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  • Question 1 - A 22 year old professional athlete sustains an inversion injury to her left...

    Correct

    • A 22 year old professional athlete sustains an inversion injury to her left ankle during the 800m. Which of the following ligaments is most likely injured:

      Your Answer: Anterior talofibular ligament

      Explanation:

      Inversion injuries at the ankle in plantarflexion (such as when wearing high heels) are common, and typically result in damage to the lateral collateral ligament of the ankle, made up of the anterior talofibular, the calcaneofibular and the posterior talofibular ligaments. The anterior talofibular and the calcaneofibular ligaments are most commonly injured, and the posterior talofibular ligament rarely. The spring ligament supports the head of the talus, the deltoid ligament supports the medial aspect of the ankle joint, and the long and short plantar ligaments are involved in maintaining the lateral longitudinal arch of the foot.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      3
      Seconds

  • Question 2 - The most important nerves for inversion of the foot are: ...

    Incorrect

    • The most important nerves for inversion of the foot are:

      Your Answer:

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is achieved by the tibialis anterior which is innervated by the deep fibular nerves, and the tibialis posterior muscles which is innervated by the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 3 - You are giving a teaching session to a group of final year medical...

    Incorrect

    • You are giving a teaching session to a group of final year medical students regarding lower limb neurology. Which of the following clinical features would be expected in an obturator nerve palsy:

      Your Answer:

      Correct Answer: Weakness of hip adduction

      Explanation:

      Damage to the obturator nerve results in weak adduction of the hip with lateral swinging of the limb during walking due to unopposed abduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 4 - Which of the following would you NOT expect from a deep fibular nerve...

    Incorrect

    • Which of the following would you NOT expect from a deep fibular nerve palsy:

      Your Answer:

      Correct Answer: Loss of sensation over heel

      Explanation:

      Damage to the deep fibular nerve results in loss of dorsiflexion of the ankle, with resultant foot drop with high-stepping gait, loss of toe extension, weakness of foot inversion and loss of sensation over the webspace between the 1st and 2nd toes.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 5 - An X-ray of a 24-year-old female hockey player who arrives at the hospital...

    Incorrect

    • An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?

      Your Answer:

      Correct Answer: Fibularis brevis

      Explanation:

      An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards.

      When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle.

      The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 6 - Damage to this nerve affects the flexor digitorum longus. ...

    Incorrect

    • Damage to this nerve affects the flexor digitorum longus.

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      Like all muscles in the deep posterior compartment of the leg, flexor digitorum longus muscle is innervated by branches of the tibial nerve (root value L5, S1 and S2) which is a branch of sciatic nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 7 - A 43-year-old woman presented to the emergency room after an incident of slipping...

    Incorrect

    • A 43-year-old woman presented to the emergency room after an incident of slipping and falling onto her back and left hip. Upon physical examination, it was noted that she has pain on hip abduction, but normal hip extension.

      Which of the following muscles was most likely injured in this case?

      Your Answer:

      Correct Answer: Gluteus medius

      Explanation:

      The primary hip extensors are the gluteus maximus and the hamstrings such as the long head of the biceps femoris, the semitendinosus, and the semimembranosus. The extensor head of the adductor magnus is also considered a primary hip extensor.

      The hip abductor muscle group is located on the lateral thigh. The primary hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae.
      The secondary hip abductors include the piriformis, sartorius, and superior fibres of the gluteus maximus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 8 - A 30-year-old rugby player suffers from an anterior cruciate ligament tear while pivoting...

    Incorrect

    • A 30-year-old rugby player suffers from an anterior cruciate ligament tear while pivoting to attempt to run around another player. An MRI was performed and showed that his injury caused two other structures in the knee joint to be injured.

      Which of the following structures is most likely also injured?

      Your Answer:

      Correct Answer: Medial meniscus

      Explanation:

      The O’Donoghue unhappy triad or terrible triad often occurs in contact and non-contact sports, such as basketball, football, or rugby, when there is a lateral force applied to the knee while the foot is fixated on the ground. This produces an abduction-external rotation mechanism of injury.

      The O’Donoghue unhappy triad comprises three types of soft tissue injury that frequently tend to occur simultaneously in knee injuries. O’Donoghue described the injuries as: anterior cruciate ligament tear, medial collateral ligament injury, and medial meniscal tear (lateral compartment bone bruise).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 9 - A 29 year old woman is unable to invert her foot after sustaining...

    Incorrect

    • A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:

      Your Answer:

      Correct Answer: Tibial and deep fibular nerve

      Explanation:

      Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 10 - Which of the following nerves innervates the adductor brevis? ...

    Incorrect

    • Which of the following nerves innervates the adductor brevis?

      Your Answer:

      Correct Answer: Obturator nerve

      Explanation:

      Like the majority of the thigh adductors, adductor brevis is innervated by the obturator nerve. Obturator nerve is derived from the lumbar plexus (anterior branches of spinal nerves L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 11 - A 42-year-old man presented to the emergency room after an incident of slipping...

    Incorrect

    • A 42-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip adduction, but normal hip flexion.

      Which of the following muscles was most likely injured in this case?

      Your Answer:

      Correct Answer: Pectineus

      Explanation:

      The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.

      The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 12 - Which of the following muscles is most responsible for thigh extension at the...

    Incorrect

    • Which of the following muscles is most responsible for thigh extension at the hip joint?

      Your Answer:

      Correct Answer: Hamstrings and gluteus maximus

      Explanation:

      For hip extension, the gluteus maximus and hamstring muscles work together. To compensate for gluteus maximus weakness, the hamstring frequently acts as the primary hip extensor.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 13 - Given a patient with dislocation of the patella, which muscle is the most...

    Incorrect

    • Given a patient with dislocation of the patella, which muscle is the most important to address during rehabilitation to prevent recurrent dislocation?

      Your Answer:

      Correct Answer: Vastus medialis

      Explanation:

      Patellar dislocation is a disabling musculoskeletal disorder which predominantly affects younger people who are engaged in multidirectional physically active pursuits. Conservative (non-operative) treatment is the treatment of choice for FTPD (first time patellar dislocation). Quadriceps strengthening exercises are considered one of the principal management aims for people following FTPD. A United Kingdom (UK) survey of physiotherapy practice has shown that quadriceps strengthening and specific-vastus medialis obliquus (VMO) or distal vastus medialis (VM) muscle strengthening or recruitment exercises were two of the most frequently used interventions for this population. Specific VM exercises are favoured in some quarters based on the assumption that the VM has an important role in preventing excessive lateral patellar translation.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 14 - A foot drop is a sign of damage to which of the following...

    Incorrect

    • A foot drop is a sign of damage to which of the following nerves?

      Your Answer:

      Correct Answer: Deep fibular nerve

      Explanation:

      The deep fibular nerve was previously referred to as the anterior tibial nerve.

      It starts at the common fibular nerve bifurcation, between the fibula and the proximal part of the fibularis longus. Damage to this nerve can cause foot drop or loss of dorsiflexion since this nerve controls the anterior leg muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 15 - A patient suffers a lower limb fracture that causes damage to the nerve...

    Incorrect

    • A patient suffers a lower limb fracture that causes damage to the nerve that innervates peroneus brevis.
      Peroneus brevis receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Superficial peroneal nerve

      Explanation:

      Peroneus brevis is innervated by the superficial peroneal nerve.
      Peroneus longus is innervated by the superficial peroneal nerve.
      Peroneus tertius is innervated by the deep peroneal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 16 - A 32-year-old woman suffers a deep wound to her thigh while she was...

    Incorrect

    • A 32-year-old woman suffers a deep wound to her thigh while she was climbing over a barbed wire fence. As a consequence of her injury, the nerve that was severed innervates the gracilis muscle.

      In which of the following nerves is the gracilis muscle innervated by?

      Your Answer:

      Correct Answer: Anterior branch of the obturator nerve

      Explanation:

      The gracilis muscles is innervated by the anterior branch of the obturator nerve (L2-L4).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 17 - You are examining the lower limbs of a 54 year old man who...

    Incorrect

    • You are examining the lower limbs of a 54 year old man who presented after falling from a ladder at home. During your neurological assessment you note a weakness of hip flexion. Which of the following nerves is the most important for flexion of the thigh at the hip joint:

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Flexion of the thigh at the hip joint is produced by the sartorius, psoas major, iliacus and pectineus muscles, assisted by the rectus femoris muscle, all innervated by the femoral nerve (except for the psoas major, innervated by the anterior rami of L1 – 3).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 18 - A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.

    In...

    Incorrect

    • A 27-year-old athlete presents with buttock pain after tearing his gluteus maximus muscle.

      In which of the following nerves is the gluteus maximus muscle innervated by?

      Your Answer:

      Correct Answer: Inferior gluteal nerve

      Explanation:

      The gluteal muscles are a group of muscles that make up the buttock area. These muscles include: gluteus maximus, gluteus medius. and gluteus minimus.
      The gluteus maximus is the most superficial as well as largest of the three muscles and makes up most of the shape and form of the buttock and hip area. It is a thick, fleshy muscle with a quadrangular shape. It is a large muscle and plays a prominent role in the maintenance of keeping the upper body erect.
      The innervation of the gluteus maximus muscle is from the inferior gluteal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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  • Question 19 - Which of the following muscles laterally rotates the hip? ...

    Incorrect

    • Which of the following muscles laterally rotates the hip?

      Your Answer:

      Correct Answer: Gluteus maximus

      Explanation:

      External (lateral) rotation at the hip joint is produced by the gluteus maximus together with a group of 6 small muscles (lateral rotators): piriformis, obturator internus, superior and inferior gemelli, quadratus femoris and obturator externus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 20 - A 30-year-old man presents with piriformis syndrome pain, tingling, and numbness in her...

    Incorrect

    • A 30-year-old man presents with piriformis syndrome pain, tingling, and numbness in her buttocks. He noted that the pain gets worse upon sitting down. He was seen by a physiotherapist and a diagnosis of piriformis syndrome was made.

      Which of the following nerves becomes irritated in piriformis syndrome?

      Your Answer:

      Correct Answer: Sciatic nerve

      Explanation:

      Piriformis syndrome is a clinical condition of sciatic nerve entrapment at the level of the ischial tuberosity. While there are multiple factors potentially contributing to piriformis syndrome, the clinical presentation is fairly consistent, with patients often reporting pain in the gluteal/buttock region that may shoot, burn or ache down the back of the leg (i.e. sciatic-like pain). In addition, numbness in the buttocks and tingling sensations along the distribution of the sciatic nerve is not uncommon.

      The sciatic nerve runs just adjacent to the piriformis muscle, which functions as an external rotator of the hip. Hence, whenever the piriformis muscle is irritated or inflamed, it also affects the sciatic nerve, which then results in sciatica-like pain.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 21 - A 32 year old man is brought to ED having been thrown off...

    Incorrect

    • A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 22 - A patient suffers an injury to the nerve that innervates piriformis.
    The piriformis muscle...

    Incorrect

    • A patient suffers an injury to the nerve that innervates piriformis.
      The piriformis muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer:

      Correct Answer: Nerve to piriformis

      Explanation:

      Piriformis is innervated by the nerve to piriformis, which is a direct branch from the sacral plexus (S1 and S2).

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 23 - Which of the following nerves has been damaged when a patient presents with...

    Incorrect

    • Which of the following nerves has been damaged when a patient presents with a foot drop?

      Your Answer:

      Correct Answer: Common peroneal nerve

      Explanation:

      The common peroneal nerve often referred to as the common fibular nerve, is a major nerve that innervates the lower extremity. It is one of the two major branches off the sciatic nerve and receives fibres from the posterior divisions of L4 through S2 nerve roots. The common peroneal nerve separates from the sciatic nerve in the distal posterior thigh proximal to the popliteal fossa. After branching off of the sciatic nerve, it continues down the thigh, running posteroinferior to the biceps femoris muscle, and crosses laterally to the head of the lateral gastrocnemius muscle through the posterior intermuscular septum. The nerve then curves around the fibular neck before dividing into two branches, the superficial peroneal nerve (SPN) and the deep peroneal nerve (DPN). The common peroneal nerve does not have any motor innervation before dividing; however, it provides sensory innervation to the lateral leg via the lateral sural nerve.

      The superficial peroneal nerve innervates the lateral compartment of the leg, and the deep peroneal nerve innervates the anterior compartment of the leg and the dorsum of the foot. These two nerves are essential in the eversion of the foot and dorsiflexion of the foot, respectively. The superficial and deep peroneal nerves provide both motor and sensory innervation.

      The most common presentation with common peroneal nerve injury or palsy is acute foot drop, although symptoms may be progressive and can include sensory loss or pain. Weakness in foot eversion may occur if the superficial peroneal nerve component is involved.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 24 - Which of the following ligaments supports the head of the talus? ...

    Incorrect

    • Which of the following ligaments supports the head of the talus?

      Your Answer:

      Correct Answer: Spring ligament

      Explanation:

      The spring-ligament complex is a significant medial arch stabilizer.

      The two important functions of this ligament include promoting the stability of the talonavicular joint by acting as a support for the talus head and by acting as a static support to maintain the medial longitudinal arch.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 25 - A patient suffers from an injury and as a consequence, the nerve that...

    Incorrect

    • A patient suffers from an injury and as a consequence, the nerve that was damaged innervates the obturator internus muscle.

      In which of the following nerves is the obturator internus muscle innervated by?

      Your Answer:

      Correct Answer: Nerve to obturator internus

      Explanation:

      The obturator internus is innervated by the obturator internus nerve (L5–S2), a branch of sacral plexus.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 26 - A patient suffers an injury to his thigh that damages the nerve that...

    Incorrect

    • A patient suffers an injury to his thigh that damages the nerve that innervates pectineus.
      Which of the following nerves has been damaged in this case? Select ONE answer only.

      Your Answer:

      Correct Answer: Femoral nerve

      Explanation:

      Pectineus is innervated by the femoral nerve. It may also receive a branch from the obturator nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 27 - Which of the following best describes the popliteal artery's course? ...

    Incorrect

    • Which of the following best describes the popliteal artery's course?

      Your Answer:

      Correct Answer: After exiting the popliteal fossa terminates at the lower border of the popliteus muscle

      Explanation:

      The popliteal artery divides into the anterior and posterior tibial arteries at the lower border of the popliteus after exiting the popliteal fossa between the gastrocnemius and popliteus muscles.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 28 - Which nerve supplies the muscle flexor hallucis longus? ...

    Incorrect

    • Which nerve supplies the muscle flexor hallucis longus?

      Your Answer:

      Correct Answer: Tibial nerve

      Explanation:

      Flexor hallucis longus is innervated by the tibial nerve, composed of spinal roots L4, L5, S1, S2, and S3.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

  • Question 29 - A 25-year-old guy who has had a knee-high plaster cast on his left...

    Incorrect

    • A 25-year-old guy who has had a knee-high plaster cast on his left leg for the past 5 weeks arrives at the emergency department complaining of numbness on the dorsum of his left foot and an inability to dorsiflex or evert his foot. You know that his symptoms are due to fibular nerve compression. Where is the fibular nerve located?

      Your Answer:

      Correct Answer: Neck of fibula

      Explanation:

      Dorsiflexion and eversion of the foot are innervated by the deep fibular nerve and the superficial fibular nerve, respectively.

      The common fibular nerve runs obliquely downward along the lateral border of the popliteal fossa (medial to the biceps femoris) before branching at the neck of the fibula.

      Thus, it is prone to being affected during an impact injury or fracture to the bone or leg. Casts that are placed too high can also compress the fibular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
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      Seconds

  • Question 30 - Which of the following clinical features would you NOT expect to see in...

    Incorrect

    • Which of the following clinical features would you NOT expect to see in a tibial nerve palsy:

      Your Answer:

      Correct Answer: Weakened eversion of the foot

      Explanation:

      Damage to the tibial nerve results in loss of plantarflexion of the ankle and weakness of inversion of the foot resulting in a shuffling gait, clawing of the toes and loss of sensation in its cutaneous distribution.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      0
      Seconds

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