this case?
Your Answer: Pectineus
Correct Answer: Sartorius
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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 7
Correct
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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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 8
Incorrect
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Which of the following ligaments supports the head of the talus?
Your Answer: Anterior talofibular ligament
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 9
Incorrect
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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: Deep peroneal nerve
Correct 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
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Question 10
Incorrect
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A 25-year-old footballer develops pain and stiffness in his thigh. A diagnosis of iliopsoas syndrome is made.
Iliacus is innervated by which of the following nerves? Select ONE answer only.Your Answer: Obturator nerve
Correct Answer: Femoral nerve
Explanation:Iliacus is innervated by the femoral nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 11
Incorrect
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Regarding the lumbar plexus, which of the following is a direct muscular branch?
Your Answer: Nerve to piriformis
Correct Answer: Nerve to quadratus lumborum
Explanation:The lumbar plexus gives rise to several branches which supply various muscles and regions of the posterior abdominal wall and lower limb. These branches include the Iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral and obturator nerves.
In addition, the lumbar plexus gives off muscular branches from its roots, a branch to the lumbosacral trunk and occasionally an accessory obturator nerve.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 12
Incorrect
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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: Loss of sensation over anterior thigh
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 13
Incorrect
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An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?
Your Answer: Fibularis tertius
Correct Answer: Fibularis brevis
Explanation:An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards.
When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle.
The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 14
Incorrect
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Which of the following nerves is most important for eversion of the foot:
Your Answer: Tibial nerve
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 15
Incorrect
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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: Sartorius
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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 16
Incorrect
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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: Trendelenburg's sign
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 17
Correct
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The most important nerve for plantar flexion of the foot at the ankle joint is:
Your Answer: Tibial nerve
Explanation:Muscles of the posterior compartment of the leg, innervated by the tibial nerve, perform plantar flexion of the foot at the ankle joint. The fibularis longus (innervated by the superficial fibular nerve) assists in plantar flexion but is not the most important.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 18
Incorrect
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Which of the following nerves supplies innervation to the extensor hallucis longus?
Your Answer: Tibial nerve
Correct Answer: Deep peroneal nerve
Explanation:Extensor hallucis longus is innervated by the deep fibular nerve (root value L5 and S1).
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 19
Incorrect
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Which of the following nerves has been damaged when a patient presents with a foot drop?
Your Answer: Femoral nerve
Correct 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.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 20
Correct
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A 30-year-old man presents with piriformis syndrome pain, tingling, and numbness in her buttocks. He noted that the pain gets worse upon sitting down. He was seen by a physiotherapist and a diagnosis of piriformis syndrome was made.
Which of the following nerves becomes irritated in piriformis syndrome?Your Answer: Sciatic nerve
Explanation:Piriformis syndrome is a clinical condition of sciatic nerve entrapment at the level of the ischial tuberosity. While there are multiple factors potentially contributing to piriformis syndrome, the clinical presentation is fairly consistent, with patients often reporting pain in the gluteal/buttock region that may shoot, burn or ache down the back of the leg (i.e. sciatic-like pain). In addition, numbness in the buttocks and tingling sensations along the distribution of the sciatic nerve is not uncommon.
The sciatic nerve runs just adjacent to the piriformis muscle, which functions as an external rotator of the hip. Hence, whenever the piriformis muscle is irritated or inflamed, it also affects the sciatic nerve, which then results in sciatica-like pain.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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