Clinical Anatomy

Dr.Metwally Shaheen ( FRCS) Ortho. Consultant ( Head of
Orthopaedic Department SGH-J

)

The Upper Limb

1. The distal attachment (insertion) of the triceps brachii muscle is: A. coronoid process of the ulna B. olecranon process of ulna C. styloid process of ulna D. radial notch of ulnar E. ulnar tuberosity

ulnar tuberosity . radial notch of ulnar E. The distal attachment (insertion) of the triceps brachii muscle is: A. styloid process of ulna D.1. coronoid process of the ulna B. olecranon process of ulna C.

median nerve D. ulnar artery C. palmar branch of the ulnar nerve E.2. tendon of the palmaris longus B. Which of these structures passes deep to the flexor retinaculum at the wrist? A. radial artery .

tendon of the palmaris longus B.2. palmar branch of the ulnar nerve E. Which of these structures passes deep to the flexor retinaculum at the wrist? A. median nerve D. ulnar artery C. radial artery .

4 Median nerve.4 FDP…….The Carpal tunnel  Stractures passing deep to the flexor retinaculum:      FDS……. FPL. FCR .

extension D. adduction C. opposition . abduction B. flexion E.3. The thumb action that is totally affected by radial nerve trauma is: A.

adduction C. opposition .3. flexion E. The thumb action that is totally affected by radial nerve trauma is: A. abduction B. extension D.

which nerve is suspected to be nonfunctional? A. ulnar D. and the patient is unable to perform this action.4. radial B. deep radial E. superficial radial . median recurrent C. If you slide a piece of paper between a patients fingers and asked the patient to hold onto the paper when you try to pull it from the fingers.

median recurrent C. radial B. ulnar D. deep radial E.4. superficial radial . If you slide a piece of paper between a patients fingers and asked the patient to hold onto the paper when you try to pull it from the fingers. and the patient is unable to perform this action. which nerve is suspected to be nonfunctional? A.

flexor pollicis longus E. pronator teres D.5. Which of these muscles of the forearm has a double innervation? A. flexor digitorum superficialis C. flexor digitorum profundus B. pronator quadratus .

flexor digitorum superficialis C. flexor digitorum profundus B. pronator quadratus . Which of these muscles of the forearm has a double innervation? A. flexor pollicis longus E. pronator teres D.5.

6. Numbness to the skin on the lateral ( radial ) half of the palm of the hand would be caused by a lesion to which nerve? A. anterior interosseous . radial C. median D. superficial radial E. ulnar B.

median D. ulnar B.6. radial C. anterior interosseous . superficial radial E. Numbness to the skin on the lateral ( radial ) half of the palm of the hand would be caused by a lesion to which nerve? A.

ulnar D. musculocutaneous . axillary C.7. The nerve most likely to be injured in fractures of the medial epicondyle is the : A. median E. radial B.

7. axillary C. ulnar D. radial B. The nerve most likely to be injured in fractures of the medial epicondyle is the : A. median E. musculocutaneous .

median E. ulnar . A 25 years old male patient sustained anterior dislocation of his right shoulder after beeing involved in a car accident . axillary B. Which nerve is probably damaged if a patient cannot abduct the arm beyond 25 degrees? A.8. radial C. musculocutaneous D.R 2 weeks ago. that was reduced in the E.

8. that was reduced in the E. radial C. median E.R 2 weeks ago. Which nerve is probably damaged if a patient cannot abduct the arm beyond 25 degrees? A. ulnar . A 25 years old male patient sustained anterior dislocation of his right shoulder after beeing involved in a car accident . musculocutaneous D. axillary B.

median nerve B. ulnar nerve D. musculocutaneous nerve . intercostobrachial nerve E. radial nerve C.9. Loss of pronation of the hand suggests a lesion of the: A.

ulnar nerve D.9. musculocutaneous nerve . Loss of pronation of the hand suggests a lesion of the: A. radial nerve C. median nerve B. intercostobrachial nerve E.

thoracodorsal . If you notice that the thenar muscles are atrophied. which nerve would you suppose has been injured? A. musculocutaneous B. ulnar C. the muscles will atrophy (get smaller). radial D. when a motor nerve to a muscle is sectioned.10. median E. After a time.

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musculocutaneous B. ulnar C. radial D. the muscles will atrophy (get smaller). when a motor nerve to a muscle is sectioned. After a time. median E. which nerve would you suppose has been injured? A. If you notice that the thenar muscles are atrophied. thoracodorsal .10.

pectoralis major . sternocleidomastoid E. trapezius C. Which of the following muscles is responsible for this ? A. When the clavicle has been fractured at about the junction of the middle and distal thirds. anterior deltoid fibers B. subclavius D. The clavicle is one of the most fractured bones.11. the proximal end has been pulled upward.

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The clavicle is one of the most fractured bones. Which of the following muscles is responsible for this ? A. the proximal end has been pulled upward. anterior deltoid fibers B. subclavius D. trapezius C. When the clavicle has been fractured at about the junction of the middle and distal thirds. pectoralis major . sternocleidomastoid E.11.

C5. C5. C7 B. C8. C4. C6. Tl E.12. Tl D. C6. C6 . C6 C. C5. C5. In Klumpke's palsy the lesion involves A. C8. C7.

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C5. C8. C4. In Klumpke's palsy the lesion involves A. C6. C8. Tl E. C7 B. C5. C6. C5. C5. C7. C6 . C6 C. Tl D.12.

the deformity seen is A. Policeman's or waiter's tip position of upper limb B.In Klumpke's palsy. Wrist drop E. Claw hand C. Loss of rounded contour of the shoulder .13. Ape hand D.

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Policeman's or waiter's tip position of upper limb B. Loss of rounded contour of the shoulder .13.In Erb's palsy. Ape hand D. Wrist drop E. the deformity seen is A. Claw hand C.

In the spiral (radial groove) C.14. Above the lateral epicondyle D. In the axilla B. In the posterior compartment of the forearm . Paralysis of the triceps muscle will occur if radial nerve is injured A. In the cubital fossa E.

Paralysis of the triceps muscle will occur if radial nerve is injured A. In the cubital fossa E. In the posterior compartment of the forearm . Above the lateral epicondyle D. In the spiral (radial groove) C. In the axilla B.14.

Axillary nerve E. Radial nerve . Musculocutaneous nerve D.15. Median nerve C. The most disabling injury to the hand is due to injury to A. Ulnar nerve B.

Radial nerve . Ulnar nerve B. The most disabling injury to the hand is due to injury to A. Musculocutaneous nerve D.15. Median nerve C. Axillary nerve E.

16.lumbrical B. Inability to flex the distal phalanx of the middle finger indicates injury to which of these muscles? A.flexor digitorum superficialis D.palmar interosseous .flexor digitorum profundus E.dorsal interosseous C.

palmar interosseous . flexor digitorum superficialis D. Inability to flex the distal phalanx of the middle finger indicates injury to which of these muscles? A. lumbrical B. flexor digitorum profundus E.16. dorsal interosseous C.

radial B. musculocutaneous D. Loss of opposition of the thumb is a symptom associated with lesion of which nerve? A. ulnar C. posterior interosseous .17. median E.

radial B. musculocutaneous D. ulnar C. posterior interosseous .17. Loss of opposition of the thumb is a symptom associated with lesion of which nerve? A. median E.

infraspinatus C. supraspinatus D.18. teres minor B. The only rotator cuff muscle that does not contribute to rotation of the arm is the: A. subscapularis .

teres minor B.18. supraspinatus D. infraspinatus C. subscapularis . The only rotator cuff muscle that does not contribute to rotation of the arm is the: A.

radial D.19. The nerve most likely to be traumatized with a fracture of the surgical neck of the humerus is the: A. ulnar E. profunda brachii . axillary C. median B.

ulnar E. axillary C. radial D. The nerve most likely to be traumatized with a fracture of the surgical neck of the humerus is the: A. median B. profunda brachii .19.

20. A 9 years old child brought to the E.R in your hospital with painfull swelling of his left elbow after fall on outstretched hand while playing football . x. ray revealed presence of supracondylar fracture The child was unable to flex his index or to make a circle by the index and thumb. The nerve most likely to be injuried is : A. B. C. D. E. ulnar nerve. median nerve. radial nerve. musculocutaneous nerve. axillary nerve.

20. A 9 years old child brought to the E.R in your hospital with painfull swelling of his left elbow after fall on outstretched hand while playing football . x. ray revealed presence of supracondylar fracture The child was unable to flex his index or to make a circle by the index and thumb. The nerve most likely to be injuried is :
A. B. C. D. E. ulnar nerve. median nerve. radial nerve. musculocutaneous nerve. axillary nerve.

The Lower Limb

1. c. especially in the elderly. Subtrochanteric e. Intertrochanteric (between the trochanters) d. Cervical (neck). Hip fractures. What type of femoral fracture in adults is most likely to result in avascular necrosis of the femoral head? a. often do not heal adequately. Midfemoral shaft . Acetabular b.

Acetabular b. Intertrochanteric (between the trochanters) d. Hip fractures. Midfemoral shaft . Subtrochanteric e. especially in the elderly. often do not heal adequately.1. What type of femoral fracture in adults is most likely to result in avascular necrosis of the femoral head? a. Cervical (neck). c.

2. Femoral nerve c. Femoral branch of the genitfemoral nerve b. Ilioinguinal nerve e. or even painful sensation in the anterolateral region of the thigh may occur in obese persons. hyperesthesia. Lateral femoral cutaneous nerve . Iliohypogastric nerve d. Paresthesia. It results from an abdominal panniculus adiposus that bulges over the inguinal ligament and compresses which of the following underlying nerves? a.

Femoral branch of the genitfemoral nerve b. Iliohypogastric nerve d. or even painful sensation in the anterolateral region of the thigh may occur in obese persons. hyperesthesia. Ilioinguinal nerve e. Paresthesia. It results from an abdominal panniculus adiposus that bulges over the inguinal ligament and compresses which of the following underlying nerves? a. Lateral femoral cutaneous nerve .2. Femoral nerve c.

and plantaris muscles b.3. Gastrocnemius. The process of unlocking the fully extended knee in preparation for flexion requires initial contraction of which of the following? a. Sartorius muscle and short head of the biceps femoris muscle . Quadriceps femoris muscle e. soleus. Hamstring muscles c. Popliteus muscle d.

Gastrocnemius. Hamstring muscles c. soleus. Quadriceps femoris muscle e. Sartorius muscle and short head of the biceps femoris muscle . Popliteus muscle d. The process of unlocking the fully extended knee in preparation for flexion requires initial contraction of which of the following? a.3. and plantaris muscles b.

Loss of extension at the knee b.4. Which of the following motor deficits would be most likely to occur? a. Loss of plantar flexion c. Loss of eversion e. A patient experienced a prolonged stay in one position during a recent surgery and postoperative recovery that resulted in compression of the common fibular (peroneal) nerve against the fibular head. Loss of medial rotation of the tibia . Loss of flexion at the knee d.

Loss of eversion e. Loss of extension at the knee b. Which of the following motor deficits would be most likely to occur? a. Loss of plantar flexion c. Loss of flexion at the knee d. Loss of medial rotation of the tibia . A patient experienced a prolonged stay in one position during a recent surgery and postoperative recovery that resulted in compression of the common fibular (peroneal) nerve against the fibular head.4.

Superficial fibular e. Saphenous d. Sural . The muscles of the anterior compartment of the leg are innervated primarily by which of the following nerves? a. Deep peroneal. Lateral sural cutaneous c. b.5.

The muscles of the anterior compartment of the leg are innervated primarily by which of the following nerves? a. b. Superficial peroneal. Lateral sural cutaneous c.5. Sural . Deep peroneal. Saphenous d. e.

Negative pressure in the acetabular fossa. A 72-year-old female suffered a hip dislocation when she fell down the steps to here garage. C. Which of the following stractures is most significant in resisting hyperextension of the hip joint ? A. B. D.6. . Gluteus maximus muscle. Ischiofemoral ligament . Pubofemoral ligament. Iliofemoral ligament. E.

C. A 72-year-old female suffered a hip dislocation when she fell down the steps to here garage. Ischiofemoral ligament .6. Negative pressure in the acetabular fossa. E. . B. Pubofemoral ligament. Iliofemoral ligament. Gluteus maximus muscle. D. Which of the following stractures is most significant in resisting hyperextension of the hip joint ? A.

Anterior cruciate ligament. Which stracture would most likely also be injured due to its attachment to this ligament ? A. Unable to walk without assistance . Tendon of semitendinosus. Lateral meniscus. B. he is taken to the hospital . . Medial meniscus.An MRI examination reveales a torn medial collateral ligament . A 19-year old football player was hit on the lateral side of his knee just as he put that foot on the ground . Posterior cruciate ligament. C. D.7. E.

Unable to walk without assistance . Posterior cruciate ligament.An MRI examination reveales a torn medial collateral ligament . B. E. C. Anterior cruciate ligament. Lateral meniscus. he is taken to the hospital . A 19-year old football player was hit on the lateral side of his knee just as he put that foot on the ground . Which stracture would most likely also be injured due to its attachment to this ligament ? A. D. Tendon of semitendinosus.7. . Medial meniscus.

Tibial nerve . Medial femoral cutaneous nerve b.8. the patient experienced severe pain that radiated along the medial border of the foot. Saphenous nerve c. During the procedure. Which of the following nerves was accidentally included in a ligature during this procedure? a. In a presurgical patient. Superficial fibular nerve d. Sural cutaneous nerve e. the great saphenous vein was cannulated in the vicinity of the ankle.

During the procedure. Which of the following nerves was accidentally included in a ligature during this procedure? a. Tibial nerve .8. Sural cutaneous nerve e. Superficial fibular nerve d. Saphenous nerve c. the great saphenous vein was cannulated in the vicinity of the ankle. In a presurgical patient. Medial femoral cutaneous nerve b. the patient experienced severe pain that radiated along the medial border of the foot.

Saphenous cutdown Saphenous nerve Great Saphenous vein .

Between the tendons of the extensor digitorum longus and fibularis (peroneus) tertius muscles b. Between the tendons of the tibialis anterior and extensor hallucis longus muscles d. Between the tendons of the extensor hallucis and extensor digitorum muscles c. Immediately anterior to the lateral malleolus e. A pulse in the dorsalis pedis artery may be palpated in which of the following ways? a. Immediately posterior to the medial malleolus .9.

9. A pulse in the dorsalis pedis artery may be palpated in which of the following ways? a. Immediately posterior to the medial malleolus . Between the tendons of the extensor hallucis and extensor digitorum muscles c. Between the tendons of the tibialis anterior and extensor hallucis longus muscles d. Immediately anterior to the lateral malleolus e. Between the tendons of the extensor digitorum longus and fibularis (peroneus) tertius muscles b.

Navicular e. When you examine his foot it is tender to pressure on both the medial and lateral aspects of the heel inferior to the tibia. A 12-year-old boy is brought to the emergency room by his mother following being pushed out of the neighbor’s tree house.10 . Calcaneus b. about 10 ft off the ground. He can walk but his right heel hurts every time he puts weight on it. Cuneiform . Fibula c. Tibia d. You order plain films of his right lower extremity because you suspect he has fractured which of the following? a.

10 . You order plain films of his right lower extremity because you suspect he has fractured which of the following? a. Calcaneus b. Fibula c. A 12-year-old boy is brought to the emergency room by his mother following being pushed out of the neighbor’s tree house. When you examine his foot it is tender to pressure on both the medial and lateral aspects of the heel inferior to the tibia. Navicular e. Tibia d. Cuneiform . He can walk but his right heel hurts every time he puts weight on it. about 10 ft off the ground.

Left inferior gluteal b. Right inferior gluteal c. At his physician's clinic. causing his problem? a. his left hip drops. Which of the following nerves is most likely damaged. Left superior gluteal d. when he is asked to stand on his right foot.11.Right superior gluteal . A 45-year-old man has trouble walking.

11. A 45-year-old man has trouble walking. At his physician's clinic, when he is asked to stand on his right foot, his left hip drops. Which of the following nerves is most likely damaged, causing his problem?
a. Left inferior gluteal b. Right inferior gluteal c. Left superior gluteal d.Right superior gluteal

Glutesus medius & minimus

12. Saphenous ‘cut down’ is carried out to give intravenous infusion to patients in whom the other superficial veins in the body are either collapsed or invisible. In such situations, which of the following should be the site of incision to have an access to the vein?
a. In front of the medial malleolus b. Behind the medial malleolus c. In front of the lateral malleolus d. Behind the lateral malleolus

In front of the lateral malleolus d. which of the following should be the site of incision to have an access to the vein? a. In front of the medial malleolus b. Behind the medial malleolus c. Behind the lateral malleolus .12. In such situations. Saphenous ‘cut down’ is carried out to give intravenous infusion to patients in whom the other superficial veins in the body are either collapsed or invisible.

Saphenous cutdown Saphenous nerve Great Saphenous vein .

If a nerve injury is suspected.13. A 45-year-old woman arrives at the casualty after being injured in an automobile collision. Her right foot is in a dorsiflexed and everted position. Deep peroneal d. Common peroneal b. Superficial peroneal c. which of the following has most likely been injured? a. Tibial .

Deep peroneal d. which of the following has most likely been injured? a.13. Superficial peroneal c. If a nerve injury is suspected. Her right foot is in a dorsiflexed and everted position. Common peroneal b. A 45-year-old woman arrives at the casualty after being injured in an automobile collision. Tibial .

Which of the following structures is most likely torn? a. Posterior cruciate ligament c. The physician is able to demonstrate significant anterior movement of the tibia in relation to the femur. Fibular collateral ligament d. Tibial collateral ligament e.14. Anterior cruciate ligament b. A 22-year-old man is examined by the team physician after injuring his right leg during a football game. Lateral meniscus .

14. Anterior cruciate ligament b. Posterior cruciate ligament c. The physician is able to demonstrate significant anterior movement of the tibia in relation to the femur. Fibular collateral ligament d. Tibial collateral ligament e. Lateral meniscus . Which of the following structures is most likely torn? a. A 22-year-old man is examined by the team physician after injuring his right leg during a football game.

Common peroneal . Obturator C. A 77-year-old woman has difficulty climbing stairs because of weakness in her limb. Her knee jerk reflex is normal and she is able to stand on her heels and on the "balls" of her feet. Inferior gluteal D. Injury to which of the following nerves is the most likely cause of these findings? A. Tibial B. Femoral E.15.

Inferior gluteal D. Femoral E. Obturator C. Her knee jerk reflex is normal and she is able to stand on her heels and on the "balls" of her feet. Common peroneal . Injury to which of the following nerves is the most likely cause of these findings? A. A 77-year-old woman has difficulty climbing stairs because of weakness in her limb.15. Tibial B.

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descends through the calf between flexor digitorum longus medially and flexor hallucis longud laterally. C. innervates both medial and lateral heads of gastrocnemius. B.16. it lies on tibialis post. D. . innervates the skin over the back of the leg and the lateral border of the foot through its sural branch. its injury results in foot drop. In the upper half.All the followings are true about the tibial nerve except ? A. E.

C. it lies on tibialis post. B. innervates both medial and lateral heads of gastrocnemius. E. innervates the skin over the back of the leg and the lateral border of the foot through its sural branch. descends through the calf between flexor digitorum longus medially and flexor hallucis longud laterally. .All the followings are true about the tibial nerve except ? A. D.16. In the upper half. its injury results in foot drop.

Flexor hallucis longus b. Tibialis posterior d.17. Tibialis anterior . Flexor digitorum longus c. The tendon of which of the following muscles is injured in this case? a. She has a deep cut. which has injured a tendon immediately posterior to the medial malleolus. A 12-year-old girl is brought to the emergency department after falling on the sharp edge of a tin can.

Flexor hallucis longus b.17. Flexor digitorum longus c. Tibialis posterior d. The tendon of which of the following muscles is injured in this case? a. She has a deep cut. A 12-year-old girl is brought to the emergency department after falling on the sharp edge of a tin can. Tibialis anterior . which has injured a tendon immediately posterior to the medial malleolus.

knee-high boots during his dance routine.18. Which of the following nerves is most likely compressed? a. Femoral e. Common fibular (peroneal) . Tibial b. A 30-year-old man has numbness of the anterolateral surface of his right leg and dorsum of his right foot when he wears tight. Saphenous c. Medial plantar d.

Common fibular (peroneal) . A 30-year-old man has numbness of the anterolateral surface of his right leg and dorsum of his right foot when he wears tight. Femoral e.18. Tibial b. Which of the following nerves is most likely compressed? a. Medial plantar d. knee-high boots during his dance routine. Saphenous c.

Subcutaneous infrapatellar c. Suprapatellar b. Deep infrapatellar . Prepatellar d.19. Housemaid’s knee is associated with the inflammation of which of the following bursae? a.

Deep infrapatellar . Suprapatellar b. Housemaid’s knee is associated with the inflammation of which of the following bursae? a. Prepatellar d. Subcutaneous infrapatellar c.19.

Is subcutaneous as it corosses the neck of the fibula. b. Supplies the skin over the medial border of the hallux. . it divides in the substance of the peroneus longus. Supplies the three peroneal muscles through its superficial peroneal branch.20. d.All the followings are true about the common fibular ( peroneal ) nerve except? a. c.

d. . b.20. Is subcutaneous as it corosses the neck of the fibula. it divides in the substance of the peroneus longus. c. Supplies the three peroneal muscles through its superficial peroneal branch.All the followings are true about the common fibular ( peroneal ) nerve except? a. Supplies the skin over the medial border of the hallux.

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