1. A patient presented to the causality with dipping gait.

The following can be

the cause, except:
a. Old congenital hip dislocation.
b. Un-united femoral neck fracture.
c. Poliomyelitis.
d. Sever degree of coxa valga**.
e. Sever femoral head osteoarthritis.

2. The functional analogue of the deltoid muscle in the lower limb is:
a. the gluteus maximus.
b. the gluteus minimus.
c. the gluteus medius.**
d. the piriformis.
e. The gemelli.

3. The following cutaneous areas and supplying sensory roots are correctly paired :
a. The posterior leg – S3.
b. The lateral ankle- S1 .**
c. The lateral leg- L4.
d. The knee-L2.
e. The sitting area of the buttock-S2.

4. Regarding the lymphatics of the lower limb, the following is true:

a. the popliteal lymph nodes lie superficial to the deep fascia.
b. the deep inguinal lymph nodes drain to the internal iliac nodes.
c. the deep inguinal lymph nodes drains the clitoris.**
d. the medial superficial inguinal lymph nodes receives from the waist .
e. the distal inguinal superficial lymph nodes receives all the superficial lymphatics .

5. The following is false about the foot interossei:

They flex the metatarsopharyngeal
They extend the interpharyngeal joint
The adduction and abduction actions are of little significance
All of them are supplied by the deep branch of the lateral planter nerve.
The planter and dorsal interossei has different origins

6. Regarding the femur, the following is false:

(a) MRI has a high sensitivity and specificity in detecting avascular
necrosis of the femoral head.
(b) The anteversion of the neck of the femur decreases from childhood into
adult life.
(c) The principal blood supply to the head of the adult femur is from the
medial and lateral circumflex femoral arteries.
(d) The nutrient artery of the femur travels cranially.
(e) The medial condyle is larger than the lateral condyle.

7. The following statement is true about the tibia:

The proximal tibial growth plate is largely resistant to fractures.
The fractures of the medial part of the tibial plateau are more common than the lateral
one.
Tensile and avulsion forces may give avulsion fractures of distal end.
The children and adults show the same distal tibial shaft fracture pattern.
The tibial shaft fracture is the least common diaphyseal fracture.

8. Which of the following is most likely true?:

a. The great saphenous vein joins the femoral vein about 5 cm below the inguinal
ligament.
b. A saphenous varix can be mistaken as a psoas abcess.
c. In cases of gunshot laceration to femoral artery the vein is usually spared.
d. The femoral hernia is usually reducible.
e. The femoral artery can be compressed by backward pressure on psoas major,
inferior pubic ramus and femoral head.

9. The following facture and mechanism of injury is usually paired:

Distal fibula facture – excessive eversion of the foot
Talar head fracture-extreme dorsal flexion of the foot
Navicular fracture- fall from height
Femoral neck fracture –excessive medial rotation of the thigh
Patellar fracture-tensile stress applied to bone during knee flexion.

10. Which of the following is most likely true regarding the venous drainage of
the lower limb?
The superficial venous system is similar to that of upper limbs
The valves of the great saphenous vein are located just superior to the perforating
veins.
The perforating veins are valveless
The perforating veins penetrate the deep fascia at right angle
The use of great saphenous vein for grafting may facilitate the superficial to deep
blood drainage

11. The following muscles groups are active during midstance phase of gait except:
Knee extensors
Ankle planter flexors
Hip abductors
Intrinsic muscles of the foot
Hip extensors
12. The following is true regarding the arterial supply of the lower limb
An enlarged pubic branch of superficial epigastric artery may form accessory obturator
artery.
The profunda femoris artery arises from the medial side of the femoral artery
Developmentally, the inferior gluteal artery is the major artery of posterior
compartment
The popliteal artery runs inferomedially through the popliteal fossa
The popliteal pulsations are better felt when the knee is extended

13. The following statement is false regarding the nerves of the lower limbs:
The sural nerve may not be present.
The planter reflex is mediated via L4,L5,S1and S2.
The lateral planter nerve compression is frequently occurs to runners.
The common peroneal nerve injury is associated with foot drop.
The level of bifurcation of the sciatic nerve is variable.

14. Regarding the innervation of the lower limb :

Sciatic nerve injury is associated with loss of sensation of the leg except the upper
part of the calf.
The common peroneal nerve nerve injury result in low-stepping gait.
The obturator nerve injury is associated with loss of adduction of the hip joint not
noticed during walking.
Tibial nerve injury is common.
The saphenous nerve is accompanied by the small saphenous vein.

15. Regarding the lower limb the following is not true:

Painful neuroma may follow partial division of infrapatellar branch of the saphenous
nerve following arthroscopy
The upper and lateral part of the head of the talus can be both seen and felt 3 cm
anterior to the distal end of the tibia while the foot is inverted.
The sural nerve at the ankle has a notorious tendency to form neuromas following
ankle surgery
The top of the greater trochanter lies about a hand breadth inferior to iliac crest
tubercle
The sustentaculum tali of the calcaneus can be felt 4 cm vertically below the medial
malleolus
1. In the upper limb the following is true:
The deep palmer arch lies approximately at the level of distal boarder of the fully
extended thumb.
The distal wrist crease indicates the distal border of the flexor retinaculum .
The proximal digital crease is approximately 2 cm distal to metacarpophalangeal joint .
The distal digital crease lies distal to its corresponding interphalangeal joint .
The superior angle of the scapula lies at the level of T3.

2. The following statement is true:

The supraspinatus tendon passes above the acromion process.
The clavicle has a medullary cavity.
The rhomboid fossa marks the site of origin of the costo-clavicular ligament.
The clavicle is the last bone to ossify.
A distance of less than 8 mm between the humerus and the acromion indicates likely
supraspinatus tendon impingement.

3. Regarding the hand and wrist, the following statement is false:

In 15% of cases blood supply is from the distal to the proximal portion of the scaphoid.
The scaphoid ossifies in the sixth year.
In most cases two views are enough to exclude scaphoid fractures.
Not all the metacarpals articulate with each other and with the corresponding carpal
bones.
The commonest supernumerary bone of the wrist joint is the os Radiale

4. Concerning the wrist and carpus, the following is not true:

The mid-carpal joint does not communicate with the radiocarpal joint.
On a lateral wrist radiograph the distal radius has a slight volar tilt.
The lunate articulates proximally with the radius and distally with the capitate.
The flexor retinaculum is attached to the pisiform, hook of hamate,
scaphoid tubercle and ridge of the trapezium.
Flexor carpi-radialis attaches to the pisiform.

5. Regarding of the spaces of the hand the following is true:

All the webs of the hand contain superficial and deep transverse ligaments.
The pulp space is formed of single compartment containing fatty tissue and branches
of digital vessels.
The septum separating the thinner and midpalmer space is passing vertically between
the flexor tendons index and middle fingers.
The pulp space infection in children may result in necrosis of the proximal epiphysis.
The lumberical canal is filled normally with connective tissue.
6. On conducting axillary surgery for Ca breast the following point is FALSE:
The anterior group of axillary lymph nodes is associated with the lateral thoracic
artery.
Winging of the scapula may follow surgery as a complication.
Weak adduction and medial rotation may follow as complication.
The cephalic vein may be found obstructed due to apical lymph node enlargement.
The axillary artery may be excised if surrounded by apical lymph nodes.

7. The following cutaneous areas and supplying sensory roots are correctly paired except
C5—radial side of upper arm
C6—radial side of forearm
C7—the skin of the hand
C8—ulnar side of upper arm
T1—ulnar side of upper arm

8. The following is true regarding the ossification of bones:

The ossification begins in the distal radius about the end of third year.
The upper epiphysis joins the body of the ulna about the twentieth year.
The humerus ossifies from six centers
The acromion of the scapula has two ossification centers
The lunate ossifies during the six year

9. Regarding the lymphatic drainage of the upper limb, the following is true
The deep lymphatic vessels are more numerous than the superficial vessels
Some vessels which accompany the cephalic vein enter the cubital lymph nodes
The palmar lymphatic plexus is denser than the dorsal plexus in the hand
The scapular skin drains only to subscapular axillary nodes
The proximal palm drains away from the carpus

10. Which one of the following statements concerning the arterial supply of the hand is NOT
true?
The deep arterial arch of the palm is formed primarily by the radial artery.
The superficial arch of the palm is formed primarily by the ulnar artery.
The digital and metacarpal branches of the superficial and deep arches also exhibit
anastomoses.
The deep branch of the ulnar artery passes through the hypothenar muscles.
The continuation of the radial artery that enters the palm does so between the second
and third metacarpal bones.

11. The following joint and subtype are paired except:

The radioulnar joint-pivot.
The intercarpal joint-plane.
The elbow joint -hinge.
The sternocalvicular joint-plane.
The metacrapopharyngeal-condyloid.
12. Regarding the upper limb:
The radial groove is situated in the radius.
The capitulum articulates with the ulna.
The ligament of Struthers may compress the ulnar nerve
The capitulum is the second secondary ossification centre to appear in the
]
'
elbow.
A prominent posterior fat pad in a lateral radiograph of the elbow is
seen in cases of joint effusion.

13. The following statement is true:

Anterior dislocation of the elbow joint is common in children
Infections of the elbow invariably involves the proximal radioulnar joint
Annular ligament rupture occurs in cases of anterior dislocation of the head of the
radius in the capitulum of the humerus
Shoulder separation condition indicates that the lateral end of the clavicle is thrust
beneath the acromion
The shoulder joint is commonly dislocated superiorly

14. A 35-year-old male involved in road traffic accident presented complaining of pain in
the root of his neck. On examination, his right arm is adducted, internally rotated and
extended at the elbow. He has loss of sensation along the outer aspects of the arm and the
forearm. The most likely segments involved are:
C5 and C6.
C5, 6 and 7
C7, 8 and T1.
C5, 6,7,8, and T1.
C7 and 8.

15. The following muscles and nerves supplying them are correctly linked:
Powerful supinator of the forearm – deep branch of the radial nerve.
Extensors of the wrist joint – musculocutaneous nerve .
All muscles of the anterior fascial compartment of the forearm – median nerve.
Palmar and dorsal interossei – deep branch of the ulnar nerve.
3rd and 4th lumbricals – median nerve.

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