Professional Documents
Culture Documents
By Kate Florio, Scott Hudzinski, Chris Fung, Jaclyn Reed, and Cate Messick
1. A patient presents with a Trendelenburg gait. When analyzing his gait, you notice that
during mid-stance he is shifting his trunk to right side. This action results from a lesion to which
nerve?
a. Right Inferior Gluteal Nerve
b. Sciatic Nerve
c. Right Superior Gluteal Nerve
d. Left Superior Gluteal Nerve
10. The superior border of the body of the pubis is recognized by what bony landmark?
a. Obturator notch
b. Symphyseal surface
c. Pubic crest
d. Iliopubic eminence
11. Which of these is not a part of the pelvic surface of the ala of the ilium?
a. The tuberosity
b. The iliac fossa
c. The posterior gluteal line
d. The preauricular sulcus
12. Regarding the various surfaces and borders of the ischium, which of these is true?
a. The obturator notch transmits the tendon of the obturator externus muscle
b. The Inferior border of the ischial ramus comprises a portion of the pelvic outlet
c. The ischium does not comprise any portion of the acetabulum
d. The ischium is composed of the body, the ramus, and the pubis
13. When does the primary ossification center appear in the ilium?
a. 9th week
b. 7th week
c. 10th week
d. 14th week
15. The articulation of the auricular surface of the sacrum and the auricular surface of the ilium
forms what type of joint?
a. Synostosis
b. Syndesmosis
c. Synovial Plane
d. Synovial Hinge
18. All of these provide DIRECT blood supply to the hip joint except…
a. Medial circumflex femoral artery
b. Lateral circumflex femoral artery
c. 1st perforating artery
d. Obturator artery
19. The order of the appearance of secondary ossification centers in the femur from first to last
is:
a. Distal epiphysis, head of femur, greater trochanter, lesser trochanter
b. Greater trochanter, head of the femur, lesser trochanter, distal epiphysis
c. Distal epiphysis, head of femur, greater trochanter, lesser trochanter
d. Head of femur, distal epiphysis, lesser trochanter, greater trochanter
20. What ventral rami contribute to the formation of the superior gluteal nerve?
a. L5, S1, S2
b. S1, S2, S3
c. L3, L4, L5
d. L4, L5, S1
21. Regarding the muscles of the gluteal region, which of these is true?
a. The Gluteus Maximus is innervated by the Superior Gluteal Nerve
b. The piriformis is a medial rotator of the thigh at the hip joint
c. Gluteus minimus has an attachment to the greater trochanter
d. The obturator internus inserts onto the trochanteric fossa
22. Which of these arteries supplies a direct branch to the sciatic nerve?
a. Femoral artery
b. Iliolumbar artery
c. Inferior gluteal artery
d. Superior Gluteal artery
23. Which of these arteries does NOT contribute to the cruciate anastomosis? (IMAPTL)
a. Iliac branch of the iliolumbar artery
b. Transverse branch of the lateral circumflex femoral
c. Inferior Gluteal
d. Ascending Branch of the first perforating Artery
Section 2
1. Your patient has a herniated disc between L1 and L2 vertebrae. Which of the following
muscles is most likely to have a deficit?
a. Gluteus maximus
b. Psoas minor
c. Psoas Major
d. Biceps femoris(long head)
2. The lateral circumflex femoral artery supplies all of the following muscles except:
a. Rectus femoris
b. Vastus medialis
c. Vastus intermedius
d. Vastus lateralis
3. Perforating arteries(of the thigh) typically branch off what artery and travel in what
direction?
a. Deep femoral artery, move laterally
b. Deep femoral artery, move medially
c. Femoral artery, move laterally
d. Femoral artery, move medially
e. Lateral circumflex femoral, move laterally
Section 3
1) Which of the following is an extracapuslar ligament of the Ankle Joint?
a. Anterior Talofibular Ligament
b. Posterior Talofibular Ligament
c. Posterior Tibiotalar Ligament
d. Interosseous Ligament
e. Calcaneofibular Ligament
4) Which of the following is not part of the greater tarsal synovial cavity?
a. Proximal intermetatarsal joint b/t digits 3-4
b. The intermediate portion of the Lisfranc Joint
c. The intercuneiform joint between medial and intermediate cuneiform
d. The cuneonavicular joint
e. The medial portion of the tarsometatarsal joint
5) Which of the following joints is considered the main source of abductovalgus deformity?
a. Tarsometatarsal joint on the 2MT- Cuneiform Articulation
b. Proximal Intermetatarsal Joint on the lateral 2nd MT base- medial 3rd MT base
c. Hallucal Metatarsal Phalangeal joint
d. Interphalangeal Joint @ Hallux IPJ
e. Proximal intermetatarsal joint between 1st and 2nd MT
6) In order to appropriately side the 2nd MT base, which of the following features should you
look for?
a. An inverted “L” shape on the posterior surface
b. An oval shape facet located on the posterior surface
c. It has 2 facets on the lateral side divided by vertical ridge to make 4 articular facets
d. It’s largely divided by a vertical ridge on the anterior side
e. A large articulation on the medial side with the 1st MT
7) How many tarsometatarsal ligaments attach to the dorsal side of the 2nd metatarsal?
a. 1
b. 2
c. 3
d. 4
e. 0
8) The shape of the posterior surface of the 3rd MT can best be described as…
a. Kidney-bean shaped
b. Square shaped
c. Circular
d. Ovoid
e. Upside-down Triangle
9) Which one of the following is true regarding plantar ligaments originating from the
intermediate cuneiform?
a. There are no ligaments originating from the IC
b. There is a Y-shaped ligament which attaches to 1st and 2nd MT
c. There is one ligament which attaches onto the base of the 2nd MT
d. There is one ligament which attaches to the 1st MT
e. None of the above are true
11) Off the Talonavicular Joint, which one of the following is considered to be extracapsular?
a. Talonavicular ligament
b. Plantar Calcaneonavicular ligament
c. Bifricate Ligament
d. Interosseous Cuboideonavicular ligament
e. Plantar Cuneonavicular ligament
12) When and where does the primary ossification center of the tibia form?
a. Diaphysis- 8-9 weeks
b. Diaphysis- 7-8 weeks
c. Epiphysis- 3-22 months
d. Diaphysis- 2-3 years
e. Proximal epiphysis- 2-3 years
13) A 13yo boy who runs track and field in his middle school began developing pain in his leg.
He was taken to see his 1’ care physician who ordered an X-ray as shown below. What does this
X-ray indicate?
a. Pott’s Fracture
b. Injury in the Unhappy Triad
c. Osgood-Schlatter Disease
d. Ankylosing Spondylitis
e. Osteomyelitis
14) Suspensory Ligaments are located at the…
a. MTPJ (lesser metatarsophalangeal joint)
b. PIP
c. Hallux IPJ
d. DIP
e. LisFranc Joints
15) With 1mm of lateral talar displacement, what is the average reduction in the tibiotalar
contact area?
a. 35%
b. 42%
c. 50%
d. 63%
e. 79%
16) Which of the following is the appropriate order of ossification (from earliest to latest)?
a. Cuboid, Intermediate Cuneiform (IC), Medial Cuneiform (MC), Lateral Cuneiform (LC),
Navicular
b. Navicular, IC, MC, LC, Cuboid
c. Cuboid, Navicular, LC, MC, IC
d. Cuboid, LC, MC, IC, Navicular
e. MC, LC, IC, Navicular Cuboid
17) The inverted “L” shaped facet is located on the medial side of what bone?
a. Medial Cuneiform
b. Lateral Cuneiform
c. Intermediate Cuneiform
d. Cuboid
e. Navicular
18) How can the Os Tibiale Externum (OTE) be differentiated from the sesamoid of the Tibialis
Posterior (TP)?
a. OST is located antero-laterally to the navicular tuberosity
b. TP is located plantar-laterally from navicular tuberosity
c. OST is located posterior-laterally to the navicular tuberosity
d. TP is located dorsal-medial to the navicular tuberosity
e. OST and TP are indistinguishable from one another
C. Which is the correct innervation of the muscle that inserts most anteriorly at the pes
anserinus
a. Tibial nerve
b. Anterior division of femoral nerve
c. Posterior division of femoral nerve
d. Anterior division of obturator nerve
D. Which of the following statements regarding the inferior extensor retinaculum is true?
a. The tibialis anterior and extensor hallucis longus tendons pass deep to the
frondiform/fundiform ligament
b. The inferior extensor retinaculum has an attachment to the lateral malleolus
c. The frondiform/fundiform ligament is continuous with the inferior peroneal
retinaculum
d. Extensor digitorum longus tendon passes laterally in relation to fibularis tertius
E. Select the false statement regarding the anterior compartment of the leg.
a. Motor innervation is provided by the superficial fibular nerve
b. Blood supply is provided by the anterior tibial artery
c. The common function is ankle dorsiflexion
d. At least one of the muscles in the compartment is capable of inverting the foot
F. At which point do the combined extensor digitorum brevis and extensor digitorum longus
tendons trifurcate?
a. Proximal phalanx base
b. MT head
c. MT base
d. Proximal phalanx head
G. The anterior lateral malleolar artery is a branch of which major artery
a. Fibular
b. Anterior tibial
c. Posterior tibial
d. Lateral tarsal
H. Your patient was walking barefoot and stepped on a nail, which penetrated his adductor
hallucis muscle. The nail most likely penetrated through which compartment of his foot?
a. Lateral
b. Central
c. Medial
d. Interosseous
J. Identify “O”
a. Tibialis anterior
b. Extensor hallucis longus
c. Extensor digitorum longus
d. Fibularis tertius
K. Popliteus has an attachment to which of the following
a. Lateral surface of lateral condyle of femur
b. Lateral supracondylar ridge of femur
c. Fibular head
d. Posterior surface of tibia distal to the soleal line
R. Which of the following is not innervated by the medial terminal branch of the deep
fibular nerve?
a. MTPJ 1
b. 1st intermetatarsal space
c. ankle joint
d. medial intertarsal joints
T. Identify “3”
a. Sartorius
b. Semimembranosus
c. Gracilis
d. Semitendinosus
Section 5
1. What nerve supplies innervation to the
skin on lateral bottom 1.5 toes?
a. Lateral Sural cutaneous
b. Superficial Branch of Medial Plantar (L4, L5, S1, S2, S3)
c. Superficial Branch of Lateral Plantar (S1, S2, S3)
d. Lateral Calcaneal Nerve
2. All of the following are muscles of the first layer of the plantar foot EXCEPT
a. Abductor Digiti Minimi
b. Flexor Hallucis Longus
c. Flexor Digitorum Brevis
d. Abductor Hallucis
3. The medial calcaneal nerve branches are from which of the following nerves
a. Sural
b. Tibial
c. Superfical Fibular
d. Deep Fibular
4. Where does the tendon of Flexor Digitorum Brevis bifurcate?
a. At the plantar aspect of MT head
b. At the plantar aspect MT shaft
c. At the plantar aspect PP base
d. At the plantar aspect PP shaft
5. Which muscle has an origin from the lateral process of the calcaneal tuberosity?
a. Abductor Digiti Minimi
b. Quadratus Plantae
c. Flexor Digiti Minimi
d. Abductor Hallucis (Oblique head)
6. The Lumbrical muscles…
a. Are all innervated by the lateral plantar nerve
b. Pass superficial to the deep transverse metatarsal ligament
c. Insert on the medial side of the extensor expansion
d. Both A and B
e. Both B and C
7. What structures run between Quadratus Plantae and Flexor Digitorum Brevis?
a. Lateral Calcaneal Nerve
b. Medial Plantar Nerve, Artery and Vein
c. Lumbrical Muscles
d. Lateral Plantar Nerve, Artery and Vein
8. Which of the following in not innervated by the medial plantar nerve
a. Flexor Hallucis
b. Abductor Hallucis
c. Flexor digiti minimi brevis
d. Flexor Digitorum Brevis
9. What is the main origin of Adductor Hallucis Transverse Head?
a. Plantar MT ligaments of MTPJs 3-5
b. Plantar MT head of MTPJs 3-5
c. Plantar base of PP of MTPJs 3-5
d. Peroneal sheath and bases of MT 2-4
10. Which two muscles attach at the same spot and have the same action?
a. Second Dorsal Interosseous and First Plantar Interosseous
b. Flexor Digiti Minimi Brevis and Abductor Digiti Minimi
c. Flexor Digiti Minimi Brevis and Oblique head of Adductor Hallucis
d. Fibularis Longus and Fibularis Brevis
11. Which muscle does the lateral plantar artery Supply?
a. Abductor Hallucis
b. Flexor Digitorum Brevis
c. Flexor Hallucis Brevis
d. First Dorsal Interosseous
12. How many Common Plantar Digital Nerves does the Medial Plantar Nerve give off?
a. 1
b. 2
c. 3
d. 4
13. What artery directly anastomoses with the dorsum of the foot?
a. Circumflex Fibular Artery
b. Deep Plantar Arch
c. Anterior Perforating Artery
d. Plantar MT Artery
14. If the lateral Plantar Nerve is cut which of the following muscles will be directly
affected?
a. Abductor hallucis
b. Quadratus Plantae
c. 3rd Dorsal interossei
d. Flexor Digiti minimi Brevis
e. 3rd Plantar Interossei
f. A, B, C, D
g. B, C, D, E
15. What serves as the boundary between the superficial and deep veins on the foot?
a. Cural Fascia
b. MT shafts 1-5
c. The Cutaneous Nerves
d. The Deep Fascia of the foot
16. The primary spinal nerve that innervates the skin of the small toe is
a. L4
b. L5
c. S1
d. S2
17. Which of the following joints allow flexion, extension, abduction and adduction?
a. Distal tibiofibular
b. Tarsometatarsal
c. Interphalangeal
d. Metatarsophalangeal
18. The first Plantar interosseous muscle arises from which of the following metatarsals?
a. First
b. Second
c. Third
d. Fourth
19. The tendon of which of the following muscles is associated with the medial side of the
second metatarsophalangeal joint?
a. First Lumbrical
b. First Plantar interosseous
c. Second Doral Interosseous
d. Third Dorsal interosseous
20. Where do the superficial and deep groups of lymphatics converge and unite?
a. Tarsal Tunnel
b. Popliteal Fossa
c. Adductor Hiatus
d. Where Small Saphenous passes posterior to lateral malleolus
21. Enlargement of the superficial inguinal lymph nodes WILL NOT indicate disease in
which areas?
a. Lower Limb
b. Perinanal Region
c. Gluteal region
d. Abdominal wall (upper region)
22. Are the sympathetics to the lower limb preganglionic or postganglionic, and what spinal
levels do they originate from?
a. Preganlionic T10- L2
b. Postganglionic T10- L2
c. Preganglionic T10- L3
d. Postganglionic T10- L3
23. How would you take the Dorsalis Pedis pulse of your patient?
a. Slightly dorsiflex the patients foot and place finger tips one finger’s breadth distal
to the MT bases
b. Posterior to medial Malleolus at one fingers breadth and anterior to Achilles
tendon
c. By placing finger tips along a line from the inferior extensor retinaculum, just
lateral to EHLT
d. By placing fingers directly between the medial and lateral malleolus
24. What muscle is used to test L4?
a. Tibialis Anterior
b. Tibialis Posterior
c. Fibularis Longus
d. Quadriceps group
25. What nerve supplies the L4 dermatome?
a. Intermediate and Medial Femoral Cutaneous
b. Intermediate and Medial Dorsal Cutaneous
c. Obturator Nerve (Cutaneous Branch)
d. Saphenous nerve
26. When extending Extensor Hallucis Longus what neurological level are you testing?
a. L4
b. L5
c. S1
d. S2
27. What nerves are being tested when you plantarflex the foot?
a. L3, L4
b. L5, S1
c. L4, L5
d. S1, S2
28. What nerves are being tested when you invert the foot?
a. L3, L4
b. L4, L5
c. L4, S1
d. S1, S2
29. What is the condition when you have a Plantarflexed DIPJ?
a. Claw Toe
b. Mallet toe
c. Bunion
d. Hammer toe
30. If your patient presents with a claw toe deformity and after further investigation you
deduce that which joint is dorsiflexed?
a. DIPJ
b. MTPJ
c. PIPJ
d. Subtalar joint
31. Which of the following is associated with a tarsal tunnel syndrome?
a. Unilateral pain on ball of foot upon weight bearing.
b. Diffuse pain over medial ankle and sole of foot
c. Joint subluxation and dislocation.
d. Pain on heel of foot.
32. Your patient has a foraminal stenosis between L3 and L4 vertebrae which muscle’s
function would most likely be affected?
a. Tibialis anterior
b. Rectus femoris
c. Semitendinosus
d. Gluteus maximus