Anatomy

Question 1

A DVT in the posterior tibial vein may progress proximally to involve which vein next?

Answer 1

External iliac vein

Question 2

Pain on active flexion of the hip is most likely to be associated with which muscle?

Answer 2

Iliopsoas (chief hip flexor)

Question 3

In a patient with anaesthesia in the first web space only, which part of the nervous system is most likely to be functioning abnormally?

Answer 3

Deep fibular nerve

Question 4

Inability to extend the left wrist joint and parasesthesia of the skin of the posterior forearm and hand is most associated with which fracture pattern?

Answer 4

Midshaft fracture of the humerus (radial nerve)

Question 5

A supracondylar fracture of the humerus is most likely to cause damage to which nerve and artery?

Answer 5

Median nerve and brachial artery

Question 6

The ankle jerk (calcanea tendon) reflex specifically tests which named nerve/ spinal nerve roots?

Answer 6

Tibial nerve (S1/2)

Question 7

A history of ‘ going over on the ankle’ and an obvious inversion injury is associated with damage to which ligament?

Answer 7

Anterior talofibular ligament

Question 8

Sciatica is associated with what motor changes?

Answer 8

Decreased power of plantar flexion

Question 9

Wasting of the hypothenar eminence and tingling in the little finger and ring finger are most associated with which nerve compression syndrome?

Answer 9

Cubital tunnel syndrome

Question 10

Fractured left neck of fibula is associated with which clinical sign?

Answer 10

Foot drop

Patient also won’t be able to evert the foot

Question 11

What nerve compression syndrome is typical in cyclists?

Answer 11

Cubital tunnel

due to the position of the hands on the handle bars

Question 12

Tingling over the thumb, index and middle fingers are most associated with which nerve compression syndrome?

Answer 12

Carpal tunnel syndrome

Question 13

Where does the great (long) saphenous vein run in relation to the knee?

Answer 13

The great saphenous vein runs along the posteromedial aspect of the knee

Question 14

How is phlebitis managed if it is localised to an area?

Answer 14

NSAIDs

Question 15

What is phlebitis and how does it present?

Answer 15

Phlebitis is inflammation of a vein

It presents with an uncomfortable visible and palpable swelling which may be localised or more widespread

Question 16

Which movements are easier/ less painful in spinal stenosis?

Answer 16

Spinal flexion is easier than extension

Walking uphill is easier than walking downhill

Sitting is easier than standing

Question 17

Which sport/ activity makes spinal stenosis less painful?

Answer 17

Cycling

sitting down and flexion is easier for patients with spinal stenosis

Question 18

Which is easier in patients with spinal stenosis, walking uphill or walking downhill?

Answer 18

Walking uphill the spine is flexed which relieves some pressure

Question 19

A patient is lying prone, the examiner flexes their knee and extends their hip. The patient experiences pain in the anterior aspect of the thigh. Which neural structure is involved in transmitting the action potentials that carry the pain signals?

Answer 19

Lumbosacral plexus

femoral nerve is involved - L2,3,4

Question 20

Where do posterior and anterior rami supply?

Answer 20

Posterior (dorsal rami) supply the back (posterior trunk)

Anterior (ventral rami) supply the rest of the body trunk and the limbs

Rami carry mixed modalities

Question 21

A patient has a fall and afterwards on examination it is noted that they find it difficult to lift the right leg, the right leg is weak at the knee and they are unable to straight leg raise. They can weight bear pain free. What is the most likely structure that has been injured?

Answer 21

Quadriceps tendon (rupture)

Question 22

A patient has a smear examination in which the cervix is examined. She feels some mild pain. Which location is most likely to experience a referral of pain from the procedure?

Answer 22

Perineum and posterior thigh

Question 23

What are the areas of pain referral for the different parts of the gut?

Answer 23

Foregut refers to the epigastric region

Midgut refers to the umbilical region

Hindgut refers to the suprapubic region

Question 24

Which ligament would be transected as a consequence of a standard laminectomy procedure?

Answer 24

Ligamentum flavum

Question 25

Why might sciatica involve decreased power of plantarflexion?

Answer 25

Plantarflexion involves the posterior compartment of the leg which is innervated by the tibial nerve, a branch of the sciatic

Question 26

A DVT 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?

Answer 26

External iliac vein

Posterior tibial vein will drain into the popliteal vein and then into the femoral vein at the level of the inguinal ligament. From there it will drain into the external iliac vein and then into the common iliac vein.