LOWER LIMBS STUDY CASES Flashcards
A 27-year-old patient exhibits a loss of skin
sensation and paralysis of muscles on the plantar
aspect of the medial side of the foot. Which
of the following nerves is most likely damaged?
Tibial
A patient with a deep knife wound in the
buttock walks with a waddling gait that is characterized
by the pelvis falling toward one side
at each step. Which of the following nerves is
damaged?
Superior Gluteal nerve
A patient is unable to prevent anterior displacement
of the femur on the tibia when the
knee is flexed. Which of the following ligaments
is most likely damaged?
Posterior cruiciate
A 41-year-old man was involved in a fight and
felt weakness in extending the knee joint. On examination,
he was diagnosed with a lesion of the
femoral nerve. Which of the following symptoms
would be a result of this nerve damage?
Paralysis on VASTUS LATERALIS MUSCLE
A 47-year-old woman is unable to invert
her foot after she stumbled on her driveway.
Which of the following nerves are most likely
injured?
DEEP Peroneal & tibia
A 22-year-old patient is unable to “unlock”
the knee joint to permit flexion of the leg.
Which of the following muscles is most likely
damaged?
Popliteus
A patient presents with sensory loss on adjacent
sides of the great and second toes and
impaired dorsiflexion of the foot. These signs
probably indicate damage to which of the
following nerves?
DEEP Peroneal
A motorcyclist falls from his bike in an accident
and gets a deep gash that severs the superficial
peroneal nerve near its origin. Which of
the following muscles is paralyzed?
Peroneus longus
A 67-year-old patient has been given a
course of antibiotics by gluteal intramuscular
injections after a major abdominal surgery.
To avoid damaging the sciatic nerve during an
injection, the needle should be inserted into
which of the following areas?
Upper lateral quadrant of the gluteal region.
A 20-year-old patient cannot flex and medially
rotate the thigh while running and climbing.
Which of the following muscles is most
likely damaged?
Tensor fasciae latae
A 21-year-old man was involved in a motorcycle
accident, resulting in destruction of the
groove in the lower surface of the cuboid bone.
Which of the following muscle tendons is most
likely damaged?
Flexor hallucis longus
A construction worker falls feet first from a
roof. He sustains a fracture of the groove on the
undersurface of the sustentaculum tali of the
calcaneus bone. Which of the following muscle
tendons is most likely torn?
Flexor hallucis brevis.
A thoracic surgeon is going to collect a portion
of the greater saphenous vein for coronary
bypass surgery. He has observed that this vein
runs
Superficial to the fascia lata of the thigh
A 52-year-old woman slipped and fell
and now complains of being unable to extend
her leg at the knee joint. Which of the following
muscles was paralyzed as a result of this
accident?
Quadricep femoris
A patient experiences weakness in dorsiflexing
and inverting the foot. Which of the following
muscles is damaged?
Tibialis anterior
Questions 16 to 20: A 62-year-old woman slips
and falls on the bathroom floor. As a result, she
has a posterior dislocation of the hip joint and a
fracture of the neck of the femur.
OHK
- Rupture of the ligamentum teres capitis
femoris may lead to damage to a branch of
which of the following arteries?
Obturator
- Fracture of the neck of the femur results in
avascular necrosis of the femoral head, probably
resulting from lack of blood supply from
which of the following arteries?
Mdial femoral circumflex
18.If the acetabulum is fractured at its posterosuperior
margin by dislocation of the hip
joint, which of the following bones could be
involved?
ILIUM
- The woman experiences weakness when
abducting and medially rotating the thigh after
this accident. Which of the following muscles is
most likely damaged?
Gluteus minimus
- The woman undergoes hip surgery. If all of
the arteries that are part of the cruciate anastomosis
of the upper thigh are ligated, which of
the following arteries maintains blood flow?
Superior Gluteal
A 34-year-old woman sustains a deep cut
on the dorsum of the foot just distal to her ankle
joint by a falling kitchen knife. A physician in
the emergency department has ligated the dorsalis
pedis artery proximal to the injured area.
Which of the following conditions most likely
occurs as a result of the injury?
Reduction of blood flow in the medial tarsal artery.
A patient experiences paralysis of the
muscle that originates from the femur and contributes
directly to the stability of the knee joint.
Which of the following muscles is involved?
Vastus lateralis
A patient is involved in a motorcycle wreck
that results in avulsion of the skin over the anterolateral
leg and ankle. Which of the following
structures is most likely destroyed with this type
of injury?
Superficial peroneal nerve
A knife wound penetrates the superficial
vein that terminates in the popliteal vein.
Bleeding occurs from which of the following
vessels?
LESSER saphenous vein
A 10-year-old boy falls from a tree house.
The resultant heavy compression of the sole of
his foot against the ground caused a fracture
of the head of the talus. Which of the following
structures is unable to function normally?
MEDIAL longitudinal arch
A 24-year-old woman complains of weakness
when she extends her thigh and rotates
it laterally. Which of the following muscles is
paralyzed?
Gluteus Maximus
A patient with hereditary blood clotting
problems presents with pain in the back of her
knee. An arteriograph reveals a blood clot in the
popliteal artery at its proximal end. Which of
the following arteries will allow blood to reach
the foot?
Lateral circumflex femoral
A 72-year-old woman complains of a
cramplike pain in her thigh and leg. She was
diagnosed as having a severe intermittent claudication.
Following surgery, an infection was
found in the adductor canal, damaging the enclosed
structures. Which of the following structures
remains intact
Great saphenous vein
A basketball player was hit in the thigh by
an opponent’s knee. Which of the following arteries
is likely to compress and cause ischemia
because of the bruise and damage to the extensor
muscles of the leg?
Anterior tibia
An elderly woman fell at home and fractured
the greater trochanter of her femur.
Which of the following muscles would continue
to function normally?
Gluteus Maximus.
Questions 31 to 35: A 20-year-old college student
receives a severe blow on the inferolateral
side of the left knee joint while playing football.
Radiographic examination reveals a fracture of
the head and neck of the fibula.
OHK
31.Which of the following nerves is damaged?
Common peroneal
- After injury to this nerve, which of the following
muscles could be paralyzed?
Extensor hallucis longus
- If the lateral (fibular) collateral ligament
is torn by this fracture, which of the following
conditions may occur?
Abnormal passive adduction of the extended leg
- Which of the following arteries could also
be damaged by this fracture?
Anterior Tibial
- Which of the following conditions would
occur from this fracture?
Anterior tibial compartments syndrome
- A construction worker is hit on the leg with
a concrete block and is subsequently unable
to plantar flex and invert his foot. Which of the
following muscles is most likely damaged?
Tibialis posterior
- The obturator nerve and the sciatic (tibial
portion) nerve of a 15-year-old boy are transected
as a result of a motorcycle accident. This
injury would result in complete paralysis of
which of the following muscles?
ADDuctor magnus
- A 24-year-old woman presents to her physician
with weakness in flexing the hip joint and
extending the knee joint. Which muscle is most
likely involved in this scenario?
Rectus Femoris
- A 17-year-old boy was stabbed during
a gang fight, resulting in the transection of
the obturator nerve. Which of the following
muscles is completely paralyzed?
ADDUctor longus
- A 32-year-old carpenter fell from the roof.
The lateral longitudinal arch of his foot was
flattened from fracture and displacement of the
keystone for the arch. Which of the following
bones is damaged?
Cuboid bone
While playing football, a 19-year-old college
student receives a twisting injury to his
knee when being tackled from the lateral side.
Which of the following conditions most likely
has occurred?
Ruptured fibular collateral ligament
A patient has weakness when flexing both
her thigh and leg. Which of the following muscles
is most likely injured?
Sartorius
A 35-year-old man has difficulty in dorsiflexing
the foot. Which of the following muscles
is most likely damaged?
Tibialis anterior
An injury to the leg of a golfer results in loss
of the ability to invert the foot. Which of the following
muscles is most likely paralyzed?
Tibialis posterior
An orthopedic surgeon ligates the posterior
tibial artery at its origin. Which of the following
arteries has no blood flow immediately after the
ligation?
Peroneal
Before knee surgery, a surgeon ligates arteries
participating in the anastomosis around the
knee joint. Which of the following arteries is
most likely spared?
Saphenous branch of the descending genicular
A 25-year-old gladiator sustains a penetrating
injury that severs the superficial peroneal
nerve. This will most likely cause paralysis of
which of the following muscles?
Peroneus brevis
A patient presents with a thrombosis in
the popliteal vein. This thrombosis most likely
causes reduction of blood flow in which of the
following veins?
Femoral
A 21-year-old tennis player comes to an
emergency room and complains of pain in the
knee joint. On examination, he has an infection
inside the knee joint capsule but outside the synovial
cavity. Which of the following structures
is preserved from this infection?
Lateral collateral ligament
A 14-year-old gymnastic silver medalist falls
from the parallel bar and complains of pains
from the knee and ankle joints. On physical examination,
her physician found that the muscle
responsible for flexing the leg at the knee joint
and plantar flexing the foot is severely weakened.
Which of the following muscles involved
in both movements was most likely damaged in
this accident?
Grastrocnemius
28-year-old basketball player falls while
rebounding and is unable to run and jump. On
physical examination, he has pain and weakness
when extending his thigh and flexing his
leg. Which muscle involved in both movements
is most likely injured?
Semitendinosus
52-year-old woman comes to an orthopedic
surgeon complaining of an uncomfortable
feeling in her knee and ankle joints. After a
thorough examination, she is diagnosed as having
arthritis with mild discomfort with passive
movements. The muscles acting at the ankle
joint appear normal with good strength. Which
muscle can both dorsiflex and invert her foot?
Extensor hallucis longus
