Lower Limb Practice Questions

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 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: 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.

Q: What is the approximate length of the tibia in centimeters for an average adult?

35 cm. ***35 cm*** - The **tibia**, or shin bone, is the larger of the two bones in the lower leg and plays a crucial role in supporting body weight. - Its average length in adults is approximately **36-38 cm**, with **35 cm** being well within the normal range for an average adult. - Females typically have tibiae measuring **36-37 cm**, while males average **38-39 cm**. *30 cm* - A length of **30 cm** would be unusually short for an adult tibia, falling well below the normal range for average adults. - Such a short length might be associated with specific medical conditions or skeletal dysplasias. *40 cm* - A length of **40 cm** would be at the upper end or slightly above the typical average for an adult tibia. - This measurement might be seen in taller individuals, but it exceeds the average for most adults. *45 cm* - A length of **45 cm** would be comparatively long for an average adult tibia. - This measurement is significantly above average and would only be seen in very tall individuals.

Q: Which muscle is responsible for flexion of the hip?

Psoas major. ***Psoas major*** - The **psoas major** is a powerful **hip flexor**, originating from the lumbar vertebrae and inserting on the lesser trochanter of the femur. - Its primary action is to **flex the thigh at the hip joint**, and it plays a significant role in activities like walking and running. *Biceps femoris* - The **biceps femoris** is one of the **hamstring muscles** and its primary actions are **flexion of the knee** and **extension of the hip**, not hip flexion. - It originates from the ischial tuberosity and linea aspera, inserting on the head of the fibula and lateral condyle of the tibia. *Gluteus maximus* - The **gluteus maximus** is the largest and most superficial of the gluteal muscles and serves primarily as a powerful **extensor of the hip**, especially during activities like climbing stairs or standing up from a seated position. - It also contributes to **external rotation and abduction** of the hip. *Tensor fasciae latae (TFL)* - The **tensor fasciae latae** is a muscle on the lateral aspect of the thigh that primarily acts to **abduct and internally rotate the hip**. - While it assists in some degree of hip flexion, it is not the primary muscle responsible for this action compared to the psoas major.

Q: The blood supply to femoral head is mostly by?

Profunda femoris. ***Profunda femoris*** - The profunda femoris artery (deep femoral artery) gives rise to the **medial and lateral circumflex femoral arteries**, which are the primary blood supply to the femoral head in adults - Specifically, the **medial circumflex femoral artery** and its branches (lateral epiphyseal arteries and retinacular arteries) form an extracapsular arterial ring and penetrate the joint capsule to supply the femoral head - The profunda femoris is thus the main parent vessel responsible for femoral head blood supply *Lateral epiphyseal artery* - This artery is a branch of the **medial circumflex femoral artery**, which originates from the profunda femoris - While it directly supplies the femoral head and is the dominant terminal branch, it represents a more specific component of the arterial network rather than the main source vessel - It provides blood to the lateral and superior portions of the femoral head *Medial epiphyseal artery* - This artery is also a branch of the circumflex femoral arteries, which originate from the profunda femoris - It contributes to the blood supply but is less dominant than the lateral epiphyseal branches - Similar to lateral epiphyseal artery, it is part of the retinacular arterial system *Artery of ligamentum teres* - The **artery of the ligamentum teres** (foveal artery) is an inconsistent and often small vessel, typically a branch of the **obturator artery** or medial circumflex femoral artery - While it contributes to blood supply especially in children, its contribution is usually minor in adults and often insufficient to sustain the femoral head alone - It enters through the fovea capitis and its contribution diminishes with age

Q: Which muscle is attached to the lateral surface of the greater trochanter?

Gluteus medius. ***Gluteus medius*** - The **gluteus medius** inserts onto the **lateral surface of the greater trochanter** of the femur. - Its primary actions include **abduction** and **internal rotation** of the hip. *Gluteus maximus* - The **gluteus maximus** inserts primarily into the **iliotibial tract** and the **gluteal tuberosity** of the posterior femur, not the lateral greater trochanter. - Its main roles are **hip extension** and **external rotation**. *Gluteus minimus* - The **gluteus minimus** inserts onto the **anterior part of the lateral surface (anterolateral aspect)** of the greater trochanter, anterior to the gluteus medius insertion. - Like the gluteus medius, it also contributes to **hip abduction** and **internal rotation**. *Piriformis* - The **piriformis** muscle inserts onto the **superior and medial aspect of the greater trochanter**. - Its main actions are **external rotation** and **abduction** of the hip, particularly when the hip is flexed.

Q: Sacrotuberous ligament is pierced by

Perforating cutaneous nerve. ***Perforating cutaneous nerve*** - The **perforating cutaneous nerve** typically pierces the sacrotuberous ligament to innervate the skin over the medial part of the lower gluteal region. - This nerve originates from the **S2 and S3 anterior rami**. *Posterior femoral cutaneous* - The **posterior femoral cutaneous nerve** runs inferior to the piriformis muscle, superficial to the sacrotuberous ligament, but does not pierce it. - It supplies the skin on the posterior thigh and popliteal fossa. *Superior gluteal nerve* - The **superior gluteal nerve** exits the pelvis through the greater sciatic foramen, superior to the piriformis muscle, and does not interact with the sacrotuberous ligament in this manner. - It innervates the **gluteus medius, gluteus minimus**, and **tensor fasciae latae muscles**. *Sciatic nerve* - The **sciatic nerve** exits the pelvis via the greater sciatic foramen, inferior to the piriformis muscle, and passes superficial to the sacrotuberous ligament. - It does not pierce the ligament, but rather lies in close proximity to its inferior border.

Q: Which of the following statements about the great saphenous vein is true?

It runs anterior to medial malleolus. **It runs anterior to medial malleolus** - The **great saphenous vein** originates from the medial end of the **dorsal venous arch** of the foot and ascends anterior to the **medial malleolus** [1]. - This anatomical relationship makes it accessible for various clinical procedures, such as **venous cutdown** for rapid intravenous access [1]. *It begins at lateral end of dorsal venous arch* - The **great saphenous vein** actually begins at the **medial end** of the dorsal venous arch, not the lateral end [1]. - The **small saphenous vein** arises from the lateral end of the dorsal venous arch [1]. *It is accompanied by the sural nerve* - The **sural nerve** typically accompanies the **small saphenous vein**, not the great saphenous vein, in the posterior leg [1]. - The **saphenous nerve**, a branch of the femoral nerve, accompanies the great saphenous vein throughout its course in the leg. *Terminates into popliteal vein* - The **great saphenous vein** normally terminates by draining into the **femoral vein** in the femoral triangle, not the popliteal vein [1]. - The **small saphenous vein** is the one that typically drains into the popliteal vein [1].

Question 1

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 2

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 3

Superior gluteal nerve does not supply?

Accepted Answer

Gluteus maximus

Answer

Tensor fasciae latae

Answer

Gluteus medius

Answer

Gluteus minimus

Question 4

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 5

What is the approximate length of the tibia in centimeters for an average adult?

Accepted Answer

35 cm

Answer

30 cm

Answer

40 cm

Answer

45 cm

Question 6

Which muscle is responsible for flexion of the hip?

Accepted Answer

Psoas major

Answer

Biceps femoris

Answer

Gluteus maximus

Answer

Tensor fasciae latae (TFL)

Question 7

The blood supply to femoral head is mostly by?

Accepted Answer

Profunda femoris

Answer

Lateral epiphyseal artery

Answer

Medial epiphyseal artery

Answer

Artery of ligamentum teres

Question 8

Which muscle is attached to the lateral surface of the greater trochanter?

Accepted Answer

Gluteus medius

Answer

Gluteus maximus

Answer

Gluteus minimus

Answer

Piriformis

Question 9

Sacrotuberous ligament is pierced by

Accepted Answer

Perforating cutaneous nerve

Answer

Posterior femoral cutaneous nerve

Answer

Superior gluteal nerve

Answer

Sciatic nerve

Question 10

Which of the following statements about the great saphenous vein is true?

Accepted Answer

It runs anterior to medial malleolus

Answer

It begins at lateral end of dorsal venous arch

Answer

Terminates into popliteal vein

Answer

It is accompanied by the sural nerve

Lower Limb — MCQs

Lower Limb — MCQs

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