1: Clinical anatomy - lower limb

Question 1

What are the four pelvic bones?

Answer 1

Ilium

Ischium

Pubic bone

Sacrum

Question 2

What are the three ligaments holding the pelvic bones togther?

Answer 2

Anterior and posterior sacroiliac ligaments

Sacrospinous ligaments

Sacrotuberous ligaments

Question 3

Which nerves are found in the pelvis?

Which nerve, coming from L4 - S3, emerges from the greater sciatic foramen?

Answer 3

Pudendal nerves

Pelvic splanchnic nerves

Sciatic nerve

Question 4

Damage to pelvic nerves can affect which organs?

Answer 4

Bowel

Bladder

Question 5

What other tissues can be damaged by pelvic trauma?

Answer 5

Urethra

Rectum

Question 6

Which arteries anastomose around the head of the femur?

Where do they come from?

Answer 6

Retinacular arteries

Medial and lateral circumflex arteries

Profunda femoris artery (deep femoral artery)

Question 7

What kind of hip fracture can compromise retinacular arteries?

What may result?

Answer 7

Intracapsular hip fracture

AVN

Question 8

What bones, apart from the femur, can be affected by avascular necrosis?

Answer 8

Scaphoid

Talus

Question 9

Which posterior thigh muscles cause abduction of the thigh and stabilise the pelvis?

Answer 9

Gluteal muscles

maximus, medius, minimus

Tensor fascia latae

Question 10

What’s the dodgy gait caused by damage to the gluteal muscles?

Answer 10

Trendelenburg’s gait

pelvis doesn’t stabilise

Question 11

What is Trendelenburg’s test?

Answer 11

Normally, when a lower limb is lifted, pelvis should tilt in direction of other limb

Positive Trendelenburg test if pelvis tils in direction of lifted limb

Question 12

What is the strongest hip flexor muscle, found in the anterior compartment of the thigh?

Answer 12

Iliopsoas

Question 13

Which nerve supplies the adductor muscles of the medial compartment of the thigh?

Answer 13

Obturator nerve

Question 14

What movement do muscles in the posterior compartment of the thigh produce?

Answer 14

Lateral rotation

Question 15

What is the most anterior quadriceps muscle called?

What movement do the quadriceps muscle cause?

Answer 15

Rectus femoris

Flexion of thigh, extension of leg

Question 16

What is the longest muscle in the body, found in the anterior compartment of the thigh, and produces weak extension of the leg?

Answer 16

Sartorius

Question 17

A straight leg raise tests the (flexor / extensor) mechanism of the lower limb.

Answer 17

extensor inc tendons

Question 18

Which pelvic bone do you sit on?

Answer 18

Ischial tuberosity

Question 19

Which nerve supplies the hamstrings muscles of the posterior thigh?

Answer 19

Tibial nerve

Question 20

Which muscle is commonly used as a tendon graft in ACL surgery?

Answer 20

Semitendinosus

Question 21

Knee pain in kiddos may be caused by what serious disease?

Answer 21

SUFE

slipped upper femoral epiphysis

Question 22

Obturator nerve pain from the hip may refer to the ___.

Answer 22

knee

Question 23

Through which hole do the femoral artery and vein pass into the popliteal fossa?

Answer 23

Adductor hiatus

adductor magnus

Question 24

What are the two types of cartilage in the knee?

Answer 24

Hyaline cartilage

Fibrocartilage - found in medial and lateral menisci

Question 25

Why are medial meniscal tears more common than lateral ones?

Answer 25

**We tend to pivot on medial aspect of knee**

Question 26

The **MCL** protects against ___ stress. The **LCL** protects against ___ stress.

Answer 26

**valgus** **varus**

Question 27

What movements does the **anterior cruciate ligament** resist?

Answer 27

**Internal rotation** **Anterior translation of tibia**

Question 28

What movements does the **posterior cruciate ligament** resist?

Answer 28

**Posterior translation of tibia**

Question 29

The average person's leg is in six degrees of (varus / valgus).

Answer 29

**valgus**

Question 30

What's the advantage of physiological valgus?

Answer 30

**Joints all line up, better distribution of weight**

Question 31

Why do people with genu varum or valgus get OA?

Answer 31

**Poor distribution of load, not symmetrical**

Question 32

People with genu varum may develop **(medial / lateral)** OA. People with genu valgum develop...

Answer 32

**varum** - medial OA **valgum** - lateral OA

Question 33

What fluid filled spaces can become inflamed if you kneel a lot?

Answer 33

**Bursae**

Question 34

Inflammation of bursae is called \_\_\_.

Answer 34

**bursitis**

Question 35

Anterior leg muscles perform which movements?

Answer 35

**Dorsiflexion** and **extension of toes**

Question 36

Which nerve supplies the anterior leg muscles?

Answer 36

**Deep fibular nerve**

Question 37

The lateral leg muscles perform which movements? Which nerve supplies them?

Answer 37

Inversion of foot ## Footnote **Superficial fibular nerve**

Question 38

Which nerve supplies the posterior muscles of the leg?

Answer 38

**Tibial nerve**

Question 39

deep fibular - sensory to 1st toe space, lies in anterior compartment superficial fibular - sensory to dorsal foot, lies in lateral compartment tibial - sensory to sole of foot, lies in posterior compartment

Question 40

What is compartment syndrome?

Answer 40

**Swelling of compartment due to bleeding, inflammation etc. causes compression of veins --\> ischaemia**

Question 41

How is compartment syndrome treated?

Answer 41

**Fasciotomy**

Question 42

Where are ligaments found in the ankle?

Answer 42

**Medial / deltoid complex** **Lateral complex**

Question 43

Which movement tends to tear ankle ligaments?

Answer 43

**"going over your ankle"** i.e extreme inversion / eversion

Question 44

Ligament injury tends to make the ankle joint \_\_\_.

Answer 44

**unstable**

Question 45

What happens to the talus on an X-ray if there is pathological fracture or ligament injury?

Answer 45

**Talar shift** loss of space

Question 46

What are tarsal coalitions?

Answer 46

**Abnormal connections between tarsal bones**

Question 47

What is abduction and adduction of the foot?

Answer 47

**Abduction** - lateral rotation of foot **Adduction** - medial rotation of foot

Question 48

What are the two composite movements of the foot?

Answer 48

**Supination** **Pronation**

Question 49

Which three movements, when combined, cause **supination** of the foot?

Answer 49

**Plantarflexion** **Inversion** **Adduction**

Question 50

Which three movements, when combined, cause **pronation** of the foot?

Answer 50

**Dorsiflexion** **Eversion** **Abduction**

Question 51

Which tendon forms the medial arch of the foot?

Answer 51

**Tibialis posterior**

Question 52

What causes pathological flat footedness?

Answer 52

**Tibialis posterior injury**

Question 53

Which connective tissue forms the sole of the foot?

Answer 53

**Plantar fascia**

Question 54

What are the movement muscles of the fingers and toes?

Answer 54

**Flexor / extensor hallucis longus** **Flexor / extensor digitorum longus**

Question 55

Dysfunction of the finger and toe tendons causes \_\_\_.

Answer 55

**deformity**