Lower Limb Practice Questions

Q: 3rd and 4th lumbrical (lateral two lumbricals) of foot are supplied by ?

Lateral plantar nerve. ***Lateral plantar nerve*** - The **lateral plantar nerve** innervates the **lateral two lumbricals (3rd and 4th)** of the foot, mirroring the ulnar nerve's innervation of the medial two lumbricals in the hand. - This nerve is a branch of the **tibial nerve** and is responsible for motor innervation to most of the intrinsic foot muscles, including those in the lateral and central compartments. *Medial plantar nerve* - The **medial plantar nerve** supplies the **medial two lumbricals (1st and 2nd)** of the foot, similar to the median nerve in the hand. - It also provides motor innervation to the flexor digitorum brevis, abductor hallucis, and flexor hallucis brevis muscles. *Peroneal nerve* - The **peroneal nerve (fibular nerve)** is primarily responsible for innervating muscles in the **anterior and lateral compartments of the leg**, which control dorsiflexion and eversion of the foot. - It does not innervate the lumbrical muscles of the foot. *None of the options* - This option is incorrect because the **lateral plantar nerve** does specifically innervate the 3rd and 4th lumbricals of the foot.

Q: Which of the following statements about the popliteus muscle is false?

Causes locking of knee. ***Causes locking of knee*** - The popliteus muscle acts as the key to **unlocking the knee** from its fully extended, locked position, not causing it to lock. [1] - It achieves this by producing **internal rotation of the tibia** on the femur (or external rotation of the femur on the tibia) at the beginning of knee flexion. *Flexor of knee* - The popliteus muscle contributes to **flexion of the knee joint**, working in conjunction with the hamstrings. - This action is particularly important during the initial phases of knee flexion. *Intracapsular origin* - The popliteus muscle originates from the **lateral condyle of the femur**, specifically from an impression just anterior and inferior to the groove for the popliteal tendon. - This origin point is indeed **intracapsular**, lying within the fibrous capsule of the knee joint. *Supplied by tibial nerve* - The popliteus muscle receives its innervation from the **tibial nerve**, a branch of the sciatic nerve. - The nerve typically arises from the posterior aspect of the tibial nerve trunk as it passes through the popliteal fossa.

Q: Locking of the knee involves which of the following?

Internal rotation of the femur with the foot on the ground. ***Internal rotation of the femur with the foot on the ground*** - When the foot is on the ground (closed kinematic chain), the **femur rotates internally on the tibia** during the end stages of knee extension. This creates a more stable, "locked" position of the knee. - This **terminal rotation of the femur** increases the contact area and tension in the cruciate ligaments, enhancing joint stability for weight-bearing. *Internal rotation of the tibia with the foot on the ground* - This describes the action of the **popliteus muscle** when "unlocking" the knee from full extension, not the locking mechanism itself. - With the foot on the ground, the tibia is fixed, and internal rotation would typically be a movement for unlocking, not locking. *Contraction of the popliteus muscle* - The **popliteus muscle** is primarily responsible for **unlocking the knee** from full extension, by causing internal rotation of the tibia (or external rotation of the femur). - Its contraction would lead to initial flexion of the knee, releasing the locked position, not establishing it. *External rotation of femur with the foot off the ground* - With the foot off the ground (open kinematic chain), **external rotation of the tibia** occurs during the final degrees of extension to lock the knee, not external rotation of the femur. - The locking mechanism requires specific relative rotation between femur and tibia; external rotation of the femur alone would not achieve the screw-home mechanism necessary for knee locking.

Q: Inversion and eversion of foot occurs at which joint

Subtalar. ***Subtalar*** - The **subtalar joint** (talocalcaneal joint) is primarily responsible for **inversion** and **eversion** movements of the foot. - **Inversion** involves tilting the sole of the foot medially (turning inward), while **eversion** involves tilting the sole laterally (turning outward). - This joint allows the foot to **adapt to uneven surfaces** and plays a crucial role in the biomechanics of walking and running. - The subtalar joint is essential for shock absorption and balance during gait. *Ankle* - The **ankle joint** (talocrural joint) is a hinge joint primarily responsible for **dorsiflexion** and **plantarflexion** of the foot. - It allows moving the foot up and down but has minimal contribution to inversion and eversion. *Tarso-metatarsal* - The **tarso-metatarsal joints** (Lisfranc joints) connect the tarsal bones to the metatarsal bones. - These joints contribute primarily to the **stability and arch integrity** of the foot, with minimal movement capacity. - They allow slight gliding movements but not significant inversion or eversion. *None of the options* - This option is incorrect because the **subtalar joint** is indeed the primary joint responsible for inversion and eversion of the foot. - Understanding foot joint biomechanics is essential for diagnosing gait abnormalities, ankle sprains, and foot pathologies.

Q: Which of the following statements about the femoral triangle is NOT true?

Floor is formed by adductor longus. ***Floor is formed by adductor longus*** - The floor of the femoral triangle is actually formed by the **iliopsoas** laterally and the **pectineus** medially. - The **adductor longus** forms part of the medial boundary of the femoral triangle, not its floor. - This is the INCORRECT statement (correct answer for a "NOT true" question). *Contains the femoral vessels* - The femoral triangle is a crucial anatomical space containing the **femoral artery**, **femoral vein**, and **femoral nerve**. - These structures are organized from lateral to medial as nerve, artery, vein (NAVY). *Lateral margin is formed by sartorius* - The **sartorius muscle** forms the lateral boundary of the femoral triangle. - Its medial border defines one of the triangle's sides. *Medial margin is formed by adductor longus* - The **adductor longus** does form the medial boundary of the femoral triangle. - This is anatomically correct along with the inguinal ligament (superior boundary) and sartorius (lateral boundary).

Q: Which is the largest nerve that exits the pelvis through the greater sciatic foramen?

Sciatic nerve. ***Sciatic nerve*** - The **sciatic nerve** is the largest nerve in the human body, formed from the sacral plexus, and it is indeed the largest structure that passes through the **greater sciatic foramen** as it descends into the posterior thigh. - It supplies motor and sensory innervation to the posterior thigh, lower leg, and foot. *Superior gluteal artery* - The superior gluteal artery exits the pelvis through the **greater sciatic foramen** above the piriformis muscle. - While significant, it is an artery and not a nerve, and it is not the largest structure passing through this foramen. *Inferior gluteal artery* - The inferior gluteal artery also exits the pelvis via the **greater sciatic foramen**, inferior to the piriformis muscle. - Like the superior gluteal artery, it is an arterial structure and not a nerve, and it is not the largest structure in the foramen. *Piriformis muscle* - The **piriformis muscle** originates inside the pelvis and passes through the **greater sciatic foramen** to insert on the greater trochanter of the femur. - Although it occupies a significant portion of the foramen, it is a muscle, not a nerve, and the sciatic nerve is the largest nerve exiting this aperture.

Q: Which of the following prevents hyperextension of the thigh?

Iliofemoral ligament. ***Iliofemoral ligament*** - The **iliofemoral ligament** is the strongest ligament in the hip joint and forms an inverted Y-shape. - Its primary function is to prevent **hyperextension of the thigh** by spiraling around the femoral neck and tightening during extension. *Ischiofemoral ligament* - The **ischiofemoral ligament** is located posteriorly and prevents **over-adduction** and **internal rotation** of the hip. - It also contributes to restricting hyperextension, but is not the primary restraint compared to the iliofemoral ligament. *Patellofemoral ligament* - The **patellofemoral ligament** is located in the knee joint, connecting the patella to the femur. - It stabilizes the **patella** and helps prevent its lateral dislocation, having no role in thigh hyperextension. *Puboischial ligament* - The term **puboischial ligament** is not a standard anatomical term for a hip joint ligament that prevents hyperextension. - This option likely refers to a combination of parts of the hip bone or other ligaments without a clear function related to thigh hyperextension.

Q: Which structure is contained within the femoral canal?

Deep inguinal lymph node. ***Deep inguinal lymph node*** - The **femoral canal** contains several structures: a **lymph node (of Cloquet or Rosenmüller)**, **lymphatic vessels**, and **loose areolar tissue**. [1] - Among these contents, the **deep inguinal lymph node** (also called the lymph node of Cloquet or Rosenmüller) is the **most clinically significant and specifically named structure**. - This lymph node is an important anatomical landmark, serving as a sentinel node that drains lymph from the lower limb, external genitalia, and perineum. - **Clinically**, it is the structure most commonly referenced when discussing femoral canal contents, particularly in the context of femoral hernias and lymphatic drainage patterns. [1] *Loose areolar tissue and fat* - While **loose areolar tissue and fat** are indeed present within the femoral canal, they are **supporting contents** rather than specifically named anatomical structures. [1] - These tissues fill the space and allow for expansion of adjacent vessels (femoral artery and vein), but they are not the primary structure of anatomical or clinical significance. - When asked about "the structure" in the femoral canal, the named lymph node is the more specific answer. *Lymphatic vessels* - **Lymphatic vessels** do traverse the femoral canal, but they are **conduits** rather than a discrete, named structure. [1] - These vessels drain lymph towards the deep inguinal lymph node (of Cloquet) located within the same canal. - The specifically named lymph node is the more definitive anatomical answer than the unnamed vessels passing through. *Femoral vein* - The **femoral vein** is located in the **intermediate compartment of the femoral sheath**, NOT within the femoral canal. - The femoral sheath has three compartments: lateral (femoral artery), intermediate (femoral vein), and medial (femoral canal). - The femoral vein lies lateral to the femoral canal, making this option clearly incorrect.

Q: Superior gluteal nerve does not supply?

Gluteus maximus. ***Gluteus maximus*** - The **gluteus maximus** muscle is primarily innervated by the **inferior gluteal nerve** (L5, S1, S2), not the superior gluteal nerve. - Its main actions include **extension** and **external rotation** of the hip. *Tensor fasciae latae* - The **tensor fasciae latae** is innervated by the **superior gluteal nerve** (L4, L5, S1). - This muscle helps in **flexion**, **abduction**, and **internal rotation** of the hip. *Gluteus medius* - The **gluteus medius** muscle receives its innervation from the **superior gluteal nerve** (L4, L5, S1). - It is a primary **abductor** and **internal rotator** of the hip, crucial for pelvic stability. *Gluteus minimus* - The **gluteus minimus** is also innervated by the **superior gluteal nerve** (L4, L5, S1). - Its functions are similar to the gluteus medius, including **abduction** and **internal rotation** of the hip.

Question 1

3rd and 4th lumbrical (lateral two lumbricals) of foot are supplied by ?

Accepted Answer

Lateral plantar nerve

Answer

Medial plantar nerve

Answer

Peroneal nerve

Answer

None of the options

Question 2

Which of the following statements about the popliteus muscle is false?

Accepted Answer

Causes locking of knee

Answer

Intracapsular origin

Answer

Supplied by tibial nerve

Answer

Flexor of knee

Question 3

Locking of the knee involves which of the following?

Accepted Answer

Internal rotation of the femur with the foot on the ground

Answer

Internal rotation of the tibia with the foot on the ground

Answer

Contraction of the popliteus muscle

Answer

External rotation of femur with the foot off the ground

Question 4

Inversion and eversion of foot occurs at which joint

Accepted Answer

Subtalar

Answer

Ankle

Answer

Tarso-metatarsal

Answer

None of the options

Question 5

Which of the following statements about the femoral triangle is NOT true?

Accepted Answer

Floor is formed by adductor longus

Answer

Contains the femoral vessels

Answer

Lateral margin is formed by sartorius

Answer

Medial margin is formed by adductor longus

Question 6

Which of the following statements about the adductor muscles of the thigh is correct?

Accepted Answer

The adductor magnus has two parts: adductor and hamstring portions.

Answer

Adductor magnus is the largest muscle of the thigh.

Answer

The adductor magnus originates entirely from the pubic ramus.

Answer

The main blood supply to the adductor muscles is the obturator artery.

Question 7

Which is the largest nerve that exits the pelvis through the greater sciatic foramen?

Accepted Answer

Sciatic nerve

Answer

Superior gluteal artery

Answer

Inferior gluteal artery

Answer

Piriformis muscle

Question 8

Which of the following prevents hyperextension of the thigh?

Accepted Answer

Iliofemoral ligament

Answer

Ischiofemoral ligament

Answer

Patellofemoral ligament

Answer

Puboischial ligament

Question 9

Which structure is contained within the femoral canal?

Accepted Answer

Deep inguinal lymph node

Answer

Loose areolar tissue and fat

Answer

Lymphatic vessels

Answer

Femoral vein

Question 10

Superior gluteal nerve does not supply?

Accepted Answer

Gluteus maximus

Answer

Tensor fasciae latae

Answer

Gluteus medius

Answer

Gluteus minimus

Lower Limb — MCQs

Lower Limb — MCQs

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