Lower Limb Practice Questions

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: Main blood supply to the head and neck of femur comes from

Medial circumflex femoral artery. ***Medial circumflex femoral artery*** - The **medial circumflex femoral artery** is the primary arterial supply to the **head and neck of the femur**, particularly via its **retinacular branches**. - These branches ascend along the femoral neck within the joint capsule, supplying most of the femoral head. *Lateral circumflex femoral artery* - The **lateral circumflex femoral artery** primarily supplies the muscles of the **anterior compartment of the thigh**, including the quadriceps femoris. - While it contributes to anastomoses around the hip, its direct supply to the femoral head and neck is less significant than the medial circumflex. *Artery of ligamentum teres* - The **artery of the ligamentum teres** (foveal artery) supplies a small, variable portion of the **femoral head**, mainly in children. - Its contribution to the overall blood supply to the adult femoral head and neck is often negligible or absent. *Popliteal artery* - The **popliteal artery** is located in the **popliteal fossa** behind the knee joint and is the continuation of the femoral artery. - Its branches supply the structures around the knee and lower leg, not the femoral head and neck.

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: Which of the following statements about the linea aspera is correct?

Continues as gluteal tuberosity. Correct: Continues as gluteal tuberosity - The lateral lip of the linea aspera continues superiorly as the gluteal tuberosity (also called the gluteal ridge or line) - This anatomical continuation is a key feature of the femur's posterior surface - The gluteal tuberosity serves as the attachment site for the gluteus maximus muscle - The medial lip continues superiorly as the pectineal line (spiral line), which then joins the lesser trochanter Incorrect: Forms lateral border of femur - The linea aspera is located on the posterior surface of the femoral shaft, not on the lateral border - The lateral border of the femur is formed by the smooth lateral surface of the shaft - The linea aspera's lateral lip is a posterior ridge, distinct from the true lateral border Incorrect: Forms medial border of femur - The linea aspera is on the posterior aspect of the femur, not the medial border - The medial border of the femur is formed by the smooth medial surface of the shaft - The medial lip of the linea aspera is a muscle attachment site on the posterior surface, not a border

Q: Which muscles are known as 'Triceps surae'?

Gastro-soleus. ***Gastro-soleus*** - The **Triceps surae** refers to the two heads of the **gastrocnemius muscle** and the **soleus muscle**, which together form the powerful calf muscle. - These three muscles converge to form the **Achilles tendon** (calcaneal tendon) and are prime movers for **plantarflexion** of the ankle. *Popliteus* - The popliteus muscle is located behind the knee joint and acts to **unlock the knee** during flexion. - It does not contribute to the bulk of the calf and is not part of the Triceps surae group. *Extensor hallucis longus* - This muscle is located in the **anterior compartment** of the leg and is responsible for **dorsiflexion** of the ankle and extension of the great toe. - It is an antagonist to the Triceps surae, which primarily performs plantarflexion. *Extensor digitorum longus* - The extensor digitorum longus is also in the **anterior compartment** of the leg, responsible for **dorsiflexion** of the ankle and extension of the lateral four toes. - It is functionally opposite to the actions of the Triceps surae and in a different muscle compartment.

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].

Q: Line from midinguinal point to adductor tubercle represents?

Femoral artery. The line from the **midinguinal point** to the **adductor tubercle** accurately maps the anatomical course of the **femoral artery** in the thigh. This anatomical landmark is crucial for palpating the **femoral pulse** and locating the artery for clinical procedures like catheter insertion. *Inferior epigastric artery* - The **inferior epigastric artery** originates from the external iliac artery and ascends superiorly in the anterior abdominal wall [1]. - Its course is significantly more medial and superior, far from the line described. *Superior epigastric artery* - The **superior epigastric artery** is a terminal branch of the internal thoracic artery, descending into the rectus sheath in the upper abdomen [1]. - Its location is entirely within the anterior abdominal wall, high above the inguinal region. *None of the options* - This option is incorrect because the line from the midinguinal point to the adductor tubercle clearly represents the anatomical course of the femoral artery. - The other arteries listed are not found along this specific anatomical path.

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 arteries supply the talus?

All of the options. ***All of the options*** - The **talus** has a tenuous blood supply due to its limited muscular attachments, receiving contributions from multiple surrounding arteries to ensure adequate perfusion. - The **anterior tibial artery**, **posterior tibial artery**, and **peroneal artery** all contribute branches that form an anastomotic network around the talus. *Anterior tibial artery* - The **anterior tibial artery** contributes blood supply to the talus primarily through its **dorsal pedis branch** and ascending branches that supply the neck and head of the talus. - Its major role is in supplying the **anterior and superior talar surfaces**. *Posterior tibial artery* - The **posterior tibial artery** is a significant source of blood supply, particularly to the body and posterior aspect of the talus, via branches like the **artery of the tarsal canal** and the **deltoid branch**. - Its branches contribute to the **posterior talar artery network** which is crucial for the central part of the talus. *Peroneal artery* - The **peroneal artery** provides blood supply to the lateral and posterior parts of the talus through its **communicating branch** and perforating branches. - It contributes to the **tarsal artery network**, ensuring collateral circulation to the talus.

Q: Crural index is:

Length of tibia/femur x 100. ***Length of tibia/femur x 100*** - The **crural index** is a measure used in physical anthropology and comparative anatomy to describe the proportion of the lower leg to the thigh. - It is calculated by dividing the **length of the tibia** (lower leg bone) by the **length of the femur** (thigh bone) and multiplying by 100 to express it as a percentage. *Length of radius/humerus x 100* - This formula describes the **brachial index**, which measures the proportion of the forearm to the upper arm. - It does not represent the crural index, which refers specifically to the **lower limb**. *Length of fibula/tibia x 100* - This ratio compares the two bones within the lower leg but is not the definition of the **crural index**. - The crural index focuses on the relative length of the lower leg to the entire thigh, reflecting overall **limb proportions**. *Length of radius/ulna x 100* - This ratio compares the lengths of the two bones in the forearm and does not correspond to the **crural index**. - The crural index involves the **tibia** and **femur**, which are bones of the lower limb.

Question 1

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 2

Main blood supply to the head and neck of femur comes from

Accepted Answer

Medial circumflex femoral artery

Answer

Lateral circumflex femoral artery

Answer

Artery of ligamentum teres

Answer

Popliteal artery

Question 3

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 4

Which of the following statements about the linea aspera is correct?

Accepted Answer

Continues as gluteal tuberosity

Answer

Forms lateral border of femur

Answer

Forms medial border of femur

Answer

None of the options

Question 5

Which muscles are known as 'Triceps surae'?

Accepted Answer

Gastro-soleus

Answer

Popliteus

Answer

Extensor hallucis longus

Answer

Extensor digitorum longus

Question 6

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

Question 7

Line from midinguinal point to adductor tubercle represents?

Accepted Answer

Femoral artery

Answer

Inferior epigastric artery

Answer

Superior epigastric artery

Answer

None of the options

Question 8

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 9

Which arteries supply the talus?

Accepted Answer

All of the options

Answer

Peroneal artery

Answer

Posterior tibial artery

Answer

Anterior tibial artery

Question 10

Crural index is:

Accepted Answer

Length of tibia/femur x 100

Answer

Length of radius/humerus x 100

Answer

Length of fibula/tibia x 100

Answer

Length of radius/ulna x 100

Lower Limb — MCQs

Lower Limb — MCQs

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