Lower Limb

A 27-year-old patient exhibits a loss of skin sensation and paralysis of muscles on the plantar aspect of the medial side of the foot. Which of the following nerves is most likely damaged?

A. Common peroneal
B. Tibial
C. Superficial peroneal
D. Deep peroneal
E. Sural

A patient with a deep knife wound in the buttock walks with a a waddling gait that is characterized by the pelvis falling toward one side at each step. Which of the following nerves is damaged?

A. Obturator nerve
B. Nerve to obturator internus
C. Superior gluteal nerve
D. Inferior gluteal nerve
E. Femoral nerve

A patient is unable to prevent anterior displacement of the femur on the tibia when the knee is flexed. Which of the following ligaments is most likely damaged?

A. Anterior cruciate
B. Fibular collateral
C. Patellar
D. Posterior cruciate
E. Tibial collateral

A 41-year-old man was involved in a fight and felt weakness in extending the knee joint. On examination, he was diagnosed with a lesion of the femoral nerve. Which of the following symptoms would be a result of this nerve damage?

A. Paralysis of the psoas major muscle
B. Loss of skin sensation on the lateral side of the foot
C. Loss of skin sensation over the greater trochanter
D. Paralysis of the vastus lateralis muscle
E. Paralysis of the tensor fasciae latae

A 47-year-old woman is unable to invert foot after she stumbled on her driveway. Which of the following nerves are most likely injured?

A. Superficial and deep peroneal
B. Deep peroneal and tibial
C. Superficial peroneal and tibial
D. Medial and lateral plantar
E. Obturator and tibial

A 23-year-old patient is unable to "unlock" the knee joint to permit flexion of the leg. Which of the following muscles is most likely damaged?

A. Rectus femoris
B. Semimembranosus
C. Popliteus
D. Gastrocnemius
E. Biceps femoris

A patient presents with sensory loss on adjacent sides of the great and second toes and impaired dorsiflexion of the foot. These signs probably indicate damage to which of the following nerves?

A. Superficial peroneal
B. Lateral plantar
C. Deep peroneal
D. Sural
E. Tibial

A motorcyclist falls from his bike in an accident and gets a deep gash the severs the superficial peroneal nerve nears its origin. Which of the following muscles is paralyzed?

A. Peroneus longus
B. Extensor hallucis longus
C. Extensor digitorum longus
D. Petroneus tertius
E. Extensor digitorum brevis

A 67-year-old patient has been given a course of antibiotics by gluteal intramuscular injections after a major abdominal surgery. To avoid damaging the sciatic nerve during an injection, the needle should be inserted into which of the following areas?

A. Over the sacropinous
B. Midway between the ischial tuberosity and the lesser trochanter
C. Midpoint of the gemelli muscles
D. Upper lateral quadrant of the gluteal region
E. Lower medial quadrant of the gluteal region

A 20-year-old patient cannot flex and medially rotate the thigh while running and climbing. Which of the following muscles is most likely damaged?

A. Semimembranosus
B. Sartorius
C.Rectus femoris
D. Vastus intermedius
E. Tensor fasciae latae

A 21-year-old man was involved in a motorcycle accident, resulting in destruction of the groove in the lower surface of the cuboid bone. Which of the following muscle tendons is most likely damaged?

A. Flex hallucis longus
B. Peroneus brevis
C. Peroneus longus
D. Tibalis anterior
E. Tibalis posterior

A construction worker falls feet first from a roof. He sustains a fracture of the groove on the undersurface of the sustentaculum tali of the calcaneus bone. Which of the following muscle tendons is most likely torn?

A. Flexor digitorum brevis
B. Flexor digtorum longus
C. Flexor hallucis brevis
D. Flexor hallucis longus
E. Tibialis posterior

A thoracic surgeon is going to harvest a portion of the greater saphenous vein for coronary bypass surgery. He has observed that this vien runs:

A. Posterior to the medial malleolus
B. Into the popliteal vein
C. Anterior to the medial condyles of the tibia and femur
D. Superficial to the fascia lata of the thigh
E. Along with the femoral artery

A 52-year-old woman slipped and fell and now complains of being unable to extend her leg at the knee joint. Which of the following muscles were paralyzed as a result of the accident?

A. Semitendinosus
B. Sartorius
C. Gracilis
D. Quadriceps femoris
E. Biceps femoris

A patient experiences weakness in dorsiflexing and inverting the foot. Which of the following muscles is damaged?

A. Peroneus longus
B. Peroneus brevis
C. Tibialis anterior
D. Extensor digitorum longus
E. Peroneus tertius

A 62-year-old woman slips and falls on the bathroom floor. As a result, she has a dislocation of the hip joint and a fracture of the neck of the femur.

Rupture of the ligamentum teres capitis femoris may lead to damage to a branch of which of the following arteries?

A. Medial circunflex femoral
B. Lateral cicumflex femoral
C. Obturator
D. Superior gluteal
E. Inferior gluteal

A 62-year-old woman slips and falls on the bathroom floor. As a result, she has a dislocation of the hip joint and a fracture of the neck of the femur.

Fracture of the neck of the femur results in avascular necrosis of the femoral head, probably resulting from lack of blood supply from which of the following arteries?

A. Obturator
B. Superior gluteal
C. Inferior gluteal
D. Medial femoral circumflex
E. Lateral femoral circumflex

A 62-year-old woman slips and falls on the bathroom floor. As a result, she has a dislocation of the hip joint and a fracture of the neck of the femur.

If the acetabulum is fractured at its posterosuperior margin by dislocation of the hip joint, which of the following bones could be involved?

A. Pubis
B. Ischium
C. Ilium
D. Sacrum
E. Head of the femur

A 62-year-old woman slips and falls on the bathroom floor. As a result, she has a dislocation of the hip joint and a fracture of the neck of the femur.

The woman experiences weakness when abducting and medially rotating the thigh after this accident. Which of the following muscles is most likely damaged?

A. Piriformis
B. Obturator internus
C. Quadratus femoris
D. Gluteus maximus
E. Gluteus minimus

A 62-year-old woman slips and falls on the bathroom floor. As a result, she has a dislocation of the hip joint and a fracture of the neck of the femur.

The woman undergoes hip surgery. If all of the arteries that are part of the cruciate anastomosis of the upper thigh are ligated, which of the following arteries maintains blood flow?

A. Medial femoral circumflex
B. Lateral femoral circumflex
C. Superior gluteal
D. Inferior gluteal
E. First perforating

A 34-year-old woman sustains a deep cut on the dorsum of the foot just distal to her ankle joint by a falling kitchen knife. A physician in the emergency department has ligated the doralis pedis artery proximal to the injured area. Which of the following conditions most likely occurs as a result of the injury?

A. Ischemia in the peroneus longus muscle
B. Aneurysm in the plantar arterial arch
C. Reduction of blood flow in the medial tarsal artery
D. Low blood pressure in the anterior tibial artery
E. High blood pressure in the arcuate artery

A patient experiences paralysis of the muscle that originates from the femur and contributes directly to the stability of the knee joint. Which of the following muscles is involved?

A. Vastus lateralis
B. Semimembranosus
C. Sartorius
D. Biceps femoris (long head)
E. Rectus femoris

A patient is involved in a motorcycle wreck that results in avulsion of the skin over the aterolateral leg and ankle. Which of the following structures is most likely destroyed with this type of injury?

A. Deep peroneal nerve
B. Extensor digitorium longus muscle tendon
C. Doralis pedis artery
D. Great saphenous vein
E. Superficial peroneal nerve

A knife wound penetrates the superficial vein that terminates in the popliteal vein. Bleeding occurs from which of the following vessels?

A. Posterior tibial vein
B. Anterior tibial vein
C. Peroneal vein
D. Great saphenous vein
E. Lesser saphenous vein

A ten-year-old boy falls from a tree house. The resultant heavy compression of the sole of his foot against the ground caused a fracture of the head of the talus. Which of the following structures is unable to function normally?

A. Transverse arch
B. Medial longitundinal arch
C. Lateral longitundinal arch
D. Tendon of the peroneus longus
E. Long plantar ligament

A 24-year-old woman complains of weakness when she extends her thigh and rotates it laterally. Which of the following muscles is paralyzed?

A. Obturator externus
B. Sartorius
C. Tensor fasciae latae
D. Gluteus maximus
E. Semitendinosus

A patient with hereditary blood clotting problem presents with a pain in the back of her knee. An arteriogram reveals a blood clot in the popliteal artery at its proximal end. Which of the following arteries will allow blood to reach the foot?

A. Anterior tibial
B. Posterior tibial
C. Peroneal
D. Lateral circumflex femoral
E. Superior medial genicular

A 72-year-old complains of cramp-like pain in her thigh and leg. She was diagnosed as having a severe intermittent claudication. Following surgery, an infection was found in the adductor canal, damaging the enclosed structures. Which of the following structures remains intact?

A. Femoral artery
B. Femoral vein
C. Saphenous nerve
D. Great saphenous vein
E. Nerve to the vastus medialis

A basketball player was hit in the thigh by an opponent's knee. Which of the following arteries is likely to compress and cause ischemia because of the bruise and damage to the extensor muscles of the leg?

A. Popliteal
B. Deep femoral
C. Anterior tibial
D. Posterior tibial
E. Peroneal

An elderly woman fell at home and fractured the greater trochanter of her femur. Which of the following muscles would continue to function normally?

A. Piriformis
B. Obturator internus
C. Gluteus medius
D. Gluteus maximus
E. Gluteus minmus

A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

Which of the following nerves is damaged?

A. Sciatic
B. Tibial
C. Common peroneal
D. Deep peroneal
E. Superficial peroneal

A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

After injury to the common peroneal nerve, which of the following muscles could be paralyzed?

A. Gastrocnemius
B. Popliteus
C. Extensor hallucis longus
D. Flexor digitorium longus
E. Tibialis posterior

A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

If the lateral (fibular) collateral ligament is torn by this fracture, which of the following conditions may occur?

A. Abnormal passive abduction of the extended leg
B. Abnormal passive adduction of the extended leg
C. Anterior displacement of the femur on the tibia
D. Posterior displacement of the femur on the tibia
E. Maximal flexion of the leg

A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

Which of the following arteries could also be damaged by this fracture?

A. Popliteal
B. Posterior tibial
C. Anterior tibial
D. Peroneal
E. Lateral inferior genicular

A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

Which of the following conditions would occur from this fracture?

A. Ischemia in the gastrocnemius
B. Loss of plantar flexion
C. Trendelenburg's sign
D. Anterior tibial compartment syndrome
E. Flat foot

A construction worker is hit on the leg with a concrete block and is subsequently unable to plantar flex and invert his foot. Which of the following muscles is most likely damaged?

A. Extensor digitorum longus
B. Tibialis anterior
C. Tibialis posterior
D. Peroneus longus
E. Peroneus brevis

The obturator nerve and the sciatic (tibial portion) nerve of a 15-year-old boy are transected as a result of a motorcycle accident. This injury would result incomplete paralysis of which of the following muscles?

A. Rectus femoris
B. Biceps femoris short head
C. Pectineus
D. Adductor magnus
E. Sartorius

A 24-year-old woman presents to her physician with weakness in flexing the hip joint and extending the knee joint. What muscle is most likely involved in this scenario?

A. Sartorius
B. Gacilis
C. Rectus femoris
D. Vastus medialis
E. Semimembranosus

A 17-year-old boy was stabbed during a gang fight resulting in transection of the obturator nerve. Which of the following muscles is completely paralyzed?

A. Pectineus
B. Adductor magnus
C. Adductor longus
D. Biceps femoris
E. Semimembranosus

A 32-year-old carpenter fell from the roof. The lateral longitudinal arch of his foot was flattened from fracture and displacement of the keystone for the arch. Which of the following bones is damaged?

A. Calcaneus
B. Cuboid bone
C. Head of talus
D. Medial cuneiform
E. Navicular bone

While playing football, a 19-year-old college student receives a twisting injury to his knee when being tackled from the lateral side. Which of the following conditions most likely has occurred?

A. Tear of the medial meniscus
B. Ruptured fibular collateral ligament
C. Tenderness on pressure along the fibular collateral ligament
D. Injury to the posterior cruciate ligament
E. Swelling on the back of the knee joint

A patient has weakness when flexing both her thigh and leg. Which of the following muscles is most likely injured?

A. Rectus femoris
B. Semitendinosus
C. Bicep femoris
D. Sartorius
E. Adductor longus

A 35-year-old man has difficulty in dorsiflexing the foot. Which of the following muscles is most likely damaged?

A. Tibialis posterior
B. Flexor digitorum longus
C. Tibialis anterior
D. Peroneus longus
E. Peroneus brevis

An injury to the leg of a golfer results in loss of ability to invert the foot. Which of the following muscles is most likely paralyzed?

A. Tibialis posterior
B. Peroneus longus
C. Peroneus brevis
D. Peroneus tertius
E. Extensor digitorum longus

An orthopedic surgeon ligates the posterior artery at its origin. Which of the following arteries has no blood flow immediately after the ligation?

A. Peroneal
B. Doralis pedis
C. Superior medial genicular
D. Anterior tibial
E. Descending genicular

Before knee surgery, a surgeon ligates arteries participating in the anastomosis around the knee joint. Which of the following arteries is most likely spared?

A. Lateral superior genicular
B. Medial inferior genicular
C. Descending branch of the lateral femoral circumflex D. Saphenous branch of the descending genicular
E. Anterior tibial recurrent

A 25-year-old gladiator sustains a penetrating injury that severs the superficial peroneal nerve. This will most likely cause paralysis of which of the following muscles?

A. Peroneus tertius
B. Peroneus brevis
C. Flexor hallucis longus
D. Tibalis anterior
E. Tibalis posterior

A patient presents with a thrombosis int eh popliteal vein. This thrombosis most likely causes reduction of blood flow in which of the following veins?

A. Greater saphenous
B. Lesser saphenous
C. Femoral
D. Posterior tibial
E. Anterior tibial

A 21-year-old tennis player comes to an emergency room and complains of pain in the knee joint. On examination, he has an infection inside the knee joint capsule but outside the synovial cavity. Which of the following structures is preserved from this infection?

A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Lateral meniscus
D. Lateral collateral ligament
E. Medial meniscus

A 14-year-old gymnastic silver medalists falls from the parallel bar and complains of pains from the knee and ankle joints. On physical examination, her physician that the muscle responsible for flexing the leg at the knee joint and plantar flexing the foot is severely weakened. Which of the following muscles involved in both movements was most likely damaged in this accident?

A. Tibialis posterior
B. Gastrocnemius
C. Soleus
D. Peroneus longus
E. Flexor digitorium longus

A 28-year-old basketball player falls while rebounding and is unable to run and jump. On physical examination, he has pain and weakness when extending his thigh and flexing his leg. Which muscle involved in both movements is most likely injured?

A. Short head of biceps femoris
B. Adductor magnus
C. Semitendinosus
D. Sartorius
E. Gracilis

A 52-year-old woman comes to an orthopedic surgeon complaining of an uncomfortable felling in her knee and ankle joints. After a thorough examination, she is diagnosed as having arthritis with mild discomfort with passive movements. The muscles acting at the ankle joint appear normal with good strength. Which muscle can both dorsiflex and invert her foot?

A. Peroneus longus
B. Peroneus brevis
C. Peroneus tertius
D. Extensor hallucis longus
E. Extensor digitorum longus

Rupture of the tendon superior to this structure would most likely cause an inability to extend the knee joint.

Fracture of this structure would most likely cause weakness in adduction, flexion, and extension of the thigh.

A knife penetrating through this point would most likely cause muscle ischemia in the anterior compartment of the leg.

Fracture of this structure would most likely cause a lesion of the common peroneal nerve, resulting in paralysis of the muscles in the anterior and lateral compartments of the leg.

Which structure in this radiograph may be fractured, resulting in loss of the chief flexor of the thigh?

Fracture of which structure may destroy the site of insertion of the muscle that can rotate the thigh laterally and its tendon that passes through the lesser sciatic foramen?

Which fractured structure is likely to cause paralysis of the adductor magnus?

Which structure becomes necrotic after the medial femoral circumflex artery is severed?

The flexor hallucis longus tendon is damaged in a groove on the posterior surface of a tarsal bone. Which bone in the radiograph is likely fractured?

The tibialis anterior and peroneus longus muscles are weakened. Which bone in the radiograph is most likely fractured?

The medial longitudinal arch of the foot is flattened because the spring ligament is torn. Which bone in the radiograph is most likely fractured?

The peroneus longus muscle tendon is damaged in a groove of a tarsal bone by fracture. Which bone in the radiograph is most likely fractured?