Lower Limb ( 25% )

Question 1

5) The adductor canal:

• a) contains the femoral artery and nerve
• b) ends distally in the adductor longus hiatus
• c) contains no muscular nerves
• d) has adductor longus forming the root
• e) always has the femoral artery lying between the saphenous nerve and the femoral vein

Answer 1

e) always has the femoral artery lying between the saphenous nerve and the femoral vein ​

• a) contains the femoral artery, vein, nerve to vastus medialis, and saphenous nerve
  
  • ​Femoral nerve splits into terminal branches in femoral triangle
• b) ends distally in the adductor magnus hiatus
• c) contains 1 muscular nerve - to vastus medialis

Question 2

7) Regarding the femoral artery:

• a) adductor magnus lies between it and the profunda femoris artery
• b) the profunda femoris vein lies behind the profunda femoris artery
• c) profunda femoris artery arises from its posterior surface
• d) the lateral circumflex femoral artery separates the superficial and deep branches of the femoral nerve
• e) the femoral vein is always on its medial side

Answer 2

d) the lateral circumflex femoral artery separates the superficial and deep branches of the femoral nerve

• a) adductor longus lies between it and the profunda femoris artery
• b) the profunda femoris vein lies behind the profunda femoris artery
  
  • ??
• c) profunda femoris artery arises from its lateral or posterior surface
• e) the femoral vein is medial at the inguinal ligament, posterior at the apex of triangle, posterolateral in the adductor canal

Question 3

9) Regarding the adductor compartment:

• a) adductor magnus lies between the anterior and posterior divisions of the obturator nerve
• b) adductor longus inserts into the upper two thirds of the linear aspect of the femur
• c) the hamstring part of adductor magnus is supplied by the tibial part of the sciatic nerve
• d) the medial intermuscular septum separates the adductor compartment from the posterior compartment
• e) obturator externus medially rotates the hip

Answer 3

c) the hamstring part of adductor magnus is supplied by the tibial part of the sciatic nerve

• a) adductor brevis lies between the anterior and posterior divisions of the obturator nerve
• b) adductor longus inserts into the middle third of the linea aspera of the femur
• d) the (???posterior or lateral - TBD) intermuscular septum separates the adductor compartment from the posterior compartment
• e) obturator externus laterally rotates the hip
  
  • Origin at margins of obturator membrane, inserts into trochanteric fossa (on posterior aspect of greater trochanter) of femur

Question 4

18) The following are branches of the femoral artery except:

• a) superficial circumflex iliac artery
• b) superficial epigastric artery
• c) superficial external pudendal artery
• d) deep external pudendal artery

Answer 4

e) middle genicular artery

branch of popliteal artery

Question 5

24) Which of the following muscles is not found in the floor of the femoral triangle?

• a) iliacus
• b) psoas
• c) pectineus
• d) adductor magnus
• e) adductor longus

Answer 5

d) adductor magnus

Question 6

25) Which of the following is not found within the femoral sheath?

• a) femoral artery
• b) femoral canal
• c) femoral hernia
• d) femoral nerve
• e) lymph node of Cloquet

Answer 6

d) femoral nerve

Question 7

26) The profunda femoris artery does not:

• a) normally supply all the thigh muscles
• b) arise from the lateral side of the femoral artery, 3-4cm distal to the inguinal ligament
• c) give off the deep external pudendal artery
• d) lie behind the profunda vein
• e) lie directly anterior to adductor brevis and magnus

Answer 7

c) give off the deep external pudendal artery

This is a branch of the femoral artery

Question 8

27) Which of the following is INCORRECT regarding the femoral nerve?

• a) is formed from the anterior divisions of the anterior rami of the lumbar nerves 2, 3 and 4
• b) supplies iliacus in the abdomen
• c) lies in the iliac fossa between psoas and iliacus
• d) gives a branch to pectineus as it enters the femoral triangle
• e) divides into several branches just distal to the inguinal ligament

Answer 8

a) is formed from the anterior divisions of the anterior rami of the lumbar nerves 2, 3 and 4

Not sure why this is wrong - is definitely off the anterior rami of L2-4. ?not from anterior divisionsa

Question 9

28) All the following are branches of the femoral nerve except:

• a) medial femoral cutaneous nerve
• b) saphenous nerve
• c) nerve to vastus medialis
• d) lateral femoral cutaneous nerve
• e) nerve to sartorius

Answer 9

d) lateral femoral cutaneous nerve

From lumbar plexus L2-3

Question 10

29) Which factor is most important in preventing lateral displacement of the patella during quadriceps contraction?

• a) the forward prominence of the lateral condyle of the femur
• b) the action of articularis genu
• c) the action of vastus medialis
• d) the action of rectus femoris
• e) the tension of the medial patellar retinaculum

Answer 10

c) the action of vastus medialis

Prominent medial epicondyle presents medial dislocation.

Vastus medialis prevents lateral dislocation

Question 11

30) The adductor canal is not:

• a) roofed by fascia containing the subsartorial plexus
• b) occupied by the sciatic nerve
• c) also known as Hunter’s canal
• d) occupied by the femoral artery
• e) a gutter shaped groove between vastus medialis and the front of the adductor muscles

Answer 11

b) occupied by the sciatic nerve

Contains femoral artery, femoral vein, saphenous nerve, and nerve to vastus medialis

Question 12

31) Which of the following is INCORRECT regarding the adductor canal?

• a) sartorius lies on the fascial roof
• b) in the distal part of the canal, the femoral vein is posterolateral to the artery
• c) at all levels, the artery lies between saphenous nerve and femoral vein
• d) the subsartorial plexus supplies overlying fascia lata and an area of skin above medial side of the knee
• e) the adductors in the floor of the canal are the adductor brevis above and the adductor longus below

Answer 12

e) the adductors in the floor of the canal are the adductor magnus and the adductor longus

From apex of femoral triangle to the adductor hiatus

Carries femoral artery, vein, saphenous nerve, and nerve to vastus medialis

Boundaries:

Ant + lat - vastus medialis

Post - adductors longus + magnus

Med/roof - sartorius

Question 13

32) In the medial compartment of the thigh:

• a) adductor magnus consists of adductor and hamstring muscle masses
• b) the contents are separated from the posterior compartment by the posterior intermuscular septum
• c) adductor longus is the most superficial muscle of the medial side of the thigh
• d) the anterior division of the obturator nerve passes through obturator externus
• e) the posterior division of the obturator nerve is the prime motor supply

Answer 13

a) adductor magnus consists of adductor and hamstring muscle masses

Question 14

36) Muscles in the floor of the femoral triangle include all EXCEPT:

• a) adductor magnus
• b) pectineus
• c) psoas
• d) ilacus
• e) adductor longus

Answer 14

a) adductor magnus

Boundries:

• Superior - inguinal ligament
• Medial - lateral border of adductor longs
• Lateral - sartorius; apex is where sartorius crosses over adductor longus
• Floor - iliopsoas laterally, pectineus medially
• Roof - fascia lata and cribiform fascia

Question 15

9) Which of the following structures is NOT found in the adductor (subsartorial) canal?

• a) femoral artery
• b) femoral vein
• c) femoral nerve
• d) saphenous nerve
• e) nerve to vastus medialis

Answer 15

c) femoral nerve

Question 16

11) The femoral canal:

• a) is the lateral compartment of the femoral sheath
• b) lies medial to the pubic tubercle
• c) contains the femoral nerve
• d) is medial to the femoral vein
• e) transmits the femoral branch of the genitofemoral nerve

Answer 16

d) is medial to the femoral vein

• a) is the medial compartment of the femoral sheath
• b) lies medial to the pubic tubercle
• c) contains the lower limb lymph, fat, and loose connective tissue
• e) transmits the femoral branch of the genitofemoral nerve

Question 17

18) Regarding the femoral triangle:

• a) the lateral border of the adductor longus makes up its medial boundary
• b) it is bisected by the femoral nerve
• c) the lateral border of sartorius muscle makes up its lateral boundary
• d) the long saphenous vein joins the femoral vein within the triangle
• e) rectus femoris makes up part of the floor

Answer 17

a) the lateral border of the adductor longus makes up its medial boundary

‘Medially by the lateral border of the adductor longus’

d) the long saphenous vein joins the femoral vein within the triangle (along with profunda vein)

They say D, A is also correct as per Moores 8th ed

• b) it is bisected by the femoral nerve
  
  • Femoral nerve splits into terminal branches within the triangle
• c) the medial border of sartorius muscle makes up its lateral boundary
• e) iliacus and pectineus makes up part of the floor

Question 18

24) Regarding the femoral artery:

• a) it enters the thigh directly beneath the deep inguinal ring
• b) it lies lateral to the femoral nerve in the femoral sheath
• c) it gives rise to the profunda femoris artery which pierces the femoral sheath
• d) does not contribute to the trochanteric anastomosis
• e) its branches include the superficial epigastric artery and the deep external pudendal artery

Answer 18

e) its branches include the superficial epigastric artery and the deep external pudendal artery ​

• a) it enters the thigh directly beneath the deep inguinal ring
  
  • Enters at mid-inguinal point (sometimes claimed to also be site of deep inguinal ring, but E is more correct [deep ring is not mentioned in the section on the femoral artery in Moores])
• b) it lies medial to the femoral nerve in the femoral sheath
  
  • NAVY Lat->Med
• c) it gives rise to the profunda femoris artery which pierces the femoral sheath
  
  • The femoral sheath blends with adventitia of vessels prior to profunda splitting (or at least is implied by Moores).
  • If a long sheath occurs, it is pierced by the great saphenous vein and lymph (does not mention profunda artery)
• d) does not contribute to the trochanteric anastomosis
  
  • Medial and lateral circumflex femoral arteries are branches of the profunda femoral artery usually

Question 19

31) The psoas muscle:

• a) passes across the front of the capsule of the hip joint
• b) is a powerful lateral rotator of the femur
• c) inserts into the greater trochanter
• d) is supplied by L4 and L5 nerve roots
• e) arises from the iliac crest and sacroiliac joint

Answer 19

• a) passes across the front of the capsule of the hip joint
• b) is a powerful flexor and stabiliser of the femur,
• c) inserts into the lesser trochanter
• d) is supplied by L1+2 nerve roots
• e) Iliacus arises from the iliac crest and sacroiliac joint
  
  • Psoas major - T12-L5 vertebra and discs, and transverse processes of all lumbar vertebra
  • Minor - Sides of T12-L1 vertebra and discs

Question 20

32) The femoral nerve:

• a) is formed from the anterior divisions of the anterior primary rami of L2-4
• b) is formed from the same spinal segments as the obturator nerve
• c) divides after passing through the femoral triangle
• d) has no cutaneous branches other than the saphenous nerve
• e) enters the thigh in the femoral sheath

Answer 20

b) is formed from the same spinal segments as the obturator nerve

L2-4 for both

• a) is formed from the (??something other than anterior divison) of the anterior primary rami of L2-4
• c) divides within the femoral triangle
• d) cuteneous branches are the saphenous nerve, and the medial and intermediate cutaneous nerves of the thigh
• e) enters the thigh lateral to the femoral sheath, on top of iliopsoas

Question 21

35) Following a subcapital fracture of the neck of the femur, an 80 year old man sustains avascular necrosis of the femoral head. This is most likely to be the consequence of interruption to the blood supply to the head from which of the following sources:

• a) arteries from trochanteric anastomosis in the retinacula
• b) artery of the ligament of the head from the obturator artery
• c) branches from the profunda femoris artery
• d) branches from the pudendal artery
• e) branches from the inferior gluteal artery

Answer 21

a) arteries from trochanteric anastomosis in the retinacula

Main supply is retinacular arteries which are branches of the circumflex femoral (medial primarily as they pass beneath the unattached posterior joint capsule, rather than penetrating it)

Question 22

36) Which structure does NOT bass under the inguinal ligament?

• a) femoral vein
• b) lateral cutaneous nerve of the thigh
• c) femoral nerve
• d) femoral branch of the genitofemoral nerve
• e) great saphenous vein

Answer 22

e) great saphenous vein

Enters the femoral vein in the femoral triangle

Question 23

37) Regarding the femoral triangle:

• a) adductor magnus makes up part of the floor
• b) no motor branches of the femoral nerve leave the triangle to enter the sartorius canal
• c) the femoral artery occupies the lateral compartment of the femoral sheath
• d) the main cutaneous nerve supply of the skin overlying the triangle is by the ilioinguinal nerve
• e) the femoral vein lies medial to the femoral artery throughout the triangle

Answer 23

c) the femoral artery occupies the lateral compartment of the femoral sheath

• a) adductor longus, iliopsoas, and pectineus makes up the floor
• b) One motor branche of the femoral nerve leaves the triangle to enter the sartorius canal: nerve to vastus medialis
• d) the main cutaneous nerve supply of the skin overlying the triangle is by branches of the genitofemoral nerve
• e) the femoral vein lies medial to the femoral artery throughout the triangle
  
  • Proximally it is medial but at the base it is posterior

Question 24

45) Which of the following is correctly paired?

• a) adductor brevis – femoral nerve
• b) adductor longus – sciatic nerve
• c) adductor magnus – saphenous nerve
• d) adductor longus – obturator nerve
• e) adductor magnus – femoral nerve

Answer 24

d) adductor longus – obturator nerve

Question 25

47) The surface marking for the femoral nerve is:

• a) midway between the A.S.I.S. and pubic tubercle
• b) midway between the A.S.I.S. and pubic synthesis
• c) medial to the femoral artery
• d) 2cm lateral and 2cm interior to the pubic tubercle
• e) none of the above

Answer 25

a) midway between the A.S.I.S. and pubic tubercle

Question 26

50) Adductor longus is inserted onto the:

• a) upper half of the linea aspera of the femur
• b) upper two thirds of the linea aspera of the femur
• c) upper one third of the linea aspera of the femur
• d) middle third of the linea aspera of the femur
• e) lower half of the linea aspera of the femur

Answer 26

d) middle third of the linea aspera of the femur

(Initially the answer was lower two-thrids of linea aspera, I have changed it to reflect what Moores states)

Question 27

53) The medial compartment of the thigh:

• a) contains obturator internus
• b) contains the adductor canal
• c) contains the femoral triangle
• d) is limited superiorly by the obturator membrane
• e) is supplied mainly by the obturator artery

Answer 27

d) is limited superiorly by the obturator membrane

Question 28

1) Tensor fasciae latae is supplied by :

• a) anterior division of femoral nerve
• b) superior gluteal nerve
• c) nerve to vastus lateralis
• d) inferior gluteal nerve
• e) lateral femoral cutaneous nerve

Answer 28

b) superior gluteal nerve

Supplies TFL, gluteus medius and minimus

Inferior gluteal nerve supplies maximus

Question 29

8) Gluteus maximus:

• a) forms the gluteal fold
• b) has four bursae beneath it
• c) has blood supply solely from the inferior gluteal artery
• d) is the chief control of hip flexion
• e) has 50% of fibres inserting into the gluteal tuberosity

Answer 29

a) forms the gluteal fold

Not 100% certain this is right but all others are wrong (as per Moores - ‘the inferiorn edge…is located just superior to the gluteal fold’)

As per Moores, ‘some’ fibres insert into the gluteal tuberosity, but this is only a portion of the smaller, deep portion and unlikely 50%

Blood supply is superior and inferior gluteal arteries

Acts as hip extension and lateral rotation (although is not generally used to stable walking or standing - just if power is needed or walking uphill/steps)

Has three bursae - trochanteric, ischial, and gluteofemoral

Question 30

10) Which vessel is NOT involved in the trochanteric anastomosis?

• a) superior gluteal artery
• b) obturator artery
• c) lateral circumflex femoral artery
• d) medial circumflex femoral artery
• e) inferior gluteal artery

Answer 30

b) obturator artery

Inferior + superior gluteal and medial + lateral circumflex all anastamose in the gluteal region, as well as the first perforation branch of the profunda femoris

Question 31

11) The sciatic nerve:

• a) lies deep to the posterior femoral cutaneous nerve
• b) passes down over obturator internus, quadratus, femoris and piriformis
• c) tibial and common peroneal components separate behind the hip joint
• d) in the buttock it lies midway between the greater trochanter and pubic tuberosity
• e) is derived from L3, 4, 5, S1, 2

Answer 31

a) lies deep to the posterior femoral cutaneous nerve

• b) passes down under obturator internus, quadratus, femoris and piriformis
• c) tibial and common peroneal components separate in the mid to distal thigh (usually - otherwise the seperate on entering the greater sciatic foramen)
• d) in the buttock it lies midway between the greater trochanter and ischial tuberosity
• e) is derived from L4-S3 anterior rami (ant + post divisions)

Question 32

12) Which is the odd one out?

• a) sciatic nerve
• b) nerve to obturator internus
• c) superior gluteal nerve
• d) pudendal nerve
• e) posterior femoral cutaneous nerve

Answer 32

c) superior gluteal nerve

• This is the given answer, likely because the others all enter inferior to piriformis and this enters superior to it (Piriformis noted to be an important landmark for the region so things are likely to be related to that around here)*
• Alternatives are pudendal as it is the only one entering the lesser sciatic foramen etc, but given the importance of piriformis, think piriformis first.*

Question 33

13) Regarding the hamstring compartment:

• a) the cutaneous nerve supply is from the posterior circumflex femoral nerve
• b) ischial fibres of adductor magnus degenerate to form the tibial collateral ligament
• c) semitendinosus lies deep to semimembranosus
• d) the oblique popliteal ligament is an expansion of biceps femoris
• e) the long head of biceps arises from the lateral facet of the ischial tuberosity

Answer 33

b) ischial fibres of adductor magnus degenerate to form the tibial collateral ligament

• This is the answer given - I cannot find information in Moores. Ischial fibres are the hamstring portion which insertions into the adductor tubercle and neither words nor pictures suggest there is continuity between it and the TCL. I would hazard a guess at e)*
  e) the long head of biceps arises from the ischial tuberosity (moores does not specify where, but looks to be on the lateral aspect in pictures)
• a) the cutaneous nerve supply is from the inferior cluneal nerves superioly, and the posterior cutaneous nerve of thigh distally
• c) semitendinosus lies superficial to semimembranosus
• d) the oblique popliteal ligament is an expansion of semimembranosus

Question 34

23) The iliotibial tract:

• a) lies lateral to tensor fascia latae
• b) inserts onto the head of the fibula
• c) is the origin of 60% of gluteus maximus
• d) is a weak flexor of the knee via tensor fascia latae
• e) is attached superiorly to the iliac crest

Answer 34

e) is attached superiorly to the iliac tubercle​​ (a part of the crest)

• a) lies postero**lateral and inferior to tensor fascia latae (judging by pictures)
• b) inserts onto the anterolateral tubercle of tibia
• c) is the origin of 60% of gluteus maximus
  
  • Gluteus maximus primarily inserts into the ITB, but a specific percentage is not given
• d) cannot flex the knee due to its attachement to the femur/intermuscular septum of thigh, so it does not have the necessary freedom. It does stabilise the knee though.

Question 35

33) With respect to the posterior compartment of the thigh:

• a) blood supply is mainly from the femoral artery
• b) the sciatic nerve lies lateral to the long head of biceps
• c) the long head of biceps is supplied by the common peroneal nerve
• d) the hamstrings form the apex of the popliteal fossa
• e) semimembranosus arises in common with the long head of biceps

Answer 35

d) the hamstrings form the apex of the popliteal fossa

• a) blood supply is mainly from the branches of internal iliac artery (superior and inferior gluteal), and perforating branches of the profunda femoris
• b) the sciatic nerve lies deep to the long head of biceps
• c) the long head of biceps is supplied by the tibial nerve, and ther short head by common fibular nerve
• e) semimembranosus arises in common with the long head of biceps
  
  • All hamstings - the ‘semis’ and biceps long head - arise from ischial tuberosity, but seem to have distinct attachements there without a common insertion tendon.

Question 36

35) Dermatomes of lower limb:

• a) S1 supplies the great toe
• b) L2 supplies anterior upper thigh
• c) S3 supplies perianal area
• d) L4 supplies medial thigh
• e) L5 supplies medial calf

Answer 36

b) L2 supplies anterior upper thigh

Question 37

6) The great saphenous vein:

• a) joins the femoral vein above the inguinal ligament
• b) begins as the upward continuation of the lateral marginal vein of the foot
• c) travels with the saphenous nerve along its course
• d) runs behind the medial malleolus
• e) enters the femoral vein on its anteromedial side

Answer 37

e) enters the femoral vein on its anteromedial side

Question 38

20) Which of the following, regarding the great saphenous vein, is INCORRECT?

• a) it is the longest vein in the body
• b) it passes behind the medial malleolus
• c) at the knee, it lies a hand’s breadth behind the medial border of the patella
• d) the saphenous opening lies about 3cm below and lateral to the pubic tubercle
• e) the deep external pudendal artery runs medially behind the saphenous vein near its termination

Answer 38

b) it passes behind the medial malleolus

It actually passes anterior to it

Question 39

21) Which of the following is CORRECT regarding lymphatic drainage of the lower limb?

• a) the superficial inguinal node group consists of about 15 nodes
• b) the lateral nodes of the proximal superficial group receive lymph from the buttock, flank and back below the waist
• c) the medial nodes of proximal superficial group receive lymph from testes, glans penis, lower anal canal and perineum
• d) the distal nodes of the superficial group receive all the superficial lymphatics of the lower limb
• e) the superficial inguinal nodes drain mainly to the internal iliac nodes

Answer 39

b) the lateral nodes of the proximal superficial group receive lymph from the buttock, flank and back below the waist

Question 40

22) Fascia lata is not:

• a) attached inferiorly to the tibial condyles and head of the fibula
• b) reinforced anteriorly by expansions from the quadriceps tendon
• c) attached to Scarpa’s fascia above the inguinal ligament
• d) continuous below the popliteal fossa into the deep fascia of the calf
• e) attached superiorly along the external lip of the iliac crest

Answer 40

c) attached to Scarpa’s fascia above the inguinal ligament

Scarpas fascia attaches about a fingers breadth below the inguinal ligament

Question 41

34) Slipped upper femoral epiphysis:

• a) is more common in girls than boys
• b) usually occurs in the 5-8 year age group
• c) may present as referred pain in the knee
• d) the limb may be internally rotated and shortened
• e) can be treated conservatively

Answer 41

c) may present as referred pain in the knee

Question 42

2) Which structure is intrasynovial at the knee joint:

• a) oblique popliteal ligament
• b) tendon of popliteus
• c) medial and lateral menisci
• d) anterior cruciate ligament
• e) none of the above

Answer 42

c) medial and lateral menisci

They said e), but wikipedia and pictures would suggest c)

Question 43

3) The ‘screw-home’ movement in extension of the knee joint begins with tightening of the:

• a) anterior cruciate ligament
• b) oblique popliteal ligament
• c) medial collateral ligament
• d) lateral collateral ligament
• e) posterior cruciate ligament

Answer 43

a) anterior cruciate ligament

Not specifically mentioned in the Moores, but a quick google search says ‘the cruciates tighten’, without being more specific

Question 44

4) Tibialis anterior:

• a) is supplied by the tibial nerve
• b) inserts into the second metatarsal bone
• c) is pierced by the posterior tibial artery
• d) tendon is deep to the superior extensor retinaculum
• e) does not arise from the interosseous membrane

Answer 44

d) tendon is deep to the superior (and inferior) extensor retinaculum in its own sheath

question changed, as original answer given was ‘tendon pierces the reticaculum’, but Moores clearly states the tendon is deep to the retinculae. Assume this is an old question.

• a) is supplied by the deep fibular nerve
• b) inserts into the first metatarsal bone (+ cuneiform)
• c) Tibialis posterior is pierced by the nutrient artery of the tibia
• e) arises from tibia and the interosseous membrane

Question 45

14) Regarding the popliteal vessels:

• a) the tibial nerve lies between the popliteal artery and vein
• b) the sural arteries supply soleus
• c) the middle genicular artery supplies the cruciate ligaments
• d) lymph nodes lie alongside the popliteal artery
• e) the popliteal artery enters the fossa on the lateral side of the femur

Answer 45

c) the middle genicular artery supplies the cruciate ligaments

• a) the tibial nerve lies superficial to the popliteal vein then artery is deepest
• b) the tibial arteries supply soleus
  
  • Sural nerve is cutaneous to the lateral lower leg and foot
• e) the popliteal artery enters the fossa on the posterior side of the femur

Question 46

15) At the knee joint:

• a) the fibular collateral ligament is not attached to the lateral meniscus or joint capsule
• b) there are three main gaps in the joint capsule
• c) the tibial collateral ligament is tight in flexion
• d) the posterior cruciate ligament is attached to the lateral condyle of the femur
• e) the cruciate ligaments are sensitive and the menisci are not

Answer 46

a) the fibular collateral ligament is not attached to the lateral meniscus and joint capsule - seperated by popliteus

Changed wording of question as none seemed right - initially e) given as correct but this seems wrong

• b) there is one main gap in the capsule, for tendon of popliteus, and 4 bursae that communicate with the joint
• c) the tibial collateral ligament is tight in extension (same for all ligaments - hence this is the position of joint stability)
• d) the posterior cruciate ligament is attached to the medial condyle of the femur
  
  • Antero->lateral - postero->medial
• e) the cruciate ligaments are sensitive and the menisci are not
  
  • ​Innervation of specific ligaments not mentioned in Moores, but this seems wrong (ie a ruptured ACL can be painless, but meniscal tears are painful - speaking from experience).

Question 47

16) Regarding nerve supply of the lower limb:

• a) superficial fibular nerve supplies the muscles in the anterior compartment of the leg
• b) the cruciate ligaments are supplied by the tibial nerve
• c) the obturator nerve supplies obturator internus muscle
• d) the sciatic nerve does not make contact with bone
• e) the tibial part of the sciatic nerve is the sole supply to hamstring muscles

Answer 47

e) the tibial part of the sciatic nerve is the sole supply to muscles in the hamstring compartment

Confusing wording - I have changed it in the question but left original above, to try and get a learning point across. All hamstring muscles are supplied by the Tibial nerve (as per Moores this is a common feature of them), but shorthead of biceps is supplied by common fibular, which is technically not a hamstring, but they could be referring to posterior thigh as the ‘hamstring compartment’, a term I havent heard before. This seems most correct based ln current textbook.

b) the cruciate ligaments are supplied by the tibial nerve

This was given as correct: not mentioned in Moores, but google search seems to confirms it. femoral, tibial, and common fibular supply the anterior, posterior, and lateral aspects respectively - the cruciates are seperated from the joint cavity by a reflection of the synovial membrane, leaving them exposed posteriorly. I wouldn’t dwell on this point as not in the prescribed text.

• a) deep fibular nerve supplies the muscles in the anterior compartment of the leg
• c) the obturator nerve supplies obturator externus muscle
  
  • internus is supplied by nerve to obturator internus off the sacral plexus
• d) the sciatic nerve does make contact with bone
  
  • ’..rests on the ischium and then passes posterior to obturator internus, quadratus femoris, and adductor magnus’

Question 48

17) Regarding flexor digitorum longus:

• a) its four tendons divide under the flexor retinaculum
• b) it arises from the tibia and interosseous membrane only
• c) the medial two tendons receive a strong slip from the tendon of flexor hallucis longus
• d) the tendons have flexor sheaths
• e) it inserts into the bases of the middle phalanges

Answer 48

d) the tendons have flexor sheaths

Have altered question stem (initially had ‘no’ flexor sheaths as a wrong answer) because the answer given as correct (below) does not appear in Moores at all.

c) the medial two tendons receive a strong slip from the tendon of flexor hallucis longus

Moores states that Quadratus Planae gives slips to FDL, no mention made of tendon of FHL giving slips to anything.

• a) its four tendons divide under the sole of the foot
• b) it arises from the tibia, interosseous membrane, and a broad tendon to fibula
• e) it inserts into the bases of the distal phalanges

Question 49

38) The most medial structure passing under the inferior extensor retinaculum of the foot is:

• a) deep peroneal nerve
• b) tibialis anterior
• c) extensor hallucis longus
• d) anterior tibial artery
• e) peroneus brevis

Answer 49

b) tibialis anterior

Question 50

19) The following cutaneous nerves of the thigh are derived in part form the second lumbar nerve except::

• a) ilioinguinal
• b) medial femoral cutaneous nerve
• c) obturator nerve
• d) lateral femoral cutaneous nerve
• e) genitofemoral nerve

Answer 50

a) ilioinguinal

From L1 +/- T12

Question 51

1) Cutaneous nerve supply of the thigh involves all but which of the following:

• a) the intermediate femoral cutaneous nerve
• b) the obturator nerve
• c) the genital branch of the genitofemoral nerve
• d) the ilioinguinal nerve
• e) the posterior cutaneous nerves of the thigh

Answer 51

c) the genital branch of the genitofemoral nerve

Question 52

3) The inferior gluteal nerve supplies:

• a) gluteus maximus
• b) gluteus medius
• c) gluteus minimus
• d) all of the above
• e) none of the above

Answer 52

a) gluteus maximus

Question 53

4) Within the buttock:

• a) the pudendal nerve emerges beneath piriformis, turns around the back of the sacrospinous ligament and passes between the sacrotuberous and sacrospinous ligaments
• b) the internal pudendal artery can be compressed against the base of the ischial tuberosity
• c) the sciatic nerve (L4, 5, S1) emerges from below piriformis muscle more laterally than the inferior gluteal and pudendal nerves and vessels
• d) the posterior femoral cutaneous nerve lies medially to the sciatic nerve
• e) the cruciate anastomosis provides the main source of blood for the supply of the head of femur

Answer 53

a) the pudendal nerve emerges beneath piriformis, turns around the back of the sacrospinous ligament and passes between the sacrotuberous and sacrospinous ligaments

For what its worth, I cant find exact answers to the others

Sciatic nerve is L4-S3, but is the most lateral structure passing greater sciatic foramen (as per Moores - but i would then assume d) was correct also)

Question 54

5) With respect to the ligaments around the knee joint:

• a) the fibular collateral ligament blends with the capsule and is attached to the lateral meniscus
• b) the tibial collateral ligament blends posteriorly with the capsule and is attached to the medial meniscus
• c) the oblique popliteal ligament is an expansion from the tendon of semitendinosis that blends with the capsule posteriorly
• d) the posterior cruciate ligament runs from anterior tibial plateau to the posteromedial aspect of the lateral femoral condyle
• e) the transverse ligament runs posteriorly between menisci

Answer 54

b) the tibial collateral ligament blends posteriorly with the capsule and is attached to the medial meniscus

• a) the fibular collateral ligament blends with the capsule and is seperated from the lateral meniscus by the tendon of popliteus
• c) the oblique popliteal ligament is an expansion from the tendon of semimembranosus that blends with the capsule posteriorly
• d) the posterior cruciate ligament runs from posterior tibial plateau to the anterior aspect of the medial femoral condyle
• e) the transverse ligament runs posteriorly between menisci
  
  • ????

Question 55

6) With respect to the posterior compartment of the leg, which is FALSE?

• a) plantaris arises from the lower part of the lateral supracondylar line and is absent in 10%
• b) the medial head of gastrocnemius is larger than the lateral
• c) the small saphenous vein drains the medial side of the dorsal venous arch and medial margin of the foot
• d) the soleal muscle contains a rich plexus of small veins → the soleal pump
• e) the nerve of this compartment is the tibial nerve

Answer 55

c) the small saphenous vein drains the medial side of the dorsal venous arch and medial margin of the foot

Drains the lateral side

Question 56

7) The myotome for plantar flexion of the great toe is:

• a) L3,4
• b) L4,5
• c) L5, S1
• d) S1,2
• e) S2,3

Answer 56

e) S2,3

As per Moores

Dorsiflexion is L5/S1

Hip: L2/3 (flex); L4/5 (ext)

Knee: L3/4 (ext); L5/S1 (flex)

Ankle: L4/5 (dorsi); S1/2 (plantar)

Question 57

10) The surface markings of the sciatic nerve are from:

• a) the ischial tuberosity to the adductor tubercle of the medial femoral condyle
• b) the posterior superior iliac spine to the apex of the popliteal fossa
• c) the midpoint of a line between the ischial tuberosity and the greater trochanter to the adductor tubercle of the medial femoral condyle
• d) the ischial tuberosity to the apex of the popliteal fossa
• e) the midpoint of a line between ischial tuberosity and greater trochanter to apex of the popliteal fossa

Answer 57

e) the midpoint of a line between ischial tuberosity and greater trochanter to apex of the popliteal fossa

Question 58

12) The great saphenous vein:

• a) commences at the medial end of the dorsal venous arch
• b) passes behind the medial malleolus
• c) is accompanied by the saphenous nerve throughout its course
• d) passes under the inguinal ligament and enters the femoral vein
• e) drains the medial side of the leg between the tibia and the tendocalcaneus

Answer 58

a) commences at the medial end of the dorsal venous arch

Passes in front of medial malleolus (small saphenous passes behind lateral though)

Enters femoral vein in the inferior femoral triangle

Question 59

13) Which is NOT true of the tendoachilles?

• a) it inserts into the middle third of the posterior surface of the calcaneus
• b) it is invested in a synovial sheath
• c) it is formed from the soleus and gastrocnemius
• d) a bursa lies between the tendon and the upper third of the calcaneus
• e) a bursa lies between it and the deep fascia near its insertion

Answer 59

b) it is invested in a synovial sheath

Does not pass under a retinaculum or such, so does not require one.

Question 60

14) Which of the following structures lies within the knee joint?

• a) patellar ligament
• b) tibial collateral ligament
• c) fibular collateral ligament
• d) tendon of popliteus
• e) patellar retinacula

Answer 60

d) tendon of popliteus

But outside synovial membrane, im pretty sure

Question 61

15) Following an injury to the leg, a patient is unable to dorsiflex their foot. Which nerve is most likely to be damaged?

• a) the deep branch of the common peroneal nerve
• b) the sural nerve
• c) the superficial branch of the common peroneal nerve
• d) the saphenous nerve
• e) none of the above

Answer 61

a) the deep branch of the common peroneal nerve

Question 62

16) With respect to peroneus longus:

• a) it inserts into the base of the 5th metacarpal
• b) it is supplied by the superficial peroneal nerve
• c) it has a broad tendon that lies between the lateral malleolus and the tendon of peroneus brevis
• d) it arises from the upper two thirds of the tibia
• e) it is mainly supplied by L4 and L5 segments

Answer 62

b) it is supplied by the superficial peroneal nerve

Question 63

17) The stability of the weightbearing flexed knee is maintained by:

• a) anterior cruciate ligament
• b) iliotibial tract
• c) posterior cruciate ligament
• d) popliteus and posterior cruciate ligament
• e) arcuate popliteal ligament and anterior cruciate ligament

Answer 63

c) posterior cruciate ligament

apparently

Question 64

19) Inversion of the foot is performed by which pair of muscles?

• a) peroneus longus and peroneus brevis
• b) peroneus longus and tibialis posterior
• c) tibialis anterior and tibialis posterior
• d) peroneus brevis and plantaris
• e) none of the above

Answer 64

c) tibialis anterior and tibialis posterior

Question 65

20) The anterior tibial artery:

• a) pierces the interosseous membrane
• b) supplies the lateral compartment of the leg
• c) lies lateral to the deep peroneal nerve
• d) lies lateral to tibialis anterior
• e) gives the nutrient artery to the tibia

Answer 65

d) lies lateral to tibialis anterior

Tib ant is the most medial structure in the anterior compartment

Posterior tibial gives the nutrient artery to tibia (and fibular artery gives it to the fibula)

ATA passes through a hiatus in the IOM, it does not pierce it

Lateral compartment has no artery of its own, perforating branches of ATA supply it superiorly, and fibular artery inferiorly

Question 66

21) The suprapatellar bursa:

• a) does not communicate with the knee joint
• b) lies in front of the vastus intermedius muscle
• c) extends 5cm or more above the patella
• d) lies deep to the patellar retinacula
• e) none of the above

Answer 66

c) extends 5cm or more above the patella

Question 67

22) Which of the following does NOT apply to the popliteus muscle?

• a) it inserts into the lateral meniscus of the knee joint
• b) it is innervated by the tibial nerve
• c) it acts to extend the knee joint
• d) it inserts into the lateral condyle of the femur
• e) it acts to laterally rotate the femur of the fixed tibia

Answer 67

c) it acts to extend the knee joint

Unlocks the knee / rotates the femur externally or tibia internally depending if the foot is planted / weak flexor of knee

Question 68

23) A 30 year old man presents with adenopathy of the medial group of superficial inguinal lymph nodes on the right side. Which of the following is the primary site resulting in this finding?

• a) right testis
• b) right buttock
• c) the skin of the right lower limb
• d) the anal canal
• e) none of the above

Answer 68

d) the anal canal

Small saphenous vein region -> popliteal nodes

Great saphenous region -> superficial inguinal nodes -> external iliac nodes

Moores does not get more specific about regions

Question 69

25) Regarding the popliteal fossa:

• a) the common peroneal nerve passes through the lateral part of the fossa
• b) it contains no lymph nodes
• c) it has a roof pierced by the tibial nerve
• d) the popliteal artery lies superficial to the popliteal vein throughout the fossa
• e) the small saphenous vein joins the popliteal vein before its entry into the fossa

Answer 69

• *a) the common peroneal nerve passes through the lateral part of the fossa**
• Not specifically mentioned in Moores but given it supplies the anterior and lateral compartments, is likely.*

Nerve - Vein - Artery (superficial to deep)

Contains LN in its fat (drains small saphenous region)

SSV joins in the popliteal fossa, not before

Tibial nerve enters as sciatic, and leaves between heads of gastroc / under tendinous arch of soleus

Question 70

26) Regarding the movements at the knee joint:

• a) popliteus ‘unlocks’ the extended knee by producing medial rotation of the femur
• b) there is no active rotation of the extended knee
• c) passive extension of the knee does not result in ‘locking’ of the joint
• d) the posterior cruciate ligament prevents backward displacement of the femur on the tibial plateau
• e) the major role of the menisci is in flexion/extension of the knee

Answer 70

b) there is no active rotation of the extended knee

• a) popliteus ‘unlocks’ the extended knee by producing lateral rotation of the femur (if the foot is fixed, otherwise medial rotation of the tibia)
• c) passive extension of the knee does result in ‘locking’ of the joint
• d) the posterior cruciate ligament prevents forward displacement of the femur on the tibial plateau (attaches posteriorly on the tibia, so stops itself being pulled forwards)
• e) the major role of the menisci is in cushioning/weightbearing

Question 71

27) The dorsalis pedis artery:

• a) lies medial to the tendon of extensor hallucis longus
• b) lies lateral to the detail branch of the deep peroneal nerve
• c) crosses superficial to the tendon of extensor hallucis brevis
• d) terminates at the arcuate artery
• e) joins the lateral plantar artery to form the plantar arch

Answer 71

e) joins the lateral plantar artery to form the plantar arch

• a) lies lateral to the tendon of extensor hallucis longus
• b) lies lateral to the detail branch of the deep peroneal nerve
  
  • ??? cant be bothererd looking up
• c) lateral tarsal artery crosses deep to the tendon of EDB
• d) terminates i**nto 1st dorsal metatarsal artery and deep plantar artery (arcuate and lateral tarsal arteries seem to be branches of it, but not terminal ones)

Question 72

28) A 25 year old man is unable to plantar flex his foot. The most likely cause is damage to:

• a) the superficial peroneal nerve
• b) the L5 nerve root
• c) the tibial nerve
• d) soleus
• e) gastrocnemius

Answer 72

c) the tibial nerve

Question 73

30) Which of the following structures does NOT pass through the greater sciatic foramen?

• a) the sciatic nerve
• b) the pudendal nerve and vessels
• c) the posterior cutaneous nerve of the thigh
• d) the inferior gluteal nerve and vessels
• e) the nerve to obturator externus

Answer 73

e) the nerve to obturator externus

Supplied by obturator nerve (cf obturator internus - nerve to obturator internus, directly off sacral plexus -> through greater sciatic foramen -> back into lesser sciatic foramen)

Question 74

33) The peroneus longus muscle:

• a) passes superficial to the superior peroneal retinaculum
• b) inserts into the styloid process of the fifth metatarsal bone
• c) is supplied by the common peroneal nerve
• d) assists in the maintenance of the lateral longitudinal arch
• e) has no origin from the tibia

Answer 74

e) has no origin from the tibia

Origin - head and superior 2/3rds of lateral surface of fibula

(they thought d) but this is not mentioned in Moores, and e) is definitely correct)

• a) passes deep to the superior peroneal retinaculum
• b) inserts into the first metatarsal bone after running under the sole of the foot
• c) is supplied by the superficial peroneal nerve
• d) assists in the maintenance of the lateral longitudinal arch
  
  • Its role in arch maintenence is not mentioned in Moores. FDL and FHL support the medial arch.

Question 75

34) The short saphenous vein:

• a) lies anterior to the lateral malleolus
• b) is accompanied by the saphenous nerve
• c) drains into the great saphenous vein
• d) drains the lateral margin of the foot
• e) lies deep to the deep fascia of the calf

Answer 75

d) drains the lateral margin of the foot

• a) lies posterior to the lateral malleolus
• b) is accompanied by the saphenous nerve
• c) drains into the popliteal vein
• e) lies superficial to the deep fascia of the calf

Question 76

8) With respect to the hip bone:

• a) the pelvic rim is formed by the iliac crest, top curricular area and pectineal line
• b) the iliofemoral ligament and sartorius are attached to the anterosuperior iliac spine
• c) the iliopubic eminence on anterior margin of acetabulum joins the ischium and pubic bone
• d) the tubercle of the iliac crest lies 7.5cm behind the anterosuperior iliac spine
• e) the line between the highest points of the iliac crest passes through the spine at L5

Answer 76

e) the line between the highest points of the iliac crest passes through the spine at L5

(Note I had to change this question as previously the answer was ‘…spine of ????’

• a) the pelvic rim is formed by the prominence of sacrum, arcutate and pectineal lines, and upper margin of pubic symphesis
• b) the iliofemoral ligament is attached to the AIIS and sartorius is attached to the anterosuperior iliac spine
  
  • Inguinal ligament attaches to the ASIS
• c) the iliopubic eminence on anterior margin of acetabulum joins the ischium and pubic bone
  
  • ???
• d) the tubercle of the iliac crest lies 5-6cm behind the anterosuperior iliac spine

Question 77

9) Which of the following structures is NOT found in the adductor (subsartorial) canal?

• a) femoral artery
• b) femoral vein
• c) femoral nerve
• d) saphenous nerve
• e) nerve to vastus medialis

Answer 77

c) femoral nerve

Question 78

11) The femoral canal:

• a) is the lateral compartment of the femoral sheath
• b) lies medial to the pubic tubercle
• c) contains the femoral nerve
• d) is medial to the femoral vein
• e) transmits the femoral branch of the genitofemoral nerve

Answer 78

d) is medial to the femoral vein

Question 79

39) Regarding the hip joint all of the following statements are true EXCEPT:

• a) the anterior fibres of the gluteus medius and minimus act as medial rotator of the hip joint
• b) the gluteus maximus is the most powerful lateral rotator of the hip joint
• c) gluteus medius and minimus are supplied by the inferior gluteal nerve (L5, S1, S2)
• d) the superior gluteal nerve (L4, L5, S1) emerges from the greater sciatic notch
• e) the iliofemoral ligament limits extension at the hip joint

Answer 79

c) gluteus maximus is supplied by the inferior gluteal nerve (L5, S1, S2)

medius and minimus are supplied by the superior gluteal nerve (L4-S1)

Question 80

40) Regarding the popliteal fossa, which of the following statements is true?

• a) the common peroneal nerve slopes downwards lateral to the biceps tendon
• b) the sural nerve is a cutaneous branch of the common peroneal nerve
• c) the middle genicular artery of the popliteal artery supply the cruciate ligaments
• d) the popliteus muscle is supplied by a branch of the common peroneal nerve
• e) the recurrent genicular nerve is a branch of the tibial nerve

Answer 80

c) the middle genicular artery of the popliteal artery supply the cruciate ligaments

There are no good pictures demonstrating this, but remember the synovial membrane reflects anteriorly away around the cruciates, leaving them exposed posteriorly. Thus the middle genicular branch (as opposed to all the listed ones in the picture around the knee) just dives straight on in there.

Question 81

41) Regarding the extensor compartment of the lower leg, all of the following statements are true EXCEPT:

• a) the tibialis anterior muscle is supplied by the deep peroneal and recurrent genicular nerves (L4)
• b) extensor digitorum longus and peroneus tertius muscle lie lateral to tibialis anterior artery throughout
• c) the deep peroneal nerve arises within the peroneus longus muscle
• d) the extensor digitorum longus dorsiflex the lateral toes
• e) the extensor hallucis longus arises from the middle two-fourths of the tibia and the adjacent interosseous membrane

Answer 81

e) the extensor hallucis longus arises from the middle two-fourths of the tibia and the adjacent interosseous membrane

Actually arises from inferior two-thirds of the fibula and IOM

Question 82

43) The popliteal artery:

• a) is superficial to the tibial nerve
• b) extends from the hiatus in adductor longus
• c) enters the popliteal fossa on lateral aspect of the femur
• d) has four genicular branches in fossa
• e) supplies the cruciate ligaments

Answer 82

e) supplies the cruciate ligaments

Via the middle genicular artery

• a) is deep to the tibial nerve (nerve - vein - artery)
• b) extends from the hiatus in adductor magnus
• c) enters the popliteal fossa on posterior aspect of the femur
• d) has five genicular branches in fossa

Question 83

44) The obturator nerve:

• a) adductor magnus
• b) obturator internus
• c) quadratus femoris
• d) sartorius
• e) inferior gemellus

Answer 83

a) adductor magnus

• b) obturator internus - nerve to OI, off sacral plexus
• c) quadratus femoris - femoral nerve (posterior division)
• d) sartorius - femoral nerve (anterior division)
• e) inferior gemellus - nerve to quadratus femoris (superior is supplied by nerve to OI)

Question 84

46) The anterior cruciate ligament:

• a) lies within the synovial membrane of the knee joint
• b) attaches from the anterior tibial plateau to the medial condyle of the femur
• c) prevents forward displacement of the femur on the tibial plateau
• d) produces lateral rotation of the femur in the ‘screw home’ position of full extension
• e) none of the above

Answer 84

e) none of the above

• a) lies outside the synovial membrane of the knee joint
• b) attaches from the anterior tibial plateau to the lateral condyle of the femur
  
  • ACL - anterior tibia -> lateral condyle
  • PCL - posterior tibia -> medial condyle
• c) prevents posterior displacement of the femur on the tibial plateau
• d) produces medial rotation of the femur in the ‘screw home’ position of full extension (popliteus unlocks with a lateral rotation)

Question 85

48) In the popliteal fossa, the deepest of these structures is:

• a) popliteal vein
• b) popliteal artery
• c) tibial nerve
• d) sural nerve
• e) plantaris muscle

Answer 85

b) popliteal artery

Nerve - artery - vein from superficial -> deep

Plantaris is a shitty small muscle arising just superior to the lateral head of gastroc and merging with it. Arteries and nerves run between/under gastroc/plantaris.

Question 86

49) Which of the following bursae is most likely to communicate with the knee joint?

• a) deep infrapatellar bursa
• b) superficial infrapatellar bursa
• c) prepatellar bursa
• d) semimembranosis bursa
• e) suprapatellar bursa

Answer 86

e) suprapatellar bursa

Question 87

51) The muscle which provides the most control of hip joint movement during the act of sitting is:

• a) iliacus
• b) semitendinosis
• c) semimembranosis
• d) gluteus maximus
• e) gluteus medius

Answer 87

d) gluteus maximus

Primary muscle for rising from sitting, so makes sense it eccentric contraction would help control sitting down

Question 88

52) Structures passing through the greater sciatic foramen include all of the following EXCEPT:

• a) tendon of obturator internus
• b) piriformis muscle
• c) posterior cutaneous nerve of the thigh
• d) pudendal nerve
• e) nerve to quadratus femoris

Answer 88

a) tendon of obturator internus

• OI leaves the pelvis through the lesser sciatic foramen (which its nerve also runs through)*
• Piriformis is partly inside the lesser pelvis, and leaves through the GSF*

Question 89

54) The strongest fibres of the ‘deltoid’ ligament in the ankle run from the tibial malleolus to:

• a) medial tubercle of the talus
• b) the neck of the talus
• c) the sustenaculum tali
• d) the navicular bone
• e) the medial cuneiform

Answer 89

c) the sustenaculum tali

• Neither the relative strengths of the portions of the ligament, nor the word ‘sustenaculum’ appear in Moores.*
• Parts are: tibionavicular, tibiocalcaneal, anterior + posterior tibiotalar parts*

Question 90

29) Which of the following is NOT a component of the second layer of the sole of the foot?

• a) tendon of flexor hallucis longus
• b) abductor hallucis
• c) quadratus planae
• d) the lumbrical muscles
• e) tendon of flexor digitorum longus

Answer 90

b) abductor hallucis

This is in the first layer (along with FDB and ABd digiti minimi)

Second layer contains quadratus planae, lumbricals

Question 91

42) Regarding the foot, all of the following statements are true EXCEPT:

• a) the tibialis posterior muscle inverts and adducts the forefoot
• b) the tibialis posterior muscle plantarflex the ankle joint
• c) the tibialis anterior muscle dorsiflex the ankle and inverts the foot
• d) all interossei muscles are supplied by the lateral plantar nerve
• e) calcaneal branches of the deep peroneal nerve supply the skin of the heel

Answer 91

e) calcaneal branches of the deep peroneal nerve supply the skin of the heel

• Actually calcaneal branches of the TIBIAL nerve*
• Deep fibular nerve supplies the first webspace*

Question 92

1) In the femoral triangle

• a) the femoral nerve emerges from the femoral sheath
• b) the saphenous nerve lies medial to the femoral artery at the apex
• c) the genitofemoral nerve pierces the anterior surface of the femoral sheath
• d) the profunda femoris artery arises from the medial aspect of the femoral artery
• e) the obturator nerve passes anterior to pectineus

Answer 92

c) the genitofemoral nerve pierces the anterior surface of the femoral sheath

• Vein is medial at inguinal ligament, posterior at apex of triangle*
• Femoral nerve does not run in the sheath*
• Profunda arises from posterior or lateral aspect*

Question 93

2) The iliotibial tract is the conjoined aponeurosis of the tensor fasciae lata and:

• a) gluteus minimus
• b) gluteus medius
• c) gluteus maximus
• d) Camper’s fascia
• e) Scarpa’s fascia

Answer 93

c) gluteus maximus

Question 94

3) Fourth lumbar nerve root supplies:

• a) hip flexors
• b) tibialis anterior
• c) skin on the big toe
• d) flexor longus digitorum
• e) flexor accessories (quadratus plantae)

Answer 94

b) tibialis anterior

plantar flexion based on myotomes

Question 95

4) The base of Scarpa’s femoral triangle is formed by:

• a) sartorius
• b) adductor longus
• c) inguinal ligament
• d) pubic tubercle
• e) none of the above

Answer 95

c) inguinal ligament

• Base, not floor.*
• Superior - inguinal ligament*
• Medial - lateral border of adductor longs*
• Lateral - sartorius; apex is where sartorius crosses over adductor longus*
• Floor - iliopsoas laterally, pectineus medially*
• Roof - fascia lata and cribiform fascia*

Question 96

5) Passing through the greater sciatic notch deep to the sciatic nerve is which of the following?

• a) internal pudendal vessels and nerve
• b) inferior gemellus muscle
• c) posterior cutaneous nerve of the thigh
• d) nerve to quadratus femoris
• e) none of the above

Answer 96

d) nerve to quadratus femoris

Question 97

6) The femoral vein lies …….. to the femoral artery in the femoral sheath:

• a) lateral
• b) medial
• c) anterior
• d) posterior
• e) femoral vein is not in the femoral sheath

Answer 97

b) medial

Question 98

7) The main function of gluteus maximus is which of the following:

• a) a site for injections
• b) a cushion for sitting
• c) a flexor of the hip
• d) a lateral rotator of the hip
• e) none of the above

Answer 98

e) none of the above

Extensor of the hip, primarily to rise from sitting or develop power - does not activate in normal walking

Question 99

8) Tensor fascia latae:

• a) is quadrangular in shape
• b) is supplied by the femoral nerve
• c) extends the hip
• d) is an atavistic remnant of the panniculus carnosus muscle
• e) lies edge to edge with sartorius at the anterior superior iliac spine

Answer 99

e) lies edge to edge with sartorius at the anterior superior iliac spine

Question 100

9) The superior gluteal nerve supplies:

• a) gluteus medius
• b) gluteus minimus
• c) tensor fascia latae
• d) none of the above
• e) all of the above

Answer 100

e) all of the above

Question 101

10) The hamstring muscles originate from:

• a) body of the ischium
• b) ramus of the pubis
• c) iliac crest
• d) ischial tuberosity
• e) symphysis pubis

Answer 101

d) ischial tuberosity

Question 102

11) The upper tibial epiphysis appears at:

• a) birth
• b) 1 year
• c) 2 year
• d) 3 years
• e) puberty

Answer 102

a) birth

Question 103

13) Which of the following is found in the popliteal fossa?

• a) sciatic nerve
• b) femoral vein
• c) common peroneal nerve
• d) femoral artery
• e) saphenous nerve

Answer 103

c) common peroneal nerve

Sciatic divides at the apex of the fossa

Question 104

14) The short saphenous vein passes below and behind the:

• a) medial malleolus
• b) lateral malleolus
• c) medial epicondyle
• d) lateral epicondyle
• e) greater trochanter

Answer 104

b) lateral malleolus

and terminates in the popliteal fossa

Question 105

15) When standing, the knee joint is locked in extension by:

• a) lateral rotation of the tibia
• b) medial rotation of the femur
• c) tightening of the medial ligament
• d) tightening of the lateral ligament
• e) tension in the oblique popliteal ligament

Answer 105

b) medial rotation of the femur

on a fixed foot.

Question 106

16) The posterior cutaneous nerve of the thigh:

• a) consists only of S2, 3
• b) travels most of its course superficial to the fascia lata
• c) innervates a small area on the labia majora
• d) emerges above pinforris
• e) none of the above

Answer 106

c) innervates a small area on the labia majora

Question 107

17) The deep peroneal nerve supplies:

• a) skin between the first and second toes
• b) skin between the second and third toes
• c) skin on the medial side of the shin
• d) skin on the dorsolateral side of the foot
• e) the great toe only

Answer 107

a) skin between the first and second toes

Question 108

18) Attached to lateral meniscus is which of the following:

• a) posterior cruciate ligament
• b) lateral ligament of the knee
• c) mucous fold
• d) popliteus muscle
• e) oblique popliteal ligament

Answer 108

d) popliteus muscle

Question 109

19) The obturator nerve is derived from the anterior rami of:

• a) T12, L1 and L2
• b) L1, L2 and L3
• c) L2, L3 and L4
• d) L3, L4 and S1
• e) none of the above

Answer 109

c) L2, L3 and L4

Question 110

20) The skin crease of the hip:

• a) is where the inguinal ligament is attached to the fascia lata
• b) is where the external oblique aponeurosis is joined to Scarpa’s fascia
• c) is where Scarpa’s fascia is attached to the fascia lata
• d) is mainly supplied by the femoral nerve
• e) none of the above

Answer 110

c) is where Scarpa’s fascia is attached to the fascia lata

Question 111

21) Peroneus tertius:

• a) acts only to evert the foot
• b) arises from the lower anterior part of the tibia
• c) may insert into the neck of the fifth metatarsal
• d) passes superficial to the extensor retinaculum
• e) is innervated by the superficial peroneal nerve

Answer 111

c) may insert into the neck of the fifth metatarsal

arises from the lower anterior part of the fibula

• Is in the anterior compartment so supplied by deep fibular nerve*
• Dorsiflex and evert ankle*

Question 112

22) Structures closely related to long saphenous vein at ankle include which of the following?

• a) major perforating veins to deep venous system
• b) a branch of the femoral nerve
• c) medial superficial lymphatic trunks
• d) a branch of the anterior tibial nerve
• e) dorsalis pedis artery

Answer 112

b) a branch of the femoral nerve

Question 113

24) The dorsalis pedis artery is:

• a) lateral to extensor hallucis longus at the ankle
• b) medial to extensor hallucis longus at the ankle
• c) medial to tibialis anterior at the ankle
• d) found perforating the first metatarsal space and joining with the medial plantar artery
• e) lateral to the digital branch of the deep peroneal nerve

Answer 113

a) lateral to extensor hallucis longus at the ankle

• Structures passing under extensor retinaculum (medial to lateral):
  
  • “Tom Has A Very Nasty Disease - Funny Toes”
  • Tibialis anterior
  • Extensor Hallucis longus
  • Tibial artery (→ dorsalis pedis)
  • Vein
  • Sural Nerve
  • Extensor digitorum Longus
  • Fibularis Tertius (inserts into 5th MT)

Question 114

25) Features of the fibula include which of the following?

• a) it is on the medial side of the tibia
• b) its medial surface is grooved for the origin of tibialis posterior
• c) it is ossified from five centres
• d) it does not provide origin for flexor digitorum longus
• e) its lower third is rough for the origin of soleus

Answer 114

b) its medial surface is grooved for the origin of tibialis posterior

Lateral to tibia

FDL comes primarily off tibia but has a broad tendon to fibula

Soleus is off superior fibula

Question 115

26) Which of the following is true of the saphenous nerve?

• a) is predominantly from L2
• b) supplies adductor magnus
• c) pierces the deep fascia in the femoral triangle
• d) is cutaneous only
• e) terminates just below the knee

Answer 115

d) is cutaneous only

Question 116

27) The superficial epigastric, superior perforating and deep external pudendal arteries are all branches of:

• a) profunda femoris
• b) popliteal
• c) internal iliac
• d) external iliac
• e) none of the above

Answer 116

e) none of the above

Seems to be common femoral artery

Question 117

28) Which of the following is NOT a branch of the profunda femoris artery?

• a) medial femoral circumflex
• b) lateral femoral circumflex
• c) popliteal
• d) perforating
• e) all are branches of the profunda

Answer 117

c) popliteal

(continuation of femoral)

Question 118

29) The long saphenous vein:

• a) passes anterior to the inguinal ligament
• b) passes posteriorly to the medial malleolus
• c) ascends the lateral side of the leg
• d) receives tributaries from the perineum
• e) is in close relation with the saphenous nerve throughout the length of its course

Answer 118

d) receives tributaries from the perineum

Question 119

30) The chief dorsiflexor of the ankle joint:

• a) peroneus tertius
• b) tibialis anterior
• c) extensor longus hallucis
• d) extensor longus digitorum
• e) none of the above

Answer 119

b) tibialis anterior

Question 120

31) Iliopsoas:

• a) supplied by obturator nerve
• b) medial rotator of hip
• c) synergist of quadriceps femoris
• d) lateral rotator of hip
• e) none of the above

Answer 120

b) medial rotator of hip

Question 121

32) The lumbar plexus is formed by ventral primary rami of:

• a) T12, L1, L2 and L3
• b) L1, L2, L3 and L4
• c) L2, L3, L4 and L5
• d) L2, L4, L5 and S1
• e) formed by dorsal primary rami

Answer 121

b) L1, L2, L3 and L4

Question 122

33) The cutaneous nerve supplying the medial aspect of the calf is:

• a) anterior femoral cutaneous
• b) sural
• c) superficial peroneal
• d) saphenous
• e) posterior femoral cutaneous

Answer 122

d) saphenous

Question 123

34) The nerve supply to the knee joint comes from:

• a) sciatic
• b) femoral
• c) obturator
• d) all of these
• e) none of these

Answer 123

d) all of these

Question 124

35) The most powerful extensor of the hip is:

• a) gluteus maximus
• b) psoas major
• c) iliacus
• d) obturator externus
• e) piriformis

Answer 124

a) gluteus maximus

Question 125

36) Which of the following is not an action of gracilis?

• a) adduction of thigh
• b) flexion of knee
• c) extension of thigh
• d) medial rotation of the flexed knee
• e) none of these

Answer 125

c) extension of thigh

• Origin: Body and inferior ramus of pubis
• Insertion: Superior part of medial surface of tibia
• Nerve supply: Obturator nerve (L2,3)
• Action: Adducts thigh, flexes leg, medially rotates leg
• Part of pes anserinus

Question 126

37) Obturator externus:

• a) is pierced by femoral circumflex artery
• b) external rotator of hip
• c) internal rotator of hip
• d) hip flexor
• e) supplied by S.I.

Answer 126

b) external rotator of hip

• O: Margins of obturator foramen and membrane
• I: Trochanteric fossa of femur
• Nerve: Obturator nerve (L3,4)
• Action: Laterally rotates thigh, steadies of of femur in acetabulum