WINDSOR UNIVERSITY SCHOOL OF MEDICINE

Anatomy- lower limb ( august 10th 2009)

1. A common peroneal nerve palsy

a. Can occur following a fracture of the neck of the fibula

b. Causes loss of extension of the big toe
c. Causes a characteristic foot drop
d. Causes a loss of inversion of the foot
e. Produces anaesthesia of the sole of the foot

2. What is the name of the muscle that inserts on the base of the 5th metatarsal bone?
a. Fibularis brevis
b. Flexor carpi ulnaris
c. Tibialis posterior
d. Abductor digiti minimi
e. The 4th lumbrical

3. What is the nerve of the anterior compartment of the thigh?

a. Femoral nerve
b. Obturator nerve
c. Saphenous nerve
d. Tibial portion of sciatic nerve
e. Common fibular (peroneal) portion of the sciatic nerve

4. If the sciatic nerve is injured near the greater sciatic foramen, what action at the hip will be
weakened?
a. Abduction
b. Lateral (external) rotation
c. Flexion
d. Extension
e. Medial (internal) rotation

5. The homolog of the median nerve in the foot is the:

a. Sural nerve
b. Saphenous nerve
c. Deep fibular (peroneal) nerve
d. Medial plantar nerve
e. Lateral plantar nerve
6. Which of following muscles is innervated by the deep fibular (peroneal) nerve?
a. Fibularis tertius
b. Flexor digitorum brevis
c. Flexor digitorum longus
d. All of the above
e. None of the above

7. Difficulty in standing on one’s toes is symptomatic of injury to the:

a. Tibial nerve
b. Common fibular (peroneal) nerve
c. Superficial fibular (peroneal) nerve
d. Deep fibular (peroneal) nerve
e. Both A and B are correct

8. Which statements about the knee joint are true?

a. The femur rotates medially on the tibia during flexion when the foot is fixed
b. The medial meniscus is attached to the medial collateral ligament
c. The anterior cruciate ligament limits anterior displacement of the tibia
d. The anterior cruciate ligament limits lateral rotation of the femur during extension
e. B and C are correct

9. Which muscle DOES NOT cross anterior to the transverse axis of the hip joint?
a. Tensor fascia latale
b. Psoas
c. Rectus femoris
d. Sartorius
e. Vastus lateralis

10. Which of the following muscles is/are innervated by the superficial peroneal nerve?
a. Fibularis (peroneus) longus
b. Fibularis (peroneus) brevis
c. Fibularis (peroneus) tertius
d. A and B
e. A,B and C

11. Inability to hold the pelvic girdle level while standing on one foot is symptomatic of an injury to:
a. Inferior gluteal nerve
b. Superficial fibular (peroneal) nerve
c. Superior gluteal nerve
d. Deep fibular (peroneal) nerve
e. Obturator nerve
12. Difficulty in crossing the knees while sitting in a chair is symptomatic injury to:
a. Femoral nerve
b. Obturator nerve
c. Superior gluteal nerve
d. Inferior gluteal nerve
e. Fibular (peroneal) division of the sciatic nerve

13. The ilioinguinal nerve is derived from:

a. T10
b. T12
c. L1
d. L2-L4
e. L4-L5

14. Which statement about the psoas major muscle is FALSE?

a. It originates in the thorax and inserts in the thigh, so infection can potentially spread
from the thorax to the thigh by following its facial sheath
b. It joins with the iliacus to form the iliiopsoas muscle, which is the chief extensor of the
thigh
c. Much of the lumbar plexus can be found within its belly
d. It inserts on the lesser trochanter of the femur

15. While standing on one foot (right) the opposite side of the hip (left) drops. Which of the
following nerve has a lesion?
a. Femoral nerve
b. Deep peroneal nerve
c. Inferior gluteal nerve
d. Tibial nerve
e. Superior gluteal nerve

16. Both the avulsion fracture of the ischial tuberosity and vertical shear fracture of the pelvis will
lead to weakened knee flexion and extension of the hip joint?
a. True
b. False

17. Varicosity of the vein in the case of lower is because of the valvular insufficiency in which of the
following veins?
a. Superficial
b. Deep
c. Perforating
d. None of the above
 18. During an examination of a patient, YOU notice that the person is displacing this right shoulder
posteriorly during right heel strike. This displacement suggests paralysis of?
a. Right Quadriceps Muscle
b. Right Anterior Tibialis
c. Right Gluteus Maximus
d. Right Gluteus Medius
e. Right Gastrocnemius

19. A patient who has had a skiing accident is brought to the emergency room. The region around
his knee is swollen. The skin of his foot is pale and no dorsalis pedis pulse can be detected. An x-
ray reveals a fracture of the femur immediately proximal to the femoral condyles. Which of the
following arteries has been compressed by the displacement of this fracture?
a. Anterior Tibial Artery
b. Femoral Artery
c. Popliteal Artery
d. Posterior Tibial Artery
e. Profunda Femoris Artery

20. A patient presents to YOU with torn medical collateral ligament of the right knee. Which of the
following signs may be elicited during physical examination?
a. Posterior Displacement of the Tibia
b. Anterior Displacement of the Femur
c. Abnormal passive Abduction of the extended knee
d. Abnormal passive Adduction of the extended knee

Lower Limb

Second heart of body?

Gastrocnemius

Pes-Planus (flat foot), foot is?

Everted

Key-stone for medial longitudinal arch?

Talus
Movement possible in knee joint (Tibiofemoral joints)?

Flexion, Extension, Medial rotation, Lateral Rotation

Osteoarthritis (OA), the pain is due to

Compression of Nerves in between the articular ends

Major muscle responsible for unlocking the knee?

Popliteus

Important tarsal bone that does not have any muscle attachments?

Talus

Most common complication of femur neck fracture?

Avascular necrosis, Osteonecrosis, Non union, Abnormal gait due to laterally rotated limb

Fracture of the femoral neck: Lower limb will be laterally rotated and shortened. This is because the
gluteus maximus, piriformis, obturator internus, superior and inferior gemelli, and quadratus femoris
rotate the distal fragment laterally. The rectus femoris, adductor muscles, and hamstrings draw the
distal fragment proximally.

Femoral hernia can be differentially diagnosed from inguinal hernia?

Neck sac always lies below & Lateral to pubic tubercle

Common action of tibialis anterior & posterior muscles?

Invertion

Posterior displacement of femur on tibia is maintained by?

ACL (anterior cruciate ligament)

Trendelburg sign is positive (+)?

Pelvis sinks downward on unsupported leg

Femoral triangle: which is incorrect

medial boundary is adductor magnus

Boundaries: Inguinal Ligament Superior, Sartorius Lateral, Adductor Longus Medial (ISSLAM)

Medial Femoral Circumflex Artery:

Does not send a branch with obturator canal

Femoral artery becomes Popliteal artery passing thru:

Adductor hiatus

Deep (Profundus) femoral artery gives rise to perforating arteries, which supply:

Post thigh muscle

Adductor tubercle:

Medial condyle of femur

Which is part of Cruciate anastomosis of hip:

All except inferior epigastic artery.

st
Above Inf Gluteal A, Below 1 Perforating A, Medial Medial Circumflex Femoral A, Lateral Lateral
Circumflex Femoral A.

Midinguinal pt:

Post triangle
Adductor canal:

femoral canal

Contains Saphenous Nerve and Nerve to Vastus Medialis.

Main Varicose Veins

Great and Small Saphenous Veins

Lat cutaneous nerve:

spinal valves b L2-L3

Root value sciatic nerve:

ventral rami L4, L5, S1-S3

Cutaneous supply peroneal nerve includes dorsum except:

st nd
Web b/w 1 and 2 toe

In femoral triangle:

profunda femoris (deep femoral) artery originates from femoral artery,

femoral nerve lies lateral to femoral artery,

some inguinal lymph nodes may be found,

femoral vein lies medial to femoral artery

52 year old female presents with groin pain. Immediately inferior to inguinal canal. Physician suspected that
patient has femoral hernia contain a loop of small end. Which structure immediately located medial to sac of
hernia:

Lacunar ligament
/*******************************************************************/

Which part of the thigh can be palpated when the hip is flexed and abducted?

Lateral thigh

When the greater trochanter of the femoral is fractured, which nerve is injured?

a. Superior gluteal nerve

b. Nerve to obturator internus

Cruciate anastomoses contributes to all except

Superior epigastric artery

st
Above Inf Gluteal A, Below 1 Perforating A, Medial Medial Circumflex Femoral A, Lateral Lateral
Circumflex Femoral A.

Which lower limb veins are most likely to become varicose?

Superficial veins (great and small saphenous veins)

Factors contributing to varicose veins

Multiple pregnancies, Long standing hours, Incompetent valves

Surgeon operating on popliteal aneurysm ligates Adductor Canal which begins at apex of femoral triangle and ends
at the Adductor Hiatus?

Lies between adductor magnus/longus, and vastus medialis muscle

Femoral triangle boundaries?

ISSLAM (Inguinal Sup, Sartorius Lat, Adductor Longus Med)

Femoral sheath

L- femoral artery
 M- femoral canal

Mid- femoral V

Also, Femoral branch of genitor femoral nerve, no saphenous opening

No Femoral Nerve.

Saphenous opening provide pathways for?

Great saphenous vein

What is not a part of the femoral triangle?

Obturator nerve

Mid inguinal point?

Mid point between Anterior Superior Iliac Spine and Pubic Symphysis.

Nerve passing along great saphenous vein?

Saphenous nerve.

Trauma to inguinal ligament

Loss of sensation to all except Lateral Thigh

Popliteal Aneurysm operated in

Adductor Canal

Adductor Canal

Apex of femoral triangle ends at adductor hiatus

Vastus medialis – Antero lateral boundary

Contains femoral vessels, Saphenous N, Nerve to vastus medialis

Adductor Hiatus

Inserted tendon of adductor magnus, allows passage of femoral vessels to popliteal fossa

Popliteal fossa

All except saphenous nerve

Contents: Common Peroneal, Tibial Nerve, Popliteal Vessels, Saphenous Vein.

Femoral Hernia

Common in women

Passes thru femoral ring and canal

Deep inguinal lymph node

Femoral canal

Muscle extended leg and knee joint

Quadriceps femoris

Function of muscles of Anterior of Thigh

Extend leg

Femoral sheath has all except

Femoral nerve

What inserts between Tibia and Fibula

Soleus (Superficial Posterior Leg Muscle)

Unhappy triad

ACL (ant cruciate lig.), Medial Meniscus, Tibial Collateral lig (tcl)

Anterior compartment syndrome, the ligament involved is

ACL

Artery affected in Anterior Compt. Syndrome

a) Anterior tibial artery

b) Dosalis Pedis Artery

Hyper extension of femoral on hip is done by

Ilio Femoral Ligament

Anterior drawer test

Lachman’s test (other test following it is ADT)

Muscle inserts fascia lata

Gluteus maximus

Profunda femoris artery does not give rise to

None of the above

Foot drop

Deep peroneal nerve

Pott’s Fracture

Forced eversion of foot (Dupytren’s Fracture)

Fracture of lower end of Fibula with medial malleolus fracture and rupture of deltoid ligament
Which nerve is vulnerable to injury around neck of fibula

Common peroneal nerve (fibular nerve)

Supplying lateral side of skin and back of leg

Lateral sural cutaneous nerve

Nerve less vulnerable than common peroneal nerve

Superficial peroneal or musculo cutaneous nerve

Loss of skin sensation, paralysis of plantar aspect of medial side of foot

Medial plantar nerve…branch of tibial nerve

Intra muscular injection injury

Common peroneal nerve, branch of sciatic nerve

Medial rotator of tibia

When knee is extended

Ligament supports head of talus and passes from subtant? Tali of calcenous to navicular bone

Plantar calcenus ligament (spring lig)

Injury to dorsalis pedis

nd
Loss of sensation to great and 2 toe

Which muscle cannot do both; extend knee and hip

Semi membranous
Cannot flex thigh and knee

Soleus (sartorius and gracilis do)

Muscle for abduction and flexion of knee

Gracilis and sartorius

Foot drop and high stepping gate, loss of sensation to dorsum of foot and medial aspect

Leads to paralysis (due to damage of DPN) of all dorsi flexors and evertor muscles

Tibialis anterior

Deep peroneal nerve; dorsi-flexion and inversion

Tibialis posterior

Plantar flexes and inversion

Flexor retinaculum components

Tibialis posterior, flexor digitorum longus, flexor hallucis longus

Adductor magnus

Obturator sciatic (tibial portion)

Insertion – Linea Aspera

Action – Adducts, Flexes, Extends Thighs

Pes Anserinus (goose foot)- Anserine Bursa

Lies between TCL – tendons of sartorius, gracilis, semi tendonosus

Not a flexor of hip

Vastus medialis (iliopsoas  great flexor)

Medial meniscus MCL

Posterior Tear (both b and C)

Proximal and medial to the shaft of the femur

Tibia, fibula

Palpation of greater trochantar and ischial tuberosity

Sciatic nerve

Piriformis muscles

Inserts into upper end of greater trochanter of femur- rotates thigh laterally

Waddling Gait

Pelvis falls towards the unaffected side of each step

Paralysis of gluteus medius

Trendelenburgs sign

fracture of neck of femur

dislocation of hip (weakness of gluteus max and med-unsupported side falls instead of rising)

Flexor digiti minimi brevis

affect proximal paralysis of little toe

Sciatic nerve divides into

 Tibial nerve & Common peroneal nerve

Lateral thigh supplied by

Femoral nerve

Superior lateral quadrant

Preferred site to give intramuscular injection

Inserts into iliac crest

Tensor fasciae latae by superior gluteal nerve

Flexor retinaculum

medial malleolus  holds tendons of tibialis posterior

holds flexor digitorum longus

holds flexor hallucis longus

Kick on lateral knee, which ligament is torn

lateral collateral ligament (LCL)

Flexor hallucis longus tendon

inserts into calcaneus

Ilio femoral ligament

largest and most important ligament, reinforces the fibrous capsule

Posterior cruciate lig

prevents anterior displacement of the femur on the tibia

Saphenous nerve

Passes along with the saphenous vein

Femoral nerve

Does not lie in the femoral sheath

Dural nerve

Innervates the lateral side of the head and foot

Great Saphenous vein

Passes thru the Saphenous opening

Structures passing thru both the greater and lesser sciatic foramen

Nerve to the Obturator Internus

Gluteus maximus

Extends and rotates thigh laterally

Gluteus medius and gluteus minimus

Abducts and rotates thigh medially

Quadratus femoris

Rotates the thigh laterally

Femoral canal

site of femoral herniation

Femoral ring

abdominal opening of the femoral canal

Popliteal fossa

Contains popliteal vessels, common peroneal tibial nerves and the small saphenous vein

Saphenous opening

provides pathway for saphenous vein

Football injuries

medial meniscus ligament and lateral connected ligaments

Vastus medialis

extends leg

Obturator internus

rotates thigh laterally

Extensor hallucis longus

extends big toe, dosiflexes and innervates foot

Extensor digitorum longus

extends toes, dorsiflexes and everts foot

Flexor hallucis longus

plantar flexes foot, flexes distal phalynx of big toe

Flexor digitorum longus

flexes lateral four toes

Tibialis posterior

plantar flexes out and inverts foot

Lateral longitudinal arch formed by

cuboid bone

Spring ligament

planta calcaneonavicular

Femoral nerve

Arises from lumbar plexus (L2-L4)

Inferior gluteal nerve

Innervates the gluteus maximus

Sciatic nerve

Largest nerve in the body

Superior gluteal artery

Arises from internal iliac artery

Obturator nerve

Arises from the internal iliac artery

Femoral artery

continuation of the external iliac artery

Popliteal artery

continuation of the femoral artery

Femoral vein

Passes thru Saphenous opening

Femoral hernia

common in women

Potts fracture

caused by forces eversion of the foot

Damage to the femoral nerve

paralysis of quadriceps femoris

Damage to obturator nerve

weakness of adduction

Damage to DPN (Deep Peroneal Nerve)

Results in foot drop

Damage to SPN (Superficial Peroneal Nerve)

Loss of eversion of the foot

Adductor longus

innvervates the obturator nerve

Vastus lateralis

extends leg

Indirect inguinal hernia

occurs on right side

Xiphoid process…..attaches via its pointed causal end to the linea alba

Internal spermatic fascia

derives from transversalis fascia

Cremasteric fascia

originated in the internal oblique muscle

Processes vaginalis

may result in congenital indirect inguinal hernia

Gubernaculum testis

homologus to the round ligament of the uterus

Hip Flexion cannot be produced by:

Vastus Medialis
Individual right gluteus medius muscle will:

demonstrate lowering of left side of Pelvis

Foot drop is:

Deep peronial nerve

Sartoris, Gracilis and Semi tendonosus muscle:

medial shaft of tibia

All produce movement on Hip and Knee joint :

Adductor Magnus

Potts Fracture involve Fracture of Fibula and Rupture of Deltoid ligament produced by:

forced Eversion of foot

38yr old woman brought to woman by fork lift operator. Examation revels loss of sensation of dorsum of left foot.
Dorsiflexion against resistance is not possible. Inversion of subtalar joints on left limb. Diagnosis is trauma to:

Common peroneal nerve and neck of Fibula

Palpation at point equidistant between Ischial tuberosity and greater trochanter of femur reveals what:

Sciatic nerve

Which ligament involved in clipping Injury:

ACL, MCL, MM

/*********************************************************/
Test 1

1. Femoral triangle: which is incorrect

medial boundary is adductor magnus

2. Medial femoral circumflex Artery:

d/n send a branch with obturator canal

3. Femoral triangle: deep femoral artery originiates from femoral artery:

Nerve lateral to artery; Inginual lymph Vein medial to artery

4. Femoral artery becomes popliteal artery passing thru:

adductor hiatus

5. Deep (Profundus) femoral artery gives rise to perforating arteries, which supply:
post thigh muscle

6. Adductor tubercle:
medial condyle of femur

7. which is directly beside Femoral Hernia:

medial to lacunar ligament

8. Which is part of Cruciate anastomis of hip:

all except inferior epigastic artery

9. Trendleburg’s sign:
pelvis will sink downwards on unsupported leg side

10. Post displacement of femur on tibia is maintained by:

anterior Cruciate ligament

11. Common action of tibialis ant and post:

inversion

12. Femoral hernia differentially diagnosed from inginual by:

neck of sac below and lateral to pubic tubercle

13. Fracture of neck femur:

Osteonecrosis, avascular necrosis, abnormal gait due to laterally rotated limb, non union
 14. Tarsal bone with no muscle attachments:
talus

15. Unlocking knee:

Popliteus

16. Osteoarthritis, pain due to:

compression of nerve b/w articular ends

17. Key stone for medial longitudinal arch:

talus

18. Movements in knee joint (Tibio- femoral joints):

flexion, extension, medial and lateral rotation

19. Flat foot:

foot is everted

20. 2nd heart of body:

Gastrocnemius

Test 2:

1. Midinguinal pt: post triangle

2. Adductor canal: femoral canal
3. Saphenous nerve: small saphenous is false
4. Saphenous nerve art is medial side of foot: e
5. varicose veins
6. lat cutaneous nerve: spinal valves b L2-L3
7. Root value sciatic nerve: ventral rami L4, L5, S1-S3
8. Cutaneous supply peroneal nerve includes dorsum except: web b/w 1st and 2nd toe

Test 1:

1. In respect to femoral triangle, select incorrect:

Medial boundary in adductor magnus

2. Which of the following statement about medial femoral circumflex a is false: it sends a branch
with obturator canal
3. In femoral triangle: profunda femoris (deep femoral) artery originates from femoral artery,
femoral nerve lies lateral to femoral artery, some inguinal lymph nodes may be found, femoral
vein lies medial to femoral artery
4. femoral artery: becomes popliteal artery after passing thru adductor hiatus
5. Profunda femoris a (deep femoral a): gives perforating arteries which supply post thigh muscle
6. Adductor tubercle is located in: medial condyle femur
 7. 52 year old female presents with groin pain. Immediately inferior to inguinal canal. Physician
suspected that patient has femoral hernia contain a loop of small end?…which structure
immediately located medial to sac of hernia: lacunar ligament
8. Cruciate anastomosis is of hip joint receives primary contribution from following arteries except:
inf epigastric artery
9. Which of following statements regarding postive trendelburg’s sign is correct: pelvis sinks
downwards on unsupported leg side

Lower Limb Review Questions

2. Which part of the thigh can be palpated when the hip is flexed and abducted?
 lateral thigh

3. When the greater trochanter of the femoral is fractured, which nerve is injured?
a. Superior gluteal nerve
b. Nerve to obturator internus
4. Cruciate anastomoses contributes to all except
 Superior epigastric artery

5. Which lower limb veins are most likely to become varicose?

 superficial veins (great and small saphenous veins)

6. Factors contributing to varicose veins

a. Multiple pregnancies
b. Long standing hours
c. Incompetent valves
7. Surgeon operating on popliteal aneurysm ligates Adductor Canal which begins at apex of
femoral triangle and ends at the Adductor Hiatus
 lies between adductor magnus/longus, and vastus medialis muscle

8. Femoral triangle boundaries

 ISSLAM (Inguinal Sup, Sartorius Lat, Adductor Longus Med)

9. Femoral sheath
L- femoral artery

M- femoral canal

Mid- femoral V

Also, Femoral branch of genitor femoral nerve, no saphenous opening

10. Saphenous opening provide pathways for

 great saphenous vein
11. What is not a part of the femoral triangle?
 obturator nerve

12. Mid inguinal point?

 mid pt between Ant Sup Iliac Spine and Pubic Symphysis

13. Nerve passing along great saphenous vein

 saphenous nerve

14. Trauma to inguinal ligament

 loss of sensation to all except Lateral Thigh

15. Popliteal Aneurysm operated in

 Adductor Canal

16. Adductor Canal

 Apex of femoral triangle ends at adductor hiatus

Vastus medialis – Antero lateral boundary

Contains femoral vessels, Saphenous N, Nerve to vastus medialis

17. Adductor Hiatus

 inserted tendon of adductor magnus, allows passage of femoral vessels to popliteal fossa

18. Popliteal fossa

 all except saphenous nerve

19. Femoral Hernia

 common in women

 passes thru femoral ring and canal

20. Deep inguinal lymph node

 femoral canal

21. Muscle extended leg and knee joint

 Quadriceps femoris

22. Function of muscles of Anterior of Thigh

 extend leg

23. Femoral sheath has all except

 femoral nerve

24. What inserts between Tibia and Fibula

 Soleus

25. Unhappy triad

 ACL (ant cruciate lig.), Medial Meniscus, tibial collateral lig (tcl)
26. Anterior compartment syndrome, the ligament involved is
 ACL

27. Artery affected in Anterior Compt. Syndrome

a) Anterior tibial artery
b) Dosalis Pedis Artery
28. Hyper extension of femoral on hip is done by
 Ilio Femoral Ligament

29. Anterior drawer test

 Lachman’s test (other test following it is ADT)

30. Muscle inserts fascia lata

 Gluteus maximus

31. Profunda femoris artery does not give rise to

 none of the above

32. Foot drop

 deep peroneal nerve

33. Pott’s Fracture

 forced eversion of foot (Dupytren’s Fracture)

 fracture of lower end of Fibula with medial malleolus fracture and rupture of deltoid ligament

34. Which nerve is vulnerable to injury around neck of fibula

 commen peroneal nerve (fibular nerve)

35. Supplying lateral side of skin and back of leg

 Lateral surreal cutaneus nerve

36. Nerve less vulnerable than common peroneal nerve

 superficial peroneal or musculo cutaneous nerve

37. Loss of skin sensation, paralysis of plantar aspect of medial side of foot
 medial plantar nerve…branch of tibial nerve

38. Intra muscular injection injury

 common peroneal nerve, branch of sciatic nerve

39. Medial rotator of tibia

 when knee is extended

40. Ligament supports head of talus and passes from subtant? Tali of calcenous to navicular bone
 plantar calcenus ligament (spring lig)

41. Injury to dorsalis pedis

 loss of sensation to great and 2nd toe
42. Which muscle cannot do both; extend knee and hip
 semi membranous

43. Cannot flex thigh and knee

 soleus (satorius and gracilis do)

44. Muscle for abduction and flexion of knee

 gracilis and satorius

45. Foot drop and high stepping gate, loss of sensation to dorsum of foot and medial aspect
 leads to paralysis (due to damage of DPN) of all dorsi flexors and evertor muscles

46. Tibialis anterior

 deep peroneal nerve ; dorsiflexion and inversion

47. Tibialis posterior

 plantar flexes and inversion

48. Flexor retinaculum components

 tibialis posterior, flexor digitorum longus, flexor hallucis longus

49. Adductor magnus

 obturator sciatic (tibial portion)

 Insertion – Linea Aspera

 Action – Adducts, Flexes, Extends Thighs

50. Pes Anserinus (goose foot)- Anserine Bursa

 lies between TCL – tendons of sartorius, gracilis, semi tendonosus

51. Not a flexor of hip

 Vastus medialis (iliopsoas  great flexor)

52. Medial meniscus MCL

 Posterior Tear (both b and C)

53. Proximal and medial to the shaft of the femur

 tibia, fibula

54. Palpation of greater tochantar and ischial tuberosity

 sciatic nerve

55. Piriformis muscles

 inserts into upper end of greater trochanter of femur- rotates thigh laterally

56. Waddling Gait

 Pelvis falls towards the unaffected side of each step

 paralysis of gluteus medius

57. Trendelenburgs sign
 fracture of neck of femur

 dislocation of hip (weakness of gluteus max and med-unsupported side falls instead of rising)

58. Flexor digiti minimi brevis

 affect proximal paralysis of little toe

59. Sciatic nerve divides into

 tibial, common peroneal nerve

60. Lateral thigh supplied by

 femoral nerve

61. Superior lateral quadrant

 preffered site to give instramuscular injection

62. Inserts into iliac crest

 tensor fascia lata by superior gluteal nerve

63. Flexor retinaculum

 medial malleolus  holds tendons of tibialis posterior

 holds flexor digitorum longus

 holds flexor hallucis longus

64. Kick on lateral knee, which ligament is torn

 lateral collateral ligament (LCL)

65. Flexor hallucis longus tendon

 inserts into calcaneus

66. Ilio femoral ligament

 largest and most important ligament, reinforces the fibrous capsule

67. Posterior cruciate lig

 prevents anterior displacement of the femur on the tibia

68. Saphenous nerve

 passes along with the saphenous vein

69. Femoral nerve

 does not lie in the femoral sheath

70. Dural nerve

 invervates the lateral side of the head and foot

71. Great saphenous vein

 passes thru the saphenous opening
72. Structures passing thru both the greater and lesser sciatic foramen
 nerve to the obturator internus

73. Gluteus maximus

 extends and rotates thigh laterally

74. Gluteus medius and gluteus minimus

 abducts and rotates thigh medially

75. Quadratus femoris

 rotates the thigh laterally

76. Femoral canal

 site of femoral herniation

77. Femoral ring

 abdominal opening of the femoral canal

78. Femoral sheath

 does not contain femoral nerve

79. Popliteal fossa

 contains popliteal vessels, common peroneal tibial nerves and the small saphenous vein

80. Saphenous opening

 provides pathway for saphenous vein

81. Football injuries

 medial meniscus ligament and lateral connected ligaments

82. Vastus medialis

 extends leg

83. Obturator internus

 rotates thigh laterally

84. Extensor hallucis longus

 extends big toe, dosiflexes and innervates foot

85. Extensor digitorum longus

 extends toes, dorsiflexes and everts foot

86. Flexor hallucis longus

 plantar flexes foot, flexes distal phalynx of big toe

87. Flexor digitorum longus

 flexes lateral four toes

88. Tibialis posterior

  plantar flexes out and inverts foot

89. Lateral longitudinal arch formed by

 cuboid bone

90. Spring ligament

 planta calcaneonavicular

91. Femoral nerve

 arises from lumbar plexus (L2-L4)

92. Inferior gluteal nerve

 innvervates the gluteus maximus

93. Sciatic nerve

 is the largest nerve in the body

94. Superior gluteal artery

 arises from internal iliac artery

95. Obturator nerve

 arises from the internal iliac artery

96. Femoral artery

 continuation of the external iliac artery

97. Popliteal artery

 continuation of the femoral artery

98. Femoral vein

 passes thru saphenous opening

99. Femoral hernia

 common in women

100. Potts fracture

 caused by forces eversion of the foot

101. Damage to the femoral nerve

 paralysis of quadriceps femoris

102. Damage to obturator nerve

 weakness of adduction

103. Damage to DPN

 results in foot drop

104. Damage to SPN

 loss of eversion of the foot

105. Adductor longus

 innvervates the obturator nerve

106. Vastus lateralis

 extends leg

107. Indirect inguinal hernia

 occurs on right side

108. Xiphoid process…..attaches via its pointed causal end to the linea alba

109. Internal spermatic fascia

 derives from transversalis fascia

110. Cremasteric fascia

 originated in the internal oblique muscle

111. Processes vaginalis

 may result in congenital indirect inguinal hernia

112. Gubernaculum testis

 homologus to the round ligament of the uterus

Abdomen

1. Thin fatty layer

 Campers Fascia

2. Scarpas Fascia
 deep membranous layer

3. Pretineal ligaments ????????

 Coopers Ligament

4. Inguinal triangle
  common site of direct inguinal hernia

5. Inguinal triangle (Hasselbach’s triangle) is bounded laterally by

 inferior epigastric vessels

6. Transversalis fascia
 gives rise to spermatic fascia

7. Median umbilical ligament

 remnant of urachus

8. Superior epigastric artery

 arises from internal thoracic artery

9. Superior and inferior epigastric arteries anastomoses within

 rectus abdominus

10. Inferior epigastric arteries

 arise from external iliac artery

11. Indirect inguinal hernia

 common than direct inguinal hernia

12. Greater omentum

 abdominal policeman

13. Central veins

 does not form portal system

14. Falciform ligament

 connects the liver to the diaphragm

15. Ligamentum teres hepatic

 round ligament of liver

16. Coronary ligament

 round bare area of the liver

17. Ligamentum venosus

 remant of ductus venosus

18. Epiploic foramen

 Winslow’s Foramen

19. Stomach bed

 Pancreas, spleen, left kidney, left supra renal gland, transverse colon, diaphragm

20. Acidic area

 lesser curvature
 21. Jejunum
 has lung plicae circularis

22. Ileum
 has Peyer’s Patches

23. Enteric division ?????????????????

 consists of Auerbach’s Plexus

24. Ileum
 short vasa recta and plicae circularis

25. Mc Burney’s Point

 lateral one third of a line between right anterior superior iliac spine and umbilicus

26. Mc Burney’s Point

 site of acute appendicitis

27. Liver
 coronary and falciform ligaments

28. Meisners Valves

 present in gallbladder

29. Ampulla of Voter

 Duct of w…………..?????????????

30. Sartorius duct????????????

 accessory pancreactic duct

31. Sphincter ani

 muscle in lower part???????????????

32. Left gastric artery gives rise to

 esophageal branch

33. Meckels diverticulum

 occurs in about 2% of population

34. Liver Cirrhosis????????

 portal hypertension, esophageal v, hemorrhoid, caput medusa

35. Common bile duct

 obstructs bile flow leading to jaundice

36. Supra renal gland empties into

 inferior vena cava

…………………….
37. Portal hypertension can cause venous blood of the portal system to be shunted through the
anastomatic connections with the systemic venous system. Clinical sign produced due to portal
hypertension around the umbilical is
Caput Medusa

38. The conjoint tendon (falx inguinalis) is formed by the

a) rectus abdominis muscle or its aponeurosis
b) external oblique muscle or its aponeurosis
c) both a and b
d) neither a or b
39. The following facts are true for inguinal ligament
a) It is an aponeurosis of the external abdominal oblique muscle
b) It dorms the flood of inguinal canal
c) It extends from the anterior superior iliac spine to pub tubercle
d) All of the above
40. Omental bursa is communicated to greater sac via
 foramen of winslow

41. An indirect hernia

 passes thru the deep inguinal ring

42. Tunica vaginalis is the remnant of

 processus vaginalis

43. A CT scan reveals that a loop of gait exits the abdominal cavity by passing medial to the inferior
epigastric artery. This type of hernial would be called
 direct inguinal hernia

44. In reference to the covering layers of the spermatic cord and testis
 the cremaster muscle is innervated by the genital branch of the genitofemoral nerve

45. The inguinal canal

a) Begins at the deep inguinal ring
b) Has the inf. Oblique forming part of its roof
c) Has the inguinal lig forming its floor
d) Has the ilio inguinal nerve coursing through the superficial ring
e) All of the above
46. A 10 year old boy brought to your office…boy is asked to cough…the most likely diagnosis is the
presence of a(n)
 indirect inguinal hernia

47. In this case, which of the following layers of the abdominal wall would not contribute to the wall
of the hernial sac
 transverse abdominus muscle

48. Hydrocele is the collection of fluid between the layers of

 tunica vaginalis

49. Ventra root of spinal nerve carries

  motor fibres

50. The nerves of the abdominal wall

 in the mid axillary line are located between transverse abdominis and internal oblique

51. Which abdominal structure gives rise to (is continuous with) the tunica vaginalis following
descent of testes during development
 peritoneum

52. The left inguinal hernia is made more common than right
 FALSE

53. Left testicular vein drains into

 left renal vein

54. Trans pyloric plane passes at the

 upper border of L3 vertebra

55. Direct inguinal hernia passes the

 inguinal triangle

56. Sinus of testes lies

 laterally

1) Mc Burneys point:
Max tenderness felt in appendicites and point in right spine umblical line
2) Following vein form imp. Portal systemic anastomoses except:
Superior Rectal vein and IVC
3) Mostly vermiform appendix directly lie on top of cecum and also know to be tucked into:
Meso appendix
4) Patient in cirrhosis in liver venous hypertension might be found in the:
Short Gastric vein
5) Portal hypertension can cause venous blood of Portal system to be shunted through anastomic
connection of systemic venous system. Examples of clinical signs are:
External Hemmoriods
6) Bare area of Liver is linked by Limenia of:
Corornary Ligaments
7) All are features are of Portal tract area Except:
Hepatic Vein
8) Correct statement:
Root of mesentry is found to Transverse obquiley from the body of 2nd lumbar vertebra to
right sacro iliac joint
9) Correct statement:
Interior aspect of duodenum is crossed by Transverse Mesocolin Mesentery
10) Houstans valves are Konlvansh fold are known as:
Semilunar folds of colon
11) Muscle resulting from thickening of circular smooth musculature of anal canal is: Sphincter ani
internus muscle
12) Which is not moveable:
Desending colon
13) Which structure is not present in Stomach bed:
Splenic vein
14) Appendix is supplied by:
T10
15) Not true in relation to Stomach:
Cardiac notch is an incisura found at most dependent point of lesser curvature
16) Surgical mobilization of descending colon from posterior abdominal wall can be accomplished by
restablizing mesentery for this section of bowel restablished portion of mesentery could
contain:
Left lumbar artery
17) Which abdominal structures give rise to tunica vaginalis following descend of testis during
development:
Peritoneum
18) Correct statement:
Falciform ligament actively suspends liver
19) Short numerous vasa recta are contain within:
Ileum
20) Concerning Inf Mesentric artery which is false:
gives off Inf pancreatico duodenal artery
21) Which structures not present within lesser omentum:
IVC
22) Ligamentum vinosum is remnant of:
Ductus Venosus
23) Ligamentum Teres is remnant of:
Obulaterated Left Umblical artery
24) Transversalis Fascia:
Both a and b
25) Conjoint Tendon formed by:
Neither a nor b
26) Following facts are true for Inguinal Ligament:
All of the above
27) Notch and Lesser curvature of stomach is:
Insura Angularis
28) Following are structures which form stomach bed except:
Splenic vein
29) Gastric ulcers are common in:
Lesser curvatures
30) Omental bursa is communicated to Greater sac via:
Foramen of Winslow
31) Arteries supply stomach except:
Gastro duodenal
32) Litters Hernias content is:
Meckels diverticulum
33) Indirect Hernia:
passes through deep inguinal ring
34) Tunica vaginalis is remnant of:
Process vaganilis
35) Not correct about Meckels diverticulum:
All of the above
36) Congential Inguinal hernia is due to:
Persistent Process vaginalis
37) Direct Inguinal hernia is medial to:
stem of inferior epigastric artery
38) Structures form medial boundary of Inguinal Triangle:
Inferior Epigastric artery
39) Due to rupture appendix duodenal ulcer and gallbladder disease subphrenic access is likely to
occur on:
Right side
40) Porta Hepatis is where:
All of the above
41) Circular Muscle around distal end of bile duct form the:
Sphincter of Oddi
42) Duct leading out of the Gallbladder is the:
Cystic duct
43) Surgeon making incision for appendectomy:
over Mc Burney’s point
44) Appendix represents:
Lymphoid Tissue
45) Which peritoneal pouch is most dependent in female Pelvis:
Recto Utherine Pouch or Douglas pouch

1) Hip Flexion cannot be produced by:

Vastus Medialis
2) Tibial nerve injury slightly below mid thigh level will modify gait because he less able to:
Both A and B
3) Individual right gluteus medius muscle will:
demonstrate lowering of left side of Pelvis
4) Foot drop is:
Deep peronial nerve
5) Sartoris, Gracilis and Semi tendonosus muscle:
medial shaft of tibia
 6) All produce movement on Hip and Knee joint :
Adductor Magnus
7) Potts Fracture involve Fracture of Fibula and Rupture of Deltoid ligament produced by:
forced Eversion of foot
8) 38yr old woman brought to woman by fork lift operator. Examation revels loss of sensation of
dorsum of left foot. Dorsiflexion against resistance is not possible. Inversion of subtalar joints on
left limb. Diagnosis is trauma to:
Common peroneal nerve and neck of Fibula
9) Palpation at point equidistant between Ischial tuberosity and greater trochanter of femur
reveals what:
Sciatic nerve
10) Which ligament involved in clipping Injury:
ACL, MCL, MM

Anatomy Exam- Lower Limb (Hip & Thigh) TEST I

1. Regarding femoral triangle; incorrect statement is:

Medial boundary is adductor magnus (B)

2. Regarding femoral circumflex artery; false statement is:

It sends branch through obturator canal (E)

3. In relation to femoral triangle:

All the above

4. Femoral artery becomes:

Popliteal artery (D)

5. Profunda femoris artery (deep femoral artery) gives rise to:

Perforating arteries which supply posterior thigh muscles (C)

6. Adductor tubercle located:

Medial epicondyle of femur (C)

7. Groin pain, bulge in groin area, inferior to inguinal canal; femoral hernia with

intestinal group- what is immediately medial to it?

Lacunar ligament (E)

8. Cruciate anatomosis of hip joint gets supply from all arteries except:
 Inferior epigastric artery (C)

9. Positive Tredenberg sign:

Pelvis will sink downwards on unsupported leg side (C)

10. Femoral hernia is different from inguinal hernia:

Neck of sack lies below pubic tubercle (B)

11. Common result of femoral fracture:

All of the above (C)

12. Trauma to right buttock, difficulty in extending right hip but strength of right knee

flexion is similar to left knee, hip does not sink (no + tredenburg sign), abnormal

cutaneous sensation in thigh; nerve to be damaged:

Inferior gluteal nerve (C)

13. Nerve supply to anterior thigh

Femoral nerve (A)

14. Lateral rotator of thigh except:

Tensor fascia lata

15. Not a true hamstring muscle:

Short head of femoris biceps (D)

16. Difficulty crossing leg, indicates damage in:

Femoral nerve

17. Inguinal ligament:

Between A.S.I.S. and Pubic ligament AND in lower abdominal quadrant ((E) A &

D)

18. Name of socket of hip joint

Acetabulum (D)

19. Piriformis muscle in pelvis travels to gluteal region via:

 Greater sciatic foramen (A)

20. Mid-Ingunal point:

Femoral artery immediately posterior to it (D)

21. Incorrect statement regarding adductor canal:

Contains femoral nerve (E)

22. Regarding saphenous opening; the false statement is:

Pierced by small saphenous vein (C)

23. Great saphenous vein:

Longest vein in body (A)

24. Root value of lateral femoral cutaneous nerve:

L2, L3 (B)

25. Root value of sciatic nerve:

Ventral Rami of L4-S3

Anatomy-Knee and Leg

1.) Posterior displacement of femur on tibia maintained by Anterior Cruciate Ligament (ACL)
2.) Common action of tibialis anterior and posterior is inversion
3.) Major muscle responsible for unlocking of knee is the popliteus
4.) Movements possible in knee joint (tibio-fibular jt) are: flexion, extension, medial and lateral
rotation
5.) 2nd heart of the body is the gastrocnemius muscle b/c it pumps impure blood against gravity to
the heart
6.) Saphenous nerve is the cutaneous nerve of the medial side of leg and foot
7.) 35 year old female with pain in leg that aggrevates upon standing and is alleviated when
propped up, what is wrong?  Varicose Veins
8.) Muscles innervated by deep fibular nerve (AKA deep peroneal nerve)  dorsiflexors of foot
9.) In the knee joint, medial meniscus is attached to the medial collateral ligament
10.) Inability to do plantar flexion of foot due to tibial nerve
11.) Player hit lateral side of knee-medial collateral ligament and the ACL are damaged
12.) Rupture of a long slender tendon that rolls up between the gastrocnemius and the soleus, what
tendon rolls up?  plantaris
 13.) Nerve that carries both efferent and afferent sensors when the knee is tapped is the femoral
nerve
14.) Root values of the tibial nerve are L4-S3
15.) Football triad clipping injury  lateral side of the knee is injured, rupture of the medial
collateral ligament and meniscus
16.) Plantar flexors unopposed and dorsiflexors are damaged so there is damage to the deep
peroneal nerve
17.) Tibialis anterior responsible for the dorsiflexion of the foot
18.) Not found the popliteal fossa-the lesser saphenous vein
19.) Potts fracture involves fracture of the tibia, rupture of the deltoid ligament, what movement is
affected?  inversion
20.) Supracondylar fracture of distal femur-in order to avoid injury to the popliteal artery, the knee
has to be maintained in a flexed position

Test 1

Test 1- Lower Limb

1. Femoral triangle: which is incorrect

medial boundary is adductor magnus

2. Medial femoral circumflex Artery:

d/n send a branch with obturator canal

3. Femoral triangle: deep femoral artery originiates from femoral artery:

Nerve lateral to artery; Inginual lymph Vein medial to artery

4. Femoral artery becomes popliteal artery passing thru:

adductor hiatus

5. Deep (Profundus) femoral artery gives rise to perforating arteries, which supply:
post thigh muscle

6. Adductor tubercle:
medial condyle of femur

7. which is directly beside Femoral Hernia:

medial to lacunar ligament

8. Which is part of Cruciate anastomis of hip:

all except inferior epigastic artery

9. Trendleburg’s sign:
pelvis will sink downwards on unsupported leg side

10. Post displacement of femur on tibia is maintained by:

anterior Cruciate ligament
 11. Common action of tibialis ant and post:
inversion

12. Femoral hernia differentially diagnosed from inginual by:

neck of sac below and lateral to pubic tubercle

13. Fracture of neck femur:

Osteonecrosis, avascular necrosis, abnormal gait due to laterally rotated limb, non union

14. Tarsal bone with no muscle attachments:

talus

15. Unlocking knee:

Popliteus

16. Osteoarthritis, pain due to:

compression of nerve b/w articular ends

17. Key stone for medial longitudinal arch:

talus

18. Movements in knee joint (Tibio- femoral joints):

flexion, extension, medial and lateral rotation

19. Flat foot:

foot is everted

20. 2nd heart of body:

Gastrocnemius

Test 2-Lower Limb:

9. Midinguinal pt: post triangle

10. Adductor canal: femoral canal
11. Saphenous nerve: small saphenous is false
12. Saphenous nerve art is medial side of foot: e
13. varicose veins
14. lat cutaneous nerve: spinal valves b L2-L3
15. Root value sciatic nerve: ventral rami L4, L5, S1-S3
16. Cutaneous supply peroneal nerve includes dorsum except: web b/w 1st and 2nd toe

Test 1- Lower Limb:

10. In respect to femoral triangle, select incorrect:

Medial boundary in adductor magnus
 11. Which of the following statement about medial femoral circumflex a is false: it sends a branch
with obturator canal
12. In femoral triangle: profunda femoris (deep femoral) artery originates from femoral artery,
femoral nerve lies lateral to femoral artery, some inguinal lymph nodes may be found, femoral
vein lies medial to femoral artery
13. femoral artery: becomes popliteal artery after passing thru adductor hiatus
14. Profunda femoris a (deep femoral a): gives perforating arteries which supply post thigh muscle
15. Adductor tubercle is located in: medial condyle femur
16. 52 year old female presents with groin pain. Immediately inferior to inguinal canal. Physician
suspected that patient has femoral hernia contain a loop of small end?…which structure
immediately located medial to sac of hernia: lacunar ligament
17. Cruciate anastomosis is of hip joint receives primary contribution from following arteries
except: inf epigastric artery
18. Which of following statements regarding postive trendelburg’s sign is correct: pelvis sinks
downwards on unsupported leg side

Lower Limb Review Questions

100. Which part of the thigh can be palpated when the hip is flexed and abducted?
 lateral thigh

101. When the greater trochanter of the femoral is fractured, which nerve is injured?
a. Superior gluteal nerve
b. Nerve to obturator internus
102. Cruciate anastomoses contributes to all except
 Superior epigastric artery

103. Which lower limb veins are most likely to become varicose?
 superficial veins (great and small saphenous veins)

104. Factors contributing to varicose veins

a. Multiple pregnancies
b. Long standing hours
c. Incompetent valves
105. Surgeon operating on popliteal aneurysm ligates Adductor Canal which begins at apex of
femoral triangle and ends at the Adductor Hiatus
 lies between adductor magnus/longus, and vastus medialis muscle

106. Femoral triangle boundaries

 ISSLAM (Inguinal Sup, Sartorius Lat, Adductor Longus Med)

107. Femoral sheath

L- femoral artery

M- femoral canal
 Mid- femoral V

Also, Femoral branch of genitor femoral nerve, no saphenous opening

108. Saphenous opening provide pathways for

 great saphenous vein

109. What is not a part of the femoral triangle?

 obturator nerve

110. Mid inguinal point?

 mid pt between Ant Sup Iliac Spine and Pubic Symphysis

111. Nerve passing along great saphenous vein

 saphenous nerve

112. Trauma to inguinal ligament

 loss of sensation to all except Lateral Thigh

113. Popliteal Aneurysm operated in

 Adductor Canal

114. Adductor Canal

 Apex of femoral triangle ends at adductor hiatus

Vastus medialis – Antero lateral boundary

Contains femoral vessels, Saphenous N, Nerve to vastus medialis

115. Adductor Hiatus

 inserted tendon of adductor magnus, allows passage of femoral vessels to popliteal fossa

116. Popliteal fossa

 all except saphenous nerve

117. Femoral Hernia

 common in women

 passes thru femoral ring and canal

118. Deep inguinal lymph node

 femoral canal

119. Muscle extended leg and knee joint

 Quadriceps femoris

120. Function of muscles of Anterior of Thigh

 extend leg

121. Femoral sheath has all except

  femoral nerve

122. What inserts between Tibia and Fibula

 Soleus

123. Unhappy triad

 ACL (ant cruciate lig.), Medial Meniscus, tibial collateral lig (tcl)

124. Anterior compartment syndrome, the ligament involved is

 ACL

125. Artery affected in Anterior Compt. Syndrome

a) Anterior tibial artery
b) Dosalis Pedis Artery
126. Hyper extension of femoral on hip is done by
 Ilio Femoral Ligament

127. Anterior drawer test

 Lachman’s test (other test following it is ADT)

128. Muscle inserts fascia lata

 Gluteus maximus

129. Profunda femoris artery does not give rise to

 none of the above

130. Foot drop

 deep peroneal nerve

131. Pott’s Fracture

 forced eversion of foot (Dupytren’s Fracture)

 fracture of lower end of Fibula with medial malleolus fracture and rupture of deltoid ligament

132. Which nerve is vulnerable to injury around neck of fibula

 commen peroneal nerve (fibular nerve)

133. Supplying lateral side of skin and back of leg

 Lateral surreal cutaneus nerve

134. Nerve less vulnerable than common peroneal nerve

 superficial peroneal or musculo cutaneous nerve

135. Loss of skin sensation, paralysis of plantar aspect of medial side of foot
 medial plantar nerve…branch of tibial nerve

136. Intra muscular injection injury

 common peroneal nerve, branch of sciatic nerve
137. Medial rotator of tibia
 when knee is extended

138. Ligament supports head of talus and passes from subtant? Tali of calcenous to navicular
bone
 plantar calcenus ligament (spring lig)

139. Injury to dorsalis pedis

 loss of sensation to great and 2nd toe

140. Which muscle cannot do both; extend knee and hip

 semi membranous

141. Cannot flex thigh and knee

 soleus (satorius and gracilis do)

142. Muscle for abduction and flexion of knee

 gracilis and satorius

143. Foot drop and high stepping gate, loss of sensation to dorsum of foot and medial
aspect
 leads to paralysis (due to damage of DPN) of all dorsi flexors and evertor muscles

144. Tibialis anterior

 deep peroneal nerve ; dorsiflexion and inversion

145. Tibialis posterior

 plantar flexes and inversion

146. Flexor retinaculum components

 tibialis posterior, flexor digitorum longus, flexor hallucis longus

147. Adductor magnus

 obturator sciatic (tibial portion)

 Insertion – Linea Aspera

 Action – Adducts, Flexes, Extends Thighs

148. Pes Anserinus (goose foot)- Anserine Bursa

 lies between TCL – tendons of sartorius, gracilis, semi tendonosus

149. Not a flexor of hip

 Vastus medialis (iliopsoas  great flexor)

150. Medial meniscus MCL

 Posterior Tear (both b and C)

151. Proximal and medial to the shaft of the femur

  tibia, fibula

152. Palpation of greater tochantar and ischial tuberosity

 sciatic nerve

153. Piriformis muscles

 inserts into upper end of greater trochanter of femur- rotates thigh laterally

154. Waddling Gait

 Pelvis falls towards the unaffected side of each step

 paralysis of gluteus medius

155. Trendelenburgs sign

 fracture of neck of femur

 dislocation of hip (weakness of gluteus max and med-unsupported side falls instead of rising)

156. Flexor digiti minimi brevis

 affect proximal paralysis of little toe

157. Sciatic nerve divides into

 tibial, common peroneal nerve

158. Lateral thigh supplied by

 femoral nerve

159. Superior lateral quadrant

 preffered site to give instramuscular injection

160. Inserts into iliac crest

 tensor fascia lata by superior gluteal nerve

161. Flexor retinaculum

 medial malleolus  holds tendons of tibialis posterior

 holds flexor digitorum longus

 holds flexor hallucis longus

162. Kick on lateral knee, which ligament is torn

 lateral collateral ligament (LCL)

163. Flexor hallucis longus tendon

 inserts into calcaneus

164. Ilio femoral ligament

 largest and most important ligament, reinforces the fibrous capsule

165. Posterior cruciate lig

  prevents anterior displacement of the femur on the tibia

166. Saphenous nerve

 passes along with the saphenous vein

167. Femoral nerve

 does not lie in the femoral sheath

168. Dural nerve

 invervates the lateral side of the head and foot

169. Great saphenous vein

 passes thru the saphenous opening

170. Structures passing thru both the greater and lesser sciatic foramen
 nerve to the obturator internus

171. Gluteus maximus

 extends and rotates thigh laterally

172. Gluteus medius and gluteus minimus

 abducts and rotates thigh medially

173. Quadratus femoris

 rotates the thigh laterally

174. Femoral canal

 site of femoral herniation

175. Femoral ring

 abdominal opening of the femoral canal

176. Femoral sheath

 does not contain femoral nerve

177. Popliteal fossa

 contains popliteal vessels, common peroneal tibial nerves and the small saphenous vein

178. Saphenous opening

 provides pathway for saphenous vein

179. Football injuries

 medial meniscus ligament and lateral connected ligaments

180. Vastus medialis

 extends leg

181. Obturator internus

 rotates thigh laterally
 182. Extensor hallucis longus
 extends big toe, dosiflexes and innervates foot

183. Extensor digitorum longus

 extends toes, dorsiflexes and everts foot

184. Flexor hallucis longus

 plantar flexes foot, flexes distal phalynx of big toe

185. Flexor digitorum longus

 flexes lateral four toes

186. Tibialis posterior

 plantar flexes out and inverts foot

187. Lateral longitudinal arch formed by

 cuboid bone

188. Spring ligament

 planta calcaneonavicular

189. Femoral nerve

 arises from lumbar plexus (L2-L4)

190. Inferior gluteal nerve

 innvervates the gluteus maximus

191. Sciatic nerve

 is the largest nerve in the body

192. Superior gluteal artery

 arises from internal iliac artery

193. Obturator nerve

 arises from the internal iliac artery

194. Femoral artery

 continuation of the external iliac artery

195. Popliteal artery

 continuation of the femoral artery

196. Femoral vein

 passes thru saphenous opening

197. Femoral hernia

 common in women

100. Potts fracture

  caused by forces eversion of the foot

101. Damage to the femoral nerve

 paralysis of quadriceps femoris

102. Damage to obturator nerve

 weakness of adduction

103. Damage to DPN

 results in foot drop

104. Damage to SPN

 loss of eversion of the foot

105. Adductor longus

 innvervates the obturator nerve

106. Vastus lateralis

 extends leg

107. Indirect inguinal hernia

 occurs on right side

108. Xiphoid process…..attaches via its pointed causal end to the linea alba

109. Internal spermatic fascia

 derives from transversalis fascia

110. Cremasteric fascia

 originated in the internal oblique muscle

111. Processes vaginalis

 may result in congenital indirect inguinal hernia

112. Gubernaculum testis

 homologus to the round ligament of the uterus

------------------------------------------------------------------------------------------
 11) Hip Flexion cannot be produced by:
Vastus Medialis
12) Tibial nerve injury slightly below mid thigh level will modify gait because he less able to:
Both A and B
13) Individual right gluteus medius muscle will:
demonstrate lowering of left side of Pelvis
14) Foot drop is:
Deep peronial nerve
15) Sartoris, Gracilis and Semi tendonosus muscle:
medial shaft of tibia
16) All produce movement on Hip and Knee joint :
Adductor Magnus
17) Potts Fracture involve Fracture of Fibula and Rupture of Deltoid ligament produced by:
forced Eversion of foot
18) 38yr old woman brought to woman by fork lift operator. Examation revels loss of sensation of
dorsum of left foot. Dorsiflexion against resistance is not possible. Inversion of subtalar joints
on left limb. Diagnosis is trauma to:
Common peroneal nerve and neck of Fibula
19) Palpation at point equidistant between Ischial tuberosity and greater trochanter of femur
reveals what:
Sciatic nerve
20) Which ligament involved in clipping Injury:
ACL, MCL, MM

Abdomen

57. Thin fatty layer

 Campers Fascia

58. Scarpas Fascia

 deep membranous layer

59. Pretineal ligaments ????????

 Coopers Ligament

60. Inguinal triangle

 common site of direct inguinal hernia

61. Inguinal triangle (Hasselbach’s triangle) is bounded laterally by

 inferior epigastric vessels

62. Transversalis fascia

 gives rise to spermatic fascia
63. Median umbilical ligament
 remnant of urachus

64. Superior epigastric artery

 arises from internal thoracic artery

65. Superior and inferior epigastric arteries anastomoses within

 rectus abdominus

66. Inferior epigastric arteries

 arise from external iliac artery

67. Indirect inguinal hernia

 common than direct inguinal hernia

68. Greater omentum

 abdominal policeman

69. Central veins

 does not form portal system

70. Falciform ligament

 connects the liver to the diaphragm

71. Ligamentum teres hepatic

 round ligament of liver

72. Coronary ligament

 round bare area of the liver

73. Ligamentum venosus

 remant of ductus venosus

74. Epiploic foramen

 Winslow’s Foramen

75. Stomach bed

 Pancreas, spleen, left kidney, left supra renal gland, transverse colon, diaphragm

76. Acidic area

 lesser curvature

77. Jejunum
 has lung plicae circularis

78. Ileum
 has Peyer’s Patches

79. Enteric division ?????????????????

  consists of Auerbach’s Plexus

80. Ileum
 short vasa recta and plicae circularis

81. Mc Burney’s Point

 lateral one third of a line between right anterior superior iliac spine and umbilicus

82. Mc Burney’s Point

 site of acute appendicitis

83. Liver
 coronary and falciform ligaments

84. Meisners Valves

 present in gallbladder

85. Ampulla of Voter

 Duct of w…………..?????????????

86. Sartorius duct????????????

 accessory pancreactic duct

87. Sphincter ani

 muscle in lower part???????????????

88. Left gastric artery gives rise to

 esophageal branch

89. Meckels diverticulum

 occurs in about 2% of population

90. Liver Cirrhosis????????

 portal hypertension, esophageal v, hemorrhoid, caput medusa

91. Common bile duct

 obstructs bile flow leading to jaundice

92. Supra renal gland empties into

 inferior vena cava

…………………….

93. Portal hypertension can cause venous blood of the portal system to be shunted through the
anastomatic connections with the systemic venous system. Clinical sign produced due to portal
hypertension around the umbilical is
Caput Medusa

94. The conjoint tendon (falx inguinalis) is formed by the

 a) rectus abdominis muscle or its aponeurosis
b) external oblique muscle or its aponeurosis
c) both a and b
d) neither a or b
95. The following facts are true for inguinal ligament
a) It is an aponeurosis of the external abdominal oblique muscle
b) It dorms the flood of inguinal canal
c) It extends from the anterior superior iliac spine to pub tubercle
d) All of the above
96. Omental bursa is communicated to greater sac via
 foramen of winslow

97. An indirect hernia

 passes thru the deep inguinal ring

98. Tunica vaginalis is the remnant of

 processus vaginalis

99. A CT scan reveals that a loop of gait exits the abdominal cavity by passing medial to the inferior
epigastric artery. This type of hernial would be called
 direct inguinal hernia

100. In reference to the covering layers of the spermatic cord and testis
 the cremaster muscle is innervated by the genital branch of the genitofemoral nerve

101. The inguinal canal

a) Begins at the deep inguinal ring
b) Has the inf. Oblique forming part of its roof
c) Has the inguinal lig forming its floor
d) Has the ilio inguinal nerve coursing through the superficial ring
e) All of the above
102. A 10 year old boy brought to your office…boy is asked to cough…the most likely
diagnosis is the presence of a(n)
 indirect inguinal hernia

103. In this case, which of the following layers of the abdominal wall would not contribute to
the wall of the hernial sac
 transverse abdominus muscle

104. Hydrocele is the collection of fluid between the layers of

 tunica vaginalis

105. Ventra root of spinal nerve carries

 motor fibres

106. The nerves of the abdominal wall

 in the mid axillary line are located between transverse abdominis and internal oblique
107. Which abdominal structure gives rise to (is continuous with) the tunica vaginalis
following descent of testes during development
 peritoneum

108. The left inguinal hernia is made more common than right
 FALSE

109. Left testicular vein drains into

 left renal vein

110. Trans pyloric plane passes at the

 upper border of L3 vertebra

111. Direct inguinal hernia passes the

 inguinal triangle

112. Sinus of testes lies

 laterally

46) Mc Burneys point:

Max tenderness felt in appendicites and point in right spine umblical line
47) Following vein form imp. Portal systemic anastomoses except:
Superior Rectal vein and IVC
48) Mostly vermiform appendix directly lie on top of cecum and also know to be tucked into:
Meso appendix
49) Patient in cirrhosis in liver venous hypertension might be found in the:
Short Gastric vein
50) Portal hypertension can cause venous blood of Portal system to be shunted through anastomic
connection of systemic venous system. Examples of clinical signs are:
External Hemmoriods
51) Bare area of Liver is linked by Limenia of:
Corornary Ligaments
52) All are features are of Portal tract area Except:
Hepatic Vein
53) Correct statement:
Root of mesentry is found to Transverse obquiley from the body of 2nd lumbar vertebra to
right sacro iliac joint
54) Correct statement:
Interior aspect of duodenum is crossed by Transverse Mesocolin Mesentery
55) Houstans valves are Konlvansh fold are known as:
Semilunar folds of colon
56) Muscle resulting from thickening of circular smooth musculature of anal canal is: Sphincter ani
internus muscle
57) Which is not moveable:
Desending colon
58) Which structure is not present in Stomach bed:
Splenic vein
59) Appendix is supplied by:
T10
60) Not true in relation to Stomach:
Cardiac notch is an incisura found at most dependent point of lesser curvature
61) Surgical mobilization of descending colon from posterior abdominal wall can be accomplished by
restablizing mesentery for this section of bowel restablished portion of mesentery could
contain:
Left lumbar artery
62) Which abdominal structures give rise to tunica vaginalis following descend of testis during
development:
Peritoneum
63) Correct statement:
Falciform ligament actively suspends liver
64) Short numerous vasa recta are contain within:
Ileum
65) Concerning Inf Mesentric artery which is false:
gives off Inf pancreatico duodenal artery
66) Which structures not present within lesser omentum:
IVC
67) Ligamentum vinosum is remnant of:
Ductus Venosus
68) Ligamentum Teres is remnant of:
Obulaterated Left Umblical artery
69) Transversalis Fascia:
Both a and b
70) Conjoint Tendon formed by:
Neither a nor b
71) Following facts are true for Inguinal Ligament:
All of the above
72) Notch and Lesser curvature of stomach is:
Insura Angularis
73) Following are structures which form stomach bed except:
Splenic vein
74) Gastric ulcers are common in:
Lesser curvatures
75) Omental bursa is communicated to Greater sac via:
Foramen of Winslow
76) Arteries supply stomach except:
Gastro duodenal
77) Litters Hernias content is:
Meckels diverticulum
78) Indirect Hernia:
passes through deep inguinal ring
79) Tunica vaginalis is remnant of:
Process vaganilis
80) Not correct about Meckels diverticulum:
All of the above
81) Congential Inguinal hernia is due to:
Persistent Process vaginalis
82) Direct Inguinal hernia is medial to:
stem of inferior epigastric artery
83) Structures form medial boundary of Inguinal Triangle:
Inferior Epigastric artery
84) Due to rupture appendix duodenal ulcer and gallbladder disease subphrenic access is likely to
occur on:
Right side
85) Porta Hepatis is where:
All of the above
86) Circular Muscle around distal end of bile duct form the:
Sphincter of Oddi
87) Duct leading out of the Gallbladder is the:
Cystic duct
88) Surgeon making incision for appendectomy:
over Mc Burney’s point
89) Appendix represents:
Lymphoid Tissue
90) Which peritoneal pouch is most dependent in female Pelvis:
Recto Utherine Pouch or Douglas pouch