Final Exam DB

Question 1

1. The following structures emerge directly below the inferior border of the piriformis muscle except:
   a. Obturator nerve
   b. Sciatic nerve
   c. Inferior gluteal artery
   d. Inferior gluteal nerve

Answer 1

A

Question 2

2. The triceps coxae includes the following muscles except:
   a. Obturator externus
   b. Obturator internus
   c. Gemelli superior
   d. Gemelli inferior

Answer 2

A

Question 3

3. Identify the strongest lateral rotator of the thigh:
   a. Gluteus medius
   b. Gluteus maximus
   c. Obturator internus
   d. Quadratus femoris

Answer 3

D

Question 4

4. Piriformis syndrome is most often caused by:
   a. Compression of lumbosacral nerve roots as they exit the spinal canal
   b. Irritation of the sciatic nerve just proximal to its bifurcation in the popliteal fossa
   c. Irritation of the sciatic nerve by piriformis muscle spasm
   d. Irritation of the sciatic nerve by a weak piriformis muscle

Answer 4

C

Question 5

5. Piriformis syndrome differs from “sciatica” by:

a. The distribution of the sensory deficits
b. The cause
c. Distribution of weakness
d. All of the above

Answer 5

B

Question 6

6. Which hamstring muscle has an insertion that reinforces the intercondylar part of the knee capsule?
   a. Semitendionsus
   b. Semimembranosus
   c. Long head biceps femoris
   d. Short head biceps femoris

Answer 6

B

Question 7

7. Identify the hamstring muscle that is innervated by the fibular division of the sciatic nerve.
   a. Semitendinosus
   b. Semimembranosus
   c. Long head biceps femoris
   d. Short head biceps femoris

Answer 7

D

Question 8

8. Which hamstring muscle provides a protective covering over the sciatic nerve as it descends in the posterior thigh?
   a. Semitendinosus
   b. Semimembranosus
   c. Long head biceps femoris
   d. Short head biceps femoris

Answer 8

C

Question 9

9. Identify the following statement regarding hamstring injuries that is the least accurate.
   a. The biceps femoris is rarely injured
   b. Most injuries occur in the process of decelerating the tibia
   c. The risk of hamstring injury increases with age
   d. Hamstring strengthening decreases the risk of injury

Answer 9

A

Question 10

10. The following statements accurately describe the femoral nerve except:
    a. The femoral nerve is composed of nerve roots from L2-4
    b. Passes beneath the inguinal canal medial to the femoral artery
    c. Forms in the psoas muscle in the abdomen
    d. Supplies the anterior compartment of the thigh

Answer 10

B

Question 11

11. The obturator nerve:
    a. Supplies the muscles of the posterior compartment of the thigh
    b. Is composed of sacral nerve roots
    c. Passes through the adductor canal
    d. Splits into anterior and posterior branches that surround the adductor brevis

Answer 11

D

Question 12

12. The following statements regarding the sciatic nerve are accurate except:
    a. The sciatic nerve supplies a number of gluteal muscles
    b. It is the largest nerve in the body
    c. It is large enough to have its own named arterial supply
    d. As it passes from beneath the piriformis muscle it is lateral to the inferior gluteal artery & nerve

Answer 12

A

Question 13

13. The perforating arteries of the profunda femoris supply blood to:
    a. The anterior compartment of the thigh
    b. The posterior compartment of the thigh
    c. The medial compartment of the thigh
    d. All of the above

Answer 13

D

Question 14

14. The femoral artery supplies all of the following except:
    a. The anterior compartment
    b. The head & neck of the femur
    c. The gluteal muscles
    d. The profunda femoris

Answer 14

C

Question 15

15. Dorsiflexion of the foot
    a. Is as powerful as plantar flexion
    b. Employs muscles from the posterior compartment
    c. Employs lateral compartment muscles
    d. Is 25% as powerful as plantar flexion

Answer 15

D

Question 16

16. The anterior compartment of the leg is innervated by:
    a. The deep fibular nerve
    b. The common tibial nerve
    c. The superficial fibular nerve
    d. The tibial nerve

Answer 16

A

Question 17

17. The posterior compartment of the leg is innervated by:
    a. The deep fibular nerve
    b. The common fibular nerve
    c. The superficial fibular nerve
    d. The tibial nerve

Answer 17

D

Question 18

18. The common fibular nerve is vulnerable to compression
    a. As it crosses posterior to the femoral artery at the adductor hiatus
    b. As it loops around the distal fibular medial to the lateral malleolus
    c. As it winds around the lateral aspect of the fibular neck
    d. As it branches off laterally from the sciatic nerve

Answer 18

C

Question 19

19. Common fibular nerve injury results in impaired:

a. Plantar flexion
b. Dorsiflexion
c. Both
d. Neither

Answer 19

C

Question 20

20. Laceration of the ulnar nerve just proximal to the Guyon canal would result in:

a. Loss of flexion at the distal interphalangeal joint
b. Loss of extension of the thumb
c. Loss of flexion at the metacarpophalangeal joint of the 2nd & 3rd digits
d. Loss of abduction of the digits

Answer 20

D

Question 21

21. The gluteus medias acts in relation to the gluteus maximus as a(n)
    a. Antagonist
    b. Synergist
    c. Both
    d. Neither

Answer 21

C

Question 22

22. The tibialis anterior is located in what compartment?

Answer 22

Anterior compartment

Question 23

23. The soleus is located in which compartment?

Answer 23

Superficial posterior compartment

Question 24

24. The flexor digitorum longus is located in which compartment?

Answer 24

Deep posterior compartment

Question 25

25. The superficial fibular nerve supplies innervation to this compartment?

Answer 25

Lateral compartment

Question 26

26. This compartment contains the triceps surae muscles

Answer 26

superficial posterior compartment

Question 27

27. Damage to the nerves in this compartment would result in greater use of the thigh flexors in ambulation:

Answer 27

Anterior compartment

Question 28

28. The plantar flexion to dorsiflexion strength ratio is approximately: a. 4:1 b. 2:1 c. 1:2 d. 1:1

Answer 28

A

Question 29

29. Shin splints are most accurately described as a mild: (FALL ’15) a. Muscle strain b. Nerve irritation c. Compartment syndrome d. Muscle weakness

Answer 29

C

Question 30

30. The triceps surae includes the following except: a. Medial head gastrocnemius muscle b. Lateral head gastrocnemius muscle c. Soleus muscle d. Popliteus muscle

Answer 30

D

Question 31

31. Rupture of the Achilles tendon is associated with all of the following except: a. The location of the rupture is a couple of inches from the insertion of the tendon on the calcaneus b. The injured person experiences great difficulty with flexion of the great toe c. The injured person has difficulty with plantar flexion of the ankle d. Recovery time can be 4-6 months or longer

Answer 31

B

Question 32

32. The following statements regarding the popliteal artery are accurate except: a. It supplies the major branches involved in the perigenicular anastomotic network b. It is located superficial to the popliteal vein in the popliteal fossa c. It is at risk for injury in knee dislocations d. Chronic repetitive flexion/extension cycles may play a role in the development of popliteal artery aneurysms

Answer 32

B

Question 33

33. On physical exam at the beginning of rehab of a patient with the X-ray below, the most likely physical finding would be? (A picture of a humerus fracture healed): a. Weakness of all posterior compartment muscles of the upper extremity b. Weakness of lateral head of triceps c. Weakness of anconeus d. Diminished brachial pulse

Answer 33

C

Question 34

34. With a lesion of this nerve elbow flexion is severely weakened

Answer 34

Lateral cord of the superior trunk

Question 35

35. All posterior compartment musculature of the upper extremity would be denervated by a lesion at this site:

Answer 35

Posterior cord

Question 36

36. Injury to this nerve would severely impair fine motor control of the hand, particularly the 4th and 5th digits:

Answer 36

medial cord

Question 37

37. Transection of the posterior cord would result in: a. Slightly weakened elbow flexion b. Impaired shoulder abduction c. Weakened supination of the hand with the elbow extended d. All of the above

Answer 37

D

Question 38

38. At which location will occlusion of the identified artery result in significant impairment of arterial flow to the distal upper extremity. a. Subclavian artery distal to the thyrocervical trunk b. Proximal profunda brachii artery c. Brachial artery just proximal to the profunda brachii artery d. Brachial artery just proximal to the thoracoacromial artery

Answer 38

C

Question 39

39. The interosseous membrane in the arm & leg does all of the following except: a. Connects long bones (tibia-fibula, radius-ulna) b. Provides a site of origination for muscles c. Plays a major role in force transmission from distal structures to proximal structures d. All are accurate

Answer 39

C

Question 40

40. The most powerful supinator of the hand when the elbow is flexed: a. Brachialis b. Biceps brachii c. Supinator d. Pronator quadratus

Answer 40

B

Question 41

41. The most powerful supinator of the hand when the elbow is extended: a. Brachialis b. Biceps brachii c. Supinator d. Pronator quadratus

Answer 41

C

Question 42

42. What structure lies on the posterior aspect of the knee joint capsule in the popliteal fossa? a. Popliteal vein b. The popliteal artery c. Tibial nerve d. Small saphenous vein

Answer 42

B

Question 43

43. Significant blood supply to the femoral head and neck in an adult is least likely to arise from which of the following arteries? a. The femoral artery b. The profunda femoris artery c. The medial circumflex artery d. The obturator artery

Answer 43

D

Question 44

44. Identify the ligament most effective at preventing hyper-abduction of the hip: (FALL ’15) a. Ischial femoral ligament b. Pubofemoral ligament c. Iliofemoral ligament d. Sacrospinous ligament

Answer 44

B

Question 45

45. Which motion of the hip joint results in drawing the femoral head deeper into the acetabulum? a. Flexion b. Extension c. Adduction d. Abduction

Answer 45

B

Question 46

46. The following muscles may contribute to the calcaneal ligament except: a. Gastrocnemius b. Popliteus c. Soleus d. Plantaris

Answer 46

B

Question 47

47. The ligament of the head of the femur: a. Is formed by the reflected head of the rectus femoris b. Contains an artery essential to the vascular supply of the fetal femoral head c. Forms a strong ligament key to maintaining hip integrity especially in extreme hip flexion d. Attaches to the femoral neck OR all of the above

Answer 47

B

Question 48

48. “The terrible triad of O’Donoghue” (also the “unhappy triad”) includes damage to all of the following except: a. Medial collateral ligament b. Anterior cruciate ligament c. Patellar ligament d. Medial meniscus

Answer 48

C

Question 49

49. The ankle joint is more stable in dorsiflexion because: a. The trochlea of the talus is wider anteriorly than posteriorly b. The muscles involved in dorsiflexion are stronger than those of plantar flexion c. The medial and lateral malleoli move closer together in dorsiflexion d. The calcaneal ligament provides more reinforcement of the tibio-talar joint in dorsiflexion

Answer 49

A **Also- The medial and lateral malleoli move further apart in dorsiflexion**

Question 50

50. Which lateral ligament is most often injured in ankle injuries? a. Anterior tibiofibular ligament b. Posterior talofibular ligament c. Calcaneofibular ligament d. Anterior talofibular ligament

Answer 50

D

Question 51

51. Ankle injuries most often involve a. Eversion while the foot is dorsiflexed b. Eversion while the foot is plantar flexed c. Inversion while the foot is plantar flexed d. Inversion while the foot is dorsiflexed

Answer 51

C

Question 52

52. Which arch is supported by both the tibialis posterior and fibularis longus tendons? a. Medial arch b. Lateral arch c. Transverse arch

Answer 52

C

Question 53

53. The active factors which support the arches of the foot including all of the following except: a. The reflexive bracing action of the intrinsic foot muscles b. Gastrocnemius muscle c. Flexor hallicus longus d. Flexor digitorum longus

Answer 53

B

Question 54

54. The intrinsic muscles of the foot a. Refine the efforts of the long muscles of the leg to produce a stable platform b. Function to increase the transmission of force from the leg and thigh muscles to the ground c. Function as a group in supporting body weight and maintaining the arches of the foot d. All of the above

Answer 54

D

Question 55

55. While standing at ease, the muscles that are most active include the erector spinae and… a. The triceps surae b. Biceps femoris c. Quadriceps, especially the vastus medialis d. Adductor magnus, adductor part

Answer 55

A

Question 56

56. Periarticular anastomotic networks a. Allow for continuous blood flow despite single vessel occlusion b. Allow for continued flow despite extremes of joint position c. Create difficulty in the management of penetrating injuries of the hands and feet d. All of the above

Answer 56

D

Question 57

57. When the knee is flexed to 90 which muscle is most effective for foot plantar flexion a. Gastrocnemius b. Soleus c. Posterior tibialis d. Extensor hallicus longus

Answer 57

B

Question 58

58. John has had trouble catching his great toe when he’s walking, especially on deep shag carpet and going up the stairs. Injury to which of the following nerves would cause this difficulty? a. Superficial fibular nerve b. Deep fibular nerve OR common fibular nerve c. Anterior tibial nerve d. Lateral plantar nerve

Answer 58

B

Question 59

59. All of the following are accurate regarding the fibula except: a. Distally it forms the lateral malleolus b. It bears ~10-15% of body weight while standing c. Articulates with the talus d. Articulates with the tibia

Answer 59

B

Question 60

60. The area of the acetabulum involved in weight bearing is called: a. The lunate surface b. The acetabular rim c. The acetabular articulum d. The acetabular ligament

Answer 60

A

Question 61

61. The following statements regarding the acetabular fossa are accurate except: a. It contains a fat pad b. It contains the ligament of the femoral head c. It is in direct contact with the articular surface of the femoral head during weight bearing d. The contents are covered by a synovial membrane

Answer 61

C

Question 62

62. All of the following are accurate regarding the menisci of the knee except: a. The medial meniscus is directly attached to the medial collateral ligament b. The are free along their medial margins c. The lateral meniscus is larger d. They play a role in shock absorption in the knee

Answer 62

C

Question 63

63. Which foot arch is mainly involved in maintaining balance? a. Medial arch b. Lateral arch c. Transverse arch

Answer 63

B

Question 64

64. Acquired “fallen arches” are due to: a. Dysfunction of the tibialis posterior muscle b. A defect in the spring ligament c. A stress fracture of the calcaneal head d. A congenital defect in the talonavicular joint

Answer 64

A

Question 65

65. During walking, foot/ankle dorsiflexors are most active: a. Just prior to toe-off in a concentric contraction to produce preload in the plantar flexors b. In an eccentric contraction as the forefoot is lowered to the ground immediately after heel strike c. During the mid-stance phase maintaining the transverse arch d. All of the above

Answer 65

B

Question 66

66. Most of the muscular propulsive force in normal walking is provided by: a. Plantar flexors b. Dorsiflexors c. Quadriceps muscles d. Gluteus medius & minimus

Answer 66

A

Question 67

67. The contents of the carpal tunnel includes all of the following except: a. Tendons of the flexor digitorum profundus b. Tendon of the flexor pollicis longus c. Tendon of the palmaris longus d. The median nerve

Answer 67

C

Question 68

68. Identify the structure that exits the greater sciatic foramen and enters the lesser sciatic foramen: a. Superior gluteal nerve b. Inferior gluteal nerve c. Pudendal nerve d. Obturator nerve

Answer 68

C

Question 69

he fibula forms the lateral malleolus and: a. Bears approximately 25% of the body weight b. Provides a site for muscle attachment c. Is completely avascular d. Is the attachment site for the leg muscles of the medial compartment

Answer 69

B

Question 70

70. Varicose veins are: a. Often only a cosmetic concern b. Can cause lower extremity discomfort c. Associated with hormonal changes d. All of the above

Answer 70

D

Question 71

71. The formation of varicose veins in the leg is due to: a. Arterial pressure blood entering the venous system b. Increased blood flow due to an abnormal arterio-venous connection c. Incompetence of the valves in the venous system d. A connective tissue disorder involving type IV collagen

Answer 71

C

Question 72

72. Leg flexors are supplied by which of the following nerves: a. Sciatic nerve b. Femoral nerve c. Obturator nerve d. All of the above

Answer 72

D

Question 73

73. This test indicates normal function of: (Trendelenburg’s Sign – when standing on one leg, pelvis drops on the side opposite of the stance leg = weakens on the side of the stance leg, superior gluteal nerve) a. The right femoral nerve b. The left superior gluteal nerve (If lifting left leg, answer is right superior gluteal nerve) c. The right inferior gluteal nerve d. The left inferior gluteal nerve

Answer 73

B

Question 74

74. The test pictured is used to assess the function of: a. the left gluteus medius muscle b. the right gluteus medius muscle (if lifting left leg) c. the right quadratus femoris d. the left inferior gluteal nerve

Answer 74

A

Question 75

75. With respect to the adductor muscles (longus, brevis and magnus) a. Only the adductor magnus crosses both the hip and knee joint b. Play such a critical role that any diminished function results in functional disability c. Cutting the obturator nerve results in complete loss of adductor function d. None of the above

Answer 75

D

Question 76

76. The following statements regarding the gluteus maximus are accurate except: a. It is the largest muscle in the body b. It inserts on the iliotibial tract and the gluteal tubercle of the femur c. It is a strong hip/femur extender d. It plays a major role in hip/femur abduction

Answer 76

D

Question 77

77. All the posterior compartment thigh muscles, except the short head of the biceps femoris originate from: a. Inferior pubic ramus b. Ischial ramus c. Ischial tuberosity d. Ischial spine

Answer 77

C

Question 78

78. The strongest foot dorsiflexor is: a. Extensor digitorum longus b. Extensor hallicus longus c. Tibialis anterior d. Fibularis tertius

Answer 78

C

Question 79

79. All of the following muscles have an origination on the femur except: (FALL ’15) a. Gastrocnemius b. Popliteus c. Soleus d. Plantaris

Answer 79

C

Question 80

80. The following statements regarding the posterior cruciate ligament are accurate EXCEPT: a. it is stronger than the anterior cruciate ligament b. in the flexed weight bearing knee, it is a major stabilizing element c. it passes medially to the ACL d. it prevents the anterior displacement of the tibia from the femur

Answer 80

D

Question 81

81. The deltoid ligament of the ankle connects all of the following to the distal tibia EXCEPT: a. Cuboid b. Talus c. Calcaneus d. Navicular

Answer 81

A

Question 82

82. Which arch is supported by both the tibialis anterior and the fibularis longus tendons? a. medial arch b. lateral arch c. transverse arch

Answer 82

A

Question 83

83. Passive factors maintaining the arches of the foot include all the following EXCEPT: a. the shape of the bone to the foot b. quadratus plantae muscle c. spring ligament d. plantar aponeurosis

Answer 83

B

Question 84

84. The active factors that support the arches of the foot include all of the following EXCEPT: a. the reflexive bracing action of the intrinsic foot muscles b. soleus muscle c. flexor hallicus longus d. flexor digitorum longus

Answer 84

B

Question 85

85. The following statements regarding hip dislocations are accurate EXCEPT a. posterior dislocations are more common than anterior dislocations b. although less frequent than anterior dislocations, posterior dislocations are more often associated with sciatic nerve injuries c. although less common than posterior dislocations, anterior dislocations are more often associated with fractures of the acetabular rim d. a defect in the fibrous joint capsule may facilitate posterior hip dislocations

Answer 85

B

Question 86

86. The forward motion of the thigh during the middle of the swing phase is due to a. gluteus maximus contraction b. quadriceps contraction c. iliopsoas contraction d. momentum

Answer 86

D

Question 87

87. The major propulsive force in a normal walking gait on flat ground is a. the gluteus maximus b. the quadriceps c. hip extenders d. gravity

Answer 87

D

Question 88

88. The popliteus muscle’s main function is to: a. Resist anterior rotation of the medial condyle of the knee during extension b. Pull the lateral meniscus posteriorly during knee flexion c. Assist in knee abduction d. Antagonize knee abduction

Answer 88

B

Question 89

89. The main function of the labrum of the acetabulum is to: a. Prevent hyper extension of the hip b. To resist hyper flexion of the hip c. Increase the depth of the acetabulum d. Maintain the transverse angle of the femoral neck

Answer 89

C

Question 90

90. The insertion of the Tibialis posterior: a. Navicular and cuboid bones b. Cuneiform bones c. Metatarsals d. A & B e. All of the above

Answer 90

E

Question 91

91. Which one of these has an attachment to the extracapsular ligament? a. Medial collateral ligament b. Lateral collateral ligament c. Both d. Neither

Answer 91

C

Question 92

92. A question about a runner that fractures a bone while running. Which bone is fractured that enables him to continue running and finish the race? a. Tibia b. Fibula c. Patella d. Femur

Answer 92

B

Question 93

93. Blood supply to the cruciate ligaments: a. Popliteal artery b. Femoral artery c. Middle genicular artery d. An option I can’t remember

Answer 93

C

Question 94

94. Action of the Fibularis tertius with the lateral leg compartment muscles: a. Antagonist b. Synergistic c. Both d. Neither

Answer 94

C... double check make sure this is correct...

Question 95

95. Which muscle is responsible for initiation of walking when foot is planted? a. Tibialis anterior b. Plantaris c. Patella d. An answer I can’t remember

Answer 95

A

Question 96

96. Impaired distal interphalangeal joint extension of the third digit would occur following interruption of which of the following nerves? a. Posterior interosseous nerve b. Median nerve c. Ulnar nerve d. All of the above

Answer 96

B

Question 97

99. Which posterior compartment muscle crosses the fewest joints? a. Plantaris b. Popliteus c. Flexor Hallicus longus d. Tibialis posterior

Answer 97

B

Question 98

View rest of DB questions to review more. The rest are based on pictures

Answer 98

Happy Finals week!