Practice Quiz - Leg & Foot

Tibial nerve (From anterior to posterior the structures are: tendon of Tibialis posterior, tendon of flexor Digitorum longus, posterior tibial Artery (and vein), tibial Nerve, and tendon of flexor Hallucis longus. Tom, Dick, ANd Harry!)

While at the beach in Florida after final exams, a medical student steps on a stingray, which responds by stinging her in the ankle. The stinger pierces the skin, subcutaneous tissue, and flexor retinaculum of the ankle. Which other structure passing under the retinaculum may be injured? Tibial nerve Tibialis anterior Quadratus plantae Anterior tibial artery Plantar arterial arch

common fibular (All of these symptoms are consistent with damage to the common fibular nerve, whose branches, the deep and superficial fibular nerves, innervate the anterior and lateral compartments. The anterior compartment is important for dorsiflexion. When the tibialis anterior of this compartment is denervated, you will see foot drop.)

A car strikes a pedestrian on the lateral side of her leg. Following the accident, she has "foot drop". Her foot hangs loosely in plantar flexion when she raises it off the ground. She can still invert her foot, but cannot evert it. She can flex but not extend her toes. Which nerve is most likely to have been crushed in her accident? common fibular tibial superficial fibular medial plantar sciatic

dorsalis pedis artery

A construction worker lacerates the dorsum of his foot just below his ankle. Profuse bleeding that occurs would result from cutting which vessel? small saphenous vein dorsalis pedis artery medial plantar artery anterior tibial artery fibular artery

B

A construction worker steps on a board with a nail in it. The nail pierces the sole of his boot and enters his foot 2 cm anterior to his calcaneal tuberosity, at the middle of the width of his foot. Before reaching bone, the nail would pass through, in order: A. Skin, calcaneometatarsal ligament, flexor digitorum brevis, quadratus plantae, long plantar ligament B. Skin, plantar aponeurosis, flexor digitorum brevis, quadratus plantae, long plantar ligament C. Skin, plantar aponeurosis, flexor digitorum brevis, tendons of the flexor digitorum longus, long plantar ligament D. Skin, plantar aponeurosis, quadratus plantae, flexor digitorum brevis, long plantar ligament E. Skin,transverse metatarsal ligament, flexor digitorum brevis, quadratus plantae, long plantar ligament

fibular artery

A deep laceration, 2 cm in length, immediately posterior to the medial malleolus, may injure any of the following EXCEPT: fibular artery tibial nerve tendon of tibialis posterior m. tendon of flexor digitorum longus m. tendon of flexor hallucis longus m.

deep fibular

A long distance runner complained of swelling and pain of his shin. At physical examination, skin testing showed normal cutaneous sensation of the leg. However, muscular strength tests showed marked weakness of dorsiflexion and impaired inversion of the foot. Which nerve serves the muscles involved? common fibular deep fibular sciatic superficial fibular tibial

Dorsalis pedis

A medical student goes for a swim while on vacation in Florida after final exams. A barracuda bites his foot, severing an artery on the dorsum of his foot just below his ankle. Which artery has been severed? Anterior tibial Deep fibular Deep plantar Dorsalis pedis Dorsal metatarsal

C (Flexor digitorum longus is the most medial muscle in the deep posterior compartment of the leg. This means that it takes origin from the middle half of the posterior surface of the tibia and is not attached to the fibula in any way. Biceps femoris inserts on the head of the fibula and the lateral condyle of the tibia. )

A patient has been diagnosed with bone cancer in the fibula that necessitates its removal. Which of the following muscles would be least affected following removal of the fibula? A biceps femoris B extensor digitorum longus C flexor digitorum longus D flexor hallucis longus E peroneus tertius

deep plantar artery ( branch of dorsalis pedis)

A patient has stepped on a board with a long nail sticking up from it, and the nail penetrated the patient's foot between the bases of the first and second metatarsals. What artery is most likely injured at this location? arcuate deep plantar dorsalis pedis lateral plantar medial plantar

Common fibular

A patient with a fracture to the left upper tibia was treated with a plaster cast. A few days later he started to develop progressive numbness over the dorsum of the foot and weakness in dorsiflexion. The cast was quickly changed and the signs were attributed to nerve compression. The compressed nerve was most likely the: Tibial Obturator Sciatic Femoral Common fibular

Fibularis longus (A fracture of the fibular neck commonly causes an injury to the common fibular nerve, which has two branches: the deep fibular nerve and the superficial fibular nerve. If the common fibular nerve was damaged, the deep fibular nerve would also be impaired. This would mean that the anterior compartment of the leg would be denervated, and the patient would suffer from foot drop. But that's not happening here, so you know that the common fibular nerve must be intact. The superficial fibular nerve, however, innervates the lateral compartment of the leg which allows for eversion.)

A pedestrian is struck by a car, and his fibular neck is fractured. There is no indication of foot drop, but he cannot evert his foot and the top of his foot is numb. This apparent nerve lesion would affect which of the following muscles? Tibialis posterior Tibialis anterior Fibularis tertius Fibularis longus Adductor hallucis

D (Anterior compartment syndrome leads to foot drop due to the compression of the deep fibular nerve. )

A player is kicked on the front of his leg during a soccer game, and a large bruise develops. A hematoma deep to the crural fascia can create extreme pressure within the anterior compartment of the leg, compressing structures within it. The most likely finding resulting from this anterior compartment syndrome is: A numbness on the dorsum of the foot B inability to evert the foot C inability to invert the foot D foot drop E inability to plantarflex the foot

long plantar ligament

A soldier complains of foot pain following a 50 mile hike. Upon examination, the physician diagnoses tendonitis of the fibularis longus tendon. Because the tenderness is located deeply on the sole of the foot, it appears that the irritation occurred where the tendon lies against bone, covered by a structure called the: long plantar ligament plantar aponeurosis short plantar ligament spring ligament tendon of tibialis posterior

flexor hallucis longus (passes under sustentaculum tali, creating a groove in the bone. The sustentaculum tali is a shelf-like, medial projection of the calcaneus, which supports the talus.)

A worker falls from a height and lands on his feet. Radiographs reveal a fracture of the sustentaculum tali. The muscle passing immediately beneath it that would be adversely affected is the: fibularis longus flexor digitorum longus flexor hallucis longus tibialis anterior tibialis posterior

abduction of the great toe

Compression of the lateral plantar nerve as it passes between the flexor digitorum brevis and quadratus plantae could result in weakness of any of the following actions EXCEPT: abduction of the great toe adduction of the middle toe abduction of the little toe adduction of the great toe abduction of the middle toe

D (The nerve running with the dorsalis pedis artery is the deep fibular nerve. This nerve innervates the anterior compartment of the leg and the extensors on the dorsum of the foot. At the point where it was cut, the nerve had already given off all its branches to the anterior compartment of the leg. So, the farmer should still be able to dorsiflex his foot (preventing foot drop), and all of the muscles that invert his foot should be intact. Although extensor hallucis brevis (on the dorsum of the foot) has been denervated, extensor hallucis longus is in the anterior compartment of the leg, and that muscle should still be able to extend the great toe. However, the deep fibular nerve would have been cut before it could supply fibers to the area of cutaneous innervation between the first and second toe. So, there would be numbness in that area of skin.)

In an accident involving farm machinery, a farmer receives a cut on the dorsum of his ankle. As you inspect the wound and test for functional and sensory deficits, you find that no tendons have been cut, but the dorsalis pedis artery and the accompanying nerve have been cut. You would expect to find: A club foot B foot drop C inability to extend the big toe D numbness between the first and second toes E weakness in inversion of the foot

fibularis longus (runs from the lateral side of the foot across the entire sole of the foot, traveling deep to the long plantar ligament)

Pain may result from friction of the tendon of which muscle that passes deep to the anterior fibers of the long plantar ligament. tibialis posterior flexor hallucis longus fibularis longus tibialis anterior flexor hallucis brevis

Tibial (The lateral and medial plantar nerves are both branches of the tibial nerve. )

The lateral plantar nerve is a branch of which nerve? Deep fibular Femoral Saphenous Sural Tibial

B

The most usual site for feeling the pulsations of the dorsalis pedis artery in the foot is: A Just behind the medial malleolus B Just lateral to the tendon of extensor hallucis longus C Behind the tendon of fibularis tertius muscle D In the second dorsal metatarsal space E Just behind the lateral malleolus.

Lateral plantar (This medical student is unable to abduct her toes- The medial plantar nerve innervates muscles on the plantar surface of the foot, including abductor hallucis, flexor hallucis brevis, and flexor digitorum brevis. None of these muscles are responsible for abducting the toes)

While walking barefoot on the beach in Florida following final exams, a medical student steps on a sharp shell which punctures the sole of her foot. She notices that she can no longer spread her toes apart (without using her hands, that is). Which nerve must have been injured? deep fibular lateral plantar medial plantar sural tibial

tibialis anterior

Your patient was struck by a car's bumper as she crossed the street, and her fibular neck is broken. After the bone has healed, she has "foot drop", i. e. she cannot dorsiflex her foot, and so it flops onto the ground during walking. Denervation (paralysis) of which of the following muscles would be associated with foot drop? fibularis longus tibialis posterior fibularis brevis tibialis anterior popliteus