Lower.limb.Exam.questions
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Transcript of Lower.limb.Exam.questions
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 fibulab. Causes loss of extension of the big toec. Causes a characteristic foot dropd. Causes a loss of inversion of the foote. 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 brevisb. Flexor carpi ulnarisc. Tibialis posteriord. Abductor digiti minimie. The 4th lumbrical
3. What is the nerve of the anterior compartment of the thigh?a. Femoral nerveb. Obturator nervec. Saphenous nerved. Tibial portion of sciatic nervee. 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. Abductionb. Lateral (external) rotationc. Flexiond. Extensione. Medial (internal) rotation
5. The homolog of the median nerve in the foot is the:a. Sural nerve b. Saphenous nervec. Deep fibular (peroneal) nerved. Medial plantar nervee. Lateral plantar nerve
6. Which of following muscles is innervated by the deep fibular (peroneal) nerve?a. Fibularis tertiusb. Flexor digitorum brevisc. Flexor digitorum longusd. All of the abovee. None of the above
7. Difficulty in standing on one’s toes is symptomatic of injury to the:a. Tibial nerveb. Common fibular (peroneal) nervec. Superficial fibular (peroneal) nerved. Deep fibular (peroneal) nervee. 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 fixedb. The medial meniscus is attached to the medial collateral ligamentc. The anterior cruciate ligament limits anterior displacement of the tibiad. The anterior cruciate ligament limits lateral rotation of the femur during extensione. B and C are correct
9. Which muscle DOES NOT cross anterior to the transverse axis of the hip joint?a. Tensor fascia lataleb. Psoasc. Rectus femorisd. Sartoriuse. Vastus lateralis
10. Which of the following muscles is/are innervated by the superficial peroneal nerve?a. Fibularis (peroneus) longusb. Fibularis (peroneus) brevisc. Fibularis (peroneus) tertiusd. A and Be. 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 nerveb. Superficial fibular (peroneal) nervec. Superior gluteal nerve d. Deep fibular (peroneal) nervee. Obturator nerve
12. Difficulty in crossing the knees while sitting in a chair is symptomatic injury to:a. Femoral nerveb. Obturator nervec. Superior gluteal nerved. Inferior gluteal nervee. Fibular (peroneal) division of the sciatic nerve
13. The ilioinguinal nerve is derived from:a. T10b. T12c. L1d. L2-L4e. 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 sheathb. It joins with the iliacus to form the iliiopsoas muscle, which is the chief extensor of the
thighc. Much of the lumbar plexus can be found within its bellyd. 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 nerveb. Deep peroneal nervec. Inferior gluteal nerved. Tibial nervee. 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. Trueb. False
17. Varicosity of the vein in the case of lower is because of the valvular insufficiency in which of the following veins?
a. Superficialb. Deepc. Perforatingd. 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 Muscleb. Right Anterior Tibialisc. Right Gluteus Maximusd. Right Gluteus Mediuse. 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 Arteryb. Femoral Arteryc. Popliteal Arteryd. 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 Tibiab. Anterior Displacement of the Femurc. Abnormal passive Abduction of the extended kneed. 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.
Above Inf Gluteal A, Below 1st 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:
Web b/w 1st and 2nd 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 nerveb. Nerve to obturator internus
Cruciate anastomoses contributes to all except
Superior epigastric artery
Above Inf Gluteal A, Below 1st 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 arteryb) 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
Loss of sensation to great and 2nd 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 triangle2. Adductor canal: femoral canal3. Saphenous nerve: small saphenous is false4. Saphenous nerve art is medial side of foot: e5. varicose veins6. lat cutaneous nerve: spinal valves b L2-L37. Root value sciatic nerve: ventral rami L4, L5, S1-S38. 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 hiatus5. Profunda femoris a (deep femoral a): gives perforating arteries which supply post thigh muscle6. 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 nerveb. 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 veinsa. Multiple pregnanciesb. Long standing hoursc. 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 sheathL- 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. Syndromea) Anterior tibial arteryb) 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 isCaput Medusa
38. The conjoint tendon (falx inguinalis) is formed by thea) rectus abdominis muscle or its aponeurosisb) external oblique muscle or its aponeurosisc) both a and bd) neither a or b
39. The following facts are true for inguinal ligamenta) It is an aponeurosis of the external abdominal oblique muscleb) It dorms the flood of inguinal canalc) It extends from the anterior superior iliac spine to pub tubercled) 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 canala) Begins at the deep inguinal ringb) Has the inf. Oblique forming part of its roofc) Has the inguinal lig forming its floord) Has the ilio inguinal nerve coursing through the superficial ringe) 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 inversion3.) Major muscle responsible for unlocking of knee is the popliteus4.) Movements possible in knee joint (tibio-fibular jt) are: flexion, extension, medial and lateral
rotation5.) 2nd heart of the body is the gastrocnemius muscle b/c it pumps impure blood against gravity to
the heart6.) Saphenous nerve is the cutaneous nerve of the medial side of leg and foot7.) 35 year old female with pain in leg that aggrevates upon standing and is alleviated when
propped up, what is wrong? Varicose Veins8.) Muscles innervated by deep fibular nerve (AKA deep peroneal nerve) dorsiflexors of foot9.) In the knee joint, medial meniscus is attached to the medial collateral ligament
10.) Inability to do plantar flexion of foot due to tibial nerve11.) Player hit lateral side of knee-medial collateral ligament and the ACL are damaged12.) 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-S315.) Football triad clipping injury lateral side of the knee is injured, rupture of the medial
collateral ligament and meniscus16.) Plantar flexors unopposed and dorsiflexors are damaged so there is damage to the deep
peroneal nerve17.) Tibialis anterior responsible for the dorsiflexion of the foot18.) Not found the popliteal fossa-the lesser saphenous vein19.) Potts fracture involves fracture of the tibia, rupture of the deltoid ligament, what movement is
affected? inversion20.) 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 triangle10. Adductor canal: femoral canal11. Saphenous nerve: small saphenous is false12. Saphenous nerve art is medial side of foot: e13. varicose veins14. lat cutaneous nerve: spinal valves b L2-L315. Root value sciatic nerve: ventral rami L4, L5, S1-S316. 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 hiatus14. Profunda femoris a (deep femoral a): gives perforating arteries which supply post thigh muscle15. Adductor tubercle is located in: medial condyle femur16. 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 nerveb. 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 veinsa. Multiple pregnanciesb. Long standing hoursc. 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 sheathL- 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. Syndromea) Anterior tibial arteryb) 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 isCaput Medusa
94. The conjoint tendon (falx inguinalis) is formed by the
a) rectus abdominis muscle or its aponeurosisb) external oblique muscle or its aponeurosisc) both a and bd) neither a or b
95. The following facts are true for inguinal ligamenta) It is an aponeurosis of the external abdominal oblique muscleb) It dorms the flood of inguinal canalc) It extends from the anterior superior iliac spine to pub tubercled) 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 canala) Begins at the deep inguinal ringb) Has the inf. Oblique forming part of its roofc) Has the inguinal lig forming its floord) Has the ilio inguinal nerve coursing through the superficial ringe) 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