ANATOMY (LOWER LIMB) MCQS 1ST YEAR

PORTION # 1
Loss of patellar reflex and loss of cutaneous sensation
on the anteromedial side of the leg indicate damage to
this spinal nerve:
A.L2
B.L4
C.L5
D.S2
E.S4
2. Which statement concerning the great saphenous vein
is false?
A. When it is removed and inserted as a coronary
bypass, it is reversed, so that the cusps do not obstruct
blood flow.
B. It is located about ten cm. (a handbreadth) posterior
to the medial border of the patella.
C. It passes anterior to the medial malleolus.
D. It perforates the femoral sheath
E. It is accompanied by the sural nerve in the leg.
3. The deep fascia of the thigh:
A. is thickened on its medial side to form the iliotibial
tract
B. has an oval opening which transmits the small
saphenous vein
D. is designated the cribriform fascia
E. lies superficial to the superficial inguinal lymph nodes
4. Structures passing through the adductor hiatus
include:
A. saphenous nerve
B. profunda femoral artery
C. both
D. neither
5. Skin on the most dorsal part of the foot is supplied by
the:
A. sural nerve
B. first sacral nerve
C. both
D. neither
6. The muscle which can both flex the hip and extend the
knee is:
A. sartorius
B. rectus femoris
C. semimembranosus
D. biceps femoris
E. vastus lateralis
7. The actions of the gracilis muscle include _______ of the
thigh at the hip and _______ of the leg at the knee.
A. lateral rotation, lateral rotation
B. medial rotation, extension
C. abduction, flexion
D. flexion, extension
E. adduction, flexion
8. Which muscle is able to produce flexion at the knee
joint more efficiently if the hip joint is in flexion at the
same time?
A. semimembranosus
B. rectus femoris
C. hamstring part of adductor magnus
D. sartorius
E. short head of biceps femoris

9. Difficulty extending the knee can result from damage

to the ________.
A. femoral nerve
B. inferior gluteal nerve
C. common peroneal nerve
D. superior gluteal nerve
E. tibial nerve
10. Muscles in the posterior thigh compartment are
paralyzed because the sciatic nerve has been severed.
Nevertheless the patient can still produce some flexion
of the leg at the knee due to action of the:
A. sartorius muscle
B. semitendinosus muscle
C. both A and B
D. short head of biceps femoris
E. gastrocnemius
11. The muscle that is not a medial rotator of the leg is
the:
A. semimembranosus
B. semitendinosus
C. biceps femoris
D. gracilis
E. popliteus
12. After an obturator nerve injury, some adduction of
the thigh is still possible because of double innervation
to the:
A. gracilis muscle
B. adductor magnus muscle
C. sartorius muscle
D. adductor longus muscle
E. adductor brevis muscle
13. After passing through the obturator canal, divisions
of the obturator nerve (an anterior branch and a
posterior branch) pass on either side of the:
A. pectineus muscle
B adductor brevis muscle
C. gracilis muscle
D. adductor magnus muscle
E. adductor longus muscle
15. The fibular artery:
A. supplies the muscles of the anterior compartment of
the leg
B. passes anterior to the interosseous membrane
C. usually becomes the dorsalis pedis
D. courses through the deep posterior compartment of
the leg
E. none of the above
16. A tight plaster cast that exerted pressure on the
head and neck of the fibula might result in loss of:
A. eversion of the foot
B. foot drop
C. both
D. neither
17. When the muscles of the anterior compartment of
the leg swell from some kind of overuse:
A. the deep fibular nerve may be injured
B. there is loss of sensation in the web space between
the great and second toes
C. both
D. neither
18. The medial and lateral plantar neurovascular
structures enter the foot deep to the:
A. inferior peroneal retinaculum
B. abductor digiti minimi muscle
C. abductor hallucis muscle
D. quadratus plantae muscle
E. sustentaculum tali
19. The medial plantar nerve innervates:
A. abductor hallucis muscle
B. abductor digiti minimi muscle
C. adductor hallucis muscle
D. 2-4 lumbrical muscles
20. The deep plantar arch:
A. is formed primarily from the lateral plantar artery
B. passes between the first and second muscular layers
of the foot
C. both
D. neither
21. The arcuate artery
A. is a branch of the medial plantar artery
B. courses deep to extensor digitorum brevis
C. both
D. neither

22. The lateral plantar nerve:

A. courses between quadratus plantae and flexor
digitorum brevis muscles
B. supplies quadratus plantae muscle
C. both
D. neither
23. The two bellies of flexor hallucis brevis muscle:
A. have insertions that contain sesmoid bones
B. attach to the base of the distal phalanx of the great
toe
C. pass on either side of the tendon of extensor hallucis
longus
D. are innervated by the lateral plantar nerve
E. all of the above
24. The tendon of peroneus longus:
A. attaches to the navicular bone
B. courses between quadratus plantae and flexor
digitorum brevis muscles
C. both
D. neither
25. Which statement is false concerning the hip joint?
A. it is a ball and socket joint
B. the entire acetabulum articulates with the femoral
head
C. the acetabulum is deepened by the acetabular labrum
D. the ligamentum teres is attached to the fovea on the
femoral head
E. the iliofemoral ligament attaches to the
intertrochanteric line
26. Which statement concerning the hip joint is false?
A. The transverse acetabular ligament bridges the
acetabular notch
B. The proximal attachment of the iliofemoral ligament is
to the ASIS
C. The acetabulum is formed by the ilium, ischium, and
pubis
D. The iliofemoral ligament prevents hyperextension of
the hip joint
E. Fractures of the femoral neck, rather than the femoral
shaft, usually sever arteries supplying the femoral head
27.The fibular collateral ligament is:
A. tested by the application of valgus stress, rather than
varus stress, to the leg.
B. located superficial to the tendon of popliteus
C. attached to the lateral meniscus
D. located superficial to the biceps femoris tendon
E. located deep to the iliotibial tract
28. The _______ ligament of the knee joint attaches to the
_______.
A. lateral collateral , shaft of fibula deep to pes
anserinus
B. patellar, anterior intercondylar area of the tibia
C. posterior cruciate, posterior surface of tibia just
above soleal line
D. tibial collateral, periphery of medial meniscus
E. anterior cruciate, anterior intercondylar area just
anterior to the anterior horn of the medial meniscus
29. True statements concerning the anterior cruciate
ligament include:
A. its attachment to the tibial plateau (top of tibia) is
anterior to the attachment of the anterior horn of the
medial meniscus
B. it prevents posterior displacement of the femur on the
tibia
C. both
D. neither
30. Important stabilizing structures on the lateral side of
the knee joint are:
A. tibial collateral ligament; biceps tendon; and iliotibial
tract
B. fibular collateral ligament; biceps tendon;and iliotibial
tract
C. fibular collateral ligament; cruciate ligament; and pes
anserinus
D. tibial collateral ligament; popliteus tendon;and
patellar ligament
E. fibular collateral ligament; coronary ligament;and
transverse ligament
31. The major cutaneous innervation of the anteromedial
side of the leg is provided by which nerve?
A. obturator
B. sural
C. superficial peroneal
D. saphenous
E. medial sural
32. Which muscle attaches to the lesser trochanter of
the femur?
A. iliopsoas
B. pectineus
C. quadratus femoris
D. gluteus medius
E. obturator externus
33. The principle action of the gracilis muscle is _______ of
the thigh at the hip.
A. lateral rotation
B. medial rotation
C. abduction
D. flexion
E. adduction
34. In the subsartorial canal this muscle separated the
femoral artery from the deep (profunda) femoral artery:
A. pectineus
B. adductor magnus
C. adductor brevis
D. adductor longus
E. psoas major
35. The neck of a femoral hernia lies lateral to the:
A. pubic tubercle
B. femoral vein
C. femoral artery
D. femoral nerve
E. femoral sheath
36. A 50-year-old man complained of a lump in his groin.
His physician suspected an enlarged superficial inguinal
lymph node. What areas should be examined to find the
source of the problem?
A. skin of the buttocks
B. skin of the scrotum
C. both
D. neither
37. The great saphenous vein:
A. passes anterior to the medial malleolus
B. passes a handbreadth posterior to the medial border
of the patella
C. both
D. neither

38. This structure forms the boundary between the

greater and lesser sciatic foramina:
A. ischial tuberosity
B. posterior superior iliac spine
C. sacrotuberous ligament
D. sacrospinous ligament
E. piriformis muscle
39. This is the only gluteal muscle to originate from the
posterior surface of the sacrum:
A. quadratus femoris
B. gluteus maximus
C. gluteus medius
D. piriformis
E. biceps femoris
40. Nerve injury of sacral spinal nerve 1 will result in
pain located along the:
A. anterior surface of the thigh
B. anteromedial surface of the leg
C. medial side of the foot
D. lateral side of the foot
E. none of the above
41. If the sciatic nerve were damaged by an
intramuscular injection in the buttocks, the patient
would have diminished cutaneous sensation on the:
A. dorsum of the foot
B. anteromedial side of the leg
C. both
D. neither
42. All the following pass through the greater sciatic
foramen EXCEPT:
A. piriformis muscle
B. pudendal nerve
C. sciatic nerve
D. inferior gluteal vessels and nerve
E. obturator internus tendon
43. The superior gluteal nerve:
A. contains fibers from the second and third lumbar
nerves
B. leaves the pelvis just inferior to the piriformis muscle
C. must be intact to resist pelvic tilt during gait
D. innervates the piriformis muscle
E. innervates the gemellus superior muscle
44. All of the following muscles are lateral rotators of
the thigh at the hip EXCEPT the:
A. gluteus maximus
B. gluteus minimus
C. obturator internus
D. obturator externus
E. piriformis
45. All of the following muscles are medial rotators of
the leg EXCEPT:
A. semimembranosus
B. semitendinosus
C. biceps femoris
D. gracilis
E. popliteus
46. Which statement about the semimembranosus
muscle is FALSE?
A. it extends at the hip joint
B. it attaches to the medial condyle of the tibia
C. it flexes at the knee joint
D. it forms the arcuate ligament
E. it is innervated by the tibial portion of the sciatic
nerve
47. Gracilis, sartorius, semimembranosus
A. form the pes anserinus
B. extend the knee
C. act across both hip and knee joints
D. all have the same innervation
E. help laterally rotate the femur
48. What nerve has been damaged in a patient who can
no longer extend his knee?
A. sciatic
B. common peroneal
C. femoral
D. obturator
E. tibial
49. What nerve has been damaged in a patient whose
pelvis tilts too far toward the right when walking?
A. right superior gluteal nerve
B. left superior gluteal nerve
C. right inferior gluteal nerve
D. left inferior gluteal nerve
E. right femoral nerve
50. Excessive anterior movement of the tibia when
pulling forward on the leg with the knee flexed would
indicate damage to this ligament of the knee:
A. medial collateral
B. lateral collateral
C. anterior cruciate
D. posterior cruciate
E. oblique popliteal
51. The saphenous nerve
A. is a motor branch of the femoral nerve
B. accompanies the short saphenous vein in the leg
C. is the only branch of the femoral nerve that extends
considerably below the knee
D. emerges through the saphenous hiatus
E. is a sensory branch of the obturator nerve
52. What nerve is damaged in a patient whose foot is
everted and dorsiflexed and who cannot flex his/her
toes?
A. tibial
B. superficial peroneal
C. deep peroneal
D. common peroneal
E. medial peroneal
53. The femoral sheath
A. is found in the femoral triangle
B. has a medially located compartment called the
femoral canal
C. contains the femoral artery, vein and nerve
D. all of the above are correct
E. only a and b above are correct
54. Fascia lata
A. is the investing fascia of the thigh
B. is fused with the inguinal ligament from the anterior
superior iliac spine to the pubic Tubercle
C. is thickened laterally forming the iliotibial tract
D. all of the above are correct
E. only b and c are correct
55. The lateral compartment of the leg
A. usually contains no major artery
B. contains only two muscles
C. both a and b are correct
D. contains the peroneus tertius muscle
E. includes muscles innervated by the deep fibular nerve
56. The biceps femoris muscle
A. lies lateral to the popliteal fossa
B. lies medial to the popliteal fossa
C. forms the floor of the popliteal fossa
D. gives rise to the oblique popliteal fossa
E. does not attach to the leg bone
57. Where would you feel for the pulse of the dorsalis
pedis artery?
A. directly posterior to the tendon of flexor digitorum
longus
B. directly lateral to the tendon of tibialis anterior
C. directly lateral to the tendon of extensor hallucis
longus
D. directly posterior to the tendon of peroneus longus
E. directly lateral to the tendon of extensor digitorum
longus
58. Which nerve has been damaged in a patient whose
pelvis tilts down to the left when he stands on his right
foot?
A. right inferior gluteal nerve
B. right superior gluteal nerve
C. left inferior gluteal nerve
D. left superior gluteal nerve
E. left obturator nerve
59. The gluteus maximus muscle:
A. has an origin from the ischium
B. inserts only onto the femur
C. is a flexor of the thigh at the hip
D. is innervated by the superior gluteal nerve
E. none of the above
60. The inferior gluteal nerve:
A. contains fibers from the second and third lumbar
nerves
B. leaves the pelvis just inferior to the piriformis muscle
C. must be intact to resist pelvic tilt during gait
D. innervates the tensor fasciae lata muscle
E. innervates the gemellus inferior muscle
61. The nerve supply to the muscles of the lateral fascial
compartment of the leg is directly by this nerve:
A. deep peroneal
B. superficial peroneal
C. anterior tibial
D. posterior tibial
E. common peroneal
62. The spinal cord segment that supplies the cutaneous
innervation to the lateral side of the foot is:
A. L3
B. L4
C. L5
D. S1
E. S2
63. The most important arterial supply to the head of the
femur is via:
A. the artery of the ligamentum teres
B. retinacular vessels
C. vessels traveling along the spermatic cord
D. internal pudendal artery
64. If the foot is inverted due to paralysis of some
muscles, one of the muscles that is paralyzed is the:
A. tibialis posterior
B. tibialis anterior
C. peroneus longus
D. extensor hallucis longus
E. extensor digitorum longus
65. The blood supply to the anterior compartment
muscles of the leg is normally:
A. the anterior tibial artery, a branch of the popliteal
artery
B. the peroneal artery, a branch of the posterior tibial
artery
C. the deep femoral artery
D. A and B above
E. A and C above
66. The deep peroneal nerve supplies motor fibers to:
A. peroneus longus
B. peroneus brevis
C. peroneus tertius (a portion of extensor digitorum
longus)
D. flexor hallicis longus
E. all of the above
67. The anterior tibial artery:
A. is normally a branch of the popliteal artery
B. runs with the deep peroneal nerve on the anterior
surface of the interosseus membrane of the leg
C. usually terminates as the dorsalis pedis artery
D. all of the above
E. only A and B above
68. The following structures are in the femoral sheath,
which is an extension of abdominal and pelvic fascias:
A. femoral artery
B. femoral vein
C. deep femoral lymphatics
D. fatty connective tissue
E. all of the above
69. The branch(es) of the femoral nerve that extend into
the leg proper (ie lower leg) is (are):
A. the motor nerve to the vastus lateralis
B. the common peroneal nerve
C. the obturator nerve
D. the saphenous nerve, carrying only sensory fibers
E. all of the above
70. The anterior part of the talus articulates with the:
A. cuboid
B. first, second and third cuneiform bones
C. fourth and fifth cuneiform bones
D. calcaneus
E. navicular
71. A barefoot child steps on a broken bottle and severs
an artery on the medial side of the plantar surface of the
big toe; the best place to apply pressure to stop
bleeding would be:
A. on the dorsum of the foot, between the tendons of
tibialis anterior and extensor hallucis longus
B. on the dorsum of the foot, between the tendons of
extensor digitorum longus and peroneus tertius
C. between medial malleolus and calcaneus
D. between lateral malleolus and calcaneus
E. on the plantar surface of the foot, between the first
and second metatarsal bones
72. Severing the common peroneal nerve results in
inability to:
A. evert the foot
B. extend (dorsiflex) the foot
C. both
D. neither
73. When the foot is suddenly and violently inverted, the
tuberosity of the fifth metatarsal may be avulsed (pulled
off) by the tendon of this muscle:
A. peroneus longus
B. peroneus brevis
C. peroneus tertius
D. tibialis anterior
E. tibialis posterior
74. The pulse of the posterior tibial artery is best felt:
A. against the popliteal surface of the tibia
B. lateral to the neck of the fibula
C. anterior to the lateral malleolus
D. posterior to the lateral malleolus
E. posterior to the medial malleolus
75. Muscles inserting on the medial aspect of the
proximal end of the tibia include:
A. gracilis
B. hamstring part of adductor magnus
C. both
D. neither
76. The patellar tendon reflex involves which spinal
nerves?
A. L1 and L2
B. L3 and L4
C. L4 and L5
D. L5 and S1
E. S2 and S3
ò statements concerning the quadriceps femoris is
FALSE?
A. The tone of quadriceps femoris is very important to
the stability of the knee joint.
B. The final insertion of most of its fibers is to the tibial
tuberosity via the patellar ligament.
C. The lowest fibers of vastus medialis prevent medial
displacement of the patella.
D. Much of the vastus lateralis and vastus medialis
originate from the linea aspera.
78. Each of the following matchings of thigh muscles
with points of origin is correct EXCEPT:
A. sartorius—anterior superior iliac spine
B. long head of biceps femoris—ischial tuberosity
C. straight head of rectus femoris—anterior inferior iliac
spine
D. pectineus—superior ramus of pubis
E. semitendinosus—linea aspera of femur
79. Each of the following statements concerning the
tibial nerve is true EXCEPT:
A. It is a branch of the sciatic nerve.
B. It is motor to all muscles in the superficial and deep
compartments of the leg.
C. It passes down the leg between gastrocnemius and
soleus
D. It passes posterior to the medial mallolus
E. Its terminal branches are the medial and lateral
plantar nerves.
80. The muscle that contracts to unlock the extended
knee joint is the:
A. popliteus
B. plantaris
C. medial head of the gastrocnemius
D. lateral head of gastrocnemius
E. soleus
81. Femoral hernias:
A. pass downward anterior to the inguinal ligament
B. pass medial to the pubic tubercle
C. emerge superior to the pubic tubercle
D. utilize the lateral compartment of the sheath
E. pass downward posterior and inferior to the inguinal
ligament
82. A sharp blow to the neck of the fibula is most apt to
result in damage to which structure?
A. sciatic nerve
B. common peroneal nerve
C. tibial nerve
D. popliteal nerve
E. none of the above
83. Paralysis of which nerve would result in “foot drop”?
A. femoral
B. tibial
C. superficial peroneal
D. deep peroneal
E. obturator
84. Your patient is unable to stand on his toes. The
damaged nerve is the:
A. femoral
B. tibial
C. superficial peroneal
D. deep peroneal
E. sural
85. This artery passes posterior to the medial malleolus:
A. posterior tibial
B. anterior tibial
C. peroneal
D. dorsalis pedis
E. arcuate artery
86. Tibialis anterior and tibialis posterior BOTH:
A. invert the foot
B. insert on the tuberosity of the navicular bone
C. both
D. neither
87. The flexor retinaculum of the foot attaches to which
two bony structures?
A. distal ends of tibia and fibula
B. calcaneus and medial malleolus
C. lateral malleolus and calcaneus
D. medial malleolus and talus
E. talus and navicular
88. In a very young child, the head of the femur usually
receives most of its blood supply from a branch of the:
A. obturator artery
B. external iliac artery
C. femoral artery
D. deep femoral artery
E. pudendal artery
89. The iliofemoral ligament:
A. attaches to the anterior superior iliac spine
B. resists flexion at the hip
C. both
D. neither
90. A torn anterior cruciate ligament would permit:
A. valgus displacement of the leg at the knee
B. varus displacement of the leg at the knee
C. anterior displacement of the leg at the knee
D. posterior displacement of the leg at the knee
E. all of the above
91. The “spring” ligament attaches to what two bones?
A. fibula and calcaneus
B. tibia and calcaneus
C. tibia and talus
D. talus and navicular
E. calcaneus and navicular
92. The ligament usually injured in a hyper-inversion of
the foot (sprained ankle) is the:
A. Anterior tibiotalar
B. Posterior tibiotalar
C. Medial collateral
D. Lateral collateral
93. The anterior tibial artery:
A. is the source of the peroneal artery
B. continues as dorsalis pedis artery
C. usually travels with the superficial peroneal nerve
D. all of the above
E. none of the above
94. The gastrocnemius muscle can produce:
A. plantar flexion of the foot
B. flexion of the leg at the knee
C. both
D. neither
95. The soleus muscle:
A. is innervated by the tibial nerve
B. is a plantar flexor of the foot
C. both
D. neither
96. Which muscle inserts onto the tuberosity of the fifth
metatarsal bone?
A. Abductor digiti minimi
B. Peroneus brevis
C. Peroneus longus
D. Tibialis anterior
E. Tibialis posterior
97. The muscles of the lateral compartment of the leg
are:
A. dorsiflexors of the foot
B. evertors of the foot
C. both
D. neither
98. Which muscle is essential to lift the heel off the
ground in walking?
A. peroneus longus
B. tibialis anterior
C. flexor hallucis longus
D. flexor hallucis brevis
E. gastrocnemius
99. The fibular collateral ligament is:
A. tested by the application of valgus stress, rather than
varus stress, to the knee joint
B. located superficial to the tendon of the popliteus
C. attached to the lateral meniscus
D. located superficial to the biceps femoris tendon
E. located deep to the iliotibial tract
100. Which statement concerning ligaments of the hip
joint is FALSE?
A. the iliofemoral ligament prevents hyperextension
B. the ligament of the head of the femur is attached to
the transverse acetabular ligament
C. the iliofemoral ligament is in the shape of an inverted
Y
D. the ishiofemoral ligament attaches to the
intertochanteric crest
E. the transverse acetabular ligament bridges the
acetabular notch
101. The deltoid ligament :
A. is attached to the talus, navicular and calcaneus
B. is torn less commonly than the lateral ligament of the
ankle
C. both
D. neither
102. The medial meniscus:
A. is torn less commonly than the lateral meniscus
B. is much broader behind than in front
C. is nearly circular (O- shaped)
D. is separated from the joint capsule by the popliteus
tendon
E. is attached to some of the inserting fibers of pes
anserinus
103. The suprapatellar bursa:
A. communicates directly with the knee joint cavity
A. is located superficial to the quadriceps femoris muscle
B. both
C. neither
104. Which one of the following structures attaches to
the most anterior part of the tibial plateau?
A. anterior cruciate ligament
B. posterior cruciate ligamet
C. anterior horn of the medial meniscus
D. anterior horn of the lateral semilunar cartilage
E. ligament of Wrisberg
105. Which nerve is endangered during a canulation of
the great saphenous vein?
A. lateral sural
B. medial sural
C. saphenous
D. superficial peroneal
E. medial femoral cutaneous
106. The sural nerve is located most closely to the:
A. inferior border of the gluteus maximus
B. lateral malleolus
C. great saphenous vein
D. neck of the fibula
E. medial side of the patella
107. The best diagnostic test for the anterior
compartment syndrome of the leg is to check for loss of
cutaneous sensation on the:
A. medial part of the plantar surface of the foot
B. lateral part of the plantar surface of the foot
C. dorsum of the foot, between the first and second toes
D. dorsolateral side of the foot and little (5th) toe
E. anterolateral side of the leg

Portion # 2
Clinically oriented Questions
1.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?
(A) Common peroneal
(B) Tibial
(C) Superficial peroneal
(D) Deep peroneal
(E) Sural
2. 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?
(A) Obturator nerve
(B) Nerve to obturator internus
(C) Superior gluteal nerve
(D) Inferior gluteal nerve
(E) Femoral nerve
3. 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?
(A) Anterior cruciate
(B) Fibular collateral
(C) Patellar
(D) Posterior cruciate
(E) Tibial collateral
4. 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?
(A) Paralysis of the psoas major muscle
(B) Loss of skin sensation on the lateral side of the foot
(C) Loss of skin sensation over the greater trochanter
(D) Paralysis of the vastus lateralis muscle
(E) Paralysis of the tensor fasciae latae
5. 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?
(A) Superficial and deep peroneal
(B) Deep peroneal and tibial
(C) Superfi cial peroneal and tibial
(D) Medial and lateral plantar
(E) Obturator and tibial
6. 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?
(A) Rectus femoris
(B) Semimembranosus
(C) Popliteus
(D) Gastrocnemius
(E) Biceps femoris
7. 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?
(A) Superficial peroneal
(B) Lateral plantar
(C) Deep peroneal
(D) Sural
(E) Tibial
8. 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?
(A) Peroneus longus
(B) Extensor hallucis longus
(C) Extensor digitorum longus
(D) Peroneus tertius
(E) Extensor digitorum brevis
9. 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?
(A) Over the sacrospinous ligament
(B) Midway between the ischial tuberosity and the lesser
trochanter
(C) Midpoint of the gemelli muscles
(D) Upper lateral quadrant of the gluteal region
(E) Lower medial quadrant of the gluteal region
10. 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?
(A) Semimembranosus
(B) Sartorius
(C) Rectus femoris
(D) Vastus intermedius
(E) Tensor fasciae lata
11. 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?
(A)Flexorhallucis longus
(B)Peroneus brevis
(C)Peroneus longus
(D)Tibialisanterior
(E) Tibialis posterior
12. 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?
(A) Flexor digitorum brevis
(B) Flexor digitorum longus
(C) Flexor hallucis brevis
(D) Flexor hallucis longus
(E) Tibialis posterior
13. 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:
(A) Posterior to the medial malleolus
(B) Into the popliteal vein
(C) Anterior to the medial condyles of the tibia and
femur
(D) Superficial to the fascia lata of the thigh
(E) Along with the femoral artery
14. 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?
(A) Semitendinosus
(B) Sartorius
(C) Gracilis
(D) Quadriceps femoris
(E) Biceps femoris
15. A patient experiences weakness in dorsiflexing and
inverting the foot. Which of the following muscles is
damaged?
(A) Peroneus longus
(B) Peroneus brevis
(C) Tibialis anterior
(D) Extensor digitorum longus
(E) Peroneus tertius
Questions 16–20:
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.
16. Rupture of the ligamentum teres capitis femoris may
lead to damage to a branch of which of the following
arteries?
(A) Medial circumflex femoral
(B) Lateral circumflex femoral
(C) Obturator
(D) Superior gluteal
(E) Inferior gluteal
17. 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?
(A) Obturator
(B) Superior gluteal
(C) Inferior gluteal
(D) Medial femoral circumflex
(E) Lateral femoral circumflex
18. If the acetabulum is fractured at its postero-superior
margin by dislocation of the hip joint, which of the
following bones could be involved?
(A) Pubis
(B) Ischium
(C) Ilium
(D) Sacrum
(E) Head of the femur
19. The woman experiences weakness when abducting
and medially rotating the thigh after this accident.
Which of the following muscles is most likely damaged?
(A) Piriformis
(B) Obturator internus
(C) Quadratus femoris
(D) Gluteus maximus
(E) Gluteus minimus
20. 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?
(A) Medial femoral circumflex
(B) Lateral femoral circumflex
(C) Superior gluteal
(D) Inferior gluteal
(E) First perforating
21. 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?
(A) Ischemia in the peroneus longus muscle
(B) Aneurysm in the plantar arterial arch
(C) Reduction of blood flow in the medial tarsal artery
(D) Low blood pressure in the anterior tibial artery
(E) High blood pressure in the arcuate artery
22. 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?
(A) Vastus lateralis
(B) Semimembranosus
(C) Sartorius
(D) Biceps femoris (long head)
(E) Rectus femoris
23. 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?
(A) Deep peroneal nerve
(B) Extensor digitorum longus muscle tendon
(C) Dorsalis pedis artery
(D) Great saphenous vein
(E) Superficial peroneal nerve
24. A knife wound penetrates the superficial vein that
terminates in the popliteal vein. Bleeding occurs from
which of the following vessels?
(A) Posterior tibial vein
(B) Anterior tibial vein
(C) Peroneal vein
(D) Great saphenous vein
(E) Lesser saphenous vein
25. 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?
(A) Transverse arch
(B) Medial longitudinal arch
(C) Lateral longitudinal arch
(D) Tendon of the peroneus longus
(E) Long plantar ligament
26. A 24-year-old woman complains of weakness when
she extends her thigh and rotates it laterally. Which of
the following muscles is paralyzed?
(A) Obturator externus
(B) Sartorius
(C) Tensor fasciae latae
(D) Gluteus maximus
(E) Semitendinosus
27. A patient with hereditary blood clotting problems
presents with pain in the back of her knee. An
arteriogram reveals a blood clot in the popliteal artery at
its proximal end. Which of the following arteries will
allow blood to reach the foot?
(A) Anterior tibial
(B) Posterior tibial
(C) Peroneal
(D) Lateral circumflex femoral
(E) Superior medial genicular
28. A 72-year-old woman complains of a cramp-like 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?
(A) Femoral artery
(B) Femoral vein
(C) Saphenous nerve
(D) Great saphenous vein
(E) Nerve to the vastus medialis
29. 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?
(A) Popliteal
(B) Deep femoral
(C) Anterior tibial
(D) Posterior tibial
(E) Peroneal
30. An elderly woman fell at home and fractured the
greater trochanter of her femur. Which of the following
muscles would continue to function normally?
(A) Piriformis
(B) Obturator internus
(C) Gluteus medius
(D) Gluteus maximus
(E) Gluteus minimus
Questions 31–35:
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.
31. Which of the following nerves is damaged?
(A) Sciatic
(B) Tibial
(C) Common peroneal
(D) Deep peroneal
(E) Superficial peroneal
32. After injury to this nerve, which of the following
muscles could be paralyzed?
(A) Gastrocnemius
(B) Popliteus
(C) Extensor hallucis longus
(D) Flexor digitorum longus
(E) Tibialis posterior
33. If the lateral (fibular) collateral ligament is torn by
this fracture, which of the following conditions may
occur?
(A) Abnormal passive abduction of the extended leg
(B) Abnormal passive adduction of the extended leg
(C) Anterior displacement of the femur on the tibia
(D) Posterior displacement of the femur on the tibia
(E) Maximal flexion of the leg
34. Which of the following arteries could also be
damaged by this fracture?
(A) Popliteal
(B) Posterior tibial
(C) Anterior tibial
(D) Peroneal
(E) Lateral inferior genicular
35. Which of the following conditions would occur from
this fracture?
(A) Ischemia in the gastrocnemius
(B) Loss of plantar flexion
(C) Trendelenburg’s sign
(D) Anterior tibial compartment syndrome
(E) Flat foot
36. 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?
(A) Extensor digitorum longus
(B) Tibialis anterior
(C) Tibialis posterior
(D) Peroneus longus
(E) Peroneus brevis
37. 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?
(A) Rectus femoris
(B) Biceps femoris, short head
(C) Pectineus
(D) Adductor magnus
(E) Sartorius
38. A 24-year-old woman presents to her physician with
weakness in flexing the hip joint and extending the knee
joint. Which scenario?
(A) Sartorius
(B) Gracilis
(C) Rectus femoris
(D) Vastus medialis
(E) Semimembranosus
39. A 17-year-old boy was stabbed during a gang fight
resulting in transection of the obturator nerve. Which of
the following muscles is completely paralyzed?
(A) Pectineus
(B) Adductor magnus
(C) Adductor longus
(D) Biceps femoris
(E) Semimembranosus
40. 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?
(A) Calcaneus
(B) Cuboid bone
(C) Head of the talus
(D) Medial cuneiform
(E) Navicular bone