LOWER LIMB BRAINSCAPE
16. Flexion of the hip joint (with the knee extended)
is limited by the
F. None of the above.
17. Abduction of the hip joint is limited by the
D. pubofemoral ligament.
18. Extension of the hip joint is limited by the
A. iliofemoral ligament.
19. Flexion of the hip joint (with the knee flexed) is
limited by the
E. anterior abdominal wall.
20. The long head of the biceps femoris muscle is
innervated by the
B. tibial portion of the sciatic nerve.
21. The gracilis muscle is innervated by the
D. obturator nerve.
22. The gluteus maximus muscle is innervated by the
A. inferior gluteal nerve.
23. The sartorius muscle is innervated by the
B. femoral nerve.
24. The hamstring portion of the adductor magnus
muscle is innervated by the
B. tibial portion of the sciatic nerve.
25. The adductor longus muscle is innervated by the
D. anterior division of the obturator nerve.
26. A malignant melanoma (cancer) of the skin
covering the buttock is likely to spread via
lymphatics to the
A. horizontal group of superficial inguinal nodes.
27. Lymph from the nail bed of the big toe drains
into the
E. vertical group of superficial inguinal nodes.
28. The lateral meniscus of the knee joint
E. is attached by its anterior horn to the tibia in
front
of the intercondylar eminence.
29. Lymph from the skin of the lateral side of the
foot drains into the
A. popliteal nodes.
30. Lymph from the skin of the medial side of the
knee drains into the
B. vertical group of superficial inguinal nodes.
31. Lymph from the skin around the anus drains into
the
D. medial group of horizontal superficial inguinal
nodes.
32. The sciatic nerve enters the gluteal region
through which foramen?
B. Greater sciatic
33. The common peroneal nerve can be palpated in
which region of the knee?
C. As it winds around the lateral side of the neck of
the fibula.
34. If the dorsalis pedis artery is severed just
proximal to its medial and lateral tarsal branches,
blood can still reach the dorsum of the foot through
which vessel(s)?
E. All of the above.
35. In children, the chief arterial supply to the head
of the femur is derived from which artery or
arteries?
A. The obturator artery.
36. Which statement is correct concerning the
femoral ring?
C. It is the proximal opening in the femoral canal.
37. To lift the left foot off the ground while walking,
which of the following muscles plays an important
role?
D. The right gluteus medius muscle
38. Rupture of the tendon calcaneus results in an
inability to do what?
D. Plantar flex the foot
39. A sprained ankle resulting from excessive
eversion most likely demonstrates that which
structure is torn?
C. The deltoid ligament
40. If the foot is permanently dorsiflexed and
everted, which nerve might be injured?
D. The tibial nerve
41. The femoral nerve arises from which of the
following segments of the spinal cord?
C. L2, 3, and 4
42. The dermatome present over the lateral side of
the foot is which of the following?
C. S1
 LOWER LIMB BRAINSCAPE
43. The femoral sheath is formed by which of the After a football injury, an orthopedic surgeon noted
following layer(s) of fascia? that the right tibia of the patient could be moved
anteriorly with excessive freedom when the knee
B. The fascia iliaca and the fascia transversalis
was flexed.
44. Which of the following muscles everts the foot?
54. In this patient, which ligament is most likely to
C. The peroneus longus muscle be torn?

45. Injury to the common peroneal nerve results in C. The anterior cruciate ligament
which condition?
A 69-year-old m an was walking down a flight of
E. Inability to evert the foot steps when he slipped and fell. On impact, his left
foot hit the ground and was forcibly inverted and
46. After a lesion of the tibial part of the sciatic
medially rotated. He stated that he felt something
nerve, some active flexion may still be possible at
give on the lateral side of the dorsum of the foot.
the knee joint; the muscles responsible for this
Though shocked by the fall and the resulting foot
remaining flexion include which?
pain, he was able to walk home. Within 2 h, the left
A. The short head of the biceps femoris muscle foot and ankle had swollen considerably, which
made examination by his physician difficult.
47. A patient in the supine position with the hip and
Movements of the ankle were clearly possible, but
knee joints extended is asked to abduct the lower
inversion was extremely painful. On standing, the
limb against resistance provided by the physician;
patient could bear his body weight without too
this exercise tests which of the following muscles?
much discomfort. The physician ordered an
B. The gluteus medius muscle anteroposterior and a lateral radiograph of the
ankle region, both of which showed nothing
48. A femoral hernia has the following
abnormal. This patient was diagnosed as having an
characteristics except which?
acute sprain of the lateral ankle.
D. Its neck is related immediately laterally to the
55. Which ligament is most likely to have been
femoral artery.
damaged?
49. The gastrocnemius and the soleus muscles have
B. The anterior talofibular ligament
all the following features in common except which?
A 29-year-old woman was involved in an automobile
C. They arise from the femoral condyles and flex
accident. Her car skidded into a tree, and she was
the knee joint.
thrown forward, striking her right knee on the
50. All the following statements about the sartorius dashboard. At examination in the emergency
muscle are correct except which? department, she was found to have a posterior
fracture dislocation of her right hip joint.
D. It adducts the thigh at the hip joint.
56. What bone or bones are likely to have been
51. The following structures are transmitted
fractured?
through the lesser sciatic foramen except which?
C. The posterior rim of the acetabulum and fracture
E. The inferior gluteal artery
of the femoral head
52. The following statements regarding the great
57. What anatomic structure is likely to be
saphenous vein are correct except which?
compromised in a hip dislocation of this type?
E. It has no communication with the deep veins of
B. The sciatic nerve
the leg.
53. The following statements regarding the
obturator nerve are correct except which?
B. It enters the thigh immediately beneath the
inguinal ligament.
 PELVIS AND PERINEUM BRAINSCAPE

22. The lymphatic drainage of the labia majora is into

the
B. superficial inguinal nodes. E. The obturator internus muscle receives its nerve
supply from the sacral plexus.
23. A carcinoma of the skin of the glans penis is likely
to spread via the lymphatics into the 32. The internal anal sphincter receives its nerve
D. superficial inguinal nodes. supply from the
A. hypogastric plexuses.

24. A carcinoma of the cervix of the uterus is likely to 33. The sphincter urethrae receives its innervation
spread via the lymphatics into the from the
D. internal and external iliac nodes. C. pudendal nerve.

25. A carcinoma of the prostate is likely to spread via 34. The levator ani muscle receives its innervation
the lymphatics into the from the
B. internal iliac nodes. C. pudendal nerve and the perineal branch of S4.

35. The superior rectal vein drains into the

26. A carcinoma of the vaginal orifice is likely to D. inferior mesenteric vein.
spread via the lymphatics into the
A. medial group of horizontal superficial inguinal 36. The right ovarian vein drains into the
nodes. B. inferior vena cava.

27. The superior rectal artery originates from the 37. A patient was examined with a left-sided
D. inferior mesenteric artery. varicocele; the left testicular vein drains into the
A. left renal vein.

28. The left ovarian artery originates from the 38. The prostatic venous plexus drains into the
E. abdominal part of the aorta. B. internal iliac veins.

29. The inferior rectal artery originates from the
C. internal pudendal artery.
30. The middle rectal artery originates from the
C. internal iliac artery.
39. In most women, the anatomic position of the
uterus when the bladder is empty is
D. anteverted and anteflexed.
40. The uterus receives its blood supply from the
E. uterine and ovarian arteries.

31. The obturator internus muscle receives its nerve 41. In a woman with ovarian cancer, it is judicious to
supply from the examine the
E. para-aortic lymph nodes and evidence of excessive
peritoneal fluid (ascites).
 PELVIS AND PERINEUM BRAINSCAPE
42. The narrowest part of the male urethra is the C. inferior ramus of the pubis and the ischial ramus.
D. external meatus on the glans penis.

43. Erection of the penis is a response to the activity 53. During defecation, the levator ani muscles
of the C. relax (puborectalis portion) with the anal
B. parasympathetic nerve. sphincters.

44. Ejaculation is the response to the activity of the

C. sympathetic nerves. 54. During the second stage of labor, the gutter
shape of the pelvic floor tends to
45. The posterior wall of the lower third of the vagina D. cause the baby’s head to rotate so that its
is sup- ported by the frontooccipital diameter assumes the
B. perineal body. anteroposterior position with the frontal bone lying
posterior.
46. The rectouterine pouch (pouch of Douglas) can
be most efficiently entered by a surgical incision
through the 55. The mucous membrane lining the upper half of
A. posterior fornix of the vagina. the anal canal is
E. sensitive to stretch
47. Cancer of the prostate can metastasize to the
skull via the 56. The anal columns
C. vertebral venous plexus. A. contain tributaries of the superior rectal vein.

48. The middle (median) lobe of the prostate lies
E. superior to the ejaculatory ducts and posterior to
the upper part of the prostatic urethra.
49. The promontory of the sacrum is formed by the
D. anterior and upper border of the first sacral
vertebra.
57. The female urethra
E. is readily accessible to infection.
58. The process of orgasm in the female depends in
part on the
C. ischiocavernosus muscles contracting in response
to the activity of the pudendal nerve.

50. The pelvic outlet is bounded posteriorly by the

coccyx, laterally by the sacrotuberous ligaments and 59. The rectouterine pouch (pouch of Douglas)
the ________, and anteriorly by the pubic arch. D. lies behind the posterior fornix of the vagina and
C. ischial tuberosities the body of the uterus.

51. The pelvic diaphragm is formed by the ________

and coccygeus muscles and their covering fasciae. 60. The rectouterine pouch (pouch of Douglas)
B. levator ani except which? A. Anteriorly is situated the posterior
surface of the following structures are closely related
52. The urogenital diaphragm is attached laterally to to the
the upper part of the vagina.
 PELVIS AND PERINEUM BRAINSCAPE
C. The trigone of the bladder is directly related to its examination revealed that a tender, “doughlike”
anterior wall. mass could be felt through the posterior fornix. The
patient had missed her last period. The diagnosis of
61. Support for the uterus, either directly or a ruptured ectopic pregnancy was made. In this
indirectly, is provided by the following structures ectopic pregnancy, the embryo was implanted in the
except which? right uterine tube. Rupture of the tube produced the
B. The mesosalpinx symptoms and the signs that were noted.
67. Using your knowledge of anatomy, explain the
62. The following statements regarding the ovary are relationship of the uterine tube to the peritoneal
correct except which? cavity..
C. It is attached to the lateral pelvic wall by the round D. The tube lies in the free margin of the broad
ligament of the ovary. ligament.

63. The following statements regarding the urinary 68. The tender, doughlike mass felt through the
bladder are true except which? posterior wall of the vagina resulted from what?
E. In children, the bladder is located entirely within B. Blood in the pouch of Douglas
the pelvis.

64. The except which? Broad ligament contains all
of the following
E. The ureters
65. Malignant tumors of the trigone of the bladder
spread (metastasize) to which of the following lymph
nodes?
D. External and internal iliac
66. In males, traumatic injury to the perineum may
rupture the bulb of the penis or the penile urethra.
The resulting leakage of blood or urine may be found
in all of the following areas except which?
B. The ischiorectal fossa
A 21-year-old woman complaining of severe pain in
the right iliac region was seen in the emergency
department. Just before admission, she had fainted.
On physical examination, her abdominal wall was
extremely tender on palpation in the right iliac
region, and some rigidity and guarding of the lower
abdominal muscles were noticed. A vaginal
69. What was responsible for the guarding (partial
contraction) of the lower abdominal muscles?
A. Blood in the peritoneal cavity causing irritation of
the parietal peritoneum and reflex contraction of the
lower abdominal muscles
A 56-year-old man was seen by his physician because
the patient had noticed that his “bowel” was
protruding from his anus after defecation. On
questioning, the patient stated that for the past 2
years he had frequently passed blood- stained stools.
Digital rectal examination revealed nothing
abnormal. Proctoscopic examination showed that
the mucous membrane above the level of the anal
valves tended to bulge downward in three areas
when the patient strained. The swollen mucous
membrane contained large, congested veins
beneath the surface.
70. Based on your knowledge of anatomy, make a
reasoned diagnosis.
 PELVIS AND PERINEUM BRAINSCAPE
D. Internal hemorrhoids

71. What is the venous drainage of the mucous

membrane of the anal canal?
C. Superior and inferior rectal veins