Anatomy - Lower Limb ANATOMY - LOWER LIMB 1. Which of the following structures are NOT found in the adductor canal? mOOwP femoral artery femoral vein femoral nerve saphenous nerve nerve to vastus medialis 2. The surface markings of the sciatic nerve are from: BO AMP the ischial tuberosity to the adductor tubercle of the medial femoral condyle the posterior superior iliac spine to the apex of the popliteal fossa the mid point of a line between the ischial tuberosity and the greater trochanter to the adductor tubercle of the medial femoral condyle the ischial tuberosity to the apex of the popliteal fossa the midpoint of a line between the ischial tuberosity and the greater trochanter to the apex of the popliteal fossa 3. Regarding the femoral canal: PyORP it is the lateral compartment of the femoral sheath it lies medial to the pubic tubercle it contains the femoral nerve it is medial to the femoral vein it transmits the femoral branch of the genito-femoral nerve 4. Regarding the saphenous vein: FOOD it commences at the medial end of the dorsal venous arch, it passes behind the medial malleolus it is accompanied by the saphenous nerve throughout its course it passes under the inguinal ligament and enters the femoral vein it drains only the medial side of the leg between the tibia and the tendo calcaneus 38Anatomy - Lower Limb 5. The floor of the femoral triangle is formed by all of the following muscles EXCEPT: A B. G D. E ‘The moApD pectineus adductor longus (p : iliacus Pox ) psoas P Qhg. fit) adductor brevis = ~~ femoral ring is bounded by all of the following structures, EXCEPT: femoral vein lacunar ligament superior ramus of pubis femoral artery inguinal ligament 7. Which of the following statements is CORRECT? > 9 9B boas the femoral nerve in the iliac fossa lies in the gutter between psoas and pectineus muscle the femoral nerve lies within the femoral sheath as it enters the thigh the femoral sheath (fascia) fuses with the adventitia of the femoral artery and vein as the vessels reach the adductor hiatus the femoral canal lies lateral to the femoral vein and carries the deep inguinal nodes the femoral ring has the inguinal ligament, lacunar ligament, pectineal ligaments as its boundaries 8. Which of the following statements is CORRECT? AS the femoral artery enters the thigh midway between the anterior superior iliac spine and the pubic tubercle the femoral artery lies on the iliacus muscle as it enters the thigh the femoral artery gives off three small branches below the inguinal ligament and the profunda femoris below the terminator of the femoral sheath the lateral circumflex femoral artery and medial circumflex femoral artery normally arises from the profunda femoris, but can occasionally arise from the main femoral artery the four perforating arteries pass backwards through the adductor muscle by going through adductor longus 39Anatomy - Lower Limb 10. ll. 12: 13. Factors contributing to the stability of the hip joint include all of the following EXCEPT: A. the acetabular labrum B. the ligaments arising from constituent bones of the p femoral ligament C. the gluteus medius, minimus and tensor fasciae latae D. the pectineus, adductors, gracilis, and piriformis E. the joint is most stable when flexed and adducted Regarding the popliteal fossa, which of the following is INCO elvis especially the ilio A. the roof of the fossa is formed by fascia lata and pierced | small saphenous vein and the posterior femoral cutaneous nerve to lie on the neck of the fibula heads of gastrocnemius at all levels in the popliteal fossa, the popliteal artery li and nerve Popo p cutaneous nerve of thigh halfway down the calf Damage to the superficial peroneal nerve causes: A. foot drop B. _ loss of eversion of foot C. _ ahigh skipping gait D. _loss of inversion of foot E. — ashuffling gait Flexion of the knee joint is affected by all of the following mu: A. hamstrings B. gracilis C. — sartorius D. _semitendinosus E. _ popliteus Branches of the popliteal artery include the following EXCEPT: A. superior lateral genicular artery B. __ inferior lateral genicular artery C. middle genicular artery D. descending genicular artery E, superior medial genicular artery 40 the common peroneal nerve disappears into the substance of peroneus longus tibial nerve runs along the midline of the fossa and disappears in between the ies between the vein the sural nerve is a branch of the tibial nerve and replaces the posterior scles EXCEPT:Anatomy - Lower Limb 14, 15. 16. 17. 18, ‘Which muscle is NOT supplied by the obturator nerve? moOmD adductor longus adductor brevis / ‘> adductor magaus peotineus Cong short head of biceps Regarding the sole of the foot, which statement is INCORRECT? roowb> Regarding the innervation of muscles in the sole of the INCORRECT? PDOR> Regarding the muscular layers on the sole of foot, which stat PoOwP Regarding the deep calf muscles, which statement is INCOI Bo Opp flexor digitorum brevis inserts into proxiraal phalanx axis of abduction and adduction passes through secon: only the first lumbrical is unicipital transverse head of adductor hellucis has no bony origi f great toe id toe neurovascular plane lies between first and second ~~ layers first lumbrical is supplied by the medial plantar nerve adductor hallucis is supplied by the lateral plantar nery flexor digitorum brevis is supplied by the medial plan: all interossei are supplied by the lateral plantar nerve flexor digitorum accessorius is supplied by the medial Iumbricals lies in second layer abductor digiti minimi lies in the first layer adductor hallucis lies in third layer flexor hallucis brevis lies in first layer flexor digitorum accessorius lies in second layer flexor hallucis longus grooves the under surface of the tibialis posterior is pierced by the nutrient artery to thi flexor hallucis longus tendon crosses superficial to tendons in sole of foot tibialis posterior grooves the back of the medial malle flexor digitorum longus is bipennate 41 ot, which statement is ye jar nerve plantar nerve ment is INCORRECT? CT? sustentaculum tali tibia lexor digitorum longus lusAnatomy - Lower Limb 19. 20. 21. 22. Regarding the superficial calf muscles, which statement is INCOR BoOOMD Regarding peroneus longus and brevis, which statement is INCOR moOpP Regarding the extensor compartment of the leg, which statement is INCORRECT? oO wD Regarding tibialis anterior, which statement is INCORRECT? PoORp Regarding the “hamstrings”, which statement is INCORRECT? PoOwD> soleus is a slow plantar flexor of the ankle joint lateral head of gastrocnemius is longer than the medial head plantaris inserts medially into calcaneum soleus is an anti-gravity muscle gastrocnemius is a fast plantar flexor of the ankle joint peroneus longus tendon grooves the posterior surface of lateral malleolus peroneus brevis tendon runs superior to peroneal trochlea they share a common synovial sheath the longus tendon runs inferior to peroneal trochlea peroneus longus is essential to maintaining the transverse arch of the foot extensor hallucis longus has a separate synovial sheath gRECT? RECT? extensor digitorum longus divides into its 4 tendons deep to superior extensor, retinaculum peroneus tertius is unipennate Prog extensor hallucis longus emerges between tibialis anterior and extensor. “4b digitorum longus peroneus tertius has a separate synovial sheath it inserts symmetrically with peroneus longus it has a separate synovial sheath it helps maintain the medial longitudinal arch it pierces the inferior extensor retinaculum it is pierced by the anterior tibial recurrent artery profunda femoris artery provides the majority of blood supply semi-membranosus is devoid of muscle fibres at its origin ‘common peroneal nerve innervates long head of biceps femoris includes adductor magnus biceps femoris tendon is associated with fibular collateral ligament of knee joint 2Anatomy - Lower Limb 24, 25. 26. 27. 28. 29. ‘Which muscle does NOT laterally rotate the hip joint? HoOw> obturator internus gluteus minimus (anterior fibres) piriformis quadratus femoris obturator externus Regarding the gluteal muscles, which statement is INCORRECT? Regarding adductors longus and magnus, which statement is IN maximus forms the gluteal fold minimus is separated from greater trochanter by a bursa maximus extends the hip whilst climbingstairs medius medially rotates the hip joint maximus has 3 bursae lying deeply magnus is innervated by tibial component of sciatic nervé a longus contributes to two boundaries of the femoral triangle magnus possesses 4 osseo aponeurotic openings longus may develop a “rider’s bone” CORRECT? magnus is innervated by anterior division of obturator nerve | Regarding the relations of adductor brevis, which statement is INCORRECT? Regarding pectineus, which statement is INCORRECT? A B. Cc. D. EB. Regarding quadriceps femoris, which statement is INCORRECT? OO D> pectineus lies anterior ip profunda femoris lies anterior adductor magnus lies posterior posterior division of obturator nerve lies anterior adductor longus lies anterior the adductor brevis lies posterior it contributes to floor of femoral triangle the posterior division of obturator nerve lies posterior it is quadrilateral in shape the femoral vein lies anterior nerve to rectus femoris carries hip proprioceptive fibres nerve to vastus lateralis is largest nerve to vastus medialis carries knee proprioceptive fibres nerve to rectus femoris is usually double displays the myotome L3,4 43 Dy osAnatomy - Lower Limb 30. Regarding quadriceps femoris, which statement is INCORRECT? vastus intermedius inserts into synovial membrane of knee joint__ vastus medialis prevents lateral dislocation of the patella rectus femoris forms anterior lamina of patella tendon vastus lateralis has an extensive linea origin tendon of insertion is trilaminar mOOWD> 31. Regarding sartorius, which statement is INCORRECT? itis pierced by infrapatellar branch of saphenous nerve forms antero-medial boundary (roof) of adductor canal it is the “tailor’s muscle” the medial margin forms lateral border of femoral triangle it is pierced by medial femoral cutaneous nerve A B. c D. E. 32. Which structure lies deepest in the popliteal fossa? A. tibial nerve B. popliteal vein C. popliteal lymph nodes D. popliteal artery E. common peroneal nerve 33. Which structure is NOT one of the contents of the popliteal fossa? posterior femoral cutaneous nerve small saphenous vein articular branch of femoral nerve popliteal vein ‘common peroneal nerve ppoD> 34. Which structure does NOT contribute to the boundaries of the popliteal fossa? A. semimembranosus (medially) B. plantaris (medially) (Pox, > c fascia lata ( D. _popliteus / ? 2 heft s EB biceps tendon (laterally) ae 35. Regarding lymphatic drainage of the lower limb, which statement is INCORRECT? heel drains to vertical group of superficial inguinal nodes all lymph drains via the femoral ring buttock drains to lateral group of superficial inguinal nodes popliteal nodes are unimportant labia majora drains to medial group of superficial inguinal nodes moOwD 44 oe iAnatomy - Lower Limb 36. 37. 38. 39. ‘Which structure does NOT contribute to the boundaries of the femoral ring? A. pectineal ligament B. inguinal ligament C. lacunar ligament D. femoral vein E. pubic crest Which structure is NOT one of the contents of the femoral triangle? A intermediate femoral cutaneous nerve B. fat C. saphenous nerve D. _profunda femoris artery E. medial femoral cutaneous nerve Which structure does NOT contribute to the boundaries of the femoral triangle? A. adductor longus (medial margin) B. _ pectineus C. adductor brevis: D. _sartorius (medial margin) E. inguinal ligament Which structure is NOT one of the contents of the adductor (sub sartorial) canal? A. deep lymphatics B. _ posterior division of obturator nerve C. saphenous nerve D. nerve to vastus medialis E. superficial femoral artery Which structure does NOT contribute to the boundaries of the adductor (sub sartorial) canal? A. vastus lateralis B. adductor longus C. deep fascia D. adductor magnus E. _ sartorius 45Anatomy - Lower Limb 41. 42. 43. 45, Which is NOT true of the tendo-achilles? moa m> it inserts into the middle third of the posterior surface of the calcaneus itis invested in a synovial sheath it is formed from the soleus and gastrocnemius muscles a bursa lies between the tendon and the upper third of the calcaneus a bursa lies between it and the deep fascia near its insertion Which of the following structures lies within the knee joint? moOmD patellar ligament tibial collateral ligament fibular collateral ligament tendon of popliteus patella retinacula Following an injury to the leg, a patient is unable to dorsiflex their foot. Which nerve is most likely to be damaged? PoopD> the deep branch of the common peroneal nerve the sural nerve the superficial branch of the common peroneal nerve the saphenous nerve none of the above ‘With respect to peroneus longus : mo AvP it inserts into the base of the 5th metacarpal itis supplies\by the superficial peroneal nerve ithhas a broad tendon that lies between the lateral malleolus and the tendon of peroneus brevis it arises from the upper two thirds of the tibia itis mainly supplied by L4 and LS segments The stability of the weight bearing flexed knee is maintained by : POOwD anterior cruciate ligament io-tibial tract posterior cruciate ligament popliteus and posterior cruciate ligament arcuate popliteal ligament and anterior cruciate ligament a — cd ad. a = a eeAnatomy - Lower Limb 47. 48. 49. 50. Regarding the femoral triangle : A. the lateral border of the adductor longus makes up its medial boundary B. _ itis bisected by the femoral nerve C. the lateral border of sartorius muscle makes up its lateral boundary D. the long saphenous vein joins the femoral vein within the triangle E. __ rectus femoris makes up part of the floor Inversion of the foot is performed by which pair of muscles? ‘A. peronens longus and peroneus brevis B. __peroneus longus and tibialis posterior C. tibialis anterior and tibialis posterior D. _peroneus brevis and plantaris E. none of the above A. pierces the interosseus membrane B, supplies the lateral compartment of the leg C. lies lateral to the deep peroneal nerve D. ies lateral to tibialis anterior gives the nutrient artery to the tibia ‘The suprapatellar bursa: A. does not communicate with the knee joint B. lies in front of the vastus intermedius muscle C. extends 5 centimetres or more above the patella, D. _ lies deep to the patellar retinacula E. none of the above Which of the following DOES NOT apply to the popliteus muscle? it inserts into the lateral meniscus of the knee joint it is innervated by the tibial nerve it acts to extend the knee joint it inserts into the lateral condyle of the femur it acts to laterally rotate the femur on a fixed tibia moOwp 47Anatomy - Lower Limb 51. 52. 3. 54. 55. ‘A 30 year old man presents with adenopathy of the medial group of superficial inguinal lymph nodes on the right side. Which of the following is the primary site resulting in this finding? A. right testis B. right buttock C. the skin of the right lower limb D. the anal canal E. none of the above Regarding the femoral artery: A. __ itenters the thigh directly beneath the deep inguinal ring B. __ ities lateral to the femoral nerve in the femoral sheath C. _ it gives rise to the profunda femoris artery which pierces the femoral sheath D. __ does not contribute to the trochanteric anastamosis its branches include the superficial epigastric artery and the deep external pudendal artery Regarding the popliteal fossa: POOR p the common peroneal nerve passes through the lateral part of the fossa it contains no lymph nodes it has a roof pierced by the tibial nerve the popliteal artery lies superficial to the popliteal vein throughout the fossa the small saphenous vein joins the popliteal vein before its entry into the fossa Regarding movements at the knee joint : A sop E. popliteus "unlocks" the extended knee by producing medial rotation of the femur there is no active rotation of the extended knee passive extension of the knee does not result in "locking" of the joint. the posterior cruciate ligament prevents backward displacement of the femur on the tibial plateau the major role of the menisci is in flexion-extension of the knee ‘The dorsalis pedis artery: BIOR> lies medial to the tendon of extensor hallicus longus lies lateral to the digital branch of the deep peroneal nerve crosses superficial to the tendon of extensor hallicus brevis terminates as the arcuate artery joins the lateral plantar artery to form the plantar archAnatomy - Lower Limb 56. 57. 58. 59. ‘A.25 year old man is unable to plantar flex his foot. The most likely cause is damage to: ppomD the superficial peroneal nerve the L3 nerve root ‘the tibial nerve soleus gastrocnemius Which of the following is NOT a component of the second layer of the sole of the foot? BOODP tendon of flexor hallicus longus abductor hallicus flexor accessorius the lumbrical muscles tendon of flexor digitorum longus ‘Which of the following structures DOES NOT pass through the greater sciatic foramen? BDO MD mooOpp> # BOOP 2 ‘the sciatic nerve the pudendal nerve and vessels the posterior cutaneous nerve of the thigh the inferior gluteal nerve and vessels ‘the nerve to obturator externus psoas muscle: ‘passes across the front of the capsule of the hip joint is a powerful lateral rotator of the femur inserts into the greater trochanter is supplied by L4 and LS nerve roots femoral nerve : is formed from the anterior divisions of the anterior primary rami of L2-4. is formed from the same spinal segments as the obturator nerve divides after passing through the femoral triangle has no cutaneous branches other than the saphenous nerve enters the thigh in the femoral sheath 49Anatomy - Lower Limb 61. 62. 63. 65. ‘The peroneus longus muscle: HUODD passes superficial to the superior peroneal retinaculum inserts into the styloid process of the fifth metatarsal bone is supplied by the common peroneal nerve assists in the maintenance of the lateral longitudinal arch has no origin from the tibia ‘The short saphenous vein: ryOD> lies anterior to the lateral malleolus is accompanied by the saphenous nerve drains into the great saphenous vein drains the lateral margin of the foot lies deep to the deep fascia of the calf Following a subcapital fracture of the neck of the femur, an 80-year old man sustains avascular necrosis of the femoral head. This is most likely to be the consequence of interruption to the blood supply to the head from which of the following sources: arteries from trochanteric anastamosis in the retinacula artery of the ligament of the head from the obturator artery branches from the profunda femoris artery branches from the pundendal artery branches from the inferior gluteal artery femoral vein Jateral cutaneous nerve of the thigh femoral nerve femoral branch of the genito-femoral nerve great saphenous vein Regarding the femoral triangle: © ropO BP adductor magnus makes up part of the floor sno motor branches of the femoral nerve leave the triangle to enter the sartorius canal the femoral artery occupies the lateral compartment of the femoral sheath the main cutaneous nerve supply of the skin overlying the triangle is by the iljo-inguinal nerve the femoral vein lies medial to the femoral artery throughout the triangle 50 — ntAnatomy - Lower Limb 66. 67. 68. 69. Regarding the femoral nerve all of the following are true EXCEPT: the superficial group consists of two cutaneous and two muscular branches the nerve to the vastus medialis passes down on the medial side of the femoral artery the medial femoral cutaneous nerve belongs to the superficial group the saphenous nerve is the only cutaneous branch of the deep group of the femoral nerve the femoral nerve is formed from the posterior divisions of the ventral rami of the lumbar nerves 2, 3 and 4 Regarding the hip joint all of the following statements are true EXCEPT: A mp op the anterior fibres of the gluteus medius and minimus act as medial rotator of the hip joint the gluteus maximus is the most powerful lateral rotator of the hip joint gluteus medius and minimus are supplied by the inferior gluteal nerve (LS, S1, $2) the superior gluteal nerve (L4, LS, $1) emerges from the greater sciatic notch the iliofemoral ligament limits extension at the hip joint Regarding the popliteal fossa, which of the following statements is true? A. the common peroneal nerve slopes downwards lateral to the biceps tendon B. the sural nerve is a cutancous branch of the common peroneal nerve C. the middle genicular artery of the popliteal artery supplie the cruciate ligaments D. ___ the popliteus muscle is supplied by a branch of the common peroneal nerve E. the recurrent genicular nerve is a branch of the tibial nerve Regarding the extensor compartment of the lower leg, all of the following statements are true EXCEPT: A. the tibialis anterior muscle is supplied by the deep peroneal and recurrent moO w genicular nerves (L4) extensor digitorum longus and peroneus tertius muscle lie lateral to the tibialis anteri@¥ artery throughout the deep peroneal nerve arises within the peroneus longus muscle the extensor digitorum longus dorsiflex the lateral toes the extensor hallucis longus arises from the middle two-fourths of the tibia and the adjacent interosseous membrane 51Anatomy - Lower Limb 70. n. RR. 2B. 74. Reg: moOpD> The PEORP Bo MUORP arding the foot, all of the following statements are true EXCEPT: the tibialis posterior muscle inverts and adduct the forefoot the tibialis posterior muscle plantarflex the ankle joint ‘the tibialis anterior muscle dorsiflex the ankle and inverts the foot all interossei muscles are supplied by the lateral plantar nerve calcaneal branches of the deep peroneal nerve supply the skin of the heel popliteal artery: is superficial to the tibial nerve extends from the hiatus in adductor longus enters the popliteal fossa on lateral aspect of femur has four genicular branches in fossa supplies the cruciate ligaments obturator nerve supplies: adductor magnus obturator internus quadratus femoris ‘sartorius inferior gemellus Which of the following is CORRECTLY paired? poem 2 mpom> m adductor brevis - femoral nerve adductor longus - sciatic nerve adductor magnus - saphenous nerve adductor longus - obturator nerve adductor magnus - femoral nerve anterior cruciate ligament: lies within the synovial membrane of the knee joint attaches from the anterior tibial plateau to the medial condyle of femur prevents forward displacement of the femur on the tibial plateau produces lateral rotation of the femur in the ‘screw home’ position of full extension none of the above 52Anatomy - Lower Limb 15. 76. 71. 78. 79. ‘The surface marking for the femoral nerve is: roORp moOOW> FF midway between the anterior superior iliac spine and pubic tubercle midway between the anterior superior iliac spine and pubic syithesis medial to the femoral artery 2cma lateral and 2em inferior to the pubic tubercle none of the above the popliteal fossa, the deepest of these structures is: popliteal vein popliteal artery tibial nerve ‘sural nerve plantaris muscle Which of the following bursae is most likely to communicate with the knee joint? moOmD deep infra patella bursa superficial infra patella bursa pre patella bursa semi-membranosis bursa supra patella bursa Adductor longus is inserted onto the: BUOWD upper half of the linea aspera of the femur upper two thirds of the linea aspera of the femur upper one third of the linea aspera of the femur lower two thirds of the linea aspera of the femur lower half of the linea aspera of the femur ‘The muscle which provides the most control of hip joint movement during the act of sitting is: FOOwD> iliacus semitendinosis semimembranosis gluteus maximus gluteus medius 53Anatomy - Lower Limb 80. 81 82. Structures passing through the greater sciatic foramen include all of the following EXCEPT: A tendon of obturator internus B. __pitiformis muscle C. posterior cutaneous nerve of the thigh D. pudendal nerve E. nerve to quadratus femoris The medial compartment of the thigh: ‘A. contains obturator internus B. contains the adductor canal C. contains the femoral triangle D. _ is limited superiorly by the obturator membrane E. is supplied mainly by the obturator artery The strongest fibres of the “deltoid” ligament in the ankle run fom the tibial malleolus to: A medial tubercle of talus B. _ theneck of the talus Cc. the sustentaculum tali D. the navicular bone E. — themedial cuneiform 34Anatomy - Lower Limb MULTIPLE CHOICE QUESTIONS ANATOMY - LOWER LIMB ANSWERS QUESTIONNO. ANSWER QUESTION NO. Loc 2 3 =D 4. 5 5 6. 7. OB 8 9 10. i. B 12. 3.°«=D 14, is. A 16. 17D 18. 19. B 20. 1. 22. 23. OC 24. 2. A 26. 27. D 28. a &#E 30. 31. °«#& 32. 33. CC 34, 35. A 36. 37. D 38. 39. «=B 40. 4. OB 42. 43. A 44, 45. oC 46. 47. °C 48. 49. C 50. sl. D 52. 53. A 54. 55. B 56, 57. B 38. 59. A 60. 61. D 62. 63. A 64. 65. CC 66. 67. C 68. 6. E 70. n. £ n. 55 ANSWER PHOUMUWMABDMOUOSBUPAOMTO>OmMWUPSOMMBUOUEAnatomy - Lower Limb ANSWERS \UESTION NO. B. 75. 71. 79. 81. MI ICE QUESTIONS ANAT ANSWER, voumpy - LOWER L! QUESTION NO. 56 74, 76. 78. 80. 82. opouwnm