Clinical Anatomy
Dr.Metwally Shaheen ( FRCS) Ortho. Consultant ( Head of
Orthopaedic Department SGH-J
)
The Upper Limb
1. The distal attachment (insertion) of the triceps brachii muscle is: A. coronoid process of the ulna B. olecranon process of ulna C. styloid process of ulna D. radial notch of ulnar E. ulnar tuberosity
1. The distal attachment (insertion) of the triceps brachii muscle is: A. coronoid process of the ulna B. olecranon process of ulna C. styloid process of ulna D. radial notch of ulnar E. ulnar tuberosity
2. Which of these structures passes deep to the flexor retinaculum at the wrist? A. tendon of the palmaris longus B. ulnar artery C. median nerve D. palmar branch of the ulnar nerve E. radial artery
2. Which of these structures passes deep to the flexor retinaculum at the wrist? A. tendon of the palmaris longus B. ulnar artery C. median nerve D. palmar branch of the ulnar nerve E. radial artery
The Carpal tunnel Stractures passing deep to the flexor retinaculum:
FDS…….4 FDP…….4 Median nerve. FPL. FCR
3. The thumb action that is totally affected by radial nerve trauma is: A. abduction B. adduction C. extension D. flexion E. opposition
3. The thumb action that is totally affected by radial nerve trauma is: A. abduction B. adduction C. extension D. flexion E. opposition
4. If you slide a piece of paper between a patients fingers and asked the patient to hold onto the paper when you try to pull it from the fingers, and the patient is unable to perform this action, which nerve is suspected to be nonfunctional? A. radial B. median recurrent C. ulnar D. deep radial E. superficial radial
4. If you slide a piece of paper between a patients fingers and asked the patient to hold onto the paper when you try to pull it from the fingers, and the patient is unable to perform this action, which nerve is suspected to be nonfunctional? A. radial B. median recurrent C. ulnar D. deep radial E. superficial radial
5. Which of these muscles of the forearm has a double innervation? A. flexor digitorum profundus B. flexor digitorum superficialis C. pronator teres D. flexor pollicis longus E. pronator quadratus
5. Which of these muscles of the forearm has a double innervation? A. flexor digitorum profundus B. flexor digitorum superficialis C. pronator teres D. flexor pollicis longus E. pronator quadratus
6. Numbness to the skin on the lateral ( radial ) half of the palm of the hand would be caused by a lesion to which nerve?
A. ulnar B. radial C. median D. superficial radial E. anterior interosseous
6. Numbness to the skin on the lateral ( radial ) half of the palm of the hand would be caused by a lesion to which nerve?
A. ulnar B. radial C. median D. superficial radial E. anterior interosseous
7. The nerve most likely to be injured in fractures of the medial epicondyle is the : A. radial B. axillary C. ulnar D. median E. musculocutaneous
7. The nerve most likely to be injured in fractures of the medial epicondyle is the : A. radial B. axillary C. ulnar D. median E. musculocutaneous
8. A 25 years old male patient sustained anterior dislocation of his right shoulder after beeing involved in a car accident , that was reduced in the E.R 2 weeks ago. Which nerve is probably damaged if a patient cannot abduct the arm beyond 25 degrees? A. axillary B. radial C. musculocutaneous D. median E. ulnar
8. A 25 years old male patient sustained anterior dislocation of his right shoulder after beeing involved in a car accident , that was reduced in the E.R 2 weeks ago. Which nerve is probably damaged if a patient cannot abduct the arm beyond 25 degrees? A. axillary B. radial C. musculocutaneous D. median E. ulnar
9. Loss of pronation of the hand suggests a lesion of the: A. median nerve B. radial nerve C. ulnar nerve D. intercostobrachial nerve E. musculocutaneous nerve
9. Loss of pronation of the hand suggests a lesion of the: A. median nerve B. radial nerve C. ulnar nerve D. intercostobrachial nerve E. musculocutaneous nerve
10. After a time, when a motor nerve to a muscle is sectioned, the muscles will atrophy (get smaller). If you notice that the thenar muscles are atrophied, which nerve would you suppose has been injured? A. musculocutaneous B. ulnar C. radial D. median E. thoracodorsal
10. After a time, when a motor nerve to a muscle is sectioned, the muscles will atrophy (get smaller). If you notice that the thenar muscles are atrophied, which nerve would you suppose has been injured? A. musculocutaneous B. ulnar C. radial D. median E. thoracodorsal
11. The clavicle is one of the most fractured bones. When the clavicle has been fractured at about the junction of the middle and distal thirds. the proximal end has been pulled upward. Which of the following muscles is responsible for this ? A. anterior deltoid fibers B. trapezius C. subclavius D. sternocleidomastoid E. pectoralis major
11. The clavicle is one of the most fractured bones. When the clavicle has been fractured at about the junction of the middle and distal thirds. the proximal end has been pulled upward. Which of the following muscles is responsible for this ? A. anterior deltoid fibers B. trapezius C. subclavius D. sternocleidomastoid E. pectoralis major
12. In Klumpke's palsy the lesion involves
A. C5, C6, C7 B. C5, C6 C. C8, Tl D. C5, C6, C7, C8, Tl E. C4, C5, C6
12. In Klumpke's palsy the lesion involves
A. C5, C6, C7 B. C5, C6 C. C8, Tl D. C5, C6, C7, C8, Tl E. C4, C5, C6
13.In Klumpke's palsy, the deformity seen is
A. Policeman's or waiter's tip position of upper limb B. Claw hand C. Ape hand D. Wrist drop E. Loss of rounded contour of the shoulder
13.In Erb's palsy, the deformity seen is
A. Policeman's or waiter's tip position of upper limb B. Claw hand C. Ape hand D. Wrist drop E. Loss of rounded contour of the shoulder
14. Paralysis of the triceps muscle will occur if radial nerve is injured
A. In the axilla B. In the spiral (radial groove) C. Above the lateral epicondyle D. In the cubital fossa E. In the posterior compartment of the forearm
14. Paralysis of the triceps muscle will occur if radial nerve is injured
A. In the axilla B. In the spiral (radial groove) C. Above the lateral epicondyle D. In the cubital fossa E. In the posterior compartment of the forearm
15. The most disabling injury to the hand is due to injury to
A. Ulnar nerve B. Median nerve C. Musculocutaneous nerve D. Axillary nerve E. Radial nerve
15. The most disabling injury to the hand is due to injury to
A. Ulnar nerve B. Median nerve C. Musculocutaneous nerve D. Axillary nerve E. Radial nerve
16. Inability to flex the distal phalanx of the middle finger indicates injury to which of these muscles? A.lumbrical B.dorsal interosseous C.flexor digitorum superficialis D.flexor digitorum profundus E.palmar interosseous
16. Inability to flex the distal phalanx of the middle finger indicates injury to which of these muscles? A. lumbrical B. dorsal interosseous C. flexor digitorum superficialis D. flexor digitorum profundus E. palmar interosseous
17. Loss of opposition of the thumb is a symptom associated with lesion of which nerve?
A. radial B. ulnar C. musculocutaneous D. median E. posterior interosseous
17. Loss of opposition of the thumb is a symptom associated with lesion of which nerve?
A. radial B. ulnar C. musculocutaneous D. median E. posterior interosseous
18. The only rotator cuff muscle that does not contribute to rotation of the arm is the: A. teres minor B. infraspinatus C. supraspinatus D. subscapularis
18. The only rotator cuff muscle that does not contribute to rotation of the arm is the: A. teres minor B. infraspinatus C. supraspinatus D. subscapularis
19. The nerve most likely to be traumatized with a fracture of the surgical neck of the humerus is the: A. median B. axillary C. radial D. ulnar E. profunda brachii
19. The nerve most likely to be traumatized with a fracture of the surgical neck of the humerus is the: A. median B. axillary C. radial D. ulnar E. profunda brachii
20. A 9 years old child brought to the E.R in your hospital with painfull swelling of his left elbow after fall on outstretched hand while playing football . x. ray revealed presence of supracondylar fracture The child was unable to flex his index or to make a circle by the index and thumb. The nerve most likely to be injuried is : A. B. C. D. E.
ulnar nerve. median nerve. radial nerve. musculocutaneous nerve. axillary nerve.
20. A 9 years old child brought to the E.R in your hospital with painfull swelling of his left elbow after fall on outstretched hand while playing football . x. ray revealed presence of supracondylar fracture The child was unable to flex his index or to make a circle by the index and thumb. The nerve most likely to be injuried is : A. B. C. D. E.
ulnar nerve. median nerve. radial nerve. musculocutaneous nerve. axillary nerve.
The Lower Limb
1. Hip fractures, especially in the elderly, often do not heal adequately. What type of femoral fracture in adults is most likely to result in avascular necrosis of the femoral head?
a. Acetabular b. Cervical (neck). c. Intertrochanteric (between the trochanters) d. Subtrochanteric e. Midfemoral shaft
1. Hip fractures, especially in the elderly, often do not heal adequately. What type of femoral fracture in adults is most likely to result in avascular necrosis of the femoral head?
a. Acetabular b. Cervical (neck). c. Intertrochanteric (between the trochanters) d. Subtrochanteric e. Midfemoral shaft
2. Paresthesia, hyperesthesia, or even painful sensation in the anterolateral region of the thigh may occur in obese persons. It results from an abdominal panniculus adiposus that bulges over the inguinal ligament and compresses which of the following underlying nerves? a. Femoral branch of the genitfemoral nerve b. Femoral nerve c. Iliohypogastric nerve d. Ilioinguinal nerve e. Lateral femoral cutaneous nerve
2. Paresthesia, hyperesthesia, or even painful sensation in the anterolateral region of the thigh may occur in obese persons. It results from an abdominal panniculus adiposus that bulges over the inguinal ligament and compresses which of the following underlying nerves? a. Femoral branch of the genitfemoral nerve b. Femoral nerve c. Iliohypogastric nerve d. Ilioinguinal nerve e. Lateral femoral cutaneous nerve
3. The process of unlocking the fully extended knee in preparation for flexion requires initial contraction of which of the following?
a. Gastrocnemius, soleus, and plantaris muscles b. Hamstring muscles c. Popliteus muscle d. Quadriceps femoris muscle e. Sartorius muscle and short head of the biceps femoris muscle
3. The process of unlocking the fully extended knee in preparation for flexion requires initial contraction of which of the following?
a. Gastrocnemius, soleus, and plantaris muscles b. Hamstring muscles c. Popliteus muscle d. Quadriceps femoris muscle e. Sartorius muscle and short head of the biceps femoris muscle
4. A patient experienced a prolonged stay in one position during a recent surgery and postoperative recovery that resulted in compression of the common fibular (peroneal) nerve against the fibular head. Which of the following motor deficits would be most likely to occur? a. Loss of extension at the knee b. Loss of plantar flexion c. Loss of flexion at the knee d. Loss of eversion e. Loss of medial rotation of the tibia
4. A patient experienced a prolonged stay in one position during a recent surgery and postoperative recovery that resulted in compression of the common fibular (peroneal) nerve against the fibular head. Which of the following motor deficits would be most likely to occur? a. Loss of extension at the knee b. Loss of plantar flexion c. Loss of flexion at the knee d. Loss of eversion e. Loss of medial rotation of the tibia
5. The muscles of the anterior compartment of the leg are innervated primarily by which of the following nerves? a. Deep peroneal. b. Lateral sural cutaneous c. Saphenous d. Superficial fibular e. Sural
5. The muscles of the anterior compartment of the leg are innervated primarily by which of the following nerves? a. Deep peroneal. b. Lateral sural cutaneous c. Saphenous d. Superficial peroneal. e. Sural
6. A 72-year-old female suffered a hip dislocation when she fell down the steps to here garage. Which of the following stractures is most significant in resisting hyperextension of the hip joint ?
A. B. C. D. E.
Pubofemoral ligament. Ischiofemoral ligament . Iliofemoral ligament. Negative pressure in the acetabular fossa. Gluteus maximus muscle.
6. A 72-year-old female suffered a hip dislocation when she fell down the steps to here garage. Which of the following stractures is most significant in resisting hyperextension of the hip joint ?
A. B. C. D. E.
Pubofemoral ligament. Ischiofemoral ligament . Iliofemoral ligament. Negative pressure in the acetabular fossa. Gluteus maximus muscle.
7. A 19-year old football player was hit on the lateral side of his knee just as he put that foot on the ground . Unable to walk without assistance , he is taken to the hospital .An MRI examination reveales a torn medial collateral ligament . Which stracture would most likely also be injured due to its attachment to this ligament ?
A. B. C. D. E.
Medial meniscus. Anterior cruciate ligament. Lateral meniscus. Posterior cruciate ligament. Tendon of semitendinosus.
7. A 19-year old football player was hit on the lateral side of his knee just as he put that foot on the ground . Unable to walk without assistance , he is taken to the hospital .An MRI examination reveales a torn medial collateral ligament . Which stracture would most likely also be injured due to its attachment to this ligament ?
A. B. C. D. E.
Medial meniscus. Anterior cruciate ligament. Lateral meniscus. Posterior cruciate ligament. Tendon of semitendinosus.
8. In a presurgical patient, the great saphenous vein was cannulated in the vicinity of the ankle. During the procedure, the patient experienced severe pain that radiated along the medial border of the foot. Which of the following nerves was accidentally included in a ligature during this procedure? a. Medial femoral cutaneous nerve b. Saphenous nerve c. Superficial fibular nerve d. Sural cutaneous nerve e. Tibial nerve
8. In a presurgical patient, the great saphenous vein was cannulated in the vicinity of the ankle. During the procedure, the patient experienced severe pain that radiated along the medial border of the foot. Which of the following nerves was accidentally included in a ligature during this procedure? a. Medial femoral cutaneous nerve b. Saphenous nerve c. Superficial fibular nerve d. Sural cutaneous nerve e. Tibial nerve
Saphenous cutdown
Saphenous nerve
Great Saphenous vein
9. A pulse in the dorsalis pedis artery may be palpated in which of the following ways? a. Between the tendons of the extensor digitorum longus and fibularis (peroneus) tertius muscles b. Between the tendons of the extensor hallucis and extensor digitorum muscles c. Between the tendons of the tibialis anterior and extensor hallucis longus muscles d. Immediately anterior to the lateral malleolus e. Immediately posterior to the medial malleolus
9. A pulse in the dorsalis pedis artery may be palpated in which of the following ways? a. Between the tendons of the extensor digitorum longus and fibularis (peroneus) tertius muscles b. Between the tendons of the extensor hallucis and extensor digitorum muscles c. Between the tendons of the tibialis anterior and extensor hallucis longus muscles d. Immediately anterior to the lateral malleolus e. Immediately posterior to the medial malleolus
10 . A 12-year-old boy is brought to the emergency room by his mother following being pushed out of the neighbor’s tree house, about 10 ft off the ground. He can walk but his right heel hurts every time he puts weight on it. When you examine his foot it is tender to pressure on both the medial and lateral aspects of the heel inferior to the tibia. You order plain films of his right lower extremity because you suspect he has fractured which of the following? a. Calcaneus b. Fibula c. Tibia d. Navicular e. Cuneiform
10 . A 12-year-old boy is brought to the emergency room by his mother following being pushed out of the neighbor’s tree house, about 10 ft off the ground. He can walk but his right heel hurts every time he puts weight on it. When you examine his foot it is tender to pressure on both the medial and lateral aspects of the heel inferior to the tibia. You order plain films of his right lower extremity because you suspect he has fractured which of the following? a. Calcaneus b. Fibula c. Tibia d. Navicular e. Cuneiform
11. A 45-year-old man has trouble walking. At his physician's clinic, when he is asked to stand on his right foot, his left hip drops. Which of the following nerves is most likely damaged, causing his problem? a. Left inferior gluteal b. Right inferior gluteal c. Left superior gluteal d.Right superior gluteal
11. A 45-year-old man has trouble walking. At his physician's clinic, when he is asked to stand on his right foot, his left hip drops. Which of the following nerves is most likely damaged, causing his problem? a. Left inferior gluteal b. Right inferior gluteal c. Left superior gluteal d.Right superior gluteal
Glutesus medius & minimus
12. Saphenous ‘cut down’ is carried out to give intravenous infusion to patients in whom the other superficial veins in the body are either collapsed or invisible. In such situations, which of the following should be the site of incision to have an access to the vein? a. In front of the medial malleolus b. Behind the medial malleolus c. In front of the lateral malleolus d. Behind the lateral malleolus
12. Saphenous ‘cut down’ is carried out to give intravenous infusion to patients in whom the other superficial veins in the body are either collapsed or invisible. In such situations, which of the following should be the site of incision to have an access to the vein? a. In front of the medial malleolus b. Behind the medial malleolus c. In front of the lateral malleolus d. Behind the lateral malleolus
Saphenous cutdown
Saphenous nerve
Great Saphenous vein
13. A 45-year-old woman arrives at the casualty after being injured in an automobile collision. Her right foot is in a dorsiflexed and everted position. If a nerve injury is suspected, which of the following has most likely been injured? a. Common peroneal b. Superficial peroneal c. Deep peroneal d. Tibial
13. A 45-year-old woman arrives at the casualty after being injured in an automobile collision. Her right foot is in a dorsiflexed and everted position. If a nerve injury is suspected, which of the following has most likely been injured? a. Common peroneal b. Superficial peroneal c. Deep peroneal d. Tibial
14. A 22-year-old man is examined by the team physician after injuring his right leg during a football game. The physician is able to demonstrate significant anterior movement of the tibia in relation to the femur. Which of the following structures is most likely torn?
a. Anterior cruciate ligament b. Posterior cruciate ligament c. Fibular collateral ligament d. Tibial collateral ligament e. Lateral meniscus
14. A 22-year-old man is examined by the team physician after injuring his right leg during a football game. The physician is able to demonstrate significant anterior movement of the tibia in relation to the femur. Which of the following structures is most likely torn?
a. Anterior cruciate ligament b. Posterior cruciate ligament c. Fibular collateral ligament d. Tibial collateral ligament e. Lateral meniscus
15. A 77-year-old woman has difficulty climbing stairs because of weakness in her limb. Her knee jerk reflex is normal and she is able to stand on her heels and on the "balls" of her feet. Injury to which of the following nerves is the most likely cause of these findings? A. Tibial B. Obturator C. Inferior gluteal D. Femoral E. Common peroneal
15. A 77-year-old woman has difficulty climbing stairs because of weakness in her limb. Her knee jerk reflex is normal and she is able to stand on her heels and on the "balls" of her feet. Injury to which of the following nerves is the most likely cause of these findings? A. Tibial B. Obturator C. Inferior gluteal D. Femoral E. Common peroneal
16.All the followings are true about the tibial nerve except ?
A. it lies on tibialis post. In the upper half. B. descends through the calf between flexor digitorum longus medially and flexor hallucis longud laterally. C. innervates both medial and lateral heads of gastrocnemius. D. innervates the skin over the back of the leg and the lateral border of the foot through its sural branch. E. its injury results in foot drop.
16.All the followings are true about the tibial nerve except ?
A. it lies on tibialis post. In the upper half. B. descends through the calf between flexor digitorum longus medially and flexor hallucis longud laterally. C. innervates both medial and lateral heads of gastrocnemius. D. innervates the skin over the back of the leg and the lateral border of the foot through its sural branch. E. its injury results in foot drop.
17. A 12-year-old girl is brought to the emergency department after falling on the sharp edge of a tin can. She has a deep cut, which has injured a tendon immediately posterior to the medial malleolus. The tendon of which of the following muscles is injured in this case? a. Flexor hallucis longus b. Flexor digitorum longus c. Tibialis posterior d. Tibialis anterior
17. A 12-year-old girl is brought to the emergency department after falling on the sharp edge of a tin can. She has a deep cut, which has injured a tendon immediately posterior to the medial malleolus. The tendon of which of the following muscles is injured in this case? a. Flexor hallucis longus b. Flexor digitorum longus c. Tibialis posterior d. Tibialis anterior
18. A 30-year-old man has numbness of the anterolateral surface of his right leg and dorsum of his right foot when he wears tight, knee-high boots during his dance routine. Which of the following nerves is most likely compressed? a. Tibial b. Saphenous c. Medial plantar d. Femoral e. Common fibular (peroneal)
18. A 30-year-old man has numbness of the anterolateral surface of his right leg and dorsum of his right foot when he wears tight, knee-high boots during his dance routine. Which of the following nerves is most likely compressed? a. Tibial b. Saphenous c. Medial plantar d. Femoral e. Common fibular (peroneal)
19. Housemaid’s knee is associated with the inflammation of which of the following bursae? a. Suprapatellar b. Subcutaneous infrapatellar c. Prepatellar d. Deep infrapatellar
19. Housemaid’s knee is associated with the inflammation of which of the following bursae? a. Suprapatellar b. Subcutaneous infrapatellar c. Prepatellar d. Deep infrapatellar
20.All the followings are true about the common fibular ( peroneal ) nerve except?
a. it divides in the substance of the peroneus longus. b. Is subcutaneous as it corosses the neck of the fibula. c. Supplies the three peroneal muscles through its superficial peroneal branch. d. Supplies the skin over the medial border of the hallux.
20.All the followings are true about the common fibular ( peroneal ) nerve except?
a. it divides in the substance of the peroneus longus. b. Is subcutaneous as it corosses the neck of the fibula. c. Supplies the three peroneal muscles through its superficial peroneal branch. d. Supplies the skin over the medial border of the hallux.
