Texas Tech Gross Anatomy Thigh, Leg and Foot (copy)

In the middle third of the thigh, the superficial and deep femoral arteries are separated by ...

Adductor longus

If the femoral artery is occluded at the beginning of the adductor canal, which artery could help provide viability to the leg through collateral circulation?

Descending branch of the lateral circumflex femoral

Blood flow around an occlusion of the femoral (superficial femoral) artery at the apex of the femoral triangle could be provided by ...

Descending branch of the lateral circumflex femoral

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: a. abduction of the great toe b. adduction of the middle toe c. abduction of the little toe d. adduction of the great toe e. abduction of the middle toe

Abduction of the great toe

Childhood immunizations are sometimes given via intramuscular injections into the quadriceps muscles of the anterior thigh. At the mid-thigh level, a needle passing into the space deep to the sartorius muscle might pierce the femoral vessels as they lie in the ...

Adductor canal

The femoral artery enters the popliteal fossa (becoming the popliteal artery) by passing through the ...

Adductor hiatus

An athlete has a knee injury, and the doctor performs a "drawer test" by pulling and pushing on the leg with the knee flexed. If the leg translates anteriorly, i. e. "gives" or moves anteriorly when the leg is pulled anteriorly, what joint structure is most likely injured?

Anterior cruciate ligament

During the Orange Bowl, the national championship football game between Florida State and a team from a land-locked state, a player is blocked from behind during a kick-off return, injuring his medial collateral ligament. The team doctor tests his knee by pulling anteriorly on the leg with the knee flexed. If the leg translates (moves) forward significantly, this indicates damage to which structure?

Anterior cruciate ligament

To test the integrity of the knee joint, a physician pulls anteriorly on the flexed leg of his patient. This "drawer" test is positive if the leg moves excessively anteriorward. This would indicate a weakness in or rupture of the ...

Anterior cruciate ligament

A 'saphenous vein cut-down' is a procedure used to locate the great saphenous vein at the ankle. To find this vein, the skin would be incised ...

Anterior to the medial malleolus

A saphenous cutdown is a surgical procedure that involves cutting through the skin to locate the greater saphenous vein in order to insert a catheter or cannula. You can find the vein as it passes ___________________ with the saphenous nerve.

Anterior to the medial malleolus

The short head of biceps femoris muscle is innervated by which nerve?

Common fibular

When, in approximately 12% of people, the common fibular nerve passes through the piriformis muscle, the nerve may be compressed. This would affect part of which muscle?

Biceps femoris

At which site could one expect to enter the femoral vein with a simple percutaneous (through the skin) introduction of an instrument?

Medial to the femoral arterial pulse

A patient complains of localized pain in a swollen lower calf and cannot strongly plantar flex his foot. What tendon may have ruptured?

Calcaneal

A patient with painful swelling in the distal calf cannot plantar flex at the ankle with any power. Which tendon was likely ruptured?

Calcaneal

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

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:

Common fibular

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?

Deep plantar artery

The hamstrings muscles are supplied by branches of which artery?

Deep femoral

Which of the following is NOT located within the adductor canal?

Deep femoral artery

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?

Deep fibular

The femoral canal contains the ...

Deep inguinal lymph nodes

During a basketball game, the center of the team went up for a rebound and when coming down, her foot landed on the foot of another player, sharply everting it. She limped off the floor, having severely sprained the medial side of her ankle. Which ligament was injured?

Deltoid ligament (connects medial malleolus with talus, navicular & calcaneus and prevents severe eversion)

A construction worker lacerates the dorsum of his foot just below his ankle. Profuse bleeding that occurs would result from cutting which vessel?

Doesalis pedis artery

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?

Dorsalis pedis

As a patient with paralyzed gluteus medius and minimus muscles on the left side attempts to stand on the left limb only, the right side of the pelvis typically ...

Drops

Pain may result from friction of the tendon of which muscle that passes deep to the anterior fibers of the long plantar ligament?

Fibularis longus

Which movement would fail in case of paralysis of the quadriceps femoris muscle?

Extension at the knee

A patient with a tuberculous abscess (localized collection of pus) on the iliopsoas muscle in the femoral triangle presented impaired flexion of the thigh and extension of the leg. Which of the following nerves was likely involved?

Femoral

During a surgical procedure in which the lower abdominal wall has been opened, the retractor blades damaged a nerve lying between the iliacus and psoas major muscles. The patient has weakened hip flexion and an inability to extend the knee, as well as analgesia on the anterior thigh and medial leg. What nerve has been compressed?

Femoral

A 63-year-old female patient says that she has pain in her groin and upper thigh. Upon examination, you palpate a lump located below the inguinal ligament lateral to its attachment to the pubic tubercle. You suspect that this may be a hernia passing through the ...

Femoral canal

Inability to extend the knee and loss of cutaneous sensation over the anterior surface of the thigh would indicate a lesion or compression of the ...

Femoral nerve

A ruptured aneurysm in the most proximal portion of the deep femoral artery would result in a hematoma located initially in the ...

Femoral triangle

The pulse of the femoral artery is best felt at which superficial reference point?

Femoral triangle

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

Fibular artery

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?

Fibularis longus

When walking, the action of the iliopsoas muscle results in what motion at the hip joint?

Flexion

A fracture of the ischial tuberosity might be expected to most directly affect the muscles that produce which lower limb movement?

Flexion at the knee

Because of its muscle attachments, a fracture to the ischial tuberosity would affect which movement of the lower limb?

Flexion of the leg

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?

Flexor digitorum longus

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 ...

Flexor hallucis longus

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 ...

Foot drop

An elderly patient complains of difficulty in walking up stairs. Tests by her doctor reveal weakness in extension at her hip, but no change in hip flexion, or flexion or extension of the knee. Based upon these results, what muscle is most likely not functioning properly.

Glute max

Subcutaneous venous varicosities were observed in the anteromedial thigh. The vein involved is likely to be the ...

Greater saphenous

Varicosities in the subcutaneous veins of the medial thigh were observed at physical examination. The vein involved was most likely the ...

Greater saphenous

Which ligament limits extension at the hip joint?

Iliofemoral

The medial thigh muscles rotate the femur medially, counterbalanced by muscles of the _____________ thigh, including the ___________ muscle, which rotates the femur laterally.

Lateral; piriformis

Weakness in climbing stairs or jumping would indicate a lesion of which nerve?

Inferior gluteal nerve

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?

Lateral plantar

The team doctor tells a football player that he has "a pulled hamstring" muscle. This results from a tearing of the origin of a hamstring muscle from the:

Ischial tuberosity

In an auto accident, the patient's knee strikes the dashboard which in turn pushes the head of the femur posteriorly out of its socket. Which ligament is most likely ruptured by this posterior dislocation?

Ischiofemoral

The most usual site for feeling the pulsations of the dorsalis pedis artery in the foot is:

Just lateral to the tendon of the extensor hallucis longus

A needle biopsy of the sural nerve resulted in the formation of a hematoma. Which of the following veins closely adjacent to the nerve was accidently injured?

Lesser saphenous

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

A serious complication of fractures of the femoral neck is avascular necrosis of the femoral head. This usually results from rupture of which artery?

Medial circumflex femoral

Fracture of the femoral neck may lead to avascular necrosis of the femoral head due to the interruption of which artery?

Medial circumflex femoral

One of the menisci of the knee is often injured in a sprain of the knee because the ...

Medial collateral ligmaent is attached to the medial meniscus

What anterior thigh muscle must be retracted to expose the adductor canal and its contents?

Sartorius

A construction worker, who wears a heavy work belt all day on the job, notices a tingling sensation on the anterolateral surface of his thigh. This is most likely a condition called ...

Meralgia parasthetica

In an accident involving farm machinery, a farmer recieves 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:

Numbness between first and second toes

"Scissor gait" is a condition in which one limb crosses in front of the other during stepping as a result of powerful hip adduction caused by continuous, unwanted nerve activity. What is the nerve involved in this condition?

Obturator

A female patient complains of pain in her groin region that increases with coughing. An MRI reveals a loop of ilium passing inferiorly, posterior to the superior pubic ramus. What type of hernia is this?

Obturator

An elderly woman was found to have a hernial sac in the right femoral triangle and a marked weakness in adduction at the right hip joint. Which nerve was likely compressed by this herniation?

Obturator

What muscle passes through the lesser sciatic foramen?

Obturator internus

An obturator hernia that compresses the obturator nerve in the obturator canal may affect the function of all of the following muscles EXCEPT ... a. Adductor brevis b. Adductor longus c. Gracilis d. Obturator externus e. Pectineus

Pectineus

During surgical repair of a popliteal artery aneurism, ligation of the femoral artery at mid-thigh would not interrupt supply to the hamstring muscles because the ...

Perforating branches of the deep femoral artery supply the posterior thigh

A cashier develops painful and tortuous varicose veins in her lower limb. Her doctor explains that prolonged standing at her job led to failure of the valves in the ...

Perforating veins

You are in the clinic when a patient presents with varicose saphenous veins in her lower limb. The attending physician asks where the venous valves are located that are defective and cause this condition. Having just studied a clinical case in that regard, you respond. "The valves in the ...

Perforating veins

Competency of venous valves in a patient with severe crural varicose veins was tested as follows: The superficial veins were emptied by elevating the limb and then they were compressed with a band just below the saphenous opening in the proximal thigh. When the patient quickly stood up, filling of the superficial veins took more than 30 seconds. The delayed filling of the superficial veins demonstrates that the valves of the ...

Perforating veins are incompetent

A soldier developed "fallen arches" from marching with a heavy pack in boots that lacked arch support. The ligament that normally supports the head of the talus and is primarily responsible for holding up the medial longitudinal arch of the foot is the ...

Plantar calcaneonavicular (spring)

A football player tears his calcaneal tendon. You would expect to find weakness in ...

Plantarflexion of the foot

A tennis player feels a "pop" in her calf as she is playing. Her calf becomes tender and there is some slight amount of swelling. Upon examination, her physician informs her that she has ruptured the slender tendon of a small muscle that attaches to the calcaneus. She has apparently ruptured the ...

Plantaris

When the distal femur is fractured, the sharp broken ends of the bone often damage the structure that lies closest to the femur in the popliteal fossa, i.e., the ...

Popliteal artery

When the femur is fractured, the broken distal end often turns posteriorly to enter the popliteal fossa due to muscle traction. Because of its position deepest in the fossa, which structure is most vulnerable to laceration?

Popliteal artery

The deep femoral artery is the principle blood source for the muscles in which compartment of the thigh?

Posterior

A young man involved in a head-on automobile collision had his flexed knee hit the dashboard of the car. He was later found to have a major instability of the knee, in that his tibia could be moved posteriorly relative to the femur. What ligament was likely damaged?

Posterior cruciate ligament

While on vacation in Florida following her final exams, a scuba diving medical student is accidentally speared by her diving partner. The end of the spear passes medial to lateral, posterior to the medial malleolus. It severs an artery there, which is the ...

Posterior tibial

In a hunting accident, an arrow pierces the mid-calf of a hunter. A major artery is lacerated in the posterior leg, and you notice that the sole of his foot is cold and pale. The dorsum of the foot is warm and normally colored. The artery that seems to be injured is the:

Posterior tibial artery

After suffering a penetrating injury in the left femoral triangle, a patient was unable to walk normally because her left knee collapsed into flexion upon weight bearing. The nerve to which muscle was damaged?

Quadriceps femoris

Following a penetrating injury to the left femoral triangle, a patient related that walking was virtually impossible because at every step the left knee collapsed into flexion. This history suggests paralysis of which muscle?

Quadriceps femoris

Which structure does NOT enter or leave the inguinal region by passing deep to the inguinal ligament?

Round ligament of the uterus

Following surgical opening of the adductor canal, a patient experienced a loss of cutaneous sensation of the medial side of the leg. Which nerve was cut?

Saphenous

Following a car accident in which the patient received a deep laceration on the medial side of his right knee, the patient notices numbness along the medial side of his right leg and foot. He has no motor deficit. The nerve which appears to have been injured is the ...

Saphenous nerve

If the head of the femur is dislocated postero-medially, compression of which nerve is likely to result?

Sciatic nerve

While doing a physical examination on a young boy, you noticed an enlarged superficial inguinal lymph node. The patient indicated that he has recently sustained an infected skin wound in the ...

Skin of the lower limb

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 ...

Skin, plantar aponeurosis, flexor digitorum brevis, quadratus plantae, long plantar ligament

A 50-year-old female patient has large varicose veins located primarily on the posterior aspect of her calf. These veins are most likely direct tributaries to the ...

Small saphenous vein

After suffering a deep stab wound in the medial upper quadrant of the right buttock, an emergency room patient found walking to be very difficult. The basic problem was that, during stepping, her left hip sagged down as soon as the left foot was lifted off the ground to swing forward. What nerve was damaged?

Superior gluteal

A patient with a diabetic ulcer in the anterior midline of the ankle region experienced loss of cutaneous sensation on the dorsal surface of the foot. Which nerve was most likely damaged?

Superficial fibular

Following a major operation, a patient was placed on a course of antibiotics which were delivered via intramuscular injection to the buttocks. After one injection in the right buttock, the patient complained of more pain than usual in the region of the injection. Later, as he was walking in the hall, the nurse noticed that he had a limp that had not been present before--his left hip dropped every time he lifted his left foot off the floor. Which nerve had been injured by the injection?

Superior gluteal

Of the branches of the internal iliac artery, the one exiting from the greater sciatic foramen superior to the piriformis muscle is the:

Superior gluteal artery

During recovery from a gunshot wound of the right pelvis, the patient notices a lurch in his gait. When he lifts his left foot off of the ground, his pelvis dips down on the left side. The nerve that appears to have been injured is the:

Superior gluteal nerve

The distal part of the lesser saphenous vein was mobilized for grafting. Following the operation, the patient complained of numbness (loss of cutaneous sensation) on the distal lateral side of the leg and the lateral side of the foot. What nerve was damaged during the operation?

Sural

The lesser saphenous vein was mobilized for grafting. Following the surgery, the patient complained of a loss of cutaneous sensation at the distal posterolateral side of the leg, lateral side of the foot and small toe. What nerve was damaged during the operation?

Sural

Which statement is true? a. The femoral artery lies medial to the femoral vein b. The femoral vein lies medial to the femoral artery c. The external iliac veins join to form the inferior vena cava d. The inferior vena cava can not be imaged radiographically e. A and C

The femoral vein lies medial to the femoral artery

The lateral plantar nerve is a branch of which nerve?

Tibial

In injuries of the knee, the medial meniscus is frequently torn because it is firmly attached to which structure?

Tibial collateral ligament

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

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?

Tibialis anterior

Your patient complains of pain on her calf. Upon inspection, you find tortuous, dilated vessels lying subcutaneously on the posterior aspect of her leg. These vessels are most likely ..

Tributaires to the less saphenous vein

In order to avoid injury to the sciatic nerve, intramuscular injections should be given in which quadrant of the buttock?

Upper lateral