Anatomy Flashcards
A DVT (deep venous thrombosis) originating in the posterior tibial vein has extended to the level of the inguinal ligament. Further proximal progression will extend the thrombus into which vein next?
A. Common iliac
B. Deep femoral (profunda femoris)
C. External iliac
D. Femoral
E. Greatsaphenous
C. External iliac
A patient presents with pain on active flexion of the hip. Which muscle is the most likely source of the pain?
A. Gluteus medius
B. Iliopsoas
C. Piriformis
D. Sartorius
E. Semitendinosus
B. Iliopsoas
A patient presents with anaesthesia in the first web space only. Which part of the nervous system is most likely to be functioning abnormally?
A. Deep fibular nerve
B. Internal capsule of brain
C. L5 posterior nerve root
D. Superficial fibular nerve
E. Tibialnerve
A. Deep fibular nerve
On review at the fracture clinic, a patient presents with inability to extend the left wrist joint. You also find paraesthesia of the skin of the posterior forearm and hand. Which fracture is most likely to cause this clinical picture?
A. Fracture of anatomical neck of humerus
B. Fracture of olecranon
C. Fracture of surgical neck of humerus
D. Midshaft fracture of humerus
E. Supracondylar fracture of humerus
D. Midshaft fracture of humerus
Fracture of surgical neck of humerus causes __________ injury
Axillary nerve
Which of these structures would be transected as a consequence of a standard laminectomy procedure?
A. Annulus fibrosus
B. Anterior longitudinal ligament
C. Dura mater
D. Ligamentum flavum
E. Posteriorlongitudinalligament
D. Ligamentum flavum
The “ankle jerk” (calcaneal tendon) reflex specifically tests which named nerve/spinal nerve roots?
A. Common fibular nerve/L5
B. Deep fibular nerve/L5
C. Saphenous nerve/L3,4
D. Lateral plantar nerve/S1,2
E. Tibial nerve/S1,2
E. Tibial nerve/S1,2
Dave is running forward during a basketball game when he ‘goes over’ on his ankle. On examination in A&E, you find an inversion injury to his right ankle. Which injury is most likely?
A. Achilles tendon rupture
B. Avulsion fracture of medial malleolus
C. Rupture of anterior talofibular ligament
D. Rupture of calcaneofibular ligament
E. Rupture of deltoid ligament
C. Rupture of anterior talofibular ligament
Angela has had severe left sciatica for 4 weeks. Which one of these signs is likely?
A. Reduced/absent knee jerk
B. Decreased power of hip flexion
C. Decreased power of plantar flexion
D. Impaired sensation on medial side of thigh
E. Impaired sensation on medial side of leg
C. Decreased power of plantar flexion
Sciatic nerve branches into…..
Tibial and common fibular nerve
Tibial nerve is responsible for…..
Posterior compartment of leg which controls plantarflexion
A patient complains of pins and needles in his right little finger and adjacent palm, and ‘weakness’ of his right hand. On examination, you find wasting of the muscles between the metacarpal bones of his right hand dorsally and flattening of the anteromedial border of the forearm. In which region is the affected nerve most likely to be compressed?
A. Carpal tunnel
B. Cubital tunnel
C. Guyon’s canal
D. Tarsal tunnel
E. Thoracic outlet
B. Cubital tunnel
Which injury/insult is a cause of left foot drop?
A. Fractured left neck of femur
B. Fractured left neck of fibula
C. Left femoral nerve compression
D. Ruptured left Achilles tendon
E. Stroke affecting right internal capsule of brain
B. Fractured left neck of fibula
A 45-year-old man presents with an uncomfortable swelling visible and palpable in relation to the medial aspect of the knee. In which structure is the pathology most likely to be?
A. Great (long) saphenous vein
B. Tibial nerve
C. Small (short) saphenous vein
D. Biceps femoris tendonitis
E. Popliteal artery
A. Great (long) saphenous vein
A patient in a road traffic accident has sustained a severe compression injury to the lower limb. Compartment syndrome is the definitive diagnosis. In compartment syndrome pain is maximal on stretching the muscles within the affected compartment. On examination constant and severe pain is noted, maximal on testing the function of the muscles supplied by the tibial nerve, with no relief at all from 30mg morphine IV. Which compartment of the lower limb is affected?
A. Anterior compartment of leg
B. Lateral compartment of leg
C. Medial compartment of thigh
D. Posterior compartment of thigh
E. Posterior compartment of the leg
E. Posterior compartment of the leg
It is noted during a lower limb examination that when the patient is asked to stand on their right leg, their pelvis tips inferiorly towards their left side. Which one of the options below would give this sign?
A. Ankylosing spondylitis
B. Iliopsoas sprain
C. Congenital hip dislocation
D. Femoral hernia
E. Osteoporotic fracture of L1
C. Congenitial hip dislocation
_____________ and _____________ arteries supply the abductors of the hip
Superior and inferior gluteal
Mark (aged 24yrs) has sustained a closed fracture of his mid-shaft tibia when he was knocked down by a car travelling at 40mph. His fracture has been immobilised in a below-knee Plaster-of-Paris back-slab and he has been admitted to the Orthopaedic Ward. The nursing staff on nightshift has become concerned as Mark has started to complain of increasingly severe pain in his leg. The duty FY2 doctor has come to assess the situation as there is a concern that he is developing a ‘compartment syndrome’.
Which of the following would suggest compression/injury to the tibial nerve?
A. Absence/weakness of dorsiflexion of the great (big) toe
B. Decreased sensation over the first web space
C. Decreased sensation over the sole of the foot
D. Inability to evert the ankle
E. Inability to dorsiflex the ankle
C. Decreased sensation over the sole of the foot
Hamish is a 74-year-old man who has stumbled as he walked off the pavement to cross the road just outside his house yesterday. He was helped back into his house by some neighbours. Today he has found it difficult to lift his right leg out of bed. When you see him he is able to weight-bear pain-free but he says that his right leg is ‘weak at the knee’ and ‘won’t do what he wants it to do’. On closer examination of his leg you find that he is unable to straight leg raise. Which of the following injuries would you consider as being most likely?
A. Fracture neck of femur
B. Rupture iliopsoas tendon
C. Ruptured quadriceps tendon
D. Biceps femoris tear
E. Adductor muscle strain
C. Ruptured quadriceps tendon
What principle type of injury would apply a stretch (tensile) force to the deltoid ligament complex?
Eversion
The deltoid ligament complex has multiple parts including the ________________, ______________ and ________________________________
Tibionavicular
Tibiocalcaneal
Anterior and posterior talotibial ligaments
Is the deltoid (medial) ligament or the lateral ligament stronger?
The deltoid ligament is stronger so is less likely to be damaged
The deltoid (medial) ligament can ________________________ when it is stretched
Avulse the medial malleolus
What principle type of injury would apply a stretch (tensile) force to the lateral ligament complex?
Inversion injury
Lateral complex is made up of ________________________ and ________________
Anterior & posterior talofibular ligaments
Calcaneofibular ligament
Which ankle ligament is most likely to be sprained?
Anterior talofibular ligament
If anterior talofibular ligament is sprained where is the pain/swelling most likely to be?
Anterior to the lateral malleolus
Label the following diagram
Popliteal artery is a continuation of the ________
Femoral artery
Anterior and posterior tibial arteries are branches of the ____________
Popliteal artery
Fibular artery is a branch of the….
Posterior tibial artery
Dorsal artery of the foot is a continuation of the …
Anterior tibial artery after the extensor retinaculum
Prolapse of a disc tends to impinge upon the nerve which will…..
Exit at the next intervertebral foramen inferiorly
Prolapse of the nucleus through the annulus tends to be ___________________ due to the __________________________________________
Posterolateral
Central position of the posterior longitudinal ligament
The straight leg raise (SLR) test stretches which nerve?
Sciatic nerve
Sciatic nerve divides into ______ and ______ nerves
Tibial (L4-S3)
Common fibular (perineal) nerve (L4-S2)
What can S1&S2 impingement cause problems with?
Hip lateral rotation
Hip abduction
Ankle plantarflexion
Diminished ankle jerk
Eversion
Toe dorsiflexion & plantarflexion
Prolapse of the L5/S1 disc ________________________ could put pressure on many (or all) of the __________________________________
Posteriorly (rather than postero-laterally)
Sacral and coccygeal nerves of the cauda equina
Pelvic splanchnic nerves leave the CNS with __________________ and contain __________________ to the bladder
S2,S3 & S4 spinal nerves
Parasympathetic fibres
When stimulated, pelvic splanchnic nerves causes….
Detrusor muscles to contract
Pressure on pelvic splanchnic nerves (e.g. by a prolapsed disc) could result in…
Urinary retention
Pudendal nerve formed from ___________________ and contains ________________ nerve fibres from the perineum and ___________________ nerve fibres to the external urethral and external anal sphincter muscles in the perineum
S2,S3,S4 spinal nerves
Somatic sensory
Somatic motor
Pressure on the somatic sensory fibres of pudendal nerve presents as ______________ and pressure on somatic motor fibres of pudendal nerve results in ______________________
Saddle (perianal) anaesthesia
Urinary and/or faecal incontinence with diminished anal tone felt on rectal examination
Visceral afferents contain ________ and enter the spinal cord at _________
Sensory nerve fibres from the bladder
S2,3,4 levels
Visceral afferent sense the….
Fullness of the bladders well as transmit pain impulses from it
Pressure on the visceral afferent, alongside pressure on the parasympathetic nerves above results in……
Painless urinary retention
