MSK pt2 Quiz Questions Flashcards
1
Q
A 4-year-old girl is brought to the emergency department by her parents after a day at the playground. The girl is holding her right arm close to her side, with the elbow slightly flexed and the forearm pronated. The parents were swinging their child by both arms, then she began to scream and cry. The attending physician diagnoses nursemaid’s elbow (radial head displacement). Which of the following structures encircles the head of the radius and is most likely affected in this patient?
A
Anular ligament
2
Q
Which of the following structures on the ulna describes the articulating surface for the head of the radius at the proximal radio-ulnar joint?
A
Radial notch
3
Q
Two medical students argue about the bones responsible for pronation. Which of the following takes place during pronation?
A
The distal end of the radius circumducts the distal end of the ulna
4
Q
A physician performs a clinical test by asking the patient to adduct or medially deviate the hand. Which of the following muscles is he most likely testing?
A
flexor carpi ulnaris and extensor carpi ulnaris
5
Q
A 30-year-old typist presents to your clinic with pain, numbness, and tingling on the lateral three and a half digits of her right hand. She states that the pain increases during the night. Physical examination reveals difficulty in opposition of her right thumb. Which of the following nerves is most likely affected in this patient?
A
median
6
Q
Which of the following muscles is most likely affected to result in her weakened thumb opposition?
A
opponens pollicis
7
Q
A 70-year-old woman presents with pain and numbness on the medial aspect of her right forearm and hand. Which of the following portions of the brachial plexus gives rise to the sensory nerve(s) that account for her symptoms?
A
medial cord
8
Q
Which of the following dermatome(s) are affected in this patient with pain and numbness on the medial aspect of her right forearm and hand?
A
C8-T1
9
Q
A 40-year-old woman presents to her physician with a 3-month history of worsening tingling, numbness, and weakness of the left hand. On physical examination, there is wasting of the hypothenar eminence and reduced sensation in the 4th and 5th digit. Which nerve is most likely affected in this patient?
A
ulnar
10
Q
A 30-year-old pregnant woman presents to her physician with a 2-month history of worsening tingling, numbness of her wrist and palm. On physical examination, there is numbness elicited when the anterior surface of the wrist is lightly tapped (Tinel’s test). Which of the following is the most likely cause of this presentation?
A
carpal tunnel syndrome
11
Q
A 19-year-old collegiate football player presents to the emergency department after falling hard on the wrist of his outstretched left arm during practice. He reports experiencing sudden pain when he fell. Physical examination of his wrist elicits sharp pain with palpation of the anatomical snuffbox. Which of the following carpal bones, also shown in the image, is most likely fractured in this patient?
A
scaphoid
12
Q
A 25-year-old woman is admitted to the emergency department with acute pain and swelling of her distal forearm and hand after falling from her horse onto her outstretched hand. Radiographic imaging confirms a fracture (refer to the accompanying image), which is subsequently reduced and casted. Based on the patient history and radiographic studies, which of the following bones is fractured in this patient?
A
radius
13
Q
Further imaging reveals that the shaft of the radius is anteriorly displaced. Which of the following types of fractures is identified in this patient?
A
Colle’s fracture
14
Q
When a person is in anatomical position, which two muscles rotate the radius so the back of the hand faces forward?
A
pronator teres and pronator quadratus
15
Q
What structure transmits part of the force applied to the distal radius (i.e. fall on an outstretched hand) to the ulna, and diminishes the stress transmitted from the wrist to the humerus?
A
interosseous membrane
16
Q
The articulation of the elbow joint is formed by which of the following structures?
A
trochlea and capitulum of the humerus, trochlear notch of the ulna, radial head
17
Q
A 6-year-old girl is brought to the physician’s office with painful left elbow. She was walking hand in hand with her mother when she tripped. To prevent her from falling, her mother pulled her left arm up. What structure has most likely been damaged?
A
anular ligament
18
Q
Flexor digitorum superficialis has what action?
A
flexes proximal and middle phalanges of fingers 2-5
19
Q
Superficial extensors of the forearm originate from?
A
lateral epicondyle of the humerus
20
Q
Superficial flexors of the forearm originate from?
A
medial epicondyle of the humerus
21
Q
A 33 year old man has a carrying angle of more than 19 degrees. What problem does he most likely have?
A
cubitus valgus and ulnar neuropathy
22
Q
flexes the proximal phalanges of each finger
A
flexor digitorum superficialis
23
Q
flexes the middle phalanges of each finger
A
flexor digitorum superficialis
24
Q
flexes the distal phalanges of each finger
A
flexor digitorum profundus
25
clawing of 2nd and 3rd fingers
radial nerve
26
weakness in wrist flexion against resistance
median nerve
27
muscle weakness that compromises wrist flexion the most
flexor carpi radialis
28
brachioradialis ends
proximal to the styloid process of the radius
29
Which movement would fail in case of paralysis of the quadriceps femoris muscle?
extension of the knee
30
An elderly patient was found to have a hernial sac in the right femoral triangle and a marked weakness in adduction at the right hip joint. Which nerve was likely compressed by this herniation?
obturator
31
Which of the following nerves innervates the posterior compartment of the leg?
```
A. common fibular
B. deep fibular
C. femoral
D. superficial fibular
E. tibial
```
E. tibial
32
Which of the following is the cutaneous branch of the femoral nerve?
```
A. anterior cutaneous nerve of the thigh
B. genitofemoral nerve
C. lateral cutaneous nerve of the thigh
D. posterior cutaneous nerve of the thigh
E. sural nerve
```
A. anterior cutaneous nerve of thigh
33
What is the most common site of compression of lateral femoral cutaneous nerve causing meralgia paresthetica?
A. in the adductor canal
B. in the inguinal canal
C. in the lateral side of femoral triangle
D. under the lateral side of inguinal ligament
E. under the medial side of inguinal ligament
D. under the lateral side of inguinal ligament
34
Which muscle is at greatest risk of function loss with injury of superior gluteal nerve?
```
A. adductor longus
B. gluteus maximus
C. obturator internus
D. piriformis
E. tensor fasciae latae
```
E. tensor fasciae latae
35
Which cutaneous nerve is most likely to be compressed by the piriformis leading to loss of sensation of the buttock?
```
A. anterior femoral cutaneous
B. inferior gluteal
C. lateral femoral cutaneous
D. posterior femoral cutaneous
E. superior gluteal
```
D. posterior femoral cutaneous
36
Damage to which one of the following nerves will most likely cause foot drop?
```
A. deep fibular nerve
B. femoral nerve
C. obturator nerve
D. superficial fibular nerve
E. tibial nerve
```
A. deep fibular nerve
37
A 60-year-old man is injured on the side of his leg and fractures his fibula just below its head. On physical exam he reveals that he has weakened ability to invert and dorsiflex his foot, but maintains plantar flexion. Which of the following combinations of muscles is most likely among the dysfunctional muscles?
A. fibularis tertius and tibialis anterior
B. fibularis longus and fibularis brevis
C. gastrocnemius and soleus
D. sartorius and vastus lateralis
E. tibialis posterior and flexor hallucis longus
A. fibularis tertius and tibialis anterior
38
Which of the following nerves supply the "hamstring" muscles?
```
A. deep fibular
B. femoral
C. obturator
D. pudendal
E. sciatic
```
E. sciatic
39
What is the nerve supply of the short head of the biceps femoris muscle?
```
A. common fibular
B. femoral
C. obturator
D. pudendal
E. tibial
```
A. common fibular
40
A 67-year-old man presents with complaints of pain and of difficulty while standing up from a seated position? Which one of the following nerves is most likely injured?
```
A. inferior gluteal
B. saphenous
C. sciatic
D. superior gluteal
E. sural
F. tibial
```
A. inferior gluteal
41
A 25-year-old man receives an intramuscular injection in the right buttock that inadvertently damages the superior gluteal nerve. Which of the following is the most likely consequence of damage to this nerve?
A. Altered sensation in skin covering the gluteal region
B. Weakness in the ability to abduct the thigh at the hip
C. Weakness in the ability to adduct the thigh at the hip
D. Weakness in the ability to extend the thigh at the hip
E. Weakness in the ability to laterally rotate the thigh at the hip
B. weakness in the ability to abduct the thigh at the hip
42
The patient complains of discomfort during the injection because of the large gauge of the needle. Which is the most likely spinal level for the cutaneous nerve of this region?
```
A. Anterior rami of L1-L3
B. Anterior rami of L4-S1
C. Anterior rami of S1-S3
D. Posterior rami of L1-L3
E. Posterior rami of L4-S1
F. Posterior rami of S1-S3
```
D. posterior rami L1-L3
43
You ask the patient to walk in a straight line away from you. What do you expect to observe?
A. Pelvic dropping on the left side when the left leg is planted
B. Pelvic dropping on the right side when the left leg is planted
C. Pelvic dropping on the left side when the right leg is planted
D. Pelvic dropping on the right side when the right leg is planted
E. No change in the pelvic tilt when either leg is planted
C. pelvic dropping on the L when the R leg is planted
44
A 43-year-old woman is brought to the emergency department 30 minutes after being involved in a motor vehicle collision. An x-ray of the abdomen and pelvis shows a pelvic fracture in the region of the anterior superior iliac spine. During the healing of the pelvic fracture, a nerve becomes entrapped in the bone callus and physical examination shows an area of reduced sensation on the skin of the thigh. Which of the following nerves is most likely affected?
```
A. Anterior femoral cutaneous nerve
B. Femoral nerve
C. Lateral femoral cutaneous nerve
D. Obturator nerve
E. Posterior femoral cutaneous nerve
```
C. Lateral femoral cutaneous nerve
45
A 56 year-old-male presents at the doctor’s office with back pain and weakness in his leg muscles after slipping and falling earlier that week. It is especially apparent when climbing and descending stairs, and even just walking. The pain is mostly localized in his back and radiates around to the front of his superior thigh. You suspect disc herniation. What is the most superior disc that you would expect to be herniated for this patient?
```
A. L1-L2
B. L2-L3
C. L3-L4
D. L4-L5
E. L5-S1
```
B. L1-L2
| superior most nerve root for femoral nerve is L2 which is impinged by L1,L2
46
You confirm a single disc herniation with MRI and send the man home as you consider treatment options. He returns several weeks later with new complaints of pain down the back of his leg even down to his foot, and even more pronounced muscle weakness. He has not had any additional injuries but said that he stopped taking the medication because it makes him nauseous and the pain has impacted the way he is walking. What is the most likely cause of this new pain?
```
A. Additional herniated discs
B. Enlargement of the piriformis muscle
C. Enlargement of the gluteus medius muscle
D. Spinal Arthritis
E. Tarsal tunnel edema formation
```
B. enlargement of the piriformis
| Piriformis syndrome
47
A 17-year-old female comes to the emergency department after she fractured her fibula during soccer practice. Her leg is placed in a cast. While she is still in the cast, she later says that she is experiencing numbness and tingling in skin over the dorsum of her foot. Which of the following nerves is the cast most likely compressing?
```
A. Common peroneal (fibular) nerve
B. Deep peroneal (fibular) nerve
C. Saphenous nerve
D. Sural nerve
E. Tibial nerve
```
A. common peroneal
| dorsum of foot is innervated by common fibular
48
The patient returns several days after removal of her cast after tripping by catching her foot multiple times on uneven sidewalk. There is no apparent weakness in foot eversion. You suspect nerve damage, but which of the following will best confirm your theory?
A. abnormal sensation of the lateral skin of the big toe
B. abnormal sensation of the dorsal skin of the foot
C. abnormal sensation of the plantar skin of the foot
D. abnormal sensation of the medial skin of the leg
E. abnormal sensation on the lateral skin of the leg
A. abnormal of lateral big toe
| deep - dorsiflexion (foot drop); superficial - plantar flexion
49
A 76-year-old woman comes into her physician 2 weeks following elective right inguinal hernia repair. She states that she feels well but has noticed numbness over the skin in her groin. Physical examination is remarkable for decreased sensation of the right labium majus. Which of the following nerves was most likely injured during this patient's surgery?
```
A. Anterior femoral cutaneous nerve
B. Genitofemoral nerve
C. Iliohypogastric nerve
D. Ilioinguinal nerve
E. Lateral femoral cutaneous nerve
```
B. ilioinguinal
| more superficial, more likely to be damaged due to surgery
50
After examination, a follow up surgery is scheduled to correct the issue. What is the most likely cause of the numbness and loss of sensation of the right labium majus?
```
A. entrapment of the effected nerve
B. pressure on the lumbar plexus
C. pressure on the sacral plexus
D. severed nerve at the site of surgery
E. recurrent inguinal herniation
```
D. severed nerve at the site of surgery
51
a 29-yr old male presents with persistent right knee pain after slipping down the stairs several weeks ago. The patient reports that his knee "seizes" or "gives out" when he descends the stairs.
What tests should be ordered?
What maneuver can be done to determine if the ACL is injured?
MRI test;
| Anterior Drawer Test or Lachman Test
52
what action is prevented by the ACL?
posterior movement of the femur on the tibia
53
Which of the following muscles is the strongest thigh flexor?
B. iliopsoas
54
Which of the following is the normal anatomical relationship between the femoral nerve and the femoral artery in the femoral triangle?
A. femoral nerve lies lateral to femoral artery
55
Which of the following is the largest branch of the femoral artery?
C. profunda femoris artery
56
Which of the following is the site for optimally palpating the femoral pulse?
D. Mid-inguinal point, halfway between the pubic symphysis and anterior superior iliac spine
57
Which of the following is the main function of the muscles of the medial compartment of the thigh?
B. adduction of the hip
58
riders are most susceptible to the injury of which of the following muscles?
E. adductor longus
59
Which of the following muscle groups constitute the posterior compartment of thigh muscles?
B. Semimembranosus, Semitendinosus, Biceps femoris
60
The superficial inguinal lymph nodes drain into which of the following lymph nodes?
C. external iliac
61
Which of the following structures forms the anterior border of the femoral canal?
D. inguinal ligament
62
A 34-year-old-female presented to the emergency department with sudden onset of moderate groin pain radiating towards the thigh. The pain is aggravated by standing and relieved by resting in the supine position. The patient noticed a painless bulge in the upper part of the right thigh near the groin four years ago. The patient mentioned that the bulge slowly grew in size, but she didn't seek medical attention due to the absence of pain during this period. Physical examination reveals a mass in the groin below the inguinal ligament. There is no associated vomiting, constipation, or fever. The patient has no significant family or surgical history.
Which of the following is the most common pathway of the patient's mass?
A. Femoral artery laterally and femoral vein medially
B. Through the femoral ring into the adductor canal
C. Through the femoral ring into the femoral canal
D. Superior to the inguinal ligament through the femoral canal
E. Below the femoral ring into the femoral canal
C. Through the femoral ring into the femoral canal
63
Which of the following represents the anatomical boundaries of this mass?
A. Femoral artery laterally and femoral vein medially
B. Lacunar ligament laterally and femoral vein medially
C. Femoral vein laterally and inguinal ligament medially
D. Femoral artery medially and lacunar ligament laterally
E. Femoral vein laterally and lacunar ligament medially
E. Femoral vein laterally, lacunar ligament medially
64
A 71-year-old female is rushed to the emergency department after a motor vehicle accident. She was sitting in the passenger seat and her knee hit the dashboard. The patient complained to the paramedics of severe groin pain. An anteroposterior pelvic X-ray revealed the finding indicated by the blue arrow in the image below.
Which of the following consequences are more likely associated with this injury? Check all that apply
A. Shortened leg with external rotation
B. Shortened leg with medial rotation
C. Avascular necrosis of the femoral head
D. Posterior hip dislocation
E. Internal rotation of the leg
A and C
(shortened limb, avascular necrosis of the head)
((can't determine based on shortened limb))
((head fracture -- rotated medially; neck fracture -- rotated laterally))
((lady is 71 years old -- due to hormonal changes))
65
Which of the following vessels is most likely injured if the patient starts developing avascular necrosis of the femoral head?
A. Lateral circumflex femoral artery
B. Medial circumflex femoral artery
C. Medial circumflex femoral vein
D. Lateral circumflex femoral vein
E. Obturator artery
B. medial circumflex femoral artery
66
An amateur soccer player felt a sharp pain during a soccer game while kicking the ball and he fell to the ground in pain as shown in this picture.
He was rushed to the hospital for evaluation. A muscular injury is suspected in the posterior thigh compartment. An ultrasound is most likely to show a tendon tear at which of the following anatomical attachments in this case?
```
A. Greater trochanter
B. Lesser trochanter
C. Adductor tubercle
D. Gluteal tuberosity
E. Ischial tuberosity
```
E. ischial tuberosity
67
Which of the following actions is expected to be most impacted as a result of this injury?
A. Extension of the knee and flexion of the hip
B. Extension of the hip and flexion of the knee
C. Adduction of the hip and flexion of the knee
D. Abduction of the hip and flexion of the knee
E. Adduction and abduction of the hip
B. hip extension, knee flexion
68
A 36-year-old female presented in the emergency department after suffering an injury to the anterior part of her thigh. The saphenous nerve in the adductor canal is suspected to be injured. Which of the following areas is expected to suffer sensation loss if this nerve injury is confirmed?
```
A. Anterior thigh
B. Medial side of leg
C. Lateral side of leg
D. Back of the leg
E. Posterior thigh
```
B. medial side of leg
69
An anatomist was examining the femoral triangle during cadaveric dissection in the anatomy lab. Which of the following represents the normal order of contents in this triangle from medial to lateral?
A. Femoral vein, femoral nerve, femoral artery
B. Femoral artery, femoral nerve, femoral vein
C. Femoral nerve, femoral artery, femoral vein
D. Femoral vein, femoral artery, femoral nerve
E. Femoral nerve, femoral vein, femoral artery
C. V, A, N
70
During cadaveric dissection, the anatomist starts dissecting the femoral nerve. Which of the following represents the normal anatomical location of this nerve?
A.Posterior to the inguinal ligament, inside the femoral canal, and medial to the femoral artery
B. Anterior to the inguinal ligament, outside the femoral canal, and medial to the femoral artery
C. Posterior to the inguinal ligament, inside the femoral canal, and lateral to the femoral artery.
D. Posterior to the inguinal ligament, outside the femoral canal, and lateral to the femoral artery.
E. Anterior to the inguinal ligament, outside the femoral canal, and lateral to the femoral artery,
D. posterior to inguinal ligament, outside femoral canal, lateral to femoral artery
(slide 52)
71
Cardiac catheterization allows healthcare providers to do many different tests and measurements to diagnose and treat problems with the heart and coronary arteries (the arteries that supply blood to the heart muscle). During cardiac catheterization, a thin tube called a catheter is inserted through an artery (usually the femoral artery, in the groin) and gently advanced to the heart. The proximity of the femoral nerve to the femoral artery renders it vulnerable to injury during this procedure.
Which of the following consequences can result from an injury to the cutaneous branches of this nerve?
A. Loss of sensation of the skin of the anterior surface of the thigh
B. Loss of sensation of the skin of the lateral surface of the thigh
C. Loss of sensation of the skin of the lateral aspect of the leg and lateral border of the foot
D. Difficulty in thigh flexion
E. Difficulty in thigh extension
F. Loss of sensation of the skin of the medial aspect of the leg and medial border of the foot
A. loss of anterior sensation;
F. loss of sensation medial leg and medial foot
((not D because cutaneous))
72
A 41-year-old construction worker was accidentally hit by a heavy wood lodge. The force of the impact was concentrated on his left thigh. He was rushed to the emergency department. He reported moderate pain immediately after the accident, but he started screaming of severe left thigh pain a few hours later. Physical examination revealed a significant increase in the circumference of his left thigh. X-ray results of left thigh came back normal. A decision to perform an immediate fasciotomy operation is made by the surgical team to relieve a compression located at the anterior thigh compartment?
Which of the following immediate consequences is most likely in this case?
A. Decreased circumference of the opposite thigh
B. Diminished pulses distal to the compression
C. Decreased temperature proximal to the compression
D. Increased temperature distal to the compression
E. Increased sensation of the skin distal to the compression
B. Diminished pulses
73
A 21-year-old male dancer comes to the physician's office because of pain in the posterior left thigh of three weeks duration. He reported that the symptoms first appeared during a dance rehearsal when he rapidly raised his left leg into a high, overhead position. He experienced a popping sensation in the posterior thigh at that moment and the pain ensued immediately thereafter. There is mild swelling on the posterior thigh with no bruising on physical examination. Which of the following actions IS expected to be most limited on physical examination?
A. Abduction of the hip joint
B. Flexion of the hip joint
C. Extension of the hip joint
D. Lateral rotation of the hip joint
E. Adduction of the hip joint
C. Extension of hip joint
74
A 39-year-male comes to the physician complaining of continuous pain in his groin and inability to stand on his right leg. Patient history included a hip surgery performed six months ago due to a motor vehicle accident involving the patient. MRI reveals bony changes indicating bony death of the femoral head. Which of the following arteries is most likely injured?
```
A.
Lateral circumflex artery
B.
Medial circumflex artery
C.
Femoral artery
D.
Obturator artery
E.
Tibial artery
```
B. Medial circumflex artery
75
A patient who has been having some difficulty walking is observed during the physical examination. It is noted that when he is standing on the right lower limb, the left side of his pelvis dips toward the floor. Which of the following nerves most likely innervates the muscles that are weakened in this patient?
```
A.
Common fibular nerve
B.
Femoral nerve
C.
Inferior gluteal nerve
D.
Sciatic nerve
E.
Superior gluteal nerve
```
E. superior gluteal nerve
76
```
A 56-year-old man comes to the physician because of numbness and tingling in his legs, as well as occasional sharp, shooting pain that runs down the back of his legs. An MRI scan of his lumbar spine shows a posterolateral disk herniation between the L5 and S1 vertebrae. Which of the following nerves most likely contains fibers that arise from the site of disk herniation?
A.
Femoral nerve
B.
Genitofemoral nerve
C.
Obturator nerve
D.
Pudendal nerve
E.
Tibial nerve
```
E. tibial nerve
77
A 20-year-old male presents with pain in his buttock and down through the lower limb. He reports loss of sensation of the dorsal and plantar skin of the foot, as well as both anterio- and posteriolateral skin of the lower leg. The injury occurred during an “injection” at a doctor visit to address pre-existing lower-back pain from a lifting injury. He was told to “walk it off” but has had significant muscle weakness and difficulty walking. Which of the following is showing abnormal function?
```
A.
Anterior femoral cutaneous nerve
B.
Lateral femoral cutaneous nerve
C.
Posterior femoral cutaneous nerve
D.
Saphenous nerve
E.
Sural nerve
```
E. sural nerve
((posterior cutaneous -- back of thigh))
(("muscle weakness" -- can't be cutaneous nerve))
78
A 43-year-old male presents after recovering from a knife wound. The knife penetrated in the right inguinal region, and he is complaining of weakness in walking up and down stairs. Which additional area is most likely affected as well?
```
A.
Dorsum of the foot
B.
Medial skin of the leg
C.
Lateral skin of the leg
D.
Posterior skin of the thigh
E.
Skin of the buttock
```
B. medial skin of leg
79
```
A 86-year-old male presents with a broken fibula after a fall. The skin on the dorsum of his foot has lost sensation, and he is not stable when he plantarflexes, and drop foot is apparent. Which plantar flexor muscle is most likely weakened in this injury?
A.
Fibularis longus
B.
Gastrocnemius
C.
Soleus
D.
Tibialis anterior
E.
Tibialis posterior
```
D. fibularis longus
| (lateral compartment)
80
This information does not really help him. So, you try explaining to him in a different way. Which one of the following statements is correct?
A.
If you damage the femoral nerve, you cannot bend your leg
B.
If you damage the sciatic nerve, you cannot straighten your leg
C.
If you damage the obturator nerve, you cannot bend your leg
D.
If you damage the femoral nerve, you cannot straighten your leg
D. if damage femoral nerve, can't straighten leg
81
In trying to diagnose his nerve injuries, he has purchased a self-help book call “Anatomy for Dummies”. However, he finds it to be very confusing. What is the correct information that you could give him?
A.
If you damage the obturator nerve, you will have weakness of muscles in the front of the thigh
B.
If you damage the femoral nerve, you will have weakness of muscles in the front of the thigh
C.
If you damage the femoral nerve, you will have weakness of muscles in the inner side of the thigh
D.
If you damage the obturator nerve, you will have weakness of muscles in the back of the thigh
B. if you damage femoral nerve, will have weakness of muscles in front of thigh
82
Considering that he has numerous injuries in the region of the back and gluteal region loss of blood supply to the head of the femur is of particular concern. What is the major blood supply to the head of the femur?
A.
Branches of the obturator arteries
B.
Branches of the external iliac arteries
C.
Branches of the superior gluteal arteries
D.
Branches of the circumflex femoral arteries
D. branches of the circumflex arteries
83
```
What is the most pressing concern with an injury in this region?
A.
Pressure on the inferior gluteal nerve
B.
Tearing of the superior gluteal vessels
C.
Pressure on the sciatic nerve
D.
Tearing of inferior gluteal vessels
```
C. pressure on the sciatic nerve
84
```
Along with his inability to turn his feet inwards he also had tingling and numbness in the back of the thigh. Which region of the hip bone was probably injured?
A.
Deep to the pubic symphysis
B.
Region around greater sciatic foramen
C.
Anterior to the hip joint
D.
Region around lesser sciatic foramen
```
B. region around the greater sciatic foramen
85
```
He also gives history of falling his back following which he developed pain and swelling in the gluteal region. He had trouble wearing shoes since he could not turn his feet inwards. Which nerve could have been possible injured?
A.
Sciatic nerve
B.
Superior gluteal nerve
C.
Obturator nerve
D.
Inferior gluteal nerve
```
B. superior gluteal nerve
86
Your client is a 88-year-old retired trapeze artist. During his career in the circus, he has suffered numerous injuries. He feels that his injuries are “getting to him”. However, he refuses to seek medical advice. The following questions are based on this clinical scenario.
```
He gives history of having leaned back excessively and developing a pain in the anterior aspect of the hip joint. In all probability that was a ligamentous injury. Which ligament could have been injured?
A.
Iliofemoral ligament
B.
Pubofemoral ligament
C.
Ischiofemoral ligament
D.
Sacrospinous ligament
```
A. iliofemoral
87
Imaging studies of an elderly woman reveal an occluded vessel. The vessel can be seen posteriorly, passing through the space between the proximal aspects of the tibia and fibula. Which of the following arteries is identified?
```
A.
Deep femoral
B.
Popliteal
C.
Posterior tibial
D.
Fibular
E.
Femoral
```
B. popliteal
88
```
Which of the following muscles forms the superior lateral border of the space described?
A.
Biceps femoris
B.
Gracilis
C.
Gastrocnemius
D.
Semimembranosus
```
A. biceps femoris
89
```
A college football player sustains an injury to his knee when he twists the flexed knee while in contact with another player. On physical examination, the physician is able to pull the lower leg and flexed knee toward him (the physician) and away from the patient. Which of the following ligaments is being tested by this maneuver?
A.
Tibial collateral ligament
B.
Fibular collateral ligament
C.
Anterior cruciate ligament
D.
Posterior cruciate ligament
E.
Patellar ligament
```
C. anterior cruciate ligament
90
A group of teenage boys were playing a friendly game of rugby when one of them injures his knee when hit from the lateral side. During physical examination, pressure is applied to his lateral thigh and medial leg (as shown in the image). This clinical test is a check for the integrity of which of the following ligaments?
```
A.
Tibial collateral ligament
B.
Fibular collateral ligament
C.
Anterior cruciate ligament
D.
Posterior cruciate ligament
E.
Patellar ligament
```
a. tibial collateral ligament
91
Which of the following maneuvers is being conducted on this patient?
```
A.
Anterior drawer’s test
B.
Posterior drawer’s test
C.
Varus stress test
D.
Valgus stress test
```
d. valgus stress test
92
A tall 20-year-old man is stuffed into the front seat of a small car when the speeding car collides with a guardrail. The passenger’s left shin slams against the dashboard with an impact just below the knee. He reports to the emergency room with excruciating knee pain, tenderness, and a pronounced limp during walking. When the physician tries to push the tibia posteriorly a pronounced laxity is noted in the left knee when compared to the right. What structure is most likely damaged?
A.
Anterior cruciate ligament (ACL)
B.
Posterior cruciate ligament (PCL)
C.
Tibial (medial) collateral ligament (TCL)
D.
Fibular (lateral) collateral ligament (FCL)
E.
Patellar ligament
C. PCL
93
A 30-year-old basketball player felt a sudden pressure his left knee while pivoting in a squatted position. He continued playing several more games, but 3 days later he went to an orthopedic surgeon reporting persistent pain, inflammation, and stiffness in his knee. He reported feeling like his knee was “going to give out” when he descended stairs. During a knee examination, the physician noted tenderness at the joint and a locking sound while placing a valgus stress on the lateral side of the flexed left knee. An MRI would confirm damage to which of the following knee structures?
```
A.
Anterior cruciate ligament (ACL)
B.
Patella
C.
Tibial (medial) collateral ligament (TCL)
D.
Fibular (lateral) collateral ligament (FCL)
E.
Medial meniscus
```
e. medial meniscus
