esekhaigbe kizinto aau sug'19 sec gen

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Section 1

Upper Limb Anatomy

1) With regard to the pectoral girdle:

a) contains three joints, the sternoclavicular, the acromioclavicular and the glenohumeral

b) serratus anterior, the rhomboids and subclavius attach the scapula to the axial skeleton

c) pectoralis major and deltoid are the only muscular attachments between the clavicle and the upper limb

d) teres major provides attachment between the axial skeleton and the girdle

2) Choose the odd muscle out as regards insertion/origin:

a) supraspinatus

b) subscapularis

c) biceps

d) teres minor

e) deltoid

3) Which muscle does not insert in or next to the intertubecular groove of the upper humerus?

a) pectoralis major

b) pectoralis minor

c) latissimus dorsi

d) teres major

4) Identify the incorrect pairing for testing muscles:

a) latissimus dorsi – abduct to 60° and adduct against resistance

b) trapezius – shrug shoulders against resistance

c) rhomboids – place hands on hips and draw elbows back and scapulae together

d) serratus anterior – push with arms outstretched against a wall

5) Identify the incorrect innervation:

a) subclavius – own nerve from the brachial plexus

b) serratus anterior – long thoracic nerve

c) clavicular head of pectoralis major – medial pectoral nerve

d) latissimus dorsi – dorsal scapular nerve

e) trapezius – accessory nerve

6) Which muscle does not extend from the posterior surface of the scapula to the greater tubercle of the

humerus?

a) teres major

b) infraspinatus

c) supraspinatus

d) teres minor

7) With regard to action, which muscle is the odd one out?

a) teres minor

b) deltoid

c) teres major

d) subscapularis

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8) Which statement is INCORRECT?

a) the muscles of the rotator cuff are deemed to be such because all their tendons fuse with the lateral

part of the shoulder capsule and are attached to the humerus near the joint

b) the capsule of the shoulder joint is attached at the line of the anatomical head except inferiorly where it

extends to the level of the surgical neck

c) the subacromial bursa lies between the tendon of supraspinatus and the coraco-acromial ligament and

communicates with the shoulder joint

d) the long tendon of biceps lies intracapsular and is sheathed by synovial membrane that allows it to slide

with movement

9) Stabilising factors of the shoulder joint include all but:

a) a tight capsule

b) tendons that fuse with the capsule

c) glenohumeral and coracohumeral ligaments

d) labrum

e) splinting of the humeral head between the tendons of biceps and triceps

10) Regarding the brachial plexus, which is INCORRECT?

a) it is derived from the anterior rami of C5-T1 after they have given off segmental supply to the

prevertebral and scalene muscles

b) the roots give off three branches including the long thoracic nerve to latissimus dorsi

c) the trunks give off one branch

d) the cords are divided into anterior and posterior divisions that supply the flexor and extensor

compartments respectively and give off 13 branches

e) the lateral cord supplies part of the median nerve

11) Regarding lymph nodes, the lateral side of the arm and forearm is drained initially to the:

a) supratrochlear nodes

b) posterior axillary nodes

c) infraclavicular nodes

d) central axillary nodes

12) Which of the following has some nerve supply from the radial nerve?

a) long head of biceps

b) coracobrachialis

c) short head of biceps

d) brachialis

13) As it emerges from the axilla, the median nerve lies where with regards to the brachial artery?

a) lateral

b) anterior

c) medial

d) posterior

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14) With regards to the posterior compartment of the arm, which is FALSE?

a) the medial head of triceps lies deep to the long and lateral heads

b) triceps inserts onto the upper surface of the olecranon

c) midshaft fracture of the humerus can damage the radial nerve resulting in paralysis of triceps

d) the medial intermuscular septum divides it from the anterior compartment and runs from the axilla to

the elbow

15) Blood supply to the upper limb, which is FALSE?

a) the subclavian artery is divided schematically by scalenus anterior

b) usually all branches of the subclavian come from the first segment

c) the dorsal scapular branch may arise from the third segment

d) pectoralis major schematically divides the axillary artery into three parts

e) the acromial branch of the thoracoacromial trunk accompanies the cephalic vein in the deltopectoral

triangle

16) Regarding the brachial plexus, which is FALSE?

a) the nerve to serratus anterior comes from the anterior rami of C5-C7

b) the suprascapular nerve arises from C5 anterior ramus

c) the divisions are at the level of the clavicle

d) the thoracodorsal nerve arises from the posterior cord

e) the radial nerve is the largest branch of the brachial plexus

17) Regarding the brachial plexus:

a) the lateral cord contains fibres from C5, 6, 7 & 8

b) the posterior cord has fibres from C5, 6, 7, 8 & T1

c) the medial cord has fibres from C8 and T1

d) the suprascapular nerve arises from C5

e) the ulnar nerve is a continuation of the medial cord

18) Which is CORRECT?

a) medial pectoral nerve C7 C8

b) ulnar nerve C7 C8 T1

c) dorsal scapular nerve C5 C6

d) long thoracic nerve C6 C7 C8

e) musculocutaneous C5 C6


a) the roots lie behind scalenus medius muscle

b) the trunks are formed behind the clavicle

c) at the first rib, the cords are formed

d) the cords give branches around second part of artery

20) In the cubital fossa:

a) median nerve lies lateral to the biceps tendon

b) radial nerve and interosseous branch lies beneath the brachialis

c) radial artery passes between heads of pronator teres

d) brachial artery lies beneath biceps aponeurosis

e) radial nerve leaves fossa between heads of supinator

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21) The clavicle:

a) ossifies at eight weeks

b) has atypical synovial joints at both ends

c) articulates with the first rib

d) is more curved in females

e) usually fractures between deltoid tubercle and coranoid tubercle

22) Regarding innervation of hand muscles:

a) opponens pollicis may be supplied by ulnar nerve

b) opponens digiti minimi may be supplied by median nerve

c) two radial interossei are usually supplied by median nerve

d) nail beds are supplied 3½ to 1½ by branches of radial and ulnar nerves

e) adductor pollicis is supplied by muscular (recurrent) branch of median nerve

23) At the wrist / carpal tunnel:

a) flexor retinaculum attaches to scaphoid and trapezoid laterally

b) all superficial and deep flexors, except flexor pollicis longus, share a common flexor sheath

c) the ulnar nerve lies medial to pisiform

d) tendons of flexor digitorum remain attached until they reach the palm

e) median nerve lies beneath flexor retinaculum between flexor digitorum superficialis and flexor pollicis

longus

24) Axillary artery:

a) first part is separated from the cords by axillary sheath

b) lies posterior lateral to vein – all three parts

c) medial root of median nerve crosses behind ????? to join lateral root.

d) leaves axillar through quadrangular space

e) supplies the breast via thoracoacromial branch

25) All the following arise from the common extensor origin EXCEPT:

a) extensor carpi radialis brevis

b) extensor carpi radialis longus

c) extensor digitorum

d) extensor digitorum minimi

e) extensor carpi ulnaris

26) Regarding triceps:

a) lateral head arises from humerus below radial groove

b) midshaft humerus fractures may paralyse triceps

c) has an insertion into the elbow joint capsule

d) aids in adduction of shoulder

e) is pierced by ulnar nerve

27) Which of the following pairs do not match with regard to mode of ossification?

a) ribs and cranium

b) clavicle and humerus

c) femur and 1st metatarsal

d) patella and pisiform

e) mandible and clavicle

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28) Which joint is the odd one out with regard to degrees of freedom?

a) 1st carpometacarpal joint

b) radiohumeral joint

c) sternoclavicular joint

d) acromioclavicular joint

e) radiocarpal joint

29) Which of the statements regarding ligaments is FALSE?

a) ligaments are relatively avascular

b) final healing following sprains usually restores full strength

c) torn ligaments may predispose to dislocation

d) Sharpeg’s fibres penetrate the bone

e) a healed sprain may be predisposed to reinjury

30) Regarding cartilage, which is FALSE?

a) it is essentially avascular

b) hyaline cartilage contains hyaluronic acid

c) rib cartilage is elastic type

d) TMJ is fibrous

e) all contain mucopolysaccharides

31) Regarding types of joints, which pairing is CORRECT?

a) diarthrosis – cranial suture

b) synarthrosis – symphysis pubis

c) amphiarthrosis – sternoclavicular joint

d) cromphosis – intervertebral joints

e) syndesmoses – tibiofibular joint

32) Types of muscles, which pairing is INCORRECT?

a) unipennate – flexor pollicis longus

b) bipennate – 4th lumbrical

c) fusiform – supraspinatus

d) bipennate – soleus

e) multi-pennate – anterior deltoid

33) Regarding muscle strength, which is NOT a factor?

a) resting length of muscle

b) cross sectional area

c) lever arm length

d) the extent to which the muscle is contracted

e) configuration of fibres, eg fusiform, c.f. bipennate

34) Regarding the autonomic nervous system, visceral pain is not referred to L3-5 and S1 because:

a) there are no visceral afferents related to these lumbar splanchnic nerves

b) there are no white rami communicans to these spinal nerves

c) there are no sympathetic ganglia associated with theses spinal segments

d) there is no sympathetic efferent supply to these spinal nerves

e) there are no grey rami communicans associated with the autonomic ganglia of L3-S1 spinal nerves

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Section 1

Upper Limb Anatomy – Answers

1 C

2 E

3 B

4 A

5 D

6 A

7 A

8 C

9 A

10 B

11 C

12 D

13 A

14 C

15 D & B

16 All are correct

17 A

18 No answer

19 No answer

20 No answer

21 No answer

22 No answer

23 No answer

24 No answer

25 No answer

26 No answer

27 B

28 A

29 B

30 C

31 E

32 E

33 A

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Section 2

1) At the elbow joint:

a) the tilt of the trochlear of the humerus is the main cause for the carrying angle of the elbow

b) the capsule is not attached to the radius

c) the annular ligament is attached to the head and neck of the radius

d) the middle band is the strongest of the three bands that make up the ulnar collateral ligament

e) the carrying angle is the angle between the extended ulna and the vertical

2) Regarding palmar spaces:

a) the hypothenar space contains the long tendon of abductor digiti minimi

b) the midpalmar space is deep to the common synovial sheath and flexor tendons

c) the midpalmar space is not continuous with the three ulnar lumbrical canals

d) the thenar space is open at the wrist

e) prevent spread of infection

3) Which is NOT an origin of supinator

a) radial tuberosity

b) radial collateral ligament

c) lateral epicondyle of humerus

d) supinator crest of ulnar

e) aponeurosis overlying supinator muscle

4) Regarding the nerves and vessels of the arm:

a) the circumflex vessels and the axillary nerve enter the extensor compartment in the axilla through the

triangular space

b) the ulnar nerve pierces the lateral intermuscular septum in the lower third of the arm

c) the median nerve crosses obliquely in front of the radial artery in the arm

d) supratrochlear lymph nodes lie in the subcutaneous ????? just above the medial epicondyle

e) the basilic vein is lateral to the cephalic vein

5) Brachial plexus:

a) the five roots lie in front of scalenus anterior muscle

b) the anterior division of the central trunk runs on as the medial cord

c) the suprascapular nerve is the only branch from the trunks

d) the radial nerve is a branch of the lateral cord

e) the ulna nerve is a branch of the posterior cord

6) The musculocutaneous nerve passes through which muscle?

a) coracobrachialis

b) short head of biceps

c) brachialis

d) medial head of triceps

e) long head of biceps

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7) What structure does NOT lie in the anatomical snuff box?

a) cephalic vein

b) radial artery

c) radial styloid

d) first metacarpal bone

e) extensor pollicis longus

8) Latissimus dorsi:

a) is an accessory muscle of inspiration and expiration

b) is supplied by the dorsal scapular nerve

c) forms the lower border of the medially axillary fold

d) laterally rotates the humerus

e) lies superficial to trapezius at its upper border

9) Regarding the shoulder joint, which is INCORRECT?

a) full abduction requires medial rotation

b) the long head of biceps is intracapsular

c) the subacromial bursa is attached to the coracoacromial ligaments

d) flexion involves pec major, deltoid, coracobrachialis and biceps

e) supraspinatus initiates abduction

10) In the forearm:

a) the median nerve passes between the two heads of pronator teres

b) the ulnar nerve lies deep to flexor digitorum profundus

c) superficial fibres of flexor digitorum superficialis gives rise to the tendons for index and middle fingers

d) the radial artery is on the lateral side of the radial nerve

e) the fibres of the interosseous membrane run obliquely down from ulna to radius

11) What structure does NOT pierce the clavipectoral fascia?

a) cephalic vein

b) lymphatics

c) lateral thoracic artery

d) lateral pectoral nerve

e) thoracoacromial artery

12) Regarding the thumb:

a) abductor pollicis longus originates from both radius and ulna

b) opponens pollicis rotates the first metacarpal on the triquetral

c) adductor pollicis inserts on to the radial sesamoid of the thumb, then the base of the proximal phalanx

d) nerve supply is by the median nerve (C7, C8)

e) adductor pollicis lies superficial to the thenar space

13) Which artery is the main supply of triceps?

a) dorsal scapular artery

b) brachial artery

c) profunda brachii artery

d) radial artery

e) posterior circumflex humeral artery

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14) Teres major:

a) receives its nerve supply from the lateral cord of the brachial plexus

b) is part of the medial wall of the axilla

c) forms the medial border of the triangular space

d) is separated from teres minor by the long head of triceps

e) has the same nerve supply as teres minor


a) the dorsal scapular nerve is the only branch from the trunks

b) the axillary nerve is derived from C5, 6, 7, 8, T1

c) the ulnar nerve is the largest branch of the whole plexus

d) the axillary nerve passes below teres major

e) the thoracodorsal nerve supplies lateral dorsi

16) Flexor pollicis longus:

a) is a bipennate muscle

b) arises from the common flexor origin

c) pierces the flexor retinaculum at the wrist

d) inserts into the radial border of the proximal phalanx

e) has fleshy fibres to a point, just above the wrist

17) Which nerve supplies serratus anterior?

a) axillary nerve (C5, C6)

b) long thoracic nerve (C5, C6, C7)

c) musculocutaneous nerve (C5, C6)

d) thoracodorsal nerve (C6, C7, C8)

e) suprascapular nerve (C5, C6)

18) At the elbow joint:

a) there is no communication with the proximal radioulnar joint

b) the capsule is attached to the neck of the radius

c) the radial collateral ligament is made up of three bands

d) the ulnar nerve passes between the anterior and posterior bands of the ulnar collateral ligament

e) the carrying angle is greater in men

19) Which structure does NOT insert into the flexor retinaculum?

a) abductor pollicis brevis

b) flexor digiti minimi brevis

c) palmaris longus

d) opponens pollicis

e) flexor pollicis brevis

20) Which nerve does NOT make contact with periosteum?

a) radial nerve

b) axillary nerve

c) median nerve

d) ulnar nerve

e) anterior interosseous nerve

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21) Regarding the clavicle, which is false?

a) the clavicle is longer and its curvatures more pronounced in the male

b) the articulating sternal end is covered by fibrocartilage

c) it is the first bone to ossify in the foetus

d) it has four named ligaments attached to it

e) fractures of the clavicle tend to occur between the costoclavicular and the coracoclavicular ligaments

22) Which is true of muscles of the pectoral girdle?

a) “direct” muscles are inserted into the clavicle or scapula from the axial skeleton, eg pectoralis major

b) “indirect” attachment to the axial skeleton is represented by serratus anterior

c) the sternocostal fibres of pectoralis major from the 6th costal cartilage are inserted higher on the lateral

lip of the intertubecular soleus than the fibres from the first cartilage

d) biceps muscle gives no stability to the shoulder joint

e) trapezius is the only muscle to be supplied by all five segments of the brachial plexus

23) The clavipectoral fascia is pierced by all but one of the following structures:

a) lymphatic drainage from the infraclavicular nodes to apical axillary nodes

b) cephalic vein

c) lateral pectoral nerve

d) thoracoacromial artery

e) pectoralis minor

24) With respect to the axilla:

a) the thoracodorsal nerve runs posterior to the mid axillary line on serratus anterior, which it supplies

b) the axillary artery is divided into three parts by scalenus anterior

c) the lateral wall is made up of latissimus dorsi tendon, subscapularis, teres major

d) the lateral thoracic vein is connected by the thoracoepigastric vein to the superficial epigastric vein,

therefore bypassing the IVC in its obstruction

e) the axillary vein commences at the upper border of teres major as a continuation of the basilic vein

25) With respect to the brachial plexus:

a) it consists of the entire anterior rami of C5 → T1

b) there are five roots, three trunks, five divisions and three cords

c) there are two branches from the divisions

d) there are a total of 13 branches from the cords

e) there are two branches from the roots

26) With respect to the brachial plexus:

a) the lateral cord lies in the axilla

b) the median nerve is the largest branch of the whole plexus

c) the roots lie within the posterior triangle of the neck

d) the ulnar nerve is a branch of the lateral cord

e) the musculocutaneous nerve is a branch of the medial cord

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27) The blood supply to the breast involves all but one of the following:

a) lateral thoracic artery

b) long thoracic artery

c) internal thoracic artery

d) posterior intercostal artery

e) thoracoacromial artery

28) Which muscle takes origin (in part) from both the medial and lateral intermuscular septa?

a) biceps

b) brachioradialis

c) extensor carpi radialis longus

d) supinator

e) triceps

29) The carpus:

a) there are five extensor tunnel compartments

b) the extensor expansion attaches to the anterolateral border of the radius above the styloid process, and

distally to the pisiform and trapezoid bones

c) the radiocarpal joint is an uniaxial synovial joint

d) there are no muscular attachments to the extensor surface of the carpus

e) the bones palpable in the anatomical snuff box are the radial styloid, triquetral, scaphoid and base of

first metacarpal

30) Which is true?

a) the flexor synovial sheath is only continuous from wrist to distal phalanx in the thumb

b) the medial cutaneous nerve is the smallest nerve branch of the brachial plexus

c) the capitate bone within the carpus is the last of these to ossify

d) the pisiform bone is the first bone of the carpus to ossify

e) superficial lymphatics lie with arteries, deep lymphatics with veins

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Section 2

Answers

1 B

2 B

3 A

4 D

5 C

6 A

7 E

8 A

9 A

10 A

11 C

12 A

13 C

14 D

15 E

16 E

17 B

18 D

19 C

20 C

21 D

22 C

23 E

24 D

25 D

26 A

27 B

28 E

29 D

30 B

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Section 4

Upper Limb

1) Which is true?

a) epidermis derives from mesoderma

b) the sweat glands, sebaceous glands are mesodermal in origin

c) the colour of the skin is determined by the number of melanocytes in the skin

d) the dermis has a mesodermal origin

2) Regarding sweat glands, which is true?

a) the main nerve supply is via cholinergic sympathetic fibres

b) the main nerve supply is via adrenergic sympathetic nerves

c) the sweat glands derive from the mesoderm

d) the normal tubular sweat glands undergo cyclical changes with the menstrual cycle

e) the highest number of sweat glands are found on the soles and palms

3) Regarding cartilage, which is true?

a) they have a rich blood supply

b) the intervertebral discs are hyaline cartilages

c) the hyaline and fibrocartilages never calcify

d) the elastic cartilage never calcifies

e) the commonest cartilage type is elastic cartilage

4) Regarding muscles, which is true?

a) the cardiac muscle is more powerful than the other two muscle types

b) the skeletal muscle fibre is spindle shaped

c) the smooth muscles do not have actin and myosin

d) the skeletal muscle contraction causes peristalsis in the GI tract and ureter

e) the cardiac muscle is short, branched, mononuclear and a striated muscle

5) Regarding periosteum, which is TRUE?

a) it is an avascular fibrous tissue

b) it is osteogenic

c) it covers the articular surfaces of long bones

d) it covers the inner surface of the medullary cavity

e) it receives its blood supply from overlying muscle

6) An example of secondary cartilaginous joint include:

a) hip joint

b) manubrio-sternal joint

c) costochondral joint

d) epiphysis joint

e) wrist joint

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7) An example of a fibrous joint include:

a) structures of the vault of the skull

b) the vertebral columns

c) pubic symphysis

d) hip joint

e) manubrio-sternal joint

8) Which of the following peripheral fibres have pain and temperature fibres?

a) α neurone

b) β neurone

c) γ neurone

d) δ neurone

e) group B fibres

9) Pectoralis major:

a) is innervated laterally by the lateral pectoral nerve

b) inserts into the medial lip of the intertubercular sulcus

c) receives its arterial supply via the thoracoacromial artery

d) can act as an accessory muscle of inspiration

e) acts with latissimus dorsi and teres minor to adduct the arm


a) the suprascapular nerve arises from the anterior C5, 6 division

b) ulnar nerve often carries fibres from C7

c) the radial nerve leaves the axilla via the quadrangular space

d) the radial artery lies anterior to the medial and lateral roots of the median nerve

e) the long thoracic nerve arises from the C5 nerve root only

11) The subacromial bursa:

a) communicates with the shoulder joint

b) does not extend beyond the lateral aspect of the acromion

c) innervated in part by the dorsal scapular nerve

d) attached superiorly to the conoid trapezoid and conoid ligaments

e) attached inferiorly to the tendon of supraspinatus

12) The subclavius muscle:

a) arises from the costochondral junction of the second rib

b) passes in the subclavian groove on the inferior aspect of the clavicle to attach to the acromion

c) is enclosed by the upper attachment of the clavipectoral fascia

d) is supplied by C7 and C8

e) assists shoulder adduction

13) Pectoralis minor:

a) inserts into the lateral tip of the intertubecular groove of the humerus

b) is a rectangular muscle

c) is a guide for the underlying subclavian artery

d) is superior to the suspensory ligament of the axilla

e) is supplied by the subclavian nerve

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14) Teres major:

a) is separated from subscapularis by the quadrangular space in the posterior wall of the axilla

b) is supplied by the lateral subscapular nerve

c) inserts into the lateral lip of the intertubecular groove of the humerus

d) acting alone, it abducts and medially rotates the humerus at the shoulder joint

e) arises from the lateral side of the inferior angle of the ventral aspect of the scapula

15) The shoulder joint:

a) subscapularis, supraspinatus, infraspinatus and teres minor all have rotatory action on the humerus and

their tendons form the rotator cuff with the lateral part of the shoulder capsule

b) the subacromial bursa rolls inwards under the acromion when the arm is adducted

c) the joint capsule is attached to the surgical neck of the humerus inferiorly

d) the articular surface of the head of the humerus is five times the area of the glenoid cavity

e) upward thrust on the humerus will preferentially fracture the coracoacromial arch

16) Regarding the nerves and vessels of the arm:

a) the circumflex vessels and the axillary nerve enter the extensor compartment in the axilla through the

triangular space

b) the ulnar nerve pierces the lateral intermuscular septum in the lower third of the arm

c) the median nerve crosses obliquely in front of the radial artery in the arm

d) supratrochlear lymph nodes lie in the subcutaneous fat just above the medial epicondyle

e) the basilic vein is lateral to the cephalic vein

17) Regarding triceps:

a) the long head is lateral to the medial head

b) it inserts into the posterior aspect of the radial tuberosity

c) attachment to the olecranon is by a tendon only

d) the long head receives two branches of the radial nerve

e) the medial head has origins in both lateral and medial intermuscular septums


a) the medial cord has three branches

b) the lateral cord has fibres from C7, C8 and T1

c) the musculocutaneous nerve is a branch of the medial cord

d) the five roots are found from the posterior rami and C5 – T1 nerves

e) none of the above

19) At the carpal tunnel:

a) the flexor tendon synovial sheath is incomplete on the ulnar side

b) the superficial tendons lie in the same plane

c) the four profundus tendons have not yet separated

d) the median nerve lies lateral to flexor digitorum superficialis

e) median nerve compression causes anaesthesia over the thenar eminence

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20) What structure pierces the flexor retinaculum?

a) ulnar nerve

b) flexor carpi radialis tendon

c) palmar branch of median nerve

d) flexor pollicis longus tendon

e) ulnar artery

21) The lumbrical muscles:

a) arise from the four superficial tendons

b) are all bicipital muscles

c) pass along the ulnar side of the metacarpophalangeal joint

d) flex the metacarpophalangeal joint

e) attach directly to the first phalanx

22) The following are true about flexor carpi radialis EXCEPT:

a) it arises from the common flexor origin at the humerus

b) it has its own compartment in the flexor retinaculum

c) the radial artery lies laterally to it at the wrist

d) flexor pollicis longus lies medially

e) it is supplied by the median nerve

f) it inserts into the base of the 2nd and 3rd metacarpals

23) Which is the smallest branch of the medial cord of the brachial plexus?

a) medial pectoral nerve

b) medial root of the median nerve

c) medial cutaneous nerve of the arm

d) medial cutaneous nerve of the forearm

e) ulnar nerve

24) The nerve supply of serratus anterior is:

a) axillary nerve

b) C4

c) dorsal scapular nerve

d) thoracodorsal nerve

e) long thoracic nerve

25) Which muscle arises from both the radius and ulna:

a) extensor pollicis longus

b) extensor pollicis brevis

c) abductor pollicis longus

d) extensor indicis

e) extensor digitorum

26) Which lymphatics do not drain the breast?

a) subscapular nodes

b) infraclavicular nodes

c) lateral axillary nodes

d) parasternal nodes

e) pectoral nodes

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27) At the cubital fossa:

a) the median nerve is medial to the brachial artery

b) the biceps tendon separates the brachial artery from the median nerve

c) the radial artery leaves the brachial artery at right angles

d) the medial cutaneous nerve of the forearm runs deep to the bicipital aponeurosis

e) pronator teres forms the floor of the fossa

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Section 4

Upper Limb – Answers

1 E

2 A

3 D

4 E

5 B

6 B

7 A

8 D

9 D

10 B

11 E

12 ?

13 ?

14 ?

15 ??

16 ??

17 ?

18 E

19 D

20 B

21 D

22 D

23 C

24 E

25 C

26 C

27 A

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Section 5

General Principles

1) Regarding tissues:

a) cartilage is very vascular

b) ligaments do not stretch

c) deep fascia is not sensitive

d) cardiac muscle is nonstriated

e) periosteum is not sensitive

2) An example of a unipennate muscle is:

a) sartorius

b) flexor pollicis longus

c) rectus femoris

d) deltoid

e) tibialis anterior

3) An example of a secondary cartilaginous joint is:

a) distal tibiofibular joint

b) costochondral joint

c) sagittal suture

d) sternal angle joint

e) knee joint

4) Which vessel is not an end-artery?

a) renal artery

b) retinal artery

c) pulmonary artery

d) intercostal artery

e) splenic artery

5) A group C nerve fibre:

a) is up to 20 nm in diameter

b) is myelinated

c) has motor function

d) is fusimotor to muscle spindles

e) is post-ganglionic autonomic

6) Regarding cartilage, which is INCORRECT?

a) it is essentially avascular

b) hyaline cartilage contains hyaluronic acid

c) rib cartilage is elastic type

d) TMJ is fibrous

e) all contain mucopolysaccharides

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7) At birth:

a) the transverse diameter of the thorax is thrice the AP diameter

b) the liver is relatively twice as big as that of the adult

c) the suprarenal gland is twice as big as the kidney

d) the spinal cord extends to L5

e) the rib cage is more vertically inclined than in the adult

8) In the foetal skull:

a) the vertical height of the orbit is equal to the combined vertical heights of the maxilla and the mandible

b) the mandible is ossified at birth

c) the anterior fontanelle is closed at the end of the first year

d) the volume of the vault is equal to that of the face

e) the bones of the face and the vault ossify at six years

9) Regarding the sympathetic nervous system:

a) every spinal nerve receives a white ramus communicans

b) efferent post ganglionic fibres are myelinated

c) afferent sympathetic fibres synapse in the sympathetic trunk

d) preganglionic cell bodies lie within the lateral horn cells of the T1-L2 spinal segments

e) each cervical ganglion gives off one ramus communicans

10) Which of the following nerve roots is correctly associated with the corresponding muscle action?

a) L5 – plantar flexion of the foot

b) L2 – knee extension

c) C5 – abduction of the shoulder

d) C8 – abduction of the thumb

e) S1 – extension of the great toe

11) In the skin:

a) apocrine sweat glands are confined to the axillae, breasts and urogenital region

b) dark skinned races possess greater numbers of melanocytes

c) sebaceous glands are abundant on the palms and soles

d) melanocytes predominate in the dermis

e) eccrine glands develop under the influence of the sex hormones

12) Regarding bone:

a) cancellous and compact bone show marked microscopic differences

b) the clavicle ossifies in membrane

c) the bones of the skull and face ossify in cartilage

d) the epiphyseal plates of growing bones are composed of fibrocartilage

e) sesamoid bones are only associated with flexor tendons

13) The metacarpophalangeal joints are:

a) planar

b) ellipsoid

c) hinge

d) saddle

e) ball in socket

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14) Regarding the intrinsic muscles of the hand, which of the following is NOT true?

a) the palmar and dorsal interossei are supplied by the deep branch of the median nerve

b) the intrinsic muscles of the thumb are abductor pollicis brevis, flexor pollicis brevis, opponens pollicis ,

adductor pollicis, first palmar and first dorsal interossei

c) opponens pollicis acts only on the carpometacarpal joint

d) their motor supply is derived from segment T1 of the spinal cord

e) the thenar muscles are supplied by the recurrent branch of the median nerve

15) Regarding the synovial flexor sheaths, which of the following is NOT true?

a) three synovial sheaths are found on the front of the wrist

b) a common synovial sheath envelops all the superficialis and profundus tendons

c) the sheath around flexor pollicis longus tendon extends almost to its insertion

d) the flexor carpi ulnaris tendon has a short sheath

e) the ring, middle and index fingers have digital sheaths that do not extend to the common sheath

16) The recurrent branch of the median nerve supplies:

a) opponens digiti minimi

b) first dorsal interosseous

c) adductor pollicis

d) first lumbrical

e) abductor pollicis brevis

17) The corocobrachialis muscle:

a) is functionally important

b) origin = apex of acromion

c) insertion = lateral border of humerus

d) nerve supply = C4, C5

e) is pierced by the musculocutaneous nerve

18) Which structure lies in the deltopectoral groove?

a) median pectoral nerve

b) lateral pectoral nerve

c) cephalic vein

d) basilic vein

e) axillary vein

19) Which lymph nodes drain the ulnar side of the forearm?

a) infratrochlear

b) supratrochlear

c) infraclavicular

d) anterior axillary

e) ulnar trochlear

20) Which does NOT enter posterior compartment of the arm?

a) radial nerve

b) profunda brachii artery

c) ulnar nerve

d) posterior cutaneous nerve of forearm

e) superior ulnar collateral artery

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21) The annular ligament of the elbow:

a) has minimal usefulness

b) is attached to margins of the radial notch of the ulna

c) is attached to the head and neck of the radius

d) has common attachment with ulnar collateral ligament

e) is attached to the lateral epicondy????????

22) Extensor pollicis brevis:

a) origin – radius and interosseous membrane

b) lies on ulnar side of snuffbox

c) inserts into the base of the first distal phalanx

d) nerve supply = ulnar nerve

e) joins extensor digitorum tendon at metacarpophalangeal joint

23) Extensor pollicis longus – which is INCORRECT?

a) origin = ulnar just distal to adductor pollicis longus

b) insertion = base of first distal phalanx

c) tendon hooks around Lister’s tubercle (radius)

d) forms radial boundary of snuffbox

e) nerve supply – posterior interosseous nerve (C7, 8)

24) Extensor indicis:

a) origin = radius

b) shares a common synovial sheath with E.D. (?extensor digitorum)

c) tendon lies on radial side of E.D. tendon index finger

d) separate insertion from dorsal expansion E.D.

e) nerve supply = median nerve

25) The extensor retinaculum attaches between:

a) radius and ulna

b) scaphoid and ulna

c) radius and triquetral and pisiform

d) radius and lunate

e) trapezium and ulnar

26) All the following statements concerning the scaphoid bone are true EXCEPT:

a) it articulates with radius proximally in abduction

b) it is the most susceptible of the carpal bones to fracture

c) it participates in the midcarpal joint

d) it receives an attachment for the transverse carpal ligament

e) fracture of the scaphoid is a common cause for median nerve compression in carpal tunnel syndrome

27) All of the following structures pass deep to the transverse carpal ligament EXCEPT the:

a) flexor digitorum superficialis tendon

b) flexor digitorum profundus tendon

c) flexor pollicis longus tendon

d) median nerve

e) ulnar artery

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28) Laceration of the recurrent branch of the median nerve results in paralysis of all the following muscles of

the thumb EXCEPT:

a) abductor pollicis brevis

b) deep head of flexor pollicis brevis

c) opponens pollicis

d) superficial head of flexor pollicis brevis

29) Which muscle is the odd one out?

a) pronator teres

b) flexor carpi radialis

c) first lumbrical of the hand

d) fourth lumbrical of the hand

e) flexor pollicis longus

30) Infection in the volar aspect of the little finger can spread to all EXCEPT:

a) distally to the ring finger via the tendon sheath

b) to the flexor sheath of the thumb

c) to the distal forearm through the carpal tunnel

d) rupture of the sheath and spread to deep spaces of the palm

e) ischaemic necrosis may occur to the flexor tendon involved

31) Wrist:

a) the flexor retinaculum runs between the styloid process of the radius and the pisiform and hook of

hamate

b) the median nerve passes beneath the flexor retinaculum between flexor digitorum superficialis and

flexor carpi ulnaris

c) the ulnar nerve lies on the flexor retinaculum with the ulnar artery on its ulnar side

d) the wrist joint involves the radius, ulna, scaphoid, lunate and triquetral bones

e) the radiocarpal joint is separated from the distal radioulnar joint by a triangular fibrocartilage

32) Hand:

a) palmar brevis lies across the base of the thenar eminence

b) abductor pollicis brevis and opponens pollicis both arise from the flexor retinaculum and adjacent

trapezium

c) flexor pollicis brevis lies to radial side of abductor pollicis brevis

d) the muscles of the thenar eminence are usually supplied by the recurrent branch of the median nerve

e) opponens pollicis inserts into the whole of the ulnar border of the first metacarpal

33) Trapezius inserts into:

a) vertebral border scapula

b) scapula spine

c) proximal humerus

d) medial clavicle


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34) Myotome of elbow flexion:

a) C5, 6

b) C6, 7

c) C7, 8

d) C5

e) C6

35) Vincula:

a) papillary ridges of skin that form finger prints

b) superficial fibres of palmar aponeurosis that insert into the skin

c) remnant fibres of palmar interossei inserting into the proximal phalanx at the thumb

d) communication between common flexor sheath and sheath of pollicis longus present in 50% of people

e) vascular synovial folds of flexor tendons

36) Of the hand joints, which is INCORRECT?

a) the midcarpal joint is S shaped

b) joint between hamate and fifth metacarpal is most mobile at four digits

c) the first carpometacarpal joint is reinforced by the medial and palmar ligaments

d) palmar ligaments of metacarpophalangeal joints limit extension of joint

e) interphalangeal joints ????have to obliquely place collateral ligaments as a mechanism of tightening re

flexion and extension

37) Which is true of brachial plexus?

a) the trunks lie behind scalene muscle

b) accessory phrenic nerve fibres run to superior mediastinum with long thoracic nerve

c) median nerve divides at the carpal tunnel, lateral branch supplies thenar muscles and medial branch

supplies lumbricals (2)

d) ulnar nerve in 95% of cases picks up C7 fibres from lateral cord

e) branches of radial nerve rise just proximal to their destination

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Section 5

General Principals – Answers

1) B

2) B

3) D

4) D

5) E

6) C

7) B

8) A

9) D

10) C

11) A

12) B

13) D

14) A

15) D

16) C

17) E

18) C

19) B

20) E

21) B

22) A

23) D

24) B

25) C

26) E

27) E

28) B

29) D

30) A

31) E

32) D

33) B

34) A

35) E

36) C

37) D

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Section 6

Upper Limb

1) The radial nerve gives rise to all the following except the:

a) posterior cutaneous nerve of the arm

b) lower lateral cutaneous nerve of the arm

c) posterior cutaneous nerve of the forearm

d) posterior interosseous nerve

e) medial cutaneous nerve of the arm

2) Which of the following is INCORRECT? Pectoralis minor:

a) arises from the 3rd, 4th and 5th ribs

b) inserts into the coracoid process of the scapula

c) is innervated by both pectoral nerves

d) is an important landmark to the underlying axillary artery

e) is a medial rotator and adductor of the arm

3) Which of the following is INCORRECT? Pectoralis major:

a) consists of clavicular and sternocostal heads

b) is innervated by C6 to T1

c) medially rotates and abducts the arm

d) assists flexion at the shoulder

e) can act as an accessory muscle of respiration

4) The nerve supply of latissimus dorsi is from the:

a) pectoral nerves

b) thoracodorsal nerve

c) axillary nerve

d) long thoracic nerve

e) dorsal scapular nerve

5) The nerve supply of rhomboid major and rhomboid minor is from the:

a) pectoral nerves


c) axillary nerve



6) The nerve supply of serratus anterior is from the:

a) pectoral nerves


c) axillary nerve



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7) The nerve supply of pectoralis minor is from the:

a) pectoral nerves


c) axillary nerve



8) The nerve supply to deltoid is from the:

a) pectoral nerves


c) axillary nerve



9) Which of the following is INCORRECT? The biceps:

a) is a powerful flexor of the elbow

b) supinates the forearm

c) is paralysed by an injury to the posterior cord of the brachial plexus

d) is a weak flexor of the shoulder

e) inserts into the bicipital aponeurosis

10) Which of the following is not a direct attachment of the pectoral girdle to the trunk?

a) pectoralis minor

b) pectoralis major

c) trapezius

d) serratus anterior

e) levator scapulae

11) Which of the following does not connect the arm to the pelvic girdle?

a) deltoid

b) biceps

c) subclavius

d) subscapularis

e) supraspinatus

12) The nerve supply to supraspinatus is from the:

a) lower subscapular nerve

b) dorsal scapular nerve

c) suprascapular nerve

d) upper subscapular nerve

e) thoracodorsal nerve

13) The nerve supply to teres major is from the:


b) dorsal scapular nerve

c) suprascapular nerve

d) upper subscapular nerve

e) thoracodorsal nerve

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14) Which of the following is INCORRECT, regarding branches of the posterior cord?

a) C5, 6 – upper subscapular nerve

b) C6, 7, 8 – thoracodorsal nerve

c) C5, 6 – lower subscapular nerve

d) C7, 8 – axillary

e) C5, 6, 7, 8, T1 – radial nerve

15) What is the first bone of the skeleton?

a) tibia

b) humerus

c) scapula

d) femur

e) clavicle

16) Regarding the humerus:

a) the head forms half a sphere

b) the lateral epicondyle is more prominent

c) the axillary nerve winds around the anatomical neck

d) the greater tuberosity continues distally as the medial lip of the intertubecular groove

e) the capsule of the shoulder joint extends down the medial side of the humeral shaft

17) Which muscle does not arise from the common extensor origin?


b) extensor digitorum

c) extensor digiti minimi

d) extensor carpi radialis longus


18) Regarding the extensor retinaculum:

a) septa divide the extensor region into four compartments

b) it attaches to the ulnar styloid

c) the four extensor digitorum tendons lie deep to extensor indicis

d) it is a thickening of the deep fascia of the forearm

e) it lies transversely across the extensor surface of the wrist joint

19) Brachialis is supplied by:

a) median nerve

b) musculocutaneous nerve

c) radial nerve

d) median and musculocutaneous nn (?nerves)

e) musculocutaneous and radial nn (?nerves)

20) Which carpal bone is most commonly dislocated?

a) lunate

b) scaphoid

c) trapezium

d) capitate

e) pisiform

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21) Which muscle arises from both ulnar and radius?

a) pronator teres

b) flexor carpi radialis

c) flexor digitorum superficialis

d) flexor digitorum profundus


22) Which structure is NOT attached to the pisiform?

a) abductor digiti minimi

b) ulnar collateral ligament

c) flexor carpi ulnaris

d) extensor retinaculum

e) pisometacarpal ligament

23) The median nerve goes through the heads of which muscle?

a) biceps brachii

b) supinator

c) pronator teres

d) pronator quadratus

e) flexor digitorum superficialis

24) Regarding the interosseous muscle:

a) the palmar interossei have two heads

b) there are usually four palmar interossei

c) the tendons pass on the posterior side of the deep transverse ligament

d) they insert into the extensor expansion, not the proximal phalanges

e) they are supplied by the superficial branch of the ulnar nerve (C8, T1)

25) Which nerve arises from both radius and ulna?

a) extensor pollicis longus

b) extensor pollicis brevis

c) abductor pollicis longus

d) extensor indicis


26) In the forearm:

a) the brachial artery lies medial to the median nerve in the cubital fossa

b) the radial artery lies lateral to the radial nerve in the middle third

c) the anterior interosseous nerve arises from the radial nerve

d) the median nerve passes between the two heads of flexor carpi ulnaris

e) the posterior interosseous nerve passes between the two layers of the supinator

27) The radial artery:

a) gives rise to the posterior interosseous artery

b) passes distally, lateral to the biceps tendon

c) passes across the tendon of abductor pollicis brevis to enter the anatomical snuffbox

d) passes over the tendon of insertion of pronator teres


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28) A high ulnar nerve injury might produce:

a) weakness of elbow flexion

b) a ‘claw hand’

c) weak abduction of the index finger

d) triceps paralysis

e) sensory loss over the radial three fingers

29) In the cubital fossa:

a) the floor is formed mainly by the supinator

b) the medial wall is formed by pronator teres

c) the ulnar nerve lies medially

d) the radial nerve lies medial to the biceps tendon


30) Regarding the anatomical snuffbox:

a) the cephalic vein begins in the roof

b) the extensor pollicis brevis tendon forms the ulnar side

c) the trapezoid is palpable in the base

d) the cutaneous branches of the radial nerve run deep to the tendons

e) the flexor pollicis longus tendon forms the radial side


a) is supplied by all three cords of brachial plexus

b) is supplied by all five segments of brachial plexus

c) is inserted into the medial lip of the bicipital groove

d) clavicular fibres are strong adductors of shoulder joint

e) the lowermost sternocostal fibres insert into the lowermost part of the humeral insertion site

32) Pectoralis major arises from all EXCEPT the:

a) lateral anterior half of manubrium

b) body of sternum

c) aponeurosis of external oblique

d) upper six ribs

e) medial half of anterior clavicle

33) Sternoclavicular joint:

a) the sternoclavicular ligament provides most joint stability

b) joint surfaces are covered by hyaline cartilage

c) the entire clavicle joint surface is in contact with manubrium

d) anterior/posterior movement occurs between manubrium and disc

e) dislocation occurs frequently

34) Long head of triceps:

a) lies between teres minor and teres major

b) is supplied by branch of radial nerve at the humeral groove

c) arises from the humerus above the radial groove

d) converges with the medial head

e) arises from the supraglenoid rim

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35) Deltoid:

a) anterior fibres arise from lateral two thirds of clavicle

b) posterior fibres arise from superior lip of crest of scapular spine

c) lateral fibres only are multi-pennate

d) fibres strengthen shoulder joint capsule

e) acts in isolation to abduct humerus

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Section 6

Upper limb – Answers

1 E

2 E

3 B

4 B

5 E

6 D

7 A

8 C

9 C

10 B

11 C

12 C

13 A

14 D

15 E

16 E

17 D

18 D

19 E

20 A

21 C

22 B

23 C

24 C

25 C

26 E

27 D

28 C

29 B

30 A

31 B

32 D

33 D

34 A

35 C

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Section 7

Upper Limb

1) The elbow joint:

a) is supplied exclusively by the radial nerve

b) permits flexion/extension and pronation/supination

c) has a capsule which attaches in part to the radius

d) communicates with the superior radioulnar joint


2) With respect to the thenar muscles:

a) abductor pollicis brevis inserts into the base of the distal phalanx of the thumb

b) all arise from the flexor retinaculum

c) flexor pollicis brevis is usually supplied by a branch from the ulnar nerve

d) abductor pollicis brevis has no role in opposition of the thumb

e) opponens pollicis is the most superficial muscle of the group

3) With respect to the flexor retinaculum:

a) it attaches to the scaphoid, hamate, pisiform and trapezium

b) the tendon of palmaris longus passes deep to it

c) the median nerve passes superficial to it

d) the ulnar artery passes deep to it

e) it is pierced by the tendon of flexor carpi ulnaris

4) The medial cutaneous nerve of the arm:

a) has fibres from C8 and T1

b) arises from the dorsal cord of the brachial plexus

c) pierces the deep fascia adjacent to the tendon of biceps

d) has communications with the circumflex nerve



a) is synergistic to serratus anterior

b) is innervated by the median nerve

c) can abduct the arm

d) can act as an accessory muscle of respiration

e) is a lateral rotator of the arm

6) The brachial plexus:

a) arises from C6 to T1

b) lies in the anterior triangle of the neck

c) carries sympathetic fibres

d) supplies all the skin of the upper limb

e) the posterior divisions supply the flexor compartments

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7) The superficial palmar arch:

a) lies level with the distal border of the outstretched thumb

b) is supplied mainly from the radial artery

c) supplies the thumb

d) lies deep to the long flexor tendons

e) arises proximal to the flexor retinaculum

8) Paralysis of which nerve results in inability to initiate abduction of the arm?

a) the axillary nerve

b) the suprascapular nerve

c) the subscapular nerve

d) the dorsal scapular nerve

e) the thoracodorsal nerve

9) The axilla:

a) communicates with the anterior triangle of the neck

b) contains lymph nodes draining the upper limb and lateral chest wall

c) has an anterior wall made up by the serratus anterior muscle

d) has an apex bounded by the humerus, clavicle and scapula

e) has no medial wall

10) Brachialis muscle:

a) is innervated by the median nerve

b) arises from the upper third of the humerus

c) is both a flexor and extensor of the elbow joint

d) attaches to the bicipital tuberosity of the radius

e) has no relation to the medial intermuscular septum

11) Simple pronation:

a) requires an intact radial nerve

b) requires an intact C8 nerve root

c) occurs without movement of the ulna

d) occurs about an axis which runs along the shaft of the radius

e) requires the action of anconeus

12) The musculocutaneous nerve:

a) supplies brachioradialis

b) terminates as the posterior interosseous nerve

c) supplies all of the brachialis muscle

d) contains fibres from C5, C6, C7 and C8

e) arises from the lateral cord of the brachial plexus

13) Which of the following lies immediately medial to the tubercle of the radius (Lister’s tubercle)?

a) extensor carpi ulnaris

b) extensor carpi radialis

c) extensor pollicis longus

d) extensor pollicis brevis


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14) Interossei muscles in the hand:

a) flex the interphalangeal joints

b) assist in extension of metacarpophalangeal joints

c) cannot laterally deviate the middle finger

d) the palmar interossei have two heads of origin

e) are usually supplied by the ulnar nerve

15) The brachial artery:

a) commences at the upper border of teres major

b) is in direct contact with the humerus

c) has biceps tendon lying medial to it

d) is readily compressible

e) is accompanied throughout its course by the basilic vein

16) The wrist (radiocarpal) joint:

a) has a synovial cavity continuous with the inferior radioulnar joint

b) has a synovial cavity continuous with the midcarpal joint

c) permits flexion, extension, adduction and abduction, but little rotation

d) has the articular surface of the radius facing distally, medially and dorsally

e) has the flexor retinaculum anterior to it

17) The cephalic vein:

a) arises in the region of the anatomical snuffbox

b) at the elbow, is deep to the lateral cutaneous nerve of the forearm

c) terminates by joining the brachial vein

d) is medial to biceps in the arm

e) has no valves

18) The upper end of the humerus:

a) has the subscapularis attached to the greater tuberosity

b) has teres major attached to the floor of the bicipital groove

c) has three epiphyses which fuse separately with the shaft

d) has the capsular ligament of the shoulder joint attached to the whole of the anatomical neck

e) is the growing end of the humerus

19) In the antecubital fossa:

a) the ulnar nerve is on the medial side

b) the median nerve is lateral to the brachial artery

c) the radial nerve is on the lateral side

d) all the superficial veins are deep to the cutaneous nerves

e) the brachial artery is lateral to the tendon of biceps

20) The lunate articulates with all of the following EXCEPT:

a) scaphoid

b) triquetral

c) capitate

d) radius

e) trapezoid

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21) The brachial artery:

a) crosses anterior to the median nerve in the arm

b) gives off the nutrient artery to the humerus

c) lies deep to biceps

d) has the ulnar nerve on its medial side

e) gives muscular branches to triceps

22) Following a laceration to the anterior surface of the wrist, a patient is unable to flex the proximal

interphalangeal joint of his middle finger when his other fingers are held in extension. The tendon of which

muscle has been divided?

a) palmaris longus

b) flexor indics

c) flexor digitorum profundus

d) flexor digitorum superficialis


23) The palmar interossei:

a) abduct the fingers

b) are usually supplied by a branch of the ulnar nerve

c) have two heads

d) arise from the medial side of the metacarpal bone of the index, ring and little fingers

e) have no role in extension of the terminal phalanges

24) The cubital fossa:

a) is bounded by pronator teres, brachioradialis and the tendon of biceps

b) the brachial artery lies lateral to the radial nerve

c) has a floor made up of brachialis and supinator

d) contains the median basilic vein

e) the radial nerve lies medial to the posterior interosseous nerve

25) The capsule of the shoulder joint:

a) is supplied exclusively by the axillary nerve

b) is separated from the tendons of the short scapular muscles by a bursa

c) bridges the gap between the greater and lesser tuberosities as the transverse ligament

d) the long tendon of biceps is extracapsular

e) is the major stabilising factor for the shoulder joint

26) With respect to the carpus:

a) the intercarpal joints share one continuous synovial space

b) the intercarpal synovial space is usually continuous with the wrist

c) the proximal row consists of scaphoid, lunate and trapezium

d) the scaphoid is the only carpal bone which articulates with the radius

e) in pronation/supination, the carpus moves with the ulna

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27) Compression of the median nerve in the carpal tunnel produces:

a) anaesthesia over the thenar eminence

b) wasting of the hypothenar eminence

c) loss of power of opposition of the thumb

d) anaesthesia of the little finger

e) loss of power of flexion of the thumb

28) A child has gashed the palmar aspect of her wrist on some glass. Which of the following would be

evidence of damage to her median nerve?

a) inability to flex the distal interphalangeal joint of the index finger

b) inability to flex the interphalangeal joint of the thumb

c) loss of sensation to the palmar aspect of the little finger

d) inability to oppose the thumb and little finger

e) inability to abduct the index finger

29) A 45-year-old man is unable to initiate abduction of the arm following reduction of a dislocated shoulder.

Damage to which nerve is most likely to be responsible for this condition:

a) the suprascapular nerve

b) the long thoracic nerve

c) the radial nerve

d) the infrascapular nerve

e) the axillary nerve

30) Direct attachment of the pectoral girdle to the trunk is provided by:

a) pectoralis major

b) trapezium

c) latissimus dorsi

d) subscapularis

e) deltoid

31) The posterior interosseous nerve DOES NOT supply:

a) the periosteum of the radius and ulna

b) the skin over the dorsal aspect of the thumb

c) extensor carpi ulnaris

d) extensor pollicis brevis

e) the interosseous membrane

32) The nerve supply of pectoralis minor is from the:

a) dorsal scapular nerve

b) long thoracic nerve

c) pectoral nerves

d) lower subscapular nerve

e) axillary nerve

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33) The insertion of latissimus dorsi in the arm is into the:

a) lateral lip of the intertubecular groove

b) medial lip of the intertubecular groove

c) posterior border of the proximal humerus

d) floor of the intertubecular groove

e) superior facet of the greater trochanter

34) Regarding the sternoclavicular joint, the major stabilising factor is the:

a) acromioclavicular ligament

b) costoclavicular ligament

c) interclavicular ligament

d) sternoclavicular ligament

e) coracoclavicular ligament

35) The nerve supply of infraspinatus is the:

a) axillary nerve

b) long thoracic nerve

c) infrascapular nerve

d) suprascapular nerve

e) subscapular nerve

36) The cephalic vein:

a) empties into the brachial vein

b) combines with the basilic vein to form the axillary vein

c) is the continuation of the median basilic and medial cephalic veins

d) empties into the axillary vein


37) Which one of the following structures pass beneath the flexor retinaculum at the wrist?

a) palmaris longus

b) ulnar nerve

c) radial artery

d) ulnar artery

e) median nerve

38) The skin of the top of the index finger is supplied by:

a) radial nerve only

b) median nerve only

c) ulnar nerve only

d) radial and ulnar nerve

e) radial and median nerve

39) Extensor pollicis longus muscle:

a) arises from the radius

b) extends the metacarpophalangeal joint of the thumb

c) is supplied by the arterial interosseous nerve

d) hooks around the dorsal tubercle of the radius (Lister’s tubercle)

e) arises proximal to the abductor pollicis longus

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40) The extensor retinaculum:

a) lies transversely across the extensor surface of the wrist joint

b) is attached to the radius and the ulna

c) is attached to the pisiform

d) is attached to the scaphoid

e) is attached to the trapezium

41) The anatomical snuff box:

a) is crossed by cutaneous branches of the median nerve

b) has the anterior interosseous artery on its floor

c) contains the origin of the basilic vein

d) has extensor pollicis longus on the radial side

e) is crossed by cutaneous branches of the radial nerve

42) Compression of structures in the carpal tunnel usually results in:

a) weakness of the forearm flexors

b) weakness of flexion of the terminal phalanx of the thumb

c) weakness of the interossei muscles

d) normal sensation on the palmar surface of the little finger

e) weakness of the lumbrical muscles

43) Holding a heavy hammer in your hand involves:

a) only the long flexors of the fingers

b) flexion of wrist to strengthen grip

c) immobilisation of the shoulder joint to strengthen grip

d) only the long flexors of fingers and opposition of the thumb

e) requires synergic contraction of wrist extensors

44) The anatomical snuff box:

a) has the tendon of extensor pollicis brevis on its ulnar side

b) has the radial artery lying in its floor

c) has the radial styloid process as the only palpable bony point

d) has the tendon of abductor pollicis brevis on its radial side

e) contains the origin of the basilic vein

45) Rotator cuff muscles include:

a) subclavius

b) teres minor

c) pectoralis major

d) teres major

e) deltoid

46) Regarding synovial flexor sheaths in the hand and wrist, which one of the following is INCORRECT?

a) they surround flexor tendons in the carpal tunnel

b) the superficial and deep flexors are invested with a common synovial sheath

c) the common flexor sheaths can communicate with flexor pollicis longus sheath in some people

d) for the index, ring and middle finger, a separate synovial sheath lines the fibrous sheath over the

phalanges

e) the sheath is the origin of the lumbricals

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47) Which of the following structures is NOT one of the contents of the cubital fossa?

a) brachial artery

b) tendon of biceps brachii

c) radial nerve

d) anterior interosseous nerve

e) median nerve

48) The superficial branch of the ulnar nerve supplies:

a) palmaris brevis

b) flexor digitorum ulnaris

c) palmar aspect index finger

d) opponens pollicis

e) thenar eminence

49) The order of tendons in the extensor compartment of the distal forearm from radial to ulnar sides is:

ED = extensor digitorum

ECRB = extensor carpi radialis brevis

FCU = flexor carpi ulnaris

EI = extensor indicis

ECRL = extensor carpi radialis longus

ECU = extensor carpi ulnaris

EPL = extensor pollicis longus

a) ECRB; ECRL; EPL; ED; FCU; ECU; EI

b) ECRB; ECRL; EPL; ED; ECU; FCU; EI

c) ECRL; ECRB; EPL; ED; ECU; EI; FCU

d) ECRL; ECRB; EPL; ED & EI; ECU; FCU

e) ECRB; ECRL; EPL; ECU; FCU; ED & EI

50) Which of the following is true about flexor digitorum superficialis?

a) origin forms upper limit of the space of parona

b) all four tendons lie on the same plane under flexor retinaculum

c) is innervated by median and ulnar nerves

d) tendon to index finger separates before other three tendons high in forearm

e) median nerve passes between its two heads

51) Which of the following statements about the brachial plexus is INCORRECT?

a) long thoracic nerve arises from roots

b) Erb’s palsy occurs following traction to upper roots and trunk

c) posterior cord has five branches

d) suprascapular nerve arises from trunks

e) trunks lie behind clavicle on first rib

52) Branches of the axillary artery DO NOT include:

a) superior thoracic

b) subscapular

c) medial thoracic

d) thoracoacromial

e) posterior circumflex humeral

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53) Which of the following is NOT TRUE regarding the breast?

a) it arises from the midline to mid axillary line from the second to the sixth ribs

b) it is subcutaneous

c) blood supply is mainly from the lateral thoracic and internal thoracic artery

d) most lymph drains to the axillae

e) it is invested in a thick fibrous capsule

54) Biceps:

a) long head arises from infraglenoid tubercle

b) is supplied by a branch of the medial cord of the brachial plexus

c) the two bellies do not merge

d) is a pronator of the forearm

e) short head arises from coracoid process, lateral to coracobrachialis

55) The radial nerve:

a) supplies extensors to the elbow

b) pierces the medial intermuscular septum of the mid arm

c) supplies extensor carpi ulnaris

d) runs on the lateral side of the radial artery in the forearm

e) runs in the cubital fossa

56) Which of the following DOES NOT form one of the boundaries of the cubital fossa?

a) brachialis

b) supinator

c) line connections the two humeral epicondyles

d) bicipital aponeurosis

e) medial margin of pronator teres

57) Which of the following muscles DOES NOT arise from the common extensor origin?


b) extensor digitorum comminus

c) extensor carpi radialis longus

d) extensor digiti minimi


58) Regarding the shoulder joint:

a) glenoid labrum is a ring of hyaline cartilage

b) subacromial bursa communicates with joint

c) capsule attaches only around the articular margin

d) subscapular bursa communicates with joint

e) supraspinatus is a medial rotator of humerus

59) Which of the following is CORRECT?

a) the suprascapular nerve arises from the posterior aspect of C5

b) the five roots emerge between scalenus anterior and scalenus medius to form the trunks

c) the thoracodorsal nerve arises from the posterior aspect of C5

d) the axillary nerve passes through the triangular space to lie in contact with the surgical neck of humerus

e) the median nerve is the largest branch of the whole plexus

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60) The quadrangular space between teres major and subscapularis transmits:


b) axillary artery

c) profunda brachii vessels

d) radial nerve

e) post circumflex humeral artery

61) With regard to the elbow joint, which is NOT TRUE?

a) it communicates with the radioulnar joint

b) the carrying angle is mostly determined by the obliquity of the ridge between coronoid and olecranon

prominences

c) the radial collateral, ulnar collateral and annular ligaments keep the bones together

d) the carrying angle is partly determined by the bow in the ulnar and radial shafts

e) it is supplied by the brachial nerve

62) Which of the following DOES NOT arise from the roots of the brachial plexus?

a) dorsal scapular

b) nerve to serratus anterior

c) medial pectoral nerve

d) nerve to subclavius

63) Regarding the hand:

a) deep palmar arch is level with the distal border of the outstretched thumb web

b) the superficial branch of the ulnar nerve supplies the hypothenar muscles

c) deep branch of the ulnar nerve lies within the concavity of the deep palmar arch

d) flexor digitorum superficialis tendon inserts into the base of the distal pharynx

e) lumbricals insert into the extensor expansion and proximal phalanges

64) The venous systems that contribute least to venous drainage of the forearm is:

a) the basilic vein

b) the cephalic vein

c) the deep veins which are often duplicate

d) the carpal rete

e) the median cubital

65) Which of the following IS NOT true about the flexor carpi ulnaris?

a) acts as a synergist during wrist extension

b) ulnar artery passes deep to its deep head

c) inserts into base of fifth metacarpal

d) most medial muscles arising from the common flexor origin

e) ulnar nerve passes between its two heads

66) Which of the following structures DOES NOT pierce the clavipectoral fascia in the delto-pectoral triangle?

a) lymphatics

b) medial pectoral nerve

c) acromiothoracic axis

d) lateral pectoral nerve

e) cephalic vein

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67) Radial nerve:

a) is the largest branch of the brachial plexus

b) occupies the length of the spiral groove

c) damage causes inability to extend the wrist and the interphalangeal joints

d) damage causes sensory loss to the palm

e) arises from the lateral cord of the brachial plexus

68) Regarding the shoulder joint:

a) the glenoid labrum is the most important stabilising factor

b) the strong capsule is reinforced by tight glenohumeral ligaments

c) the coracoacromial arch prevents the humeral head from displacing

d) the long head of triceps gives stability to the abducted humerus

e) the pull of teres minor stabilises the abducted humerus

69) The articulating surfaces of which of the following synovial joints are covered by fibrocartilage?

a) scapholunate joint

b) glenohumeral joint

c) acromioclavicular joint

d) manubriosternal joint

e) sternocostal joint

70) A structure that does not lie in the cubital fossa is:

a) brachial artery

b) median nerve

c) median cubital vein

d) superficial radial artery

e) radial nerve if brachioradialis is lateralised

71) Which of the following is CORRECT concerning flexor digitorum profundus?

a) it arises from both radius and ulna

b) is innervated by both median and ulnar nerves

c) the origins of the lumbricals arise from its tendons

d) it flexes the terminal phalangeal joints

72) Which of the following groups of lymph nodes directly drain the breast?

a) lateral axillary nodes

b) subscapular nodes

c) pectoral nodes

d) parasternal nodes

e) infraclavicular nodes

73) Which of the following IS NOT true about pectoralis major?

a) only upper limb muscle supplied by all five segments of brachial plexus

b) arises by two heads

c) inserts via a bilaminar tendon

d) innervated by lateral pectoral nerve

e) contributes to boundaries of axilla

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74) Axillary artery:

a) becomes brachial artery at lower border teres minor

b) axillary vein lies laterally to the artery

c) is divided into three parts by pectoralis minor

d) second part is clasped by the two heads of median nerve

e) gives off the superior thoracic artery from its second part

75) Regarding flexor digitorum profundus, which is NOT TRUE?

a) is the most powerful and bulky muscle of the forearm

b) arises from the common flexor origin

c) the tendon for the index separates in the forearm from the three other tendons

d) it gives rise to origin of four lumbricals

e) it is supplied by the anterior interosseous nerve and the ulnar nerve in a variable distribution

76) Damage to the median nerve may be suggested clinically by:

a) a wasting of the interossei

b) pointing index finger

c) ‘claw hand’

d) sensory loss over ulnar side of hand

e) inability to abduct the index finger

77) Which of the following DOES NOT form the boundaries of the cubital fossa:

a) anconeus

b) brachioradialis

c) pronator teres

d) deep fascia of the forearm

e) bicipital aponeurosis

78) Which of the following is NOT TRUE concerning the elbow joint?

a) it is a synovial joint

b) the capsule of the synovial joint is attached to the radius distal to the annular ligament

c) the humeroulnar joint space communicates with the radioulnar joint space

d) the joint is supplied by musculocutaneous, median, radial and ulnar nerves

79) Which of the following statements about the glenohumeral (shoulder joint) is INCORRECT?

a) long tendon of biceps is extrasynovial

b) subscapularis bursa communicates with joint cavity

c) innervated by medial pectoral nerve

d) branches of third part of axillary artery provide majority of blood supply

e) surface area of humeral head is about four times greater than that of glenoid fossa

80) Which of the following structures IS NOT one of the contents of the carpal tunnel?

a) flexor digitorum superficialis

b) ulnar artery

c) flexor digitorum profundus

d) median nerve


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81) Which of the following IS NOT true about pronator teres?

a) ulnar artery passes between two heads

b) forms medial boundary of cubital fossa

c) arises from common flexor origin

d) adducts radius

e) less powerful pronator than pronator quadratus

82) Which of the following statements about the cubital (elbow) joint is INCORRECT?

a) innervated by branch of musculocutaneous nerve to brachialis

b) “closed-packed” position is in extension

c) it is a compound synovial joint

d) radial collateral ligament consists of three separate bands

e) carrying-angle is about 160-170°

83) Which of the following is CORRECT about the latissimus dorsi?

a) arises from all spinous processes from T8 and S5

b) known as the “boxers muscle”

c) innervated by the long thoracic nerve

d) derivative of upper limb myotomes

e) forms the superior border of the triangle of auscultation

84) Which of the following is CORRECT about flexor carpi radialis?

a) tendon receives muscle fibres down to just above the wrist

b) tendon lies in a groove on the trapezoid

c) arises lateral to flexor digitorum superficialis

d) has median nerve ‘plastered’ to deep surface

e) tendon pierces flexor retinaculum

85) Which of the following pierce the medial intermuscular septum of the arm?

a) medial cutaneous nerve of the arm

b) ulnar nerve

c) median nerve

d) basilic nerve

e) profunda brachii artery

86) Which of the following DOES NOT arise, in part, from the lateral intermuscular septum of the arm?

a) brachioradialis

b) extensor carpi radialis longus

c) brachials

d) medial head of triceps brachii

e) none of the above arise from the lateral intermuscular septum of the arm

87) Which of the following DOES NOT contribute to the innervation of the elbow joint?

a) radial nerve

b) ulnar nerve

c) median nerve

d) musculocutaneous nerve

e) medial cutaneous nerve of the arm

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88) Regarding the axilla:

a) the posterior wall consists of subscapularis and teres minor

b) the medial wall is formed by serratus anterior down to the 6th intercostal space

c) the apex communicates directly with the posterior triangle of the neck

d) coracobrachialis forms part of the anterior wall

e) the axillary artery is generally described as having eight branches

89) The largest branch of the axillary artery is:

a) superior thoracic artery

b) thoracoacromial artery

c) lateral thoracic artery

d) subscapular artery

e) posterior circumflex humeral artery

90) The cubital fossa has:

a) a floor formed by the deep fascia of the forearm

b) the median cephalic vein lying medially on its roof

c) the brachial artery medial to the tendon of the biceps

d) supinator forming part of its lateral wall

e) flexor carpi radialis longus forming its lateral wall

91) The only carpal bone to give attached to both flexor and extensor retinacula is:

a) scaphoid

b) trapezoid

c) hamate

d) triquetral

e) pisiform

92) In the carpal tunnel:

a) the individual tendons arising from flexor digitorum profundus are all fused, and do not separate until

they reach the palm

b) the synovial sheath of flexor digitorum superficialis arises from the ulna bursa, but the sheath of

profundus does not

c) the tendon for the index finger from flexor digitorum superficialis lies medial to the median nerve

d) flexor carpi radialis and flexor pollicis longus tendons share a synovial sheath

e) the tendon of flexor digitorum superficialis to the middle finger lies deep to the tendons to the little

finger

93) Structures in the anatomical snuff box include all the following EXCEPT:

a) the radial tubercle

b) the scaphoid

c) the base of the thumb metacarpal

d) the trapezium

e) the radial artery

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94) Which muscle arises in part from the scaphoid tubercle?

a) flexor pollicis brevis

b) abductor pollicis brevis

c) opponens pollicis

d) adductor pollicis

e) first palmar interossei

95) Which of the following muscles arises, in part, from the radial collateral ligament of the elbow joint?


b) supinator

c) extensor digiti minimi

d) extensor carpi ulnaris


96) Which nerve is a branch of the lateral cord of the brachial plexus?

a) upper subscapular nerve


c) musculocutaneous nerve

d) ulnar nerve

e) lower subscapular nerve

97) The peripheral nerve arising directly from the upper trunk of the brachial plexus is the:

a) dorsal scapular

b) thoracodorsal

c) suprascapular

d) upper subscapular

e) lower subscapular

98) The first part of the subclavian artery:

a) usually gives off no branches

b) lies behind the anterior scalene muscle

c) makes a groove in the dome of the pleura

d) is encircled by the ansa cervicalis

e) on the left lies anterior to the common carotid artery

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Section 7

Upper Limb – Answers

1 D

2 B

3 A

4 A

5 D

6 C

7 A

8 B

9 B

10 C

11 C

12 E

13 C

14 E

15 D

16 C

17 A

18 E

19 C

20 E

21 B

22 D

23 B

24 C

25 C

26 A

27 C

28 D

29 A

30 B

31 B

32 C

33 D

34 B

35 D

36 D

37 E

38 B

39 D

40 C

41 E

42 D

43 E

44 B

45 B

46 E

47 D

48 A

49 D

50 A

51 E

52 C

53 E

54 E

55 D

56 E

57 C

58 D

59 B

60 E

61 E

62 C

63 C

64 C

65 B

66 B

67 A

68 D

69 C

70 C

71 A

72 A

73 C

74 C

75 B

76 B

77 A

78 B

79 C

80 B

81 A

82 D

83 D

84 E

85 B

86 C

87 E

88 C

89 D

90 C

91 E

92 C

93 A

94 B

95 B

96 C

97 C

98 C

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Dr.7aßèéß

UPPER LIMB MCQ

1. Regarding the clavicle, all are correct EXCEPT:

a. It is an example of the short bones.

b. It is the first bone to ossify in the fetal life.

c. It ossifies in membrane.

d. It is the commonly fractured bone.

e. It has no medullary cavity.

Answer a

2. The most common site of fracture of the clavicle is:

a. Medial end.

b. Lateral end.

c. Midpoint of the clavicle.

d. Junction of the medial two-thirds and the lateral third.

e. Junction of the lateral two-thirds and the medial third.

Answer d

3. The inferior surface of the clavicle gives attachment to all of the following

EXCEPT:

a. Conoid ligament.

b. Trapezoid ligament.

c. Costoclavicular ligament.

d. Pectoralis major muscle.

e. Subclavius muscle.

Answer d

4. These muscles are attached to the medial two thirds of the clavicle EXCEPT:

a. Sternomastoid.

b. Deltoid.

c. Pectoralis major.

d. Subclavius.

e. Sternohyoid.

Answer b

5. Regarding the articulations of the clavicle, one is correct:

a. The medial end articulates with the manubrium by fibrous articulation.

b. The medial end articulates with the manubrium by cartilaginous articulation.

c. The medial end articulates with the body of the sternum by saddle synovial

joint.

d. The lateral end articulates with the acromion by fibrous articulation.

e. The lateral end articulates with the acromion by plane synovial articulation.

Answer e

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6. One of he following is not attached to the medial border of the scapula:

a. Levator scapulae.

b. Teres minor.

c. Serratus anterior.

d. Rhombideus minor.

e. Rhomboideus major.

Answer b

7. All of the following parts of the scapula can be felt EXCEPT:

a. Acromion process.

b. Crest of the spine.

c. Upper border.

d. Inferior angle.

e. Tip of the coracoid process.

Answer c

8. The glenoid cavity articulates with the head of the humerus by a:

a. Fibrous articulation.

b. Cartilaginous articulation.

c. Plane synovial articulation.

d. Ball and socket synovial articulation.

e. Hinge synovial articulation.

Answer d

9. The surgical neck of the humerus is related to the:

a. Radial nerve.

b. Axillary nerve.

c. Ulnar nerve.

d. Median nerve.

e. None of the above.

Answer b

10. The back of the medial epicondyle is related to the:

a. Radial nerve.

b. Axillary nerve.

c. Ulnar nerve.

d. Median nerve.


Answer c

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11. The deltopectoral groove contains:

a. Deltoid branch of the lateral thoracic artery.

b. Cephalic vein.

c. Apical group of axillary lymph nodes.

d. All of the above.


Answer b

12. The axilla contains all of the following EXCEPT:

a. Axillary artery.

b. Axillary vein.

c. Trunks of the brachial plexus.

d. Fat.

e. Tail of the breast.

Answer c

13. The bicipital groove of the humerus lodges (contains) the:

a. Axillary artery.

b. Long head of the biceps.

c. Long head of the triceps.

d. Coracobrachialis.


Answer b

14. Muscle/s taking origin from the clavicle is/are:

a. Subclavius.

b. Trapezius.

c. Pectoralis major.


e. a and b only.

Answer c

15. One of the following is a branch of the second part of the axillary artery:

a. Lateral thoracic artery.

b. Anterior circumflex humeral artery.

c. Posterior circumflex humeral artery.

d. Superior thoracic artery.

e. Subscapular artery.

Answer a

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16. The thoracoacromial artery is a branch of the:

a. Subclavian artery.

b. First part of the axillary artery.

c. Second part of the axillary artery.

d. Third part of the axillary artery.

e. Brachial artery.

Answer c

17. The breast is supplied by:

a. Lateral thoracic artery.

b. Internal thoracic artery.

c. Intercostals arteries.



Answer d

18. The female breast:

a. Has a nipple that is usually located opposite the 6th intercostals space.

b. Has Cooper’s ligament that suspends the breast.

c. Has a bed formed mainly by the serratus anterior muscle.

d. Has about 5 lactiferous sinuses.

e. Its lymphatics drain mainly in the parasternal lymph nodes.

Answer b

19. The brachial plexus has:

a. 8 rami (roots).

b. 5 trunks.

c. 6 divisions.

d. 4 cords.


Answer c

20. The usual number of branches of the medial cord of the brachial plexus:

a. 1.

b. 2.

c. 3.

d. 4.

e. 5.

Answer e

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21. The usual number of branches of the lateral cord of the brachial plexus:

a. 1.

b. 2.

c. 3.

d. 4.

e. 5.

Answer c

22. The earliest bone to ossify in the body is:

a. Humerus.

b. Radius.

c. Ulna.

d. Clavicle.

e. Femur.

Answer d

23. The deep pectoral fascia:

a. Invests the subclavius muscle.

b. Invests the pectoralis minor muscle.

c. Separates the pectoralis major from the breast.

d. Pierced by the lateral pectoral nerve.

e. All of the above.

Answer c

24. Regarding the axilla, one is INCORRECT:

a. The axillary artery terminates at the lower border of teres major.

b. The brachial plexus terminates at the lower border of the pectoralis minor.

c. The third part of the axillary artery is related to the cords of the brachial

plexus.

d. The axillary lymph nodes receive 75% of the lymphatics of the breast.

e. The anterior fold of the axilla is higher than the posterior fold.

Answer c

25. The anterior wall of the axilla is formed by all of the following EXCEPT:

a. Pectoralis major.

b. Teres major.

c. Pectoralis minor.

d. Subclavius.

e. Clavipectoral fascia.

Answer b

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26. In Erb’s paralysis, the deformity is called:

a. Winging of the scapula.

b. Claw hand.

c. Ape hand.

d. Wrist drop.

e. Policeman’s tip position.

Answer e

27. In Klumpke’s paralysis, the deformity is called:


b. Claw hand.

c. Ape hand.

d. Wrist drop.


Answer b

28. Paralysis of the serratus anterior muscle causes:


b. Claw hand.

c. Ape hand.

d. Wrist drop.


Answer a

29. The suprascapular nerve is a branch from the:

a. Roots of the brachial plexus.

b. Upper trunk.

c. Middle trunk.

d. Posterior cord.

e. Lateral cord.

Answer b

30. The root value of the long thoracic nerve is:

a. C5.

b. C6.

c. C7.

d. C5, 6 & 7

e. C5, 6, 7 & 8

Answer d

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31. The anterior (pectoral) group of the axillary lymph nodes is located along the:

a. Upper part of the axillary vein.

b. Lower part of the axillary vein.

c. Lateral thoracic artery.

d. Subscapular artery.


Answer c

32. Lymphatics from the skin of the back above the iliac crest drain into the:

a. Pectoral group of the axillary lymph nodes.

b. Subscapular group of the axillary lymph nodes.

c. Central group of the axillary lymph nodes.

d. Apical group of the axillary lymph nodes.

e. Parasternal lymph nodes.

Answer b

33. Lymphatics that accompany the cephalic vein drain into the:





e. Lateral group of the axillary lymph nodes.

Answer d

34. Lymphatics from the medial zone of the breast drain into the:






Answer e

35. Lymphatics from the nipple and areola drain into the:






Answer a

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36. The trapezius muscle is supplied by the:

a. Cranial accessory nerve.

b. Spinal accessory nerve.

c. Long thoracic nerve.

d. Dorsal scapular nerve.

e. Thoracodorsal nerve.

Answer b

37. One of the following muscles is not a rotator cuff muscle:

a. Supraspinatus.

b. Infraspinatus.

c. Teres minor.

d. Teres major.

e. Subscapularis.

Answer d

38. Paralysis of the deltoid muscle causes:

a. Loss of abduction of the arm from zero to 15°.

b. Loss of abduction of the arm from 15° – 90°

c. Loss of abduction of the arm from zero to 90°.

d. Loss of abduction of the arm from 90° – 180°


Answer b

39. The axillary nerve supplies the:

a. Muscle that abducts the arm from zero to15°.

b. Muscle that abducts the arm from 15° – 90°.

c. Muscle that forms the rounded contour of the shoulder.

d. a and c.

e. b and c.

Answer e

40. The suprascapular nerve supplies:

a. Muscle inserted into the upper impression of the greater tuberosity of the

humerus.

b. Muscle inserted into the middle impression of the greater tuberosity of the

humerus.

c. Muscle that initiates abduction of the arm.


e. a and b only.

Answer d

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41. Lesion of the axillary nerve causes:


b. Flat shoulder.

c. Claw hand.

d. Ape hand.

e. Wrist drop.

Answer b

42. Muscles that rotate the scapula downward are attached to:

a. Ventral lip of the medial border of the scapula.

b. Dorsal lip of the medial border of the scapula.

c. Upper lip of the crest of the spine.

d. Lower lip of the crest of the spine.

e. a and c.

Answer b

43. Muscles that rotate the scapula upward are attached to the:

a. Ventral lip of the medial border of the scapula.

b. Dorsal lip of the medial border of the scapula.

c. Upper lip of the crest of the spine.

d. Lower lip of the crest of the spine.

e. a and c.

Answer e

44. All the muscles attached to the bicipital (intertubercular) groove:

a. Abduct the arm (shoulder joint).

b. Adduct the arm.

c. Medial rotation of the arm.

d. a and c.

e. b and c.

Answer e

45. Anastomosis around the scapula connects the subclavian artery with the:

a. First part of the axillary artery.

b. Second part of the axillary artery.

c. Third part of the axillary artery.

d. Brachial artery.


Answer c

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46. Actions of the latissimus dorsi:

a. Flexes the arm.

b. Abducts the arm.

c. Laterally rotates the arm.



Answer e

47. Triangle of auscultation is associated with all of the following EXCEPT:

a. Latissimus dorsi.

b. Teres major.

c. Rhomboid major.

d. Trapezius.

e. Medial border of the scapula.

Answer b

48. The quadrangular space is bounded by all of the following EXCEPT:

a. Teres minor.

b. Teres major.

c. Long head of biceps.

d. Long head of triceps.

e. Surgical neck of the humerus.

Answer c

49. Regarding the biceps brachii, one is INCORRECT:

a. Has long head attached to the supraglenoid tubercle.

b. Has short head attached to the tip of the coracoid process.

c. Has a tendon inserted into the radial tuberosity.

d. It flexes the elbow joint.

e. It is powerful supinator of the extended elbow.

Answer e

50. The direction of the nutrient foramen of the humerus is:

a. Upward.

b. Downward.

c. Medially.

d. Laterally.


Answer b

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51. The bicipital aponeurosis passes obliquely deep to the:

a. Brachial artery.

b. Median cubital vein.

c. Median nerve.

d. Radial nerve.


Answer b

52. In movements of the arm, the coracobrachialis assists in:

a. Flexion.

b. Exatension.

c. Abduction.

d. Rotation.

e. Supination.

Answer a

53. The brachial artery:

a. Bifurcates opposite the neck of the humerus.

b. Is deep throughout its entire course.

c. In the cubital fossa, it lies medial to the biceps tendon.

d. The median nerve crosses in front of the artery from the medial to the lateral

side.


Answer c

54. The cubital fossa is bounded by the:

a. Pronator quadratus.

b. Brachioradialis.

c. Coracobrachialis.

d. Biceps tendon.

e. a and b only.

Answer b

55. The lateral cutaneous nerve of the forearm is derived from the:

a. C5.

b. C6.

c. C7.

d. C5, 6, 7

e. C6, 7, 8

Answer d

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56. The anterior compartment of the arm contains all of the following EXCEPT:

a. Biceps.

b. Triceps.

c. Brachialis.

d. Coracobrachialis.

e. Brachial artery.

Answer b

57. Muscles innervated by the musculocutaneous nerve:

a. Brachialis.

b. Coracobrachialis.

c. Biceps.


e. Triceps.

Answer d

58. The cubital fossa contains all of the following EXCEPT:

a. Brachial artery.

b. Radial artery.

c. Radial nerve.

d. Ulnar nerve.

e. Median nerve.

Answer d

59. The constriction below the greater and lesser tuberosities of the humerus is

called:

a. Anatomical neck.

b. Surgical neck.

c. Humeral shaft.

d. Humeral ring.


Answer b

60. The lesser tuberosity of the humerus gives attachment to the:

a. Supraspinatus.

b. Infraspinatus.

c. Teres minor.

d. Teres major.

e. Subscapularis.

Answer e

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61. The proximal row of the carpal bones consists of all of the following EXCEPT:

a. Scaphoid.

b. Lunate.

c. Trapezium.

d. Pisiform.

e. Triquetral.

Answer c

62. Regarding the ulnar nerve, all are correct EXCEPT:

a. Is the largest branch of the medial cord of the brachial plexus.

b. Carries fibers from C6, C7 and C8.

c. Has no branches in the arm.

d. It enters the hand superficial to the flexor retinaculum.

e. Injury of the nerve causes partial claw hand.

Answer b

63. Regarding the median nerve, all are correct EXCEPT:

a. Arises from both the medial and lateral cords of the brachial plexus.

b. It crosses the brachial artery at the insertion of the coracobrachialis.

c. In the cubital fossa, it lies lateral to the brachial artery.

d. It enters the hand in the carpal tunnel.

e. Injury of the nerve causes ape-like hand.

Answer c

64. One of the following is not a branch of the radial artery:

a. Radial recurrent artery.

b. Common interosseous artery.

c. Palmar (anterior) carpal.

d. Dorsal (posterior) carpal.

e. Deep palmar arch.

Answer b

65. The median nerve supplies all of the following muscles EXCEPT:

a. Flexor carpi ulnaris.

b. Flexor carpi radialis.

c. Flexor digitorum superficialis.

d. Palmaris longus.

e. Pronator teres.

Answer a

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66. The ulnar nerve supplies all of the following muscles EXCEPT:

a. Adductor pollicis.

b. Flexor pollicis longus.

c. Interossei muscles.

d. Hypothenar muscles.

e. Medial 2 lumbricals.

Answer b

67. The ulnar nerve:

a. is a branch from the lateral cord of the brachial plexus.

b. Carries fibers from C8 and T1.

c. Supplies all the superficial muscles of the front of the forearm except flexor

carpi ulnaris.



Answer b

68. The distal row of the carpal bones consists of:

a. Scaphoid.

b. Lunate.

c. Triquetral.

d. Pisiform.


Answer e

69. Structure crossing superficial to the flexor retinaculum:

a. Median nerve.

b. Ulnar nerve.

c. Flexor digitorum superficialis.

d. Flexor pollicis longus.


Answer b

70. Carpal tunnel syndrome causes:

a. Claw hand.

b. Wrist drop.

c. Paralysis of all muscles of the hand.

d. Ape-like hand.

e. Waiter’s tip position.

Answer d

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71. The usual number of branches of the median nerve in the arm:

a. 0

b. 1

c. 3

d. 4

e. 6

Answer a

72. The usual number of branches of the ulnar nerve in the arm:

a. 0

b. 1

c. 3

d. 4

e. 6

Answer a

73. Branches of the radial artery at the wrist include:

a. 1st dorsal metacarpal artery.

b. 2nd dorsal metacarpal artery.

c. 3rd dorsal metacarpal artery.



Answer a

74. Regarding the bicipital aponeurosis, one is incorrect:

a. It is an extension from the tendon of the biceps.

b. It blends with the deep fascia covering the extensor muscles of the forearm.

c. Passes over the brachial artery.

d. Crosses the front of the median nerve.

e. Separates the median nerve from the median cubital vein.

Answer b

75. Branches of the ulnar artery in the forearm include:

a. Common interosseous artery.

b. Anterior ulnar recurrent artery.

c. Superficial palmar branch.


e. A and B only.

Answer e

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76. The following muscles are innervated by the median nerve EXCEPT:

a. Pronator teres.

b. Pronator quadratus.

c. Flexor pollicis longus.

d. Opponens pollicis.

e. Adductor pollicis.

Answer e

77. Muscles taking origin from the radius:

a. Biceps.

b. Supinator.

c. Pronator quadratus.

d. Flexor pollicis longus.


Answer d

78. Relations of the ulnar artery at the wrist:

a. Lies anterior to the flexor retinaculum.

b. Lies lateral to the pisiform bone.

c. Lies medial to the ulnar nerve.


e. A and B only.

Answer e

79. Relations of the median nerve at the wrist:

a. Lies in the carpal tunnel.

b. 2 inches above the wrist, it becomes subcutaneous.

c. Lies between the tendons of the palmaris longus and flexor carpi radialis.


e. A and B only.

Answer d

80. As a result of injury of the ulnar nerve at the wrist:

a. Marked wasting (atrophy) of the thenar eminence.

b. The thumb cannot be abducted.

c. The thumb cannot be adducted.

d. Loss of sensation over the thumb.

e. A and B are correct.

Answer c

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Section 1

Lower Limbs mcqs

1) Tensor fasciae latae is supplied by :

a) anterior division of femoral nerve

b) superior gluteal nerve

c) nerve to vastus lateralis

d) inferior gluteal nerve

e) lateral femoral cutaneous nerve

2) Which structure is intrasynovial at the knee joint:

a) oblique popliteal ligament

b) tendon of popliteus

c) medial and lateral menisci

d) anterior cruciate ligament


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

a) anterior cruciate ligament

b) oblique popliteal ligament

c) medial collateral ligament

d) lateral collateral ligament

e) posterior cruciate ligament

4) Tibialis anterior:

a) is supplied by the tibial nerve

b) inserts into the second metatarsal bone

c) is pierced by the posterior tibial artery

d) tendon perforates the superior extensor retinaculum

e) does not arise from the interosseous membrane

5) The adductor canal:

a) contains the femoral artery and nerve

b) ends distally in the adductor longus hiatus

c) contains no muscular nerves

d) has adductor longus forming the root

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

6) The great saphenous vein:

a) joins the femoral vein above the inguinal ligament

b) begins as the upward continuation of the lateral marginal vein of the foot

c) travels with the saphenous nerve along its course

d) runs behind the medial malleolus

e) enters the femoral vein on its anteromedial side

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7) Regarding the femoral artery:

a) adductor magnus lies between it and the profunda femoris artery

b) the profunda femoris vein lies behind the profunda femoris artery

c) profunda femoris artery arises from its posterior surface

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

e) the femoral vein is always on its medial side

8) Gluteus maximus:

a) forms the gluteal fold

b) has four bursae beneath it

c) has blood supply solely from the inferior gluteal artery

d) is the chief control of hip flexion

e) has 50% of fibres inserting into the gluteal tuberosity

9) Regarding the adductor compartment:

a) adductor magnus lies between the anterior and posterior divisions of the obturator nerve

b) adductor longus inserts into the upper two thirds of the linear aspect of the femur

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

d) the medial intermuscular septum separates the adductor compartment from the posterior compartment

e) obturator externus medially rotates the hip

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

a) superior gluteal artery

b) obturator artery

c) lateral circumflex femoral artery

d) medial circumflex femoral artery

e) inferior gluteal artery

11) The sciatic nerve:

a) lies deep to the posterior femoral cutaneous nerve

b) passes down over obturator internus, quadratus, femoris and piriformis

c) tibial and common peroneal components separate behind the hip joint

d) in the buttock it lies midway between the greater trochanter and pubic tuberosity

e) is derived from L3, 4, 5, S1, 2

12) Which is the odd one out?

a) sciatic nerve

b) nerve to obturator internus

c) superior gluteal nerve

d) pudendal nerve

e) posterior femoral cutaneous nerve

13) Regarding the hamstring compartment:

a) the cutaneous nerve supply is from the posterior circumflex femoral nerve

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

c) semitendinosus lies deep to semimembranosus

d) the oblique popliteal ligament is an expansion of biceps femoris

e) the long head of biceps arises from the lateral facet of the ischial tuberosity

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14) Regarding the popliteal vessels:

a) the tibial nerve lies between the popliteal artery and vein

b) the sural arteries supply soleus

c) the middle genicular artery supplies the cruciate ligaments

d) lymph nodes lie alongside the popliteal artery

e) the popliteal artery enters the fossa on the lateral side of the femur

15) At the knee joint:

a) the fibular collateral ligament is attached to the lateral meniscus and joint capsule

b) there are three main gaps in the joint capsule

c) the tibial collateral ligament is tight in flexion

d) the posterior cruciate ligament is attached to the lateral condyle of the femur

e) the cruciate ligaments are sensitive and the menisci are not

16) Regarding nerve supply of the lower limb:

a) superficial peroneal nerve supplies the muscles in the anterior compartment of the leg

b) the cruciate ligaments are supplied by the tibial nerve

c) the obturator nerve supplies obturator internus muscle

d) the sciatic nerve does not make contact with bone

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

17) Regarding flexor digitorum longus:

a) its four tendons divide under the flexor retinaculum

b) it arises from the tibia and interosseous membrane only

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

d) the tendons have no flexor sheaths

e) it inserts into the bases of the middle phalanges

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

a) superficial circumflex iliac artery

b) superficial epigastric artery

c) superficial external pudendal artery

d) deep external pudendal artery

e) middle genicular artery

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

a) ilioinguinal

b) medial femoral cutaneous nerve

c) obturator nerve

d) lateral femoral cutaneous nerve

e) genitofemoral nerve

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

a) it is the longest vein in the body

b) it passes behind the medial malleolus

c) at the knee, it lies a hand’s breadth behind the medial border of the patella

d) the saphenous opening lies about 3cm below and lateral to the pubic tubercle

e) the deep external pudendal artery runs medially behind the saphenous vein near its termination

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

a) the superficial inguinal node group consists of about 15 nodes

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

below the waist

c) the medial nodes of proximal superficial group receive lymph from testes, glans penis, lower anal canal

and perineum

d) the distal nodes of the superficial group receive all the superficial lymphatics of the lower limb

e) the superficial inguinal nodes drain mainly to the internal iliac nodes

22) Fascia lata is not:

a) attached inferiorly to the tibial condyles and head of the fibula

b) reinforced anteriorly by expansions from the quadriceps tendon

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

d) continuous below the popliteal fossa into the deep fascia of the calf

e) attached superiorly along the external lip of the iliac crest

23) The iliotibial tract:

a) lies lateral to tensor fascia latae

b) inserts onto the head of the fibula

c) is the origin of 60% of gluteus maximus

d) is a weak flexor of the knee via tensor fascia latae

e) is attached superiorly to the iliac crest

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

a) iliacus

b) psoas

c) pectineus

d) adductor magnus

e) adductor longus

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

a) femoral artery

b) femoral canal

c) femoral hernia

d) femoral nerve

e) lymph node of Cloquet

26) The profunda femoris artery does not:

a) normally supply all the thigh muscles

b) arise from the lateral side of the femoral artery, 3-4cm distal to the inguinal ligament

c) give off the deep external pudendal artery

d) lie behind the profunda vein

e) lie directly anterior to adductor brevis and magnus

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

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

b) supplies iliacus in the abdomen

c) lies in the iliac fossa between psoas and iliacus

d) gives a branch to pectineus as it enters the femoral triangle

e) divides into several branches just distal to the inguinal ligament

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

a) medial femoral cutaneous nerve

b) saphenous nerve

c) nerve to vastus medialis

d) lateral femoral cutaneous nerve

e) nerve to sartorius

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

contraction?

a) the forward prominence of the lateral condyle of the femur

b) the action of articularis genu

c) the action of vastus medialis

d) the action of rectus femoris

e) the tension of the medial patellar retinaculum

30) The adductor canal is not:

a) roofed by fascia containing the subsartorial plexus

b) occupied by the sciatic nerve

c) also known as Hunter’s canal

d) occupied by the femoral artery

e) a gutter shaped groove between vastus medialis and the front of the adductor muscles

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

a) sartorius lies on the fascial roof

b) in the distal part of the canal, the femoral vein is posterolateral to the artery

c) at all levels, the artery lies between saphenous nerve and femoral vein

d) the subsartorial plexus supplies overlying fascia lata and an area of skin above medial side of the knee

e) the adductors in the floor of the canal are the adductor brevis above and the adductor longus below

32) In the medial compartment of the thigh:

a) adductor magnus consists of adductor and hamstring muscle masses

b) the contents are separated from the posterior compartment by the posterior intermuscular septum

c) adductor longus is the most superficial muscle of the medial side of the thigh

d) the anterior division of the obturator nerve passes through obturator externus

e) the posterior division of the obturator nerve is the prime motor supply

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

a) blood supply is mainly from the femoral artery

b) the sciatic nerve lies lateral to the long head of biceps

c) the long head of biceps is supplied by the common peroneal nerve

d) the hamstrings form the apex of the popliteal fossa

e) semimembranosus arises in common with the long head of biceps

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34) Slipped upper femoral epiphysis:

a) is more common in girls than boys

b) usually occurs in the 5-8 year age group

c) may present as referred pain in the knee

d) the limb may be internally rotated and shortened

e) can be treated conservatively

35) Dermatomes of lower limb:

a) S1 supplies the great toe

b) L2 supplies anterior upper thigh

c) S3 supplies perianal area

d) L4 supplies medial thigh

e) L5 supplies medial calf

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

a) adductor magnus

b) pectineus

c) psoas

d) ilacus

e) adductor longus

37) Patellar plexus comprises of all EXCEPT:

a) posterior branch of lateral femoral cutaneous nerve

b) infrapatella branch of saphenous nerve

c) medial femoral cutaneous nerve

d) anterior branch of lateral femoral cutaneous nerve

e) intermediate femoral cutaneous nerve

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

a) deep peroneal nerve

b) tibialis anterior

c) extensor hallucis longus

d) anterior tibial artery

e) peroneus brevis

Lower Limb - Answers

1 B

2 E

3 A

4 D

5 E

6 E

7 D

8 D

9 C

10 B

11 A

12 C

13 B

14 C

15 E

16 B

17 C

18 E

19 A

20 B

21 B

22 C

23 E

24 D

25 D

26 C

27 A

28 D

29 C

30 B

31 E

32 A

33 D

34 C

35 B

36 A

37 A

38 B

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Section 2

Lower Limbs

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

a) the intermediate femoral cutaneous nerve

b) the obturator nerve

c) the genital branch of the genitofemoral nerve

d) the ilioinguinal nerve

e) the posterior cutaneous nerves of the thigh

2) The patellar plexus takes twigs from all but which of the following?

a) infrapatellar branch of the common peroneal nerve

b) medial femoral cutaneous nerve

c) lateral femoral cutaneous nerve

d) intermediate femoral cutaneous nerve

e) infrapatellar branch of the saphenous nerve

3) The inferior gluteal nerve supplies:

a) gluteus maximus

b) gluteus medius

c) gluteus minimus

d) all of the above


4) Within the buttock:

a) the pudendal nerve emerges beneath piriformis, turns around the back of the sacrospinous ligament

and passes between the sacrotuberous and sacrospinous ligaments

b) the internal pudendal artery can be compressed against the base of the ischial tuberosity

c) the sciatic nerve (L4, 5, S1) emerges from below piriformis muscle more laterally than the inferior gluteal

and pudendal nerves and vessels

d) the posterior femoral cutaneous nerve lies medially to the sciatic nerve

e) the cruciate anastomosis provides the main source of blood for the supply of the head of femur

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

a) the fibular collateral ligament blends with the capsule and is attached to the lateral meniscus

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

c) the oblique popliteal ligament is an expansion from the tendon of semitendinosis that blends with the

capsule posteriorly

d) the posterior cruciate ligament runs from anterior tibial plateau to the posteromedial aspect of the

lateral femoral condyle

e) the transverse ligament runs posteriorly between menisci

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

a) plantaris arises from the lower part of the lateral supracondylar line and is absent in 10%

b) the medial head of gastrocnemius is larger than the lateral

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

foot

d) the soleal muscle contains a rich plexus of small veins → the soleal pump

e) the nerve of this compartment is the tibial nerve

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

a) L3, 4

b) L4, 5

c) L5, S1

d) S1, 2

e) S2, 3

8) With respect to the hip bone:

a) the pelvic rim is formed by the iliac crest, top curricular area and pectineal line

b) the iliofemoral ligament and sartorius are attached to/at (??) the anterosuperior iliac spine

c) the iliopubic eminence on anterior margin of acetabulum joins the ischium and pubic bone

d) the tubercle of the iliac crest lies 7.5cm behind the anterosuperior iliac spine

e) the line between the highest point of the iliac crest passes through the spine of ??????

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

a) femoral artery

b) femoral vein

c) femoral nerve

d) saphenous nerve

e) nerve to vastus medialis

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

a) the ischial tuberosity to the adductor tubercle of the medial femoral condyle

b) the posterior superior iliac spine to the apex of the popliteal fossa

c) the midpoint of a line between the ischial tuberosity and the greater trochanter to the adductor

tubercle of the medial femoral condyle

d) the ischial tuberosity to the apex of the popliteal fossa

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

11) The femoral canal:

a) is the lateral compartment of the femoral sheath

b) lies medial to the pubic tubercle

c) contains the femoral nerve

d) is medial to the femoral vein

e) transmits the femoral branch of the genitofemoral nerve

12) The great saphenous vein:

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

b) passes behind the medial malleolus

c) is accompanied by the saphenous nerve throughout its course

d) passes under the inguinal ligament and enters the femoral vein

e) drains the medial side of the leg between the tibia and the tendocalcaneus

13) Which is NOT true of the tendoachilles?

a) it inserts into the middle third of the posterior surface of the calcaneus

b) it is invested in a synovial sheath

c) it is formed from the soleus and gastrocnemius

d) a bursa lies between the tendon and the upper third of the calcaneus

e) a bursa lies between it and the deep fascia near its insertion

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

a) patellar ligament

b) tibial collateral ligament

c) fibular collateral ligament

d) tendon of popliteus

e) patellar retinacula

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

damaged?

a) the deep branch of the common peroneal nerve

b) the sural nerve

c) the superficial branch of the common peroneal nerve

d) the saphenous nerve


16) With respect to peroneus longus:

a) it inserts into the base of the 5th metacarpal

b) it is supplied by the superficial peroneal nerve

c) it has a broad tendon that lies between the lateral malleolus and the tendon of peroneus brevis

d) it arises from the upper two thirds of the tibia

e) it is mainly supplied by L4 and L5 segments

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

a) anterior cruciate ligament

b) iliotibial tract

c) posterior cruciate ligament

d) popliteus and posterior cruciate ligament

e) arcuate popliteal ligament and anterior cruciate ligament

18) Regarding the femoral triangle:

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

b) it is bisected by the femoral nerve

c) the lateral border of sartorius muscle makes up its lateral boundary

d) the long saphenous vein joins the femoral vein within the triangle

e) rectus femoris makes up part of the floor

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

a) peroneus longus and peroneus brevis

b) peroneus longus and tibialis posterior

c) tibialis anterior and tibialis posterior

d) peroneus brevis and plantaris


20) The anterior tibial artery:

a) pierces the interosseous membrane

b) supplies the lateral compartment of the leg

c) lies lateral to the deep peroneal nerve

d) lies lateral to tibialis anterior

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e) gives the nutrient artery to the tibia

21) The suprapatellar bursa:

a) does not communicate with the knee joint

b) lies in front of the vastus intermedius muscle

c) extends 5cm or more above the patella

d) lies deep to the patellar retinacula


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

a) it inserts into the lateral meniscus of the knee joint

b) it is innervated by the tibial nerve

c) it acts to extend the knee joint

d) it inserts into the lateral condyle of the femur

e) it acts to laterally rotate the femur of the fixed tibia

23) A 30 year old man presents with adenopathy of the medial group of superficial inguinal lymph nodes on

the right side. Which of the following is the primary site resulting in this finding?

a) right testis

b) right buttock

c) the skin of the right lower limb

d) the anal canal


24) Regarding the femoral artery:

a) it enters the thigh directly beneath the deep inguinal ring

b) it lies lateral to the femoral nerve in the femoral sheath

c) it gives rise to the profunda femoris artery which pierces the femoral sheath

d) does not contribute to the trochanteric anastomosis

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

25) Regarding the popliteal fossa:

a) the common peroneal nerve passes through the lateral part of the fossa

b) it contains no lymph nodes

c) it has a roof pierced by the tibial nerve

d) the popliteal artery lies superficial to the popliteal vein throughout the fossa

e) the small saphenous vein joins the popliteal vein before its entry into the fossa

26) Regarding the movements at the knee joint:

a) popliteus ‘unlocks’ the extended knee by producing medial rotation of the femur

b) there is no active rotation of the extended knee

c) passive extension of the knee does not result in ‘locking’ of the joint

d) the posterior cruciate ligament prevents backward displacement of the femur on the tibial plateau

e) the major role of the menisci is in flexion/extension of the knee

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27) The dorsalis pedis artery:

a) lies medial to the tendon of extensor hallucis longus

b) lies lateral to the detail branch of the deep peroneal nerve

c) crosses superficial to the tendon of extensor hallucis brevis

d) terminates at the arcuate artery

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

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

a) the superficial peroneal nerve

b) the L5 nerve root

c) the tibial nerve

d) soleus

e) gastrocnemius

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

a) tendon of flexor hallucis longus

b) abductor hallucis

c) flexor accessorius

d) the lumbrical muscles

e) tendon of flexor digitorum longus

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

a) the sciatic nerve

b) the pudendal nerve and vessels

c) the posterior cutaneous nerve of the thigh

d) the inferior gluteal nerve and vessels

e) the nerve to obturator externus

31) The psoas muscle:

a) passes across the front of the capsule of the hip joint

b) is a powerful lateral rotator of the femur

c) inserts into the greater trochanter

d) is supplied by L4 and L5 nerve roots

e) arises from the iliac crest and sacroiliac joint

32) The femoral nerve:

a) is formed from the anterior divisions of the anterior primary rami of L2-4

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

c) divides after passing through the femoral triangle

d) has no cutaneous branches other than the saphenous nerve

e) enters the thigh in the femoral sheath

33) The peroneus longus muscle:

a) passes superficial to the superior peroneal retinaculum

b) inserts into the styloid process of the fifth metatarsal bone

c) is supplied by the common peroneal nerve

d) assists in the maintenance of the lateral longitudinal arch

e) has no origin from the tibia

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34) The short saphenous vein:

a) lies anterior to the lateral malleolus

b) is accompanied by the saphenous nerve

c) drains into the great saphenous vein

d) drains the lateral margin of the foot

e) lies deep to the deep fascia of the calf

35) Following a subcapital fracture of the neck of the femur, an 80 year old man sustains avascular necrosis of

the femoral head. This is most likely to be the consequence of interruption to the blood supply to the head

from which of the following sources:

a) arteries from trochanteric anastomosis in the retinacula

b) artery of the ligament of the head from the obturator artery

c) branches from the profunda femoris artery

d) branches from the pudendal artery

e) branches from the inferior gluteal artery

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

a) femoral vein

b) lateral cutaneous nerve of the thigh

c) femoral nerve

d) femoral branch of the genitofemoral nerve

e) great saphenous vein

37) Regarding the femoral triangle:

a) adductor magnus makes up part of the floor

b) no motor branches of the femoral nerve leave the triangle to enter the sartorius canal

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

d) the main cutaneous nerve supply of the skin overlying the triangle is by the ilioinguinal nerve

e) the femoral vein lies medial to the femoral artery throughout the triangle

38) Regarding the femoral nerve, all of the following are true EXCEPT:

a) the superficial group consists of two cutaneous and two muscular branches

b) the nerve to the vastus medialis passes down on the medial side of the femoral artery

c) the medial femoral cutaneous nerve belongs to the superficial group

d) the saphenous nerve is the only cutaneous branch of the deep group of the femoral nerve

e) the femoral nerve is formed from the posterior divisions of the ventral rami of the lumbar nerves 2, 3

and 4

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

a) the anterior fibres of the gluteus medius and minimus act as medial rotator of the hip joint

b) the gluteus maximus is the most powerful lateral rotator of the hip joint

c) gluteus medius and minimus are supplied by the inferior gluteal nerve (L5, S1, S2)

d) the superior gluteal nerve (L4, L5, S1) emerges from the greater sciatic notch

e) the iliofemoral ligament limits extension at the hip joint

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

a) the common peroneal nerve slopes downwards lateral to the biceps tendon

b) the sural nerve is a cutaneous branch of the common peroneal nerve

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

d) the popliteus muscle is supplied by a branch of the common peroneal nerve

e) the recurrent genicular nerve is a branch of the tibial nerve

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

a) the tibialis anterior muscle is supplied by the deep peroneal and recurrent genicular nerves (L4)

b) extensor digitorum longus and peroneus tertius muscle lie lateral to tibialis anterior artery throughout

c) the deep peroneal nerve arises within the peroneus longus muscle

d) the extensor digitorum longus dorsiflex the lateral toes

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

interosseous membrane

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

a) the tibialis posterior muscle inverts and adducts the forefoot

b) the tibialis posterior muscle plantarflex the ankle joint

c) the tibialis anterior muscle dorsiflex the ankle and inverts the foot

d) all interossei muscles are supplied by the lateral plantar nerve

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

43) The popliteal artery:

a) is superficial to the tibial nerve

b) extends from the hiatus in adductor longus

c) enters the popliteal fossa on lateral aspect of the femur

d) has four genicular branches in fossa

e) supplies the cruciate ligaments

44) The obturator nerve:

a) adductor magnus

b) obturator internus

c) quadratus femoris

d) sartorius

e) inferior gemellus

45) Which of the following is correctly paired?

a) adductor brevis – femoral nerve

b) adductor longus – sciatic nerve

c) adductor magnus – saphenous nerve

d) adductor longus – obturator nerve

e) adductor magnus – femoral nerve

46) The anterior cruciate ligament::

a) lies within the synovial membrane of the knee joint

b) attaches from the anterior tibial plateau to the medial condyle of the femur

c) prevents forward displacement of the femur on the tibial plateau

d) produces lateral rotation of the femur in the ‘screw home’ position of full extension


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47) The surface marking for the femoral nerve is:

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

b) midway between the A.S.I.S. and pubic synthesis

c) medial to the femoral artery

d) 2cm lateral and 2cm interior to the pubic tubercle


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

a) popliteal vein

b) popliteal artery

c) tibial nerve

d) sural nerve

e) plantaris muscle

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

a) deep infrapatellar bursa

b) superficial infrapatellar bursa

c) prepatellar bursa

d) semimembranosis bursa

e) suprapatellar bursa

50) Adductor longus is inserted onto the:

a) upper half of the linea aspera of the femur

b) upper two thirds of the linea aspera of the femur

c) upper one third of the linea aspera of the femur

d) lower two thirds of the linea aspera of the femur

e) lower half of the linea aspera of the femur

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

a) iliacus

b) semitendinosis

c) semimembranosis

d) gluteus maximus

e) gluteus medius

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

a) tendon of obturator internus

b) piriformis muscle

c) posterior cutaneous nerve of the thigh

d) pudendal nerve

e) nerve to quadratus femoris

53) The medial compartment of the thigh:

a) contains obturator internus

b) contains the adductor canal

c) contains the femoral triangle

d) is limited superiorly by the obturator membrane

e) is supplied mainly by the obturator artery

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

a) medial tubercle of the talus

b) the neck of the talus

c) the sustenaculum tali

d) the navicular bone

e) the medial cuneiform

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Section 2

Lower Limb – Answers

1 C

2 A

3 A

4 A

5 B

6 C

7 D

8 E

9 C

10 E

11 D

12 A

13 B

14 D

15 A

16 B

17 C

18 D

19 C

20 D

21 C

22 C

23 D

24 E

25 A

26 B

27 E

28 C

29 B

30 E

31 A

32 B

33 D

34 D

35 A

36 E

37 C

38 B

39 C

40 C

41 E

42 E

43 E

44 A

45 D

46 E

47 A

48 B

49 E

50 D

51 D

52 A

53 D

54 C

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Section 3

1) In the femoral triangle:

a) the femoral nerve emerges from the femoral sheath

b) the saphenous nerve lies medial to the femoral artery at the apex

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

d) the profunda femoris artery arises from the medial aspect of the femoral artery

e) the obturator nerve passes anterior to pectineus

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

a) gluteus minimus

b) gluteus medius

c) gluteus maximus

d) Camper’s fascia

e) Scarpa’s fascia

3) Fourth lumbar nerve root supplies:

a) hip flexors


c) skin on the big toe

d) flexor longus digitorum

e) flexor accessories (quadratus plantae)

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

a) sartorius

b) adductor longus

c) inguinal ligament

d) pubic tubercle


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

a) internal pudendal vessels and nerve

b) inferior gemellus muscle

c) posterior cutaneous nerve of the thigh

d) nerve to quadratus femoris


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

a) lateral

b) medial

c) anterior

d) posterior

e) femoral vein is not in the femoral sheath

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

a) a site for injections

b) a cushion for sitting

c) a flexor of the hip

d) a lateral rotator of the hip


8) Tensor fascia latae:

a) is quadrangular in shape

b) is supplied by the femoral nerve

c) extends the hip

d) is an atavistic remnant of the panniculus carnosus muscle

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

9) The superior gluteal nerve supplies:

a) gluteus medius

b) gluteus minimus

c) tensor fascia latae

d) none of the above

e) all of the above

10) The hamstring muscles originate from:

a) body of the ischium

b) ramus of the pubis

c) iliac crest

d) ischial tuberosity

e) symphysis pubis

11) The upper tibial epiphysis appears at:

a) birth

b) 1 year

c) 2 year

d) 3 years

e) puberty

12) At birth:

a) all the tarsal bones are ossified

b) only calcaneus is ossified

c) calcaneus and talus are ossified

d) calcaneus, talus and cuboid are ossified


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

a) sciatic nerve

b) femoral vein

c) common peroneal nerve

d) femoral artery

e) saphenous nerve

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

a) medial malleolus

b) lateral malleolus

c) medial epicondyle

d) lateral epicondyle

e) greater trochanter

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

a) lateral rotation of the tibia

b) medial rotation of the femur

c) tightening of the medial ligament

d) tightening of the lateral ligament

e) tension in the oblique popliteal ligament

16) The posterior cutaneous nerve of the thigh:

a) consists only of S2, 3

b) travels most of its course superficial to the fascia lata

c) innervates a small area on the labia majora

d) emerges above pinforris


17) The deep peroneal nerve supplies:

a) skin between the first and second toes

b) skin between the second and third toes

c) skin on the medial side of the shin

d) skin on the dorsolateral side of the foot

e) the great toe only

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

a) posterior cruciate ligament

b) lateral ligament of the knee

c) mucous fold

d) popliteus muscle

e) oblique popliteal ligament

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

a) T12, L1 and L2

b) L1, L2 and L3

c) L2, L3 and L4

d) L3, L4 and S1


20) The skin crease of the hip:

a) is where the inguinal ligament is attached to the fascia lata

b) is where the external oblique aponeurosis is joined to Scarpa’s fascia

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

d) is mainly supplied by the femoral nerve


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21) Peroneus tertius:

a) acts only to evert the foot

b) arises from the lower anterior part of the tibia

c) may insert into the neck of the fifth metatarsal

d) passes superficial to the extensor retinaculum

e) is innervated by the superficial peroneal nerve

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

a) major perforating veins to deep venous system

b) a branch of the femoral nerve

c) medial superficial lymphatic trunks

d) a branch of the anterior tibial nerve

e) dorsalis pedis artery

23) The only muscle to cross the anterior tibial artery is:

a) extensor hallucis longus

b) extensor digitorum brevis

c) extensor hallucis brevis

d) extensor digitorum longus

e) tibialis anterior

24) The dorsalis pedis artery is:

a) lateral to extensor hallucis longus at the ankle

b) medial to extensor hallucis longus at the ankle

c) medial to tibialis anterior at the ankle

d) found perforating the first metatarsal space and joining with the medial plantar artery

e) lateral to the digital branch of the deep peroneal nerve

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

a) it is on the medial side of the tibia

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

c) it is ossified from five centres

d) it does not provide origin for flexor digitorum longus

e) its lower third is rough for the origin of soleus

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

a) is predominantly from L2

b) supplies adductor magnus

c) pierces the deep fascia in the femoral triangle

d) is cutaneous only

e) terminates just below the knee

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

a) profunda femoris

b) popliteal

c) internal iliac

d) external iliac


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

a) medial femoral circumflex

b) lateral femoral circumflex

c) popliteal

d) perforating

e) all are branches of the profunda

29) The long saphenous vein:

a) passes anterior to the inguinal ligament

b) passes posteriorly to the medial malleolus

c) ascends the lateral side of the leg

d) receives tributaries from the perineum

e) is in close relation with the saphenous nerve throughout the length of its course

30) The chief dorsiflexor of the ankle joint:

a) peroneus tertius


c) extensor longus hallucis

d) extensor longus digitorum


31) Iliopsoas:

a) supplied by obturator nerve

b) medial rotator of hip

c) synergist of quadriceps femoris

d) lateral rotator of hip


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

a) T12, L1, L2 and L3

b) L1, L2, L3 and L4

c) L2, L3, L4 and L5

d) L2, L4, L5 and S1

e) formed by dorsal primary rami

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

a) anterior femoral cutaneous

b) sural

c) superficial peroneal

d) saphenous

e) posterior femoral cutaneous

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

a) sciatic

b) femoral

c) obturator

d) all of these

e) none of these

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35) The most powerful extensor of the hip is:

a) gluteus maximus

b) psoas major

c) iliacus

d) obturator externus

e) piriformis

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

a) adduction of thigh

b) flexion of knee

c) extension of thigh

d) medial rotation of the flexed knee

e) none of these

37) Obturator externus:

a) is pierced by femoral circumflex artery

b) external rotator of hip

c) internal rotator of hip

d) hip flexor

e) supplied by S.I.

38) The intermediate cutaneous nerve of the thigh:

a) arises from the sacral plexus

b) is a branch of the obturator nerve

c) pierces sartorius

d) extends beneath the knee

e) arises independently of the medial cutaneous nerve of the thigh

39) The dorsalis pedis artery is a continuation of:

a) anterior perforating branch of posterior tibial

b) anterior tibial

c) popliteal

d) femoral

e) peroneal

40) The lateral aspect of the thigh has a cutaneous nerve supply derived from:

a) L2 and 3

b) L3 and 4

c) L5, S1 and S2

d) L4, L5 and S1

e) S1 and S2

41) The sole of the foot has a cutaneous nerve supply derived from:

a) L4, L5, S1 and S2

b) L5 and S1

c) L4, L5 and S1

d) L4 and L5

e) L5, S1 and S2

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42) The adductor (subsartorial) cancal of Hunter is bounded laterally by:

a) adductor longus

b) adductor magnus

c) vastus medialis

d) sartorius

e) femoral vein

43) In the upper part of the popliteal fossa the following are found from medial to lateral:

a) popliteal artery, popliteal vein, sciatic vein

b) popliteal vein, popliteal artery, sciatic nerve

c) sciatic nerve, popliteal artery, popliteal vein

d) sciatic nerve, popliteal vein, popliteal artery

e) popliteal artery, sciatic nerve, popliteal vein

44) Flexor digitorum longus:

a) lies superficial to tibialis posterior

b) muscle belly lies medial to flexor hallucis longus

c) arises from both tibia and fibula

d) has communications with flexor longus hallucis

e) all of the above

45) Posterior tibial artery:

a) arises at the upper border of popliteus

b) has no accompanying sympathetic nerve plexus

c) lies posterior to flexor longus digitorum under flexor retinaculum

d) lies on peroneus brevis for part of its course

e) all of the above

46) Flexor longus digitorum:

a) crosses deep to tibialis posterior in calf

b) crosses superficial to flexor longus hallucis in sole

c) is an evertor of the foot

d) supplied by musculocutaneous nerve

e) supplied by L5 nerve root

47) The long saphenous vein:

a) lies deep to the deep fascia only near its termination

b) normally drains blood from deep veins

c) communicates with the deep venous system only indirectly

d) normally receives blood from the deep venous system

e) has no valves other than at saphenofemoral junction

48) Concerning the talus:

a) blood supply to body enters only through the dorsum of the neck

b) superior articular facet is broader posteriorly than anteriorly

c) articulates with cuboid

d) has no muscles attached

e) all of the above

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49) Concerning the ankle:

a) movements of dorsi and plantar flexion only are possible

b) communicates with inferior tibiofibular joint

c) communicates with posterior subtalar joint

d) dorsiflexion accompanied by some eversion

e) can be plantarflexed by flexor longus hallucis

50) At the ankle, the posterior tibial nerve:

a) has no further motor branches

b) has no further cutaneous branches

c) lies anterior to the artery

d) lies anterior to flexor longus hallucis


51) Biceps femoris:

a) inserts partially into the tibial condyle

b) has intramuscular tendon

c) attached proximally to the ilium

d) supplied by L4

e) shares its origin with semimembranosis

52) Common peroneal nerve:

a) supplies the knee joint

b) supplies semitendinosus

c) supplies skin on sole

d) all of the above


53) On the front of the ankle joint, the tendon of extensor hallucis longus:

a) is medial to tibialis anterior

b) is medial to deep peroneal nerve

c) is lateral to extensor digitorum longus

d) possesses no synovial sheath

e) is lateral to extensor hallucis brevis

54) Iliofemoral ligament:

a) limits hip flexion

b) limits hip extension

c) limits hip adduction

d) limits hip internal rotation


55) At the upper end of the femur:

a) gluteus maximus is attached to a ridge on the posterior surface

b) gluteus medius is attached to the anterior surface of the greater trochanter

c) the three secondary centres of ossification fuse together before joining the shaft

d) the posterior part of the capsular ligament is attached to the intertrochanteric crest

e) main nutrient artery enters the bone

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56) Medial longitudinal plantar arch:

a) raised by peroneus longus

b) maintained by ligamentum bifurcation

c) maintained by talocalcaneal interosseous ligament

d) all of the above


57) The femoral nerve:

a) continues as a cutaneous branch which runs along the lateral border of the foot

b) supplies iliacus muscle

c) supplies psoas muscle

d) supplies obturator externus muscle

e) lies within the femoral sheath

58) Rectus femoris muscle:

a) occupies an intermediate plane in the quadriceps muscle mass

b) arises from the anterior superior iliac spine

c) has two heads of origin

d) supplied by ilioinguinal nerve


59) The deep fascia of the thigh:

a) is attached to the inguinal ligament

b) is mostly superficial to the long saphenous vein

c) receives the insertion of the whole of the gluteus maximus

d) receives the insertion of the whole of sartorius

e) is less dense than the deep fascia of the upper arm

60) Biceps femoris muscles:

a) has a common origin with semitendinosus from the ischial tuberosity

b) has a short head attached to the femur medial to the attachment of adductor magnus

c) is entirely innervated by common peroneal nerve

d) is deep to the common peroneal nerve

e) is a lateral rotator of the leg on the thigh when the leg is fully extended at the knee joint

61) The pudendal nerve:

a) leaves the pelvis through the lesser sciatic foramen

b) enters the perineum lateral to the nerve to the obturator internus muscle

c) runs in the roof of the ischiorectal fossa

d) is sensory to the skin of the scrotum

e) innervates the internal rectal sphincter

62) The sciatic nerve in the gluteal region:

a) rests directly on ischium

b) is accompanied by posterior cutaneous nerve of thigh

c) supplies obturator internus

d) supplies quadratus femoris


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63) Short saphenous vein:

a) perforates the deep fascia in the midcalf

b) medial to the tendoachilles

c) more valves than the long saphenous

d) none of the above

e) all of the above

64) Pectineus:

a) medial rotator of hip

b) sometimes supplied by obturator nerve

c) flexor of hip

d) all of the above


65) The segmental supply to the posterior cutaneous nerve of the thigh is:

a) S3, 4

b) L4, 5

c) S1, 2, 3

d) L4, 5 and S1


66) Long saphenous vein:

a) is deep to the deep fascia for most of its course

b) drains the medial side of the leg between tibia and tendocalcaneous

c) arises in the femoral triangle

d) the superficial circumflex iliac vein is a tributary


67) Attached to proximal tibial epiphysis:

a) the whole of the medial collateral ligament of the knee

b) sartorius

c) ligamentum patellae

d) popliteus

e) semitendinosus

68) Emerging from lesser sciatic foramen:

a) piriformis

b) superior gemellus

c) obturator internus

d) inferior gemellus

e) obturator externus

69) If the common peroneal nerve is divided the following are lost:

a) plantar flexion of toes

b) inversion of foot

c) dorsiflexion of foot

d) plantar flexion of foot

e) there is no loss of cutaneous sensation

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70) Flexor hallucis longus muscle:

a) is attached to the tibia

b) has a tendon which in the sole, is superficial to that of flexor longus digitorum

c) is a unipennate muscle

d) is attached to the proximal phalanx of the great toe


71) Middle cuneiform:

a) articulates with talus

b) articulates with the third metatarsal

c) receives portion of insertion of tibialis anterior

d) gives attachment to short plantar ligament


72) Profunda femoris artery:

a) first branch from femoral artery

b) main arterial supply to leg

c) spirals down from lateral side of the femoral artery and runs behind the upper border of adductor

longus

d) lies between obturator externus and adductor magnus


73) Talus:

a) receives all its blood supply to the body through dorsal aspect of neck

b) gives attachment to spring ligament

c) posterior aspect of body grooved by flexor longus hallucis

d) gives partial origin to abductor hallucis


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Section 3

Answers

1 C

2 C

3 B

4 C

5 D

6 B

7 E

8 E

9 E

10 D

11 A

12 D

13 C

14 B

15 B

16 C

17 A

18 D

19 C

20 C

21 C

22 B

23 A

24 A

25 B

26 D

27 E

28 C

29 D

30 B

31 B

32 B

33 D

34 D

35 A

36 C

37 B

38 C

39 B

40 A

41 B

42 C

43 A

44 E

45 C

46 B

47 A

48 D

49 E

50 D

51 A

52 A

53 B

54 B

55 A

56 E

57 B

58 C

59 A

60 A

61 D

62 A

63 D

64 D

65 C

66 D

67 C

68 C

69 C

70 E

71 E

72 C

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Section 4

1) Gluteus maximus:

a) superficial muscle of buttock ch???? by small fibre size

b) 90% of muscle inserts into upper end of iliotibial tract

c) four bursa lie beneath to muscle

d) shared common nerve supply with gluteus medius

e) blood supply from both superior and inferior gluteal artery

2) Piriformis is the key to gluteal region. Which relation is not TRUE?

a) in buttock, lower border lie alongside superior gemellus

b) converges to ??? tendon and inserts on upper boarder of greater trochanter

c) emerges through greater sciatic foramen with superior gluteal nerve and vessel above it

d) emerges through the greater sciatic foramen with pudendal nerve and vessels deep to it

e) emerges through greater sciatic foramen with sciatic nerve on its surface

3) Of the hip joint ligaments and capsule:

a) capsule attaches circumferentially to neck of???? anterior trochanteric line

b) retinacular fibres of capsule bind down nutrient ????? from cruciate anaster?????

c) iliofemoral ligament becomes taut on medial rotation and extension

d) all three ligaments attach to capsule and completely enclose joint

e) psoas major tendon separates capsule from femoral nerve

4) Superficial cutaneous nerves supplying the thigh include the following EXCEPT:

a) ilioinguinal nerve

b) saphenous nerve

c) femoral branch of genitofemoral nerve

d) medial femoral cutaneous nerve

e) intermediate femoral cutaneous nerve

5) The flexor compartment of the thigh contains which of the following muscles?

a) gluteus maximus

b) adductor magnus

c) garacilis

d) semimembranosus

e) rectus femoris

6) Which of the following is true of the great saphenous vein?

a) it passes posterior to the medial malleolus

b) it runs behind the lateral border of the tibia

c) it passes through the ???cribriform fascia covering the saphenous opening below the inguinal

ligament

d) it joins the femoral vein from the anterolateral side

e) it has no tributaries

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7) Which is not an origin of vastus lateralis?

a) upper half of the intertrochanteric line

b) aponeurosis of tensor fascia lata

c) lateral lip of the linea aspera

d) upper two thirds of the lateral supracondylar line of femur

e) lateral intermuscular septum

8) Regarding the adductor canal:

a) it contains the nerve to vastus intermedialis

b) contents leave by piercing adductor longus

c) the femoral artery is always between the saphenous nerve and femoral vein in the thigh

d) below the adductor hiatus, the canal is occupied by the saphenous nerve of the descending

genicular nerve

e) at the adductor hiatus, the femoral vein is medial to the artery

9) At the hip:

a) the ligament of the head of the femur is attached to the acetabular notch

b) the pubofemoral ligament is the weakest ligament at the hip

c) flexion tightens the ligaments

d) the obturator nerve via its anterior division, innervates the capsule and retinacular fibres

e) the normal range of flexion is 160°

10) Regarding the cuneiform bones:

a) the lateral is the smallest

b) tibialis anterior is inserted into a facet on the intermediate cuneiform

c) flexor hallucis brevis has an origin on the medial cuneiform

d) the anterior surface of the medial cuneiform is triangular in shape

e) the second metatarsal bone articulates with all three cuneiforms

11) Regarding the dorsum of the foot:

a) cutaneous innervation is primarily from the sural nerve

b) extensor digitorum brevis gives off four tendons to the lateral four toes

c) the superficial peroneal nerve divides into medial and lateral branches below the ankle

d) the inferior extensor retinaculum joins medial and lateral malleoli

e) dorsalis pedis artery runs to the base of the first intermetatarsal space

12) Regarding the sole of the foot:

a) the heel is supplied by lateral calcanean nerves

b) flexor hallucis brevis lies in the first muscular layer

c) flexor digitorum brevis is the lower limb equivalent of flexor digitorum superficialis

d) the plantar arteries and nerves lie between the second and third muscular layers

e) the medial plantar artery forms the plantar arch with dorsalis pedis artery

13) At the ankle joint:

a) the distal fibular is not part of the joint

b) the medial ligament is made up of three separate bands

c) the posterior tibiofibular ligament is also known as posterior transverse ligament

d) the long and short peronei muscles assist in plantar flexion

e) nerve supply is from the anterior and posterior tibial nerves

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14) Which is NOT true about fractured neck of femurs?

a) the leg is shortened and externally rotated in most fractured neck of femurs

b) the main source of blood to the femoral head is via the vessels running within cancellous bone

from the diaphysis

c) a subcapital fracture cuts off all the blood to the head of the femur resulting in avascular necrosis

d) the blood supply to the head is increased by vessels in the capsular retinacula and it is this which

prevents avascular necrosis of the head after an intertrochanteric fracture

e) the ligamentum teres attaches to the central fovea???? on the femoral head and originates from the

acetabulum

15) Trendelenburg’s test is negative if:

a) the hip adductors are paralysed (eg in poliomyelitis)

b) there is an old unreduced or congenital dislocation of the hip

c) there is an ununited fracture of the neck of femur

d) the patient walks with a dipping gait

e) gluteus minimus and medius and tensor fascia latae are weakened severely

16) Which of the following structures can be missing in a completely stable and functional knee?

a) ACL

b) PCL

c) oblique ligament

d) patella

e) lateral collateral ligament

17) Which statement about femoral hernias is INCORRECT?

a) it is commoner in males than females

b) it is never due to a congenital sac

c) the femoral cord acts as a lymphatic pathway from the lower limb to the external iliac nodes

d) the neck of a femoral hernia can be distinguished from an inguinal hernia because it lies below and

lateral to the pubic tubercle

e) the femoral cord normally contains a fat plug and cloquet’s gland but can also accommodate a

distended femoral vein

18) In the sole:

a) plantar arteries and nerves lie between second and third layers

b) the myotome is essentially S1

c) the medial plantar nerve supplies the medial 4½ toes

d) tendons for peroneus longus and tibialis posterior lie in the third layer

e) abductor digiti minimi is in the first layer

19) Which is supplied by the medial plantar nerve?

a) adductor hallucis

b) abductor digiti minimi

c) flexor hallucis longus

d) flexor accessories

e) first lumbrical

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20) At the ankle:

a) the capsule is attached to the posterior tibiofibular ligament

b) the deltoid ligament has three parts

c) the joint is a simple hinge joint

d) the joint undergoes dorsiflexion, plantar flexion, inversion and eversion

e) nerve supply is deep and superficial peroneal nerves and tibial nerves

21) The cruciate anastomosis is NOT joined by:

a) transverse branch of the lateral circumflex A

b) descending branch of the internal pudendal A

c) ascending branch of the first perforating A

d) descending branch of the inferior gluteal A

e) transverse branch of the medial circumflex

22) Stability of the patella in knee extension is maintained primarily by:

a) inferior fibres of vastus lateralis

b) relative prominence of the medial femoral condyle

c) inferior fibres of vastus medialis

d) tension of medial patella retinaculum

e) articularis genu muscle

23) Regarding the branches of the femoral nerve:

a) does NOT supply cutaneous sensation to skin over the femoral triangle

b) femoral cutaneous nerves pass through the fascia lata via the saphenous canal

c) saphenous nerve follows the course of the great saphenous vein

d) branch to pectineus passes between the femoral artery and vein

e) generally branch within the femoral sheath

24) Profunda femoris artery is separated from the femoral artery by:

a) pectineus

b) satorius

c) fascia lata

d) femur

e) adductor longus

25) Femoral canal contains:

a) femoral nerve

b) lymph node (of cloquet)

c) femoral artery

d) femoral vein

e) B, C and D are correct

26) Regarding the saphenous opening:

a) transmits the contents of the femoral sheath

b) posterior wall lies immediately anterior to pectineus

c) the great saphenous vein passes superiomedially through it

d) bounded medially by the lacunar ligament

e) the falciform edge attaches superiorly to the pectineal line

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27) Piriformis:

a) is an abductor of the hip in hip flexion

b) passes through the lesser sciatic foramen

c) is the preferred site of intramuscular gluteal injection

d) passes anterior to the femoral neck

e) lies deep to the sciatic nerve

28) Popliteus:

a) attaches to the medial femoral condyle

b) “locks” the knee in extension

c) supplied by a branch of the femoral nerve

d) lies immediately deep to the popliteal artery

e) may attach to the medial meniscus

29) The third layers of muscles of the sole of the foot include:

a) four lumbricals and quadratus plantae

b) plantar and dorsal interossei

c) extensor hallucis longus and extensor digitorum longus

d) flexor digiti minimi brevis, adductor hallucis tranversus, adductor hallucis obliquus and flexor

hallucis brevis

e) abductor hallucis, abductor digiti minimi and flexor digitorum brevis

30) Peroneus longus inserts into:

a) medial cuneiform and first metatarsal

b) base of 5th metatarsals

c) 4th and 5th metatarsal

d) navicular tuberosity

e) cuboid tuberosity

31) The transverse arch of the foot is formed by:

a) calcaneus, talus, navicular, cuneiforms and first three metatarsals

b) navicular, cuneiforms, cuboid, all five metatarsals

c) calcaneus, cuboid, lateral two metatarsals

d) calcaneus, navicular, lateral two metatarsals

e) sustentaculum tali and cuneiforms

32) Which of the following is TRUE?

a) the popliteal fossa is bounded by the biceps medially

b) the great saphenous vein runs through the popliteal fossa

c) gluteus maximus inserts on the greater trochanter

d) the sciatic nerve leaves the pelvis by passing through the lesser sciatic foramen

e) the popliteal fossa contains the common peroneal nerve

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33) The femoral triangle:

a) the femoral triangle is bounded by the inguinal ligament medial border of sartorius and lateral

border of adductor longus

b) the mid-inguinal joint is midway between the pubic tubercle and the anterior superior iliac spine

c) the femoral canal contains the lymph node of cloquet

d) the femoral sheath contains the femoral nerve and femoral artery

e) the femoral and profunda femoris arteries are separated by adductor brevis

34) The knee:

a) the cruciate ligaments are intra-synovial

b) the posterior cruciate ligament stabilises the flexed weight-bearing knee

c) the posterior horn of the medial meniscus is attached to the intercondylar area of the tibia behind

the posterior cruciate ligament

d) the knee joint normally contains 5.0ml of synovial fluid

e) active rotation may occur in the extended knee

35) Which one of the following muscles has a double nerve supply?

a) rectus femoris

b) sartorius

c) pectineus

d) adductor longus

36) Inversion and eversion of the foot take place MAINLY at the:

a) ankle joint

b) joints between the talus and calcaneus

c) joint between calcaneus and navicular bone

d) calcanocuboid joint

e) inferior tibiofibular joint

37) Which one of the following has a tendo that is intracapsular?

a) plantaris

b) popliteas

c) rectus femoris

d) psoas major

e) peroneal longus

38) The deltoid ligament belongs to the:

a) ankle joint

b) hip joint

c) knee joint

d) talocalcaneonavicular joint

e) calcaneocuboid joint

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Section 4

Answers

1 E

2 D

3 C

4 B

5 D

6 C

7 B

8 C

9 D

10 E

11 E

12 C

13 D

14 C

15 A

16 D

17 A

18 E

19 E

20 A

21 B

22 C

23 A

24 E

25 B

26 B

27 A

28 D

29 no answer

30 no answer

31 no answer

32 no answer

33 C

34 B

35 C

36 B

37 A

38 A

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1 Regarding superficial nerves of the anterior thigh

A The ilioinguinal nerve only supplies external genitalia

B The genitofemoral nerve supplies the skin over the femoral triangle

C The medial femoral cutaneous nerve arises from L3/4

D The intermediate femoral cutaneous nerve supplies a small area of skin over the inguinal ligament

E The lateral femoral cutaneous nerve runs lateral to the anterior superior iliac spine

2 The great saphenous vein

A arises on the lateral aspect of the foot

B can be found 2cm medial to the patella

C pierces the fascia lata on the lateral side of the thigh

D receives no tributaries above the knee

E contains approximately 20 valves

3 Regarding the femoral triangle

A The lateral border is formed by the lateral border of sartorius

B The medial border is the medial border of adductor magnus

C The femoral nerve is contained in the femoral sheath

D The lymph node of cloquet lies in the femoral canal

E The femoral vein is lateral to the artery

4 Regarding the femoral artery, all of the following are true EXCEPT

A The artery enters the femoral triangle at the mid-inguinal point

B Passes anterior to the profunda femoris branch

C Supplies muscles of the adductor compartment

D Ceases at the mid point of the popliteal fossa

E Lies medial to the femoral nerve

5 Regarding the femoral nerve, all of the following are true EXCEPT

A It is formed from the anterior divisions of the anterior rami of L2/3/4

B It supplies the muscles of the anterior compartment

C It does not lie within the femoral sheath

D It supplies iliacus but not psoas

E Branches include the medial and intermediate femoral cutaneous nerves

6 Regarding the obturator nerve, all of the following are true EXCEPT

A It is formed from the anterior divisions of the anterior rami of L2/3/4

B Its anterior division supplies adductor longus, brevis, pectineus and gracilis

C Its posterior division supplies all of adductor magnus

D It gives a cutaneous branch which supplies the medial thigh

E It gives articular branches to the hip and knee joints

7 Gluteus maximus

A Arises from the gluteal fossa of the ileum between the middle and superior gluteal lines

B is supplied by the superior gluteal nerve

C extends and medially rotates the hip

D mostly inserts into the iliotibial tract

E paralysis results in a waddling gait

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8 The pudendal nerve

A Arises from L5/S1/2

B Emerges from the upper border of piriformis

C Contains only sensory fibres

D Passes medial to the ischial spine

E Passes through the greater sciatic foramen to enter the pelvis

9 Regarding the hamstring muscles, all of the following are true EXCEPT

A All of the hamstrings arise from the innominate bone

B All of the hamstring muscles are supplied by the tibial part of the sciatic nerve

C The long head of biceps femoris and semitendinosus have a common origin

D The adductor magnus is not part of the hamstring group

E Biceps forms the medial border of the popliteal fossa

10 The sciatic nerve

A Arises from L3/4/5/S1/2

B Emerges from the lower border of piriformis

C Most commonly divides onto common peroneal and tibial branches in the middle of the hamstring

compartment

D Can be injured by intramuscular injections in the upper outer quadrant of the buttock

E Gives no branches in the gluteal compartment

11 All of the following are lateral rotators of the hip EXCEPT

A Gluteus maximus

B Gluteus medius

C Gamellus superior

D Quadratus femoris

E Piriformis

12 Ligamentous stability for the hip joint is provided chiefly by the

A Ligamentum teres

B Ischiofemoral ligament

C Pubofemoral ligament

D Iliofemoral ligament

E Transverse ligament

13 Contents of the popliteal fossa include all of the following EXCEPT

A Sural nerve

B Superior medial genicular artery

C Sural communicating nerve

D Inferior medial genicular artery

E Anterior tibial artery

14 Regarding ligaments of the knee joint

A The anterior cruciate ligament inserts into the posteromedial aspect of the lateral femoral condyle

B The arcuate ligament is an expansion of the tendon of semimembranosus

C The meniscofemoral ligaments cross in front and behind the anterior cruciate

D The medial collateral ligament is a cord-like structure

E The transverse ligament connects the posterior aspects of the menisci

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15 Regarding the menisci of the knee

A They are attached to the femoral condyles

B They have a rich blood supply

C The medial meniscus is firmly attached to the capsule of the joint

D The medial meniscus gives origin to the meniscofemoral ligaments

E They are composed of mainly elastic fibres Anatomy – lower limb

16 Regarding movements of the knee joint

A Sartorius assists with flexion

B The only action of popliteus is unlocking of the knee

C Extension occurs to zero degrees

D Locking of the knee is an active process

E Rotation takes place above the menisci

17 Regarding the extensor compartment of the leg

A Tibialis anterior arises from the upper two thirds of the tibia and fibula

B Extensor digitorum longus has a small origin from the lateral condyle of the tibia

C Extensor hallucis longus is superficial to extensor digitorum longus

D All muscles are supplied by the common peroneal nerve

E Peroneus tertius and tibialis anterior both cause eversion of the foot

18 Which of the following structures does not pass anterior to the medial malleolus

A Tibialis anterior

B Extensor hallucis longus

C Flexor hallucis longus

D Anterior tibial artery

E Peroneus tertius

Q A

1 B

2 E

3 D

4 D

5 A

6 C

7 D

8 D

9 E

10 B

11 B

12 D

13 E

14 A

15 C

16 A

17 B

18 C

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Hip and thigh

1. Femoral nerve

a. is less subject to damage by penetrating injuries of the lower abdomen than of the lower limb

b. Damage may cause anaesthesia of the foot

c. Is contained within the femoral sheath

d. Is formed by the anterior divisions of L2,3,4

e. Gives a single muscular branch to iliacus

2. With respect to the hip joint

a. The fibrous capsule is strengthened by 2 ligaments

b. Anteriorly the psoas major tendon separates the capsule from the femoral vein

c. It is least stable when flexed and adducted

d. Ligament of Bigelow is the weakest ligament

e. Ischiofemoral ligament is the strongest ligament

3. Femoral nerve

a. Is formed from the anterior divisions of the anterior primary rami of L2-4

b. Is formed from the same spinal segments as the obturator nerve

c. Divides after passing through the femoral triangle

d. Has no cutaneous branches other than the saphenous nerve

e. Enters the thigh in the femoral sheath

4. Which of the following does not pass through the greater sciatic foramen

a. The sciatic nerve

b. The pudendal nerve and vessels

c. The posterior cutaneous nerve of the thigh

d. Inferior gluteal vessels and nerve

e. Nerve to obturator externus

5. Which of the following are not found in the adductor (subsartorial) canal

a. Femoral artery

b. Femoral vein

c. Femoral nerve

d. Saphenous nerve

e. Nerve to vastus medialis

6. A 30 y.o. man presents with adenopathy of the medial group of superficial inguinal lymph nodes on the

right side. Which of the following is the primary site resulting in this finding?

a. Right testis

b. Right buttock

c. Skin of lower limb

d. Anal canal

e. None of the above

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7. Following a subcapital fracture of the neck of femur, an 80 y.o. man sustains avascular necrosis of the

femoral head. This is most likely to be the consequence of interruption to the blood supply to the head

from which of the following sources?

a. Arteries from the trochanteric anastomoses in the retinacula

b. Artery of the ligament of the head from the obturator artery

c. Branches from the profunda femoris artery

d. Branches from the pudendal artery

e. Branches from the inferior gluteal artery

8. The muscle which provides the most control of hip joint movement during the act of sitting is

a. Iliacus

b. Semitendonosis

c. Semimembranosis

d. Gluteus maximus

e. Gluteus minimis

9. Which of the following are correctly paired?

a. Adductor brevis – femoral nerve

b. Adductor longus – sciatic nerve

c. Adductor magnus – saphenous nerve

d. Adductor longus – obturator nerve

e. Adductor magnus – femoral nerve

10. The great saphenous vein

a. Is a continuation of the lateral marginal vein of the foot

b. Runs between the 2 heads of gastrocnemius

c. Pierces the cribriform fascia in the upper thigh

d. Can be found immediately below and lateral to the pubic tubercle

e. Does not communicate with varicosities in the superficial veins

11. With regard to the femoral triangle

a. It is bounded by adductor longus and magnus

b. It has the fascia lata lining it s floor

c. The femoral artery lies between the femoral vein and nerve

d. It is bounded superficially by the lacunar ligament

e. The femoral sheath contains only the femoral nerve and artery

12. the femoral artery

a. Is separated from the hip joint capsule by fat only

b. Is crossed by the femoral vein from medial to lateral as it descends

c. Is found at the mid-inguinal point

d. Gives off the medial circumflex femoral artery as its major branch

13. Gluteus maximus

a. Is the deepest of the gluteal muscles

b. Forms the skin crease of the gluteal fold

c. Is supplied by L5, S1

d. Medially rotates and extends the hip joint

e. All of the above

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14. Regarding the lymphatic drainage of the lower limb

a. It is predominantly along the route of the small saphenous vein

b. Apart from a small area of skin over the heel it drains via the popliteal lymph nodes from below the knee

c. From the superficial inguinal lymph nodes it passes through the cribriform fascia to the deep inguinal

nodes

d. Deep lymphatics follow veins


15. The femoral nerve

a. Has superficial branches, one of which supplies the hip joint

b. Supplies psoas major

c. Lies within the femoral sheath

d. Emerges from the medial side of psoas major

e. Is formed from the posterior divisions of the ventral rami of L2,3,4

16. Regarding the femoral vein

a. It receives the great saphenous vein on its anterolateral surface

b. It drains into the internal iliac vein

c. It lies lateral to the femoral artery within the femoral sheath

d. It has no valves

e. It enters the inferior part of the femoral triangle posterior to the femoral artery

17. Contents of the femoral triangle include all except

a. Genital branch of the genitofemoral nerve

b. Great saphenous vein

c. Pectineus

d. Profunda femoris artery

e. Anterior division of the obturator nerve

18. The adductor canal

a. Is bounded by adductor brevis

b. Lies behind sartorius

c. Contains the femoral nerve

d. Commences just below the inguinal ligament

e. Contains the femoral artery which lies inferolaterally to the femoral vein in the lower part

19. The obturator nerve

a. Emerges on the lateral border of psoas

b. Supplies obturator externus, adductor longus and the knee joint

c. Supplies obturator internus, adductor magnus abd the hip joint

d. Runs inferior to the obturator artery in the obturator canal

e. All of the above


a. Has an anterior division which supplies skin on the antero-medial surface of the thigh

b. Runs medial to the femoral artery at the level of the inguinal canal

c. Has the sural nerve as the terminal branch

d. Supplies the posterior half of adductor magnus

e. Supplies pectineus via its posterior division

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21. With regard to the head of the femur

a. The arterial supply comes mainly from the inferior gluteal artery

b. The artery to the head assumes importance after age of 7 years

c. Psoas lies posterior to the hip joint

d. The anterior division of the obturator nerve gives partial supply to the hip joint


22. Regarding the bony pelvis

a. The obturator groove is in the ischial bone

b. The greater sciatic foramen transmits the obturator internus

c. The pectineal line lies superior to the acetabulum

d. The inguinal ligament inserts medially into the iliopubic eminence


23. The hip joint

a. Is directed slightly forward along the axis of the femoral neck

b. Is supplied by the femoral and obturator nerves only

c. Has an articular surface which does not reach the rim of the acetabulum

d. Bears weight mainly through the ischial bone

e. Has a capsule which is strengthened anteriorly by the ischiofemoral ligament

24. The femoral triangle

a. Has sartorius as its medial border

b. Contains the posterior division of the obturator nerve

c. Contains femoral nerve and vessels

d. Has the lateral border of adductor longus laterally

e. All of the above

25. The muscles supplied by the femoral nerve include all except

a. Sartorius

b. Iliacus

c. Psoas major

d. Pectineus

e. Rectus femoris

26. Concerning the origins of the quadriceps femoris

a. All 4 component muscles have an origin from the femur

b. Vastus lateralis arises from the femur above intertrochanteric line and acetabulum

c. Vastus medialis arises from femur and tendon of adductor longus

d. Rectus femoris arises from 3 heads

e. Vastus intermedius arises from shaft of femur and greater trochanter

27. The floor of the femoral triangle consists of all of the following except

a. Psoas

b. Iliacus

c. Pectineus

d. Adductor brevis

e. Adductor magnus

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28. Concerning iliacus

a. It inserts into the greater trochanter of the femur

b. It occupies and is attached to the whole of the iliac fossa

c. Nerve supply is femoral nerve

d. It acts to flex and laterally rotate the hip

e. It has the femoral vein as its intermediate anterior relation

29. Psoas major

a. Has a proximal attachment to the bodies discs and transverse processes of lumbar vertebrae

b. Has the lumbar plexus embedded within it

c. Has the lumbar arterie sand veins running behind it

d. Inserts into the lesser trochanter

e. All of the above

30. Sartorius

a. Arises from the ilium below the ASIS

b. Is pierced by the lateral cutaneous nerve of the thigh

c. Inserts into the styloid of the fibula

d. Is supplied by the obturator nerve

e. Flexes and medially rotates the thigh

31. Following Hiltons law, which nerve does not supply the hip joint

a. Sciatic

b. Obturator

c. Inferior gluteal

d. Nerve to rectus femoris

e. Femoral

32. branches of femoral artery ???

33. Superficial inguinal lymph nodes drain all of the following except

a. Anterior thigh

b. Base of penis

c. Testis

34. What goes through the lesser sciatic foramen?

a. Piriformis

b. Pudendal nerve

c. Internal pudendal artery

d. Superior gluteal artery

e. Inferior gluteal artery

35. Adductor magnus is

a. A bipennate muscle

b. A component of the femoral triangle

c. Supplied by the femoral nerve

d. A composite muscle

e. Attached by point of origin to the pectineal line of the pubic bone

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36. Regarding the femoral artery and its branches

a. Lies lateral to femoral sheath

b. Femoral artery has three branches

c. Profunda femoris artery lies anterior to the profunda vein

d. The 4 perforating arteries supply all thigh muscles

e. The profunda femoris artery supplies all anterior thigh muscles

37. Regarding the inguinal canal

a. It has a roof formed by lower edges of internal oblique and transversus muscles

b. The ilioinguinal nerve enters the canal through the deep ring

c. Its posterior wall is formed by the external oblique aponeurosis

d. Its conjoint tendon lies anterior to the superficial inguinal ring

e. The superior epigastric artery crosses the posterior wall medial to the deep inguinal ring

38. Which of the following muscles is not in the floor of the femoral triangle

a. Pectineus

b. Adductor longus

c. Sartorius

d. Psoas

e. Iliacus

39. Regarding movements of the hip joint

a. Stability is reduced by the presence of the long femoral neck

b. Medial rotation is achieved by obturator externus

c. Sartorius is a lateral rotator

d. Medial rotation is resisted by the iliotibial tract

e. Abduction is not usually required in normal walking

40. Pectineus

a. Arises from part of the obturator membrane

b. Is inserted into the greater trochanter

c. Lies posterior to the anterior division of the obturator nerve

d. Forms one wall of the femoral ring

e. Is a lateral rotator of the femur


a. Supplies the skin over the lateral thigh

b. Lies between the pectineus and psoas in the femoral triangle

c. Is formed by the posterior divisions of the anterior rami of lumbar nerves 2,3 and 4

d. Breaks into superficial and deep branches, separated by the medial circumflex femoral artery

e. Supplies the adductor muscles

42. The sciatic nerve

a. Lies on the ischial tuberosity

b. Lies on the obturator internus

c. Passes upper quadratus femoris

d. Emerges from above piriformis

e. Is comprised of L4, L5, S1, S2

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43. The medial compartment of the thigh contains all of the following except

a. The obturator nerve

b. Obturator artery

c. Gracilis muscle

d. Obturator internus

e. Obturator externus

44. Adductor magnus

a. Is a composite muscle

b. Has a hamstring part arising from ischiopubic ramus

c. Has an adductor part arising from ischial tuberosity

d. Has a tendinous attachment only onto adductor tubercle of femur

e. Has a nerve supply including the sciatic and anterior division of obturator nerves

45. The skin over the femoral triangle is supplied by

a. Ilioinguinal nerve

b. Obturator nerve

c. Medial femoral cutaneous nerve

d. Lateral femoral cutaneous nerve

e. Genitofemoral nerve

46. The great saphenous vein

a. Is a continuation of the lateral marginal vein of the foot

b. Runs between the 2 heads of gastrocnemius

c. Pierces the cribriform fascia in the upper thigh

d. Can be found immediately below and lateral to the pubic tubercle

e. Does not communicate with varicosities in the superficial veins

47. The hip joint

a. Derives its stability largely from the shape of its articular surfaces

b. Has the ischiofemoral as its strongest ligament

c. Is only supplied by the obturator and sciatic nerves

d. Is limited in full extension by the pubofemoral ligament

e. Is flexed largely by sartorius and rectus femoris

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1. e

2. c

3. b

4. e

5. c

6. d

7. a

8. d

9. d

10. c

11. c

12. c

13. c

14. c

15. e

16. e

17. a

18. b

19. b

20. a

21. d

22. e

23. c

24. c

25. c

26. e

27. e

28. c

29. e

30. a

31. c

32. ??

33. c

34. b, c

35. d

36. e

37. A

38. C

39. C

40. D

41. C

42. B

43. D

44. A

45. E

46. C

47. A

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Ankle and foot

1. The ankle joint is

a. Dorsiflexed by tibialis posterior and peroneus tertius

b. Fixed in its own axis of rotation

c. Crossed by the anterior tibial artery lateral to the extensor hallucis longus tendon

d. Supported by the lateral deltoid ligamanet

e. Innervated by the sural and superficial peroneal nerves

2. A 25 y.o. man is unable to plantarflex his foot. The most likely cause is damage to

a. The superficial peroneal nerve

b. L5 nerve root

c. Tibial nerve

d. Gastrocnemius

e. Soleus

3. Dorsalis pedis artery

a. Lies medial to the tendon of extensor hallucis longus

b. Lies lateral to the digital branch of the deep peroneal nerve

c. Crosses superficial to the tendon of extensor hallucis brevis

d. Terminates as the arcuate artery

e. Joins the lateral plantar artery to form the plantar arch

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

damaged?

a. Deep branch of the common peroneal nerve

b. Sural nerve

c. Superficial branch of the common peroneal nerve

d. Saphenous nerve


5. Which is not a component of the second layer of the sole of the foot?

a. Tendon of flexor hallucis longus

b. Abductor hallucis

c. Flexor accessorius

d. The lumbrical muscles

e. Tendon of flexor digitorum longus

6. What movement occurs at the subtalar joint

a. Inversion

b. Eversion

c. Equinovarus

d. Plantarflexion

e. ?

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7. What muscle cause dorsiflexion and inversion of the foot

a. Tibialis anterior

b. Tibialis posterior

c. Extensor hallucis longus

d. Peroneus tertius

e. ?

8. What passes superficial to the superior flexor retinacula of the foot

a. ?

b. ?

c. ?

d. ?

e. ?

9. Regarding the ossification centres of the bones of the foot, which is incorrect

a. There are 3 at birth

b. 5th metatarsus has 3 ossification centres

c. Metatarsals have 2 centres

d. ?

e. ?

10. Regarding the structures passing beneath the flexor retinaculum of the ankle which is correct?

a. Posterior tibial artery lies anterior to the flexor digitorum longus

b. Flexor hallucis longus lies anterior to posterior tibial artery

c. The posterior tibial artery lies anterior to the tibial nerve

d. Flexor hallucis longus is the most anterior structure

e. Flexor digitorum longus is the most posterior structure

11. Regarding the medial longitudinal arch

a. Its stability is due to its bony structures

b. Flexor hallucis brevis acts as a bowstring

c. The plantar aponeurosis is of minimal importance

d. Peroneus longus supports the posterior portion


12. At the ankle

a. The deltoid ligament attaches to the tibia and the calcaneous

b. The talus is more narrow anteriorly

c. The capsule attaches to the neck of the talus

d. In plantar flexion there is also eversion

e. Dorsiflexion is produced by tibialis anterior and peroneus brevis

13. All of the following are ankle joint ligaments except

a. Posterior tibio-fibular ligament

b. Deltoid ligament

c. Inferior transverse ligament

d. Posterior talofibular ligament

e. Oblique ligament

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14. Concerning the innervation of the foot

a. The medial plantar nerve supplies the first 3 lumbricals

b. The skin of the first cleft is supplied by the superficial peroneal nerve

c. The plantar digital nerves supply the nail bed

d. All interossei are supplied by the medial plantar nerve

e. The medial and lateral plantar nerves are branches of the common peroneal nerves

15. The talus

a. Has its sole articulation with calcaneous in the talocalcaneonavicular joint

b. Has a long plantar ligament attached to its plantar surface

c. Has an upper articular surface narrow in front and broad behind

d. Receives a good blood supply from dorsalis pedis, posterior tibial and peroneal arteries

e. Is connected to navicular by the spring ligament

16. The ankle joint

a. Is stabilised laterally by the deltoid ligament

b. Relies on the fibula for weight bearing

c. Acts purely as a hinge joint

d. Has 3 ligaments radiating from the lateral malleolus

e. Owes stability primarily to the shape of the tibiotalar articulating surface

17. The lumbrical muscles of the foot

a. Pass forward on the lateral sides of the metatarsophalangeal joints

b. Arise from the tendons of flexor digitorum longus

c. Are all supplied by the lateral plantar nerve

d. Have no real function in walking or running

e. Do not insert into the extensor expansions

18. With regard to the calcaneus

a. It is the largest of the tarsal bones

b. It has a convex medial surface

c. The peroneal trochlea is found on it medial surface

d. It articulates with the talus, navicular and cuboid

e. The upper surface carries articular surfaces on its posterior half

19. Regarding the ankle joint

a. The lateral ligament has 2 layers

b. The posterior talofibular ligament is strong and runs horizontally

c. The deep portion of the medial ligament is triangular in shape

d. The superficial portion of the medial ligament is rectangular in shape

e. The nerve supply of the capsule is by the superficial peroneal nerve

20. Under the extensor retinaculum of the foot the most lateral structure is

a. Sural nerve

b. Dorsalis pedis artery

c. Peroneus tertius

d. Extensor digitorum longus

e. Extensor hallucis longus

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21. With regard to the cutaneous innervation of the lower limb

a. Superficial peroneal nerve supplies the first inter-digital cleft

b. Sural nerve supplies the medial malleolus

c. Deep peroneal nerve supplies the third inter-digital cleft

d. The medial plantar nerve supplies a greater area than the lateral

e. Branches of the tibial nerve supply much of the dorsum of the foot

22. Regarding the ankle joint

a. The capsule is attached anteriorly to the neck of the talus

b. It has a fixed rotation of axis

c. The weight bearing surfaces are the upper facet of the talus, the inferior facet of the tibia and the medial

and lateral malleoli

d. The lateral ligament is made up of three separate bands that all insert into the talus

e. In full plantarflexion a significant amount of inversion and eversion is possible at the ankle joint

23. All of the following structures pass deep into the superior extensor retinaculum at the ankle except

a. Extensor digitorum longus

b. Deep peroneal nerve

c. Anterior tibial artery

d. Superficial peroneal nerve

e. Peroneus tertius

24. The dermatome supplying the great toe is usually supplied by

a. L3

b. L4

c. L5

d. S1

e. S2

1. c

2. c

3. e

4. a

5. b

6. a/b

7. a

8. ?

9. ? (a, b, c true)

10. c

11. e

12. c

13. e

14. c

15. d

16. d

17. b

18. a

19. b

20. c

21. d

22. a

23. d

24. c

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Knee and leg

1. Posterior tibial artery

a. Divides superior to the flexor retinaculum

b. Divides into the medial and lateral plantar arteries

c. Branches from 2 plantar arteries in the foot

d. Lateral plantar branch supplies the big toe

e. Divides inferior to the flexor retinaculum

2. Regarding the knee joint

a. middle geniculate artery supplies the cruciate ligament

b. Bursa beneath medial head gastrocnemius usually communicate with joint

c. Rotation takes place below the menisci

d. Coronary ligament attaches menisci to the articular margins of tibia and femur

e. All of the above

3. Popliteal fossa

a. The floor is provided by biceps femoris

b. The sural communicating nerve pierces the roof

c. Popliteal lymph nodes lie next to the popliteal artery

d. The recurrent genicular nerve pierces the roof

e. Superior and inferior geniculate nerves supply the medial ligament

4. The stability of the weight bearing flexed knee is maintined by

a. Anterior cruciate ligament

b. Ilio-tibial tract

c. Posterior cruciate ligmanet

d. Popliteus and posterior cruciate ligament

e. Arcuate popliteal ligament and anterior cruciate ligament

5. The short saphenous vein

a. Lies anterior to the lateral malleolus

b. Is accompanied by the saphenous nerve

c. Drains into the great saphenous vein

d. Drains to the lateral margin of the foot

e. Lies deep to the deep fascia of the calf

6. Which is not true of the tendo achilles

a. It inserts into the middle third of the posterior surface of the calcaneous

b. It is invested in a synovial sheath

c. It is formed from the soleus and gastrocnemius

d. A bursa lies between the tendon and the upper third of calcaneous

e. A bursa lies between it and the deep fascia near its insertion

7. The anterior tibial artery

a. Pierces the interosseous membrane

b. Supplies the lateral compartment of the leg

c. Lies lateral to the deep peroneal nerve

d. Lies lateral to tibialis anterior

e. Gives the nutrient artery to the tibia

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8. The suprapatellar bursa

a. Does not communicate with the knee joint

b. Lies in front of the vastus intermedius muscle

c. Extends 5cm or more above the patella

d. Lies deep to the patella retinacula


9. Regarding the extensor compartment of the lower leg, all of the following statements are true, except

a. The tibialis anterior muscle is supplied by the deep peroneal and recurrent genicular nerves (L4)

b. Extensor digitorum longus and peroneus tertius muscle lie lateral to the tibialis anterial artery

throughout

c. The deep peroneal nerve arises within the peroneus longus muscle

d. The extensor digitorum longus dorsiflexes the lateral toes

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

membrane

10. Regarding lower leg structures

a. The anterior tibial artery lies lateral to tibialis anterior

b. The deep peroneal nerve originates in the popliteal fossa

c. Peroneus longus is supplied by the deep peroneal nerve

d. Extensor digistorum longus lies medial to tibialis anterior

e. The tibia receives a nutrient vessel from the anterior tibial

11. Tibialis anterior inserts into

a. Navicular

b. Medial cuneiform and base of first metatarsal

c. Lateral cuneiform and base of 5th metatarsal

d. Middle three metatarsals

e. Medial cuneiform and base of 1st phalanx

12. Tibialis posterior inserts into

a. The base of the first metatarsal

b. The navicular

c. Base of 2nd and third metatarsals

d. The cuboid


13. Factors that stabilise the patella include all except

a. Forward prominence of the lateral condyle

b. Forward prominence of the medial condyle

c. Medial patellar retinacular fibres

d. Vastus medialis fibres that insert into the lowest part of the patella

e. The tone in vastus medialis

14. Popliteus muscle

a. Is a weak flexor of the knee

b. Is intracapsular

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15. Regarding the menisci of the knee joint

a. Posterior cruciate is medial

b. Medial meniscus is avascular

c. Fold of synovium lies posterior to anterior cruciate

d. Anterior horn of medial meniscus is attached to medial tibial condyle

16. Which ligament forms part of the knee capsule

a. Lateral collateral

b. Medial collateral

c. Anterior cruciate

d. Posterior cruciate

e. Popliteus tendon

17. With regard to peroneus longus muscle

a. The tendon lies below peroneus brevis in the lateral compartment of the leg

b. It is supplied by the superficial peroneal nerve (L5, S1)

c. Arises from the lower 2/3 s of the peroneal surface of fibula

d. The action is to invert the foot

e. It has a broad tendon in comparison to the narrower tendon of peroneus brevis

18. Tibialis anterior

a. Everts the foot

b. Is supplied by the superficial peroneal nerve

c. Arises from the lower 2/3s of the tibia and interosseous membrane

d. Lies medial to the anterior tibial artery

e. Lies lateral to peroneus tertius

19. Of muscles and tendons crossing the knee

a. Popliteus medially rotates the femur to unlock the knee from extension

b. Soleus crosses the posterolateral aspect of the joint

c. Semitendinosis tendon passes anterior to the medial condyle

d. Gluteus maximus crosses the knee joint by way of the iliotibial tract

e. Biceps femoris inserts into the anterolateral aspect of the tibia

20. Regarding innervation of flexion/extension of the knee

a. All muscles of the quadriceps femoris are supplied by L3/4

b. Vastus medialis are intermedius are supplied by the same branch of the femoral nerve

c. Flexion of the knee by hamstrings is supplied solely by tibial component of sciatic nerve

d. Flexor innervation of the knee can be tested by knee jerk L3

e. Traumatic fracture dislocation of hip affects knee extension greater than flexion


a. Is supplied by the superficial peroneal nerve

b. Has a synovial sheath that continues below superior extensor retinaculum

c. Dorsiflexes and everts the foot

d. Inserts into the lateral cuneiform

e. Originates from the tibia and fibula

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22. With regard to the stability of the knee joint

a. The posterior cruciate ligament prevents the femur from slipping posteriorly on the tibia

b. The lateral collateral ligament is more prone to damage than the medial

c. The medial meniscus is more prone to damage than the lateral

d. The integrity of the anterior cruciate ligament is most important when walking down stairs

e. The fit of the articular surfaces of the tibia and femur is the most important factor in providing stability

to the knee

23. The ligament important in producing the screw home position in full extension of the knee is the

a. Anterior cruciate ligament

b. Posterior cruciate ligament

c. Arcuate popliteal ligament

d. Patellar retinacula

e. All of the above

24. The cruciate ligaments would be anaesthetized by injury to

a. Femoral nerve

b. Common peroneal nerve

c. Tibial nerve

d. Obturator nerve


25. The cruciate anastomsosis

a. Is supplied by the inferior branch of the medial circumflex femoral artery

b. Is supplied by the descending branch of the first perforating artery

c. Begins at the level of the greater trochanter

d. Is supplied by the transverse branch of the lateral circumflex femoral artery

e. Gives blood supply to the head of the femur

26. In the popliteal fossa

a. The sural nerve branches from the common peroneal nerve

b. The roof is formed by biceps femoris

c. The popliteal vein lies between the popliteal artery and tibial nerve

d. The inferomedial border is soleus

e. The politeal artery runs vertically

27. Politeus

a. Arises from the tibia above the condyles

b. Slopes upwards and medially

c. Inserts into the lateral meniscus

d. In innervated by a branch of the common peroneal nerve

e. Acts to “lock” the knee in full extension

28. With regards to the knee joint

a. The medial collateral ligament extends 8cm below the joint margin

b. The medial collateral ligament is extra-articular

c. The tenson of politeus is intra-articular

d. The lateral meniscus is more C-shaped

e. All of the avove

ESEKHAIGBE K

IZIN

TO AAU S

UG'19 S

EC GEN


a. Dorsiflexes and everts the foot

b. Arises from the upper 2/3s of the fibula

c. Inserts into the medial cuneiform

d. Shares its site of insertion with peroneus tertius

e. Is supplied by L5,S1

30. In the lateral compartment of the leg

a. The muscles are supplied by the deep peroneal nerve

b. The peroneus longus muscles arise only from the fibula

c. The peroneal muscle tendons are bound at the lateral malleolus by the inferior peroneal retinaculum

d. The peroneal muscles share a common synovial sheath at the lateral malleolus

e. The blood supply is from the anterior tibial artery

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19. D

20. A

21. B

22. C

23. A

24. C

25. D

26. C

27. C

28. E

29. C

30. D

ESEKHAIGBE K

IZIN

TO AAU S

UG'19 S

EC GEN

esekhaigbe kizinto aau sug'19 sec gen

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