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LOWER LIMB MCQs - ANSWERED1. The following nerve supplies the fascia lata & skin of anterior thigh except:A. Ilioinguinal nerveB. Lateral femoral cutaneous nerve of thighC. Genitofemoral nerveD. Medial femoral cutaneous nerve of thigh <-there is no medial femoral cutaneous nerve in MooresE. All of the nerve above supplies both fascia lata & skin of anterior thigh. <-?2. Femoral branch of genitofemoral nerve:A. contains L1 & L2 fibers <- trueB. runs down pelvis along internal iliac artery <- external iliacC. travels down inguinal canal & pierce the external spermatic fascia at the superficial inguinal ring – genital branchD. supplies the area of skin over the femoral triangle <- supplies the lateral femoral triangleE. also gives articular supply to the hip joint -?3. Which of the following arise from the anterior division of femoral nerve? – none of these listedA. Medial femoral cutaneous nerve.B. Intermediate femoral cutaneous nerveC. Lateral femoral cutaneous nerveD. Medial & intermediate femoral cutaneous nerves only <-?E. Intermediate & lateral femoral cutaneous nerves only4. Lateral femoral cutaneous nerve does NOT:A. carry L2,3 fibers – it doesB. pierce inguinal ligament 1cm medial to ASIS <– 2-3cm medial to ASISC. its posterior branch also take part in patella plexus -?D. compression only occur as it pierces through iliacus fascia <-?E. all of the above are true.5. Great saphaenous vein does NOT:A. lie behind medial malleolus <- it is ANTERIOR to medial malleolusB. lies 1 hand's breadth behind medial border of patella - correctC. drains into femoral vein 3.5 cm below & lateral to pubic tubercleD. contains up to 20 valves – usually 10-12E. most valves are found below the knee level – correct6. Regarding inguinal lymph nodes: - wtfA. Lateral group of inguinal lymph nodes drain the lower lateral anterior abdominal wallB. Medial group of inguinal lymph nodes drain the lower medial anterior abdominal wallC. Vertical group of inguinal lymph nodes drain the whole lower limbD. All of the above are incorrect <-?E. All of the above are correct7. Fascia lata attachment does NOT include:A. Pectineus ligament – pectineal lineB. Femoral epicondyles <– femoral CONDYLES, the eipcondyles are for medial and lateral collateral ligamentsC. Inguinal ligaments - trueD. Sacrotuberous ligaments - trueE. Patella - true8. Fascia lata does NOT A. meet Scarpa's fascia at the inguinal ligament <- it is a fingers breadthe inferior…B. is continuous with the iliotibial tract - trueC. is continuous with the deep fascia of the calf posteriorly - trueD. splits to enclose tensor fascia latae & adductor magnus – ? should it read glut max, add mag is deepE. All of the above9. Iliotibial tract:A. arises at the level of lesser trochanter at the insertion of tensor fasciae latae & gluteus maximus – arises from iliac tubercleB. attaches to both tibial epicondyles – to the anterolateral turbercle of tibia (Gerdy tubercle)C. acts to keep the knee in hyperextension & stabilizes the pelvis in walking <- correctD. can assist extension of the fully flexed knee – b/c attached to femur via lat intermuscular septum cannot move the kneeE. attaches to medial intermuscular septum of the thigh – to the lateral intermuscluar septum10. Boundaries of femoral triangle does NOT include: A. inguinal ligamentB. medial border of sartoriusC. lateral border of adductor longus <- should be medial border, but Moore’s lists it as lateral…D. All of the aboveE. None of the above11. Floor of the femoral triangle EXCLUDES:A. adductor brevis - briefly visable between pectineus and adductor longusB. pectineus - yesC. iliacus - yesD. psoas major - part of iliopoasE. psoas minor <- from T12 – L1 to iliopectineal arch, above inguinal ligament12. Intermediate femoral cutaneous nerve pierces: - wtfA. Rectus femorisB. PectineusC. Adductor longusD. Sartorius <-? Not listed in Moore’sE. None of the above, this nerve does not pierce muscle.13. Psoas major:A. femoral artery lies on it <- correct, in the femoral triangleB. inserts into greater trochanter - lesser trochanterC. its only action is to flex hip - it stabilizes alsoD. supplied by anterior division of femoral nerve - supplied by anterior rami of L1,2,3. iliacus is by femoral n.E. all of the above14. Pectineus muscle does NOTA. lie anterior to anterior division of oburator nerve – it does, the anterior division of obturator is on the ant surface of abductor brevis posterior to pectineus B. lies posterior to femoral vein & femoral canal – its anterior surface is the floorC. acts to flex & laterally rotate hip <– it flexes, adducts and medially rotates the hipD. supplied by anterior division of femoral nerve – it is and may receive a branch from obturatorE. inserts into an area below lesser trochanter – the pectineal line, inferior to lesser trochanter15. Femoral sheath does NOT containA. Femoral canalB. Femoral nerve <– lateral and outside the sheathC. Femoral arteryD. Femoral veinE. Femoral nerve & vein ???16. Femoral artery: A. enters thigh at the midpoint of inguinal ligament – this is correct!B. is separated from the head of femur by psoas major <– also correct?C. gives supply to all thigh muscle directly – obturator helps supply adductors (and posterior branch -> acetabular branch -> NOF)D. All of the aboveE. None of the above17. Profunda femoris artery: A. arises from the lateral side of femoral artery 4 cm below inguinal ligamentB. lies between adductor longus & magnusC. ends as a perforating artery traveling beneath adductor brevisD. its branch takes part in the trochanteric & cruciate anastomosisE. All of the above are true <-18. Femoral vein:A. its tributaries mirrors that of femoral artery in the femoral triangle – great saphenous has no arterial mirrorB. lies lateral to the femoral artery - medialC. has valves just above the entry for profunda femoris vein <- not listed, but okD. profunda femoris vein enters femoral vein at the saphenous opening <- the saphenous does, the deep vein of thigh joins at the inferior end of femoral triangle 8cm below inguinal ligament, and 5cm below saphenousE. All of the above19. Branches of the femoral nerve is divided into anterior & posterior divisions by:A. medial circumflex femoral arteryB. lateral circumflex femoral artery <- not listed in Moore’sC. profunda femoris arteryD. adductor brevis - obturatorE. sartorius20. Branches of the anterior division of femoral nerve does NOT include:A. medial femoral cutaneous nerveB. intermediate femoral cutaneous nerveC. lateral femoral cutaneous nerve <- arises from lumbar plexus L2-3D. nerve to sartoriusE. nerve to pectineus21. Which of the following branches of deep division of femoral nerve gives supply to the hip joint?A. nerve to rectus femoris <- not listed in Moore’sB. nerve to vastus medialisC. nerve to vastus intermediusD. nerve to vastus lateralisE. saphenous nerve22. Which part of quadriceps femoris has attachment to the hip bone? – define hip bone = pelvisA. rectus femoris <- from AIIS, crosses 2 jointsB. vastus medialis – linea asperaC. vastus intermedius – shaft of femurD. vastus lateralis – linea asperaE. none arise from the hip bone23. Which part of quadriceps femoris has direct attachment to the patella?A. rectus femorisB. vastus medialis <- forms medial patella retinaculaC. vastus intermediusD. vastus lateralis <- ?forms lateral patella retinaculaE. none of them attaches directly to the patella24. Patellar retinacula is:A. also called patella ligament – no, the patella ligament is extension of the quadraceps tendon to the tibial tuberosityB. the lower horizontal fibers from vastus medialis attached to the medial aspect of patella – unsure, includes the lateralis, and orientation of fibres unclear in Moore’sC. fibrous expansion from the quadriceps connecting the patella to the tibial condyles <- correctD. None of the aboveE. All of the above25. Which of the following is NOT a content of the adductor canal?A. femoral arteryB. femoral veinC. femoral nerve <– saphenous nerveD. nerve to vastus medialisE. none of the above26. Subsartorial plexus does NOT receive supply from: - what is the subsatorial plexus?A. saphenous nerveB. anterior division of oburator nerve - Should be posterior division?C. intermediate femoral cutaneous nerveD. medial femoral cutaneous nerve <- can’t find this in Moore’sE. All of the above27. At the adductor hiatus, the most medial structure is:A. femoral arteryB. femoral veinC. saphenous nerve <- can’t find this detail in Moore’sD. nerve to vastus medialisE. intermediate femoral cutaneous nerve28. Saphenous nerve does NOT:A. pass into the knee between sartorius & gracilis – it doesB. accompany the great saphenous vein in the leg – it doesC. accompany a branch of the descending geniculate artery -?D. gives supply to the hip joint <- arises from femoral nerve as exits the adductor hiatusE. All of the above29. Anterior division of obturator nerve does NOT supply: - this level of detail not in Moore’sA. adductor longusB. gracilisC. adductor brevisD. adductor magnus <- nb hamstrings part is transitional m, supplied by tibial part of sciatic E. All of the above30. Obturator nerve is the nerve of:A. gluteal regionB. anterior compartment of the thighC. adductor compartment of the thigh <- finally an easy one! (but note also supplies the ‘transitional’ pectineus)D. posterior compartment of the thighE. all of the above31. Obturator nerve is divided into anterior &posterior divisions by:A. obturator externusB. obturator internus C. adductor brevis <- deep to pectineus, ant div may be visible in femoral triangleD. medial circumflex femoral arteryE. none of the above32. Which of the following is supplied by the inferior gluteal nerve?A. gluteus minimus – supplied by superior gluteal n.B. gluteus medius – also supplied by superior gluteal n., paralysis leads to Trendelenburg/gluteal dipping gaitC. gluteus maximus <- inferior gluteal supplies only glut maxD. tensor fasciae latae – also supplied by superior gluteal n.E. all of the above33. Piriformis does NOT:A. supplied by S1, S2 anterior ramiB. pass through the lesser sciatic foramen <- main landmark in the greater sciatic foramenC. superior gluteal nerve & artery passes above it D. pudendal nerve & artery passes below itE. sciatic nerve passes below it34. Which of the following does NOT insert into the greater trochanter?A. gluteus maximus <- inserts into iliotibial tract -> lateral condyle of tibia (some to gluteal tuberosity of femur), the other gluteal m. that doesn’t is quadratus femorus -> quadrate tubercleB. gluteus mediusC. gluteus minimus D. piriformisE. obturator internus35. Which of the following vessels take part in the trochanteric anastomosis?A. Superior gluteal arteryB. Inferior gluteal arteryC. Medial circumflex femoral artery D. Lateral circumflex femoral arteryE. All of the above <- not clearly listed in Moore’s36. In the adult, chief blood supply to the head of femur is conferred by:A. artery of ligament of head of femurB. trochanteric anastomosis <- most by medial circumflex a. -> retinacular b/c can pass under the unattached posterior border of the joint capsule whereas lateral circumflex must penetrate the thick iliofemoral ligament. Obturator also supplies a small artery to the head via the the ligament for the headC. cruciate anastomosisD. all of the aboveE. none of the above37. The following bursa may communicate with the hip joint:A. iliac bursa <- not listed in Moore’sB. gluteus minimus bursaC. gluteus medius bursaD. gluteus maximus bursaE. all of the above38. Regarding ligaments around the hip joint, the following is INCORRECT:A. they are lax in flexed & laterally rotated position – true, flexion unwinds the ligaments, and allows a greater range of motion. Only 10- 20 deg of extension is possible, limited by the joint capsule and ligaments.B. iliofemoral ligament formed the fulcrum around which the neck of femur rotates in the dislocated hipC. ischiofemoral ligament is the strongest ligament around the hip joint <- weakest of the 3, whereas the iliofemoral is said to be the bodies strongest ligamentD. ischiofemoral ligament is attached to zona reticularis – Moore’s lists it as the base of the greater trochanterE. all of the above 39. The following muscle is NOT responsible for hip flexion:A. iliopsoas – strongest flexorB. pectineus – transitional, adducts and flexesC. sartorius – crosses legs: flexion and lat rot of hip, flexion and med rot of legD. vastus lateralis <– only crosses the kneeE. rectus femoris – crosses 2 joints40. Regarding the hip joint, the following statement is INCORRECT:A. Axis of flexion passes through both femoral headB. Axis of rotation = axis of femoral shaft <- no, axis of rotation is the centre of femoral headC. iliofemoral ligament limits extension of the hip - trueD. The muscles attached to greater trochanter are responsible for hip abduction – glut med and min, piriformis, obturator internus and sup and inf gemelli, so trueE. Gluteal muscles stabilizes the pelvis during movement of hip joint. - true41. Stability factors of hip joint is conferred by:A. acetabular labrum – increass acetabular articlar area by 10%B. congruity between femoral head & acetabula C. ilio-femoral ligament – strongest ligament in the bodyD. short muscles of gluteal region - E. all of the above <- easy question42. Regarding the hamstring compartment, the following statement is FALSE:A. All hamstring muscles spans 2 joints – true, but only becuase short head of biceps is part of biceps femoris, and the long head does.B. It is separated from the medial compartment by the medial intermuscular septum <– posterior intermuscular septum, not named in Moore’s, only the large lateral intermuscular septumC. All hamstring muscles (except short head of biceps femoris) are supplied by the tibial component of sciatic nerve. – true, the short head is supplied by common fibular n. (from sciatic)D. All hamstrings arise from ischial tuberosity – again like answer A, becuase short head of biceps femoris arises from shaft of femur also: linea aspera and supracondylar lineE. All of the above43. Regarding the hamstring compartment, the following statement is INCORRECT:A. Semimembranosus inserts by aponeurotic attachment to the medial tibial condyle <- the tendon divides distally into 3: direct attachment to posterior medial tibial condyle, a part the blends with popliteal fascia, and a reflected part that reinforces the intercondylar part of the joint cpasule as the oblique popliteal ligamentB. Semitendinosis arise from the lateral facet of ischial tuberosity – not listed in Moore’sC. Biceps femoris is the only hamstring muscle attached to the fibula - trueD. Short head of biceps femoris does not attach to the ischial tuberosity – true, it attaches to the linea aspera and lateral supracondylar line of the femurE. All of the above44. The following muscles made up the borders of popliteal fossa EXCEPT:A. biceps femoris – superolateralB. gastrocnemius – medial head, inferomedialC. popliteus muscle - floorD. plantaris <- the borders of the popliteal fossa are: inferiorly the heads of gastrocnemius, sup lat the biceps femoris, sup med the semitendinosis and semimembrinosis, and the floor is politeus, the joint capsule and the distal end of the posterior femur (popliteal surface). Plantaris is listed as part of the lower lateral border in some texts (it lies over the lateral head of gasroc) but not in Moore’sE. semimembranosus – and semitendinosus superomedial45. The most lateral content in the popliteal fossa is:A. Popliteal artery – deepest of the three main structures, is initially medial to nerve, but lateral in inferior part of fossa -> anterior and posterior tibial arteriesB. Popliteal vein – found always between the nerve and artery, continuation of the posterior tibial vein, recieves the small saphenous vein in the fossaC. Tibial nerve – nerves are most superficial, and the tibial bisects the fossaD. Common peroneal nerve <- follows closely the medial border of the lateral head of biceps femoris, the passes superficially to lateral head of gastrocnemius, passes over the posterior aspect of the head of fibula then it winds around and neck and dividesE. Popliteal lymph nodes46. Which of the following structure does NOT pierce the roof of popliteal fossa:A. small saphenous vein – it does to enter the popliteal veinB. posterior femoral cutaneous nerve – supplies skin over the fossaC. lateral cutaneous nerve of calf <- ? there is a lateral sural cutaneous nerveD. peroneal communicating nerve – aka common fibula nerveE. sural nerve – exits the popliteal fossa and decends w/ small saphenous vein47. Which branch of the popliteal artery supplies the cruciate ligament?A. Upper medial genicular artery B. Upper lateral genicular arteryC. Middle genicular artery <- penetrates the fibrous layer of joint capsule -> cruciates, synovium, and peripheries of menisciD. Lower medial genicular arteryE. Lower lateral genicrous layer of the joint capsuleular artery48. Which muscular branch of popliteal artery is an end artery?A. branch to popliteus <-?B. branch to gastrocnemius (sural artery)C. branch to soleusD. branch to plantarisE. none of the above <- Moore’s: muscluar branches of the popliteal artery supply the hamstring, gastrocnemuis, soleus and plantaris muscles. The superior muscular branches of the popliteal artery have clinically important anastomoses with the terminal part of the deep femoral and gluteal arteries49. popliteus muscle:A. is an intrasynovial structure – no, the only intrasynovial structures are the menisci (and that applies to all synovial joints), the politeus has 2 attachements: a tendinous one to the lateral femoral condyle, and a broader membranous one to the lateral menisus that occurs btween the fibrous layer and synovial layers of the joint capsule – the apex of the belly emerges from the joint capsule.B. inserts into the posterior convexity of medial meniscus – no, it attaches weakly to the posterior limb of the lateral meniscusC. enters knee joint as the arcuate popliteal ligament – no, this arises from fibular head, passes over the popliteus muscle to posterior surface of the jointD. is supplied by the common peroneal nerve – all muscles of the posterior compartment of the leg are supplied by the tibal nerveE. all (none) of the above <-50. Regarding the knee joint, the following is FALSE:A. Medial femoral condyle is longer, narrower & more curve than the lateral femoral condyle - medial condyle = narrow/rounded, lateral = broad/flatB. Medial patellar articular surface is in contact with medial femoral condyle at all times <– not detailed in Moore’s, but from IA diagram the lateral side is not in contact in full flexion, the medial side always isC. The capsule is invaginated by a fat pad at the lower margin of patella, forming the infrapatellar fold - trueD. Joint capsule is defective posteriorly for attachment of posterior cruciate ligament & laterally for the popliteus tendon insertion <- false, the popliteus tendon peirces the fibrous layer (only) posteriorly. The cruciates are inside the joint capsule, but outside the synoviumE. Patellar retinacula is not attached to the femur – true51. The following knee joint ligament is an intracapsular structure:A. patellar ligament – no, the 5 extrapsular ligaments are: patella, TCL, FCL, oblique popliteal and arcuate poplitealB. tibial collateral ligament - noC. oblique popliteal ligament - noD. meniscofemoral ligament <– the posterior meniscofemoral ligament joins lateral meniscus to PCL and medial femoral condyleE. none of the above 52. Regarding tibial collateral ligament of the knee joint, the following is FALSE:A. It is attached to the medial meniscus - trueB. It runs from the medial femoral epicondyle to tibia a hand's breadth below the knee jointC. It has a free anterior marginD. It is drawn taut by knee extension - trueE. All of the above <- not clearly details in Moore’s53. Posterior cruciate ligament:A. attaches to the anterior part of intercondylar area of tibia – no, the names relate to the position of tibial attachment, it arises from the posterior intercondylar areaB. travels posteriorly & laterally to attach to the postero-lateral femoral condyle – PM: medial condyle. Is passes up, forward and medialC. it limits extension of the lateral femoral condyle in the screw home mechanism – knee locks in full extension with foot on ground because of medial rotation of femur/condyles on tibia about axis of ACLD. it is the only stabilizing factor in slightly flexed weight-bearing knee <– it is the main stabilizer, e.g when walking downhill (but the quads are the main stabilizer generally)E. all of the above54. Medial meniscus:A. Its 2 horns attaches to areas between the anterior & posterior cruciate ligaments – no, the attachemts are anterior to the cruciatesB. It is attached to meniscofemoral ligament posteriorly – no the lateral meniscus isC. It is attached to popliteus muscle posteriorly – no, again the lateral meniscus isD. It is attached to the medial collateral ligament <- trueE. All of the above55. The following bursa does NOT communicate with the knee joint:A. infrapatellar bursa <- Moore’s lists bursae that communicate as: suprapatella, popliteus, anserine, and gastrocnemius, the anserine being deep to semitendinsosis, gracilis and satroriusB. suprapatellar bursaC. popliteus bursaD. bursa beneath medial gastrocnemiusE. semimembranosus bursa – this is listed as being between medial head of gastroc and semimem, no mention of it communicating in Moore’s or IA56. Regarding the knee joint:A. rotation takes place beneath the menisci B. flexion & extension take place above the menisciC. extension & passive medial rotation is limited by the collateral ligament, oblique popliteal ligament & anterior cruciate ligament - trueD. in the screw home mechanism, axis of rotation is anterior cruciate ligament - trueE. all of the above <-57. Which of the following has a common synovial sheath with peroneus tertius at the inferior extensor retinaculum?A. tibialis anteriorB. extensor hallucis longus C. extensor digitorum longus <- “timothy has a very nasty disease, fever”, fibularis tertius is a separated part of EDLD. all of the aboveE. none of the above58. Which of the extensor muscles passes under the superior extensor retinaculum?A. extensor hallucis longusB. tibialis anterior C. extensor digitorum longusD. peroneus tertiusE. all of the above <- also the anterior tibial vessles and deep fibula nerve59. Regarding tibialis anterior, the following is FALSE:A. it is the only extensor muscle arising completely from the tibia – it also comes form the IOM, others are from the fibula and IOM, (EDL from the lateral condyle of tibia too)B. it inserts into the medial cuneiform & 1st metatarsal - trueC. it is supplied by the deep peroneal nerve & recurrent genicular nerve – according to Moore’s only the deep fibularD. it shares a common synovial sheath with extensor hallucis longus <– no, it has it’s own synovial sheathE. none of the above60. Regarding deep peroneal nerve, the following is FALSE:A. it lies deep to the extensor digitorum longus origin as it winds around the fibular neck – Moore’ lists that it arises deep to fibularis longus and pierces EDL?B. it lies medial to the anterior tibial vessels in the upper part of lower leg <– appears to be lateralC. it lies between extensor hallucis longus & extensor digitorum longus at the level of inferior extensor retinaculum – true, “timothy has a very nastry disease, fever”D. it lies medial to the dorsalis pedis in the dorsum of foot – true?E. it supplies extensor muscles & periosteum of tibia & fibula – true, paraysis leads to foot drop61. The following joint is a fibrous joint:A. Hip – synovial, ball and socketB. Knee – synovial, modified hingeC. Ankle – synovial, hinge typeD. Superior tibio-fibular joint – synovial, plane typeE. Inferior tibio-fibular joint <- compound fibrous, aka tibiofibular syndesmosis, the posterior tibiofibular ligament, essential for ankle stability b/c keeps the lateral malleolus against talus62. Regarding the dorsum of foot:A. Extensor digitorum brevis inserts into the lateral 4 toes – no longus does, brevis into middle 3B. There is no extensor expansion over the great toe <– this detail is not clear in Moore’sC. Medial branch of superficial peroneal nerve supplies the 1st & 2nd cleft spaces – the deep fibular provides the innervation to the 1st cleftD. Arcuate artery lies at the level of metatarsal heads – runs across the bases of the lateral 4 tarsals, deep to the extensor tendonsE. Dorsal venous arch lies at the level of base of metatarsals – not clear in Moore’s63. Regarding the peroneal compartment, (now fibular or lateral compartment)A. peroneal longus slings behind lateral malleous in direct contact with the bone – it sits on the tendon of FB and does not come in direct contact with the boneB. peroneal longus is invested in its own synovial sheath beneath the superior peroneal retinaculum – shares a sheath with brevis, this splits beneath the superior fibular retinaculum, then they pass through the inferior fibular retinaculumC. peroneal longus, brevis & tertius are supplied by the superficial peroneal nerve – tertuis is an anterior compartment m. = all supplied by the deep fibular nerve, longus and brevis are supplied by superficialD. peroneal longus is important in maintaining the lateral longitudinal & transverse arches of the foot <– true: there are 3 arches (nb the musclur/dynamic support is ambiguous in Moore’s)ArchBonesBoney supportLigamentous supMuscular supportLongitudinal medial(high)Calcaneus, talus,3 cuneiform, 3 MTsKeystone talusPlantar aponeurosisLong plantar lig.Short plantar lig.(calcaneocubiod)Spring ligament(calcaneonavicular)Intrinsic plantar m.FL (and FB)FHL, FDL, TALongitudinal lateral(low)Calcaneous, cuboid, 2 MTsTransverse (high)Cuboid, cuneiforms Base of MTsWedge shapedcuneiformsTPE. all of the above64. The achilles tendon is formed from:A. soleusB. gastrocnemiusC. plantarisD. soleus & gastrocnemius onlyE. all of the above <-65. Flexor digitorum longus in the lower limb:A. is a bipennate muscle <- not specifically detailed in Moore’sB. lies between flexor hallucis longus & tibialis posterior in the calf – med to lat: FDL (tibia) TP (tibia, IOM, fibula) FHL (fibula)C. inserts into the base of proximal phalanx – bases of distal phalanges of lateral 4D. only the lateral 2 tendons receive insertion of flexor accessorius – aka quadratus plantae: assists FDL to pull straight, inserts into all 4E. is supplied by the deep peroneal nerve – like ALL posterior muscle (deep and superficial) supplied by the tibial n.66. Tibialis posterior: A. has reciprocal insertion as the tibialis anterior in the foot – can act synergistically with TA to invert the foot (when foot is off the ground or on unevent surface to depress lateral side), they are otherwise antagonistic.B. grooves the medial malleolus beneath the flexor retinaculum <– it is the most anterior structure behind the medial malleolus: “timothy doth vex all nervous housemaids” C. grooves the undersurface of sustentaculum tali – Flexor hallucis longus grooves talus and platar surface of sustenaculum tali. The TP inserts into: navicular, cuneiform, cuboid, sustenaculum tali and bases of 2-4 MTsD. is supplied by the deep peroneal nerve - like ALL posterior muscle (deep and superficial) supplied by the tibial n.E. all of the above67. Regarding tibial nerve, the following is FALSE:A. It is the nerve of flexor compartment of the leg – true, all posterior/flexor compartment muscles are supplied by the tibial.B. It spirals behind posterior tibial artery on the flexor digitorum longus aponeurosis – not detailed in Moore’sC. It passes beneath the flexor retinaculum behind the posterior tibial artery – “Tim doth vex all nervous housmaids”, so correctD. It has no cutaneous supply <– false. A branch called medial sural cutaneous nerve in the popliteal fossa helps form the sural. A medial calcaneal branch supplies the heel and medial/lateral plantar nn.s the rest of the sole. E. None of the above68. Medial plantar nerve does NOT supply:A. flexor hallucis brevis – it doesB. abductor hallucis – it doesC. flexor digitorum brevis – it does D. adductor hallucis <- it supplies abductor hallicus, The medial plantar nerve supplies aBductor hallicus, FHB, FDB, 1st lumbircal and skin of 3.5E. all of the above69. Regarding the sole of the foot, the following is FALSE:A. flexor accesorius is supplied by the lateral plantar nerve - trueB. 1st lumbrical is supplied by medial plantar nerve & is unicipital - trueC. flexor digitorum brevis splits around the flexor digitorum longus to insert into the base of the middle phalanx – true, via decussating chiasmaD. the long axis of the foot is along 3rd metatarsal bone <– 2ndE. All of the above70. Plantar interosseous:A. is larger than the dorsal interosseous - ?B. is all supplied by the deep branch of plantar nerve – lateral deep plantar supplies: all interossei, lat 3 lumbricals and adductor hallucis, so should be correctC. arises from the 3rd, 4th & 5th metatarsals & inserts into the medial side of dorsal expansion of its own metatarsal. <- trueD. Adducts toes away from the long axis of foot – PAD, DAB. But adducts TO the long axisE. All of the above are true71. Medial plantar nerve:A. lies superficial & medial to medial plantar artery in the sole of foot <- ?B. is smaller than lateral plantar nerve – is larger and more anteriorC. supplies more muscle in the sole of foot than the lateral plantar nerve – no, more skin, fewer musclesD. supplies the skin of medial one & a half toes – no, 3.5 toesE. all of the above72. Regarding the plantar arch, the following is FALSE:A. it lies across the base of 2nd to 4th metatarsal – unclear in Moore’sB. it is a complete arch <-?C. it communicates with the dorsalis pedis at 1st metatarsal space & with arcuate artery at the 2nd & 4th metatarsal space – should be the 2nd, 3rd and 4th MT spaceD. it is chiefly supplied by the lateral plantar artery - trueE. the deep branch of lateral plantar nerve lies within its concavity <-?73. The stability of the ankle joint is conferred by:A. deltoid ligamentB. lateral collateral ligamentC. medial & lateral malleoli gripping the sides of talusD. posterior tibio-fibular ligaments E. all of the above <-74. Prime mover for ankle dorsiflexion includes:A. tibialis posterior – flexion and inversionB. extensor digitorum longus – some ADFC. peroneus tertius – weak, mainly eversion (as per Moore’s)D. extensor hallucis longus - weakE. none of the above <- as per Moore’s, the tibialis anterior tendon has its attachment (medial side of foot on cuneiform and 1st MT) farthest from axis so most mechanical advantage and it is the strongest dorsiflexor75. Regarding the talocalcaneounavicular joint, the following is FALSE:A. it is also known as the midtarsal joint – Moore’s says the transverse tarsal joint (= midtarsal)B. it is the chief site of inversion & eversion <– the chief site is the subtalar joint according to Moore’s, whereas this joint augmentsC. it is formed from the head of talus, navicular, spring ligament & the sustentaculum taliD. it is a synovial plane joint <- this detail is not clearly listed in Moore’s, only that the talonavicular part is ball and socketE. it has a haversian fat pad76. Prime mover for inversion of the foot is:A. tibialis anterior <- dorsiflexes and invertsB. peroneus tertius – dorsi flexes (weak eversion)C. peroneus brevis – eversion (weak flexion)D. peroneus longus – eversion (weak flexion)E. extensor hallucis longus – extends great toe and dorsiflexes77. Gluteal intermuscular injection should be applied to:A. Upper inner quadrant of gluteal region.B. Upper outer quadrant of gluteal region. <- superolateral C. Lower inner quadrant of gluteal region.D. Lower outer quadrant of gluteal region.E. Any of the above ................
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