Arthrology, Myology- Part 2 (MCQs: Anatomy)

Does the basilic vein perforate the brachial fascia?

Yes

Do any structures lie between the two heads of the pronator teres?

yes

Does the flexor pollicis brevis muscle have a deep head?

yes

Does the anterior lateral malleolar artery communicate with the perforating artery?

yes

In the process of escaping from T. rex in Jurassic Park the heroine punctures the skin on the medial side of her wrist on a spiny bush. A few days later, due to the toxin, an infection is seen spreading up the medial side of her arm along the large cutaneous vein extending from the dorsum of her hand to the medial side of her arm. The vein involved is the:

basilic vein

The lateral antebrachial cutaneous nerve comes from the:

musculocutaneous nerve

A sixteen-year-old boy receives a superficial cut on the thumb side of his forearm. The superficial vein most likely affected is the:

cephalic vein

A sixteen-year-old boy received a superficial cut on the ulnar side of his forearm. The superficial vein most likely affected is the:

basilic vein

During insertion of an IV cannula in the median cubital vein, the patient suddenly lost feeling on the radial side of the forearm. What nerve was injured?

lateral antebrachial cutaneous

After trying to throw a curve ball, a pitcher lost sensation from the tip of the little finger. This indicates injury to which nerve?

ulnar nerve

While having an IV needle inserted into the cephalic vein of the forearm, the patient suddenly screamed in pain and felt tingling in part of the skin of the forearm supplied by the nerve accompanying the vein. What nerve was injured?

lateral antebrachial cutaneous

Because of scarring of a patient's median cubital vein, the technician chooses to insert an infusion needle into her basilic vein at the level of the medial epicondyle. Despite the certainty that the needle does not pass through the deep (investing) fascia, there is still a chance that it might nick or impale which of the following?

medial antebrachial cutaneous nerve

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

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 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

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

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 nerve

The deep peroneal nerve supplies:

- tibialis anterior

- extensor hallucis longus

- extensor digitorum longus

The flexor digitorum superficialis muscle has attachments to the....

humerus, radius and ulna

If the median nerve is cut at the elbow there is usually loss of...

usually loss of opposition of the thumb

Supination of the hand and forearm would be diminished by loss of radial nerve function. But one very powerful supinator would remain intact and unaffected, namely:

biceps brachii

A worker doing repetitive lifting develops an inflammation in the tendon of origin of the extensor carpi radialis brevis muscle, commonly called "tennis elbow". The focal point of pain would most likely be near which palpable bony landmark?

lateral epicondyle of humerus

The anterior interosseous is a branch of which nerve?

median

In an attempt to commit suicide by slashing the ventral side of the wrist, the two tendons of the flexor digitorum superficialis located most superficially were completely severed. What movement would be affected?

flexion of the PIP joints of digits 3 and 4

What muscle is innervated by branches of both the median and ulnar nerves?

flexor digitorum profundus

A boy fell onto a sharp object and cut his deep radial nerve as it emerged from the supinator muscle. The artery joining it at this point was also injured. The injured artery is the:

posterior interosseous

The tendons on the dorsal side of the wrist are held in place by a thickening of the antebrachial fascia called the:

extensor retinaculum

Development of "tennis elbow" (lateral epicondylitis) involves the origin of which muscle?

extensor carpi radialis brevis

In an industrial accident, the artery passing lateral to the pisiform bone is cut. This artery is the...

ulnar

When falling on an outstretched hand, the most commonly dislocated carpal bone is the...

lunate

If the musculocutaneous nerve is severed at its origin from the brachial plexus, flexion at the elbow is greatly weakened but not abolished. What muscle remains operative and can contribute to flexion?

brachioradialis

If the tendon of palmaris longus were transected, what movement would be affected?

flexion of the wrist

The pulse of the radial artery at the wrist is felt immediately lateral to which tendon?

flexor carpi radialis

If the medial epicondyle of the humerus is fractured and the nerve passing dorsal to it is injured, which muscle would be most affected?

flexor carpi ulnaris

A girl playing softball cuts the palm of her hand as she scoops up a piece of glass along with the ball. If the only nerve damaged is the recurrent branch of the median nerve, she would lose what movement of the thumb?

opposition

The main source of blood to the superficial palmar arterial arch is the:

ulnar artery

What sesamoid bone develops in the tendon of flexor carpi ulnaris and is therefore not a part of the wrist joint?

pisiform

In order to check the pulse of a child whose forearm is in a cast, the pediatrician presses her finger into the depth of the "anatomical snuffbox". The tendon lying immediately medial (ulnar) to the physician's finger belongs to what muscle?

extensor pollicis longus

While watching her boyfriend split wood, a teenager was struck on the back of her carpals by a sharp- edged flying wedge. Her extensor digitorum tendons were exposed, though not severed, indicating that the surrounding synovial sheath had been opened. What other muscle has its tendon surrounded by the same synovial sheath?

extensor indicis

The signs and symptoms of carpal tunnel syndrome may vary among patients, but they always result from compression of what structure in the carpal canal?

median nerve

What muscle tendon is enclosed within its own synovial sheath in the carpal canal?

flexor pollicis longus

The point of insertion of the flexor digitorum superficialis tendon to the index finger is on the:

middle phalanx

In order to evaluate the carpal-metacarpal joint of the thumb, the median nerve must be deadened at the wrist (causing paralysis of the muscles supplied by it distal to the injection) to test the joint. Which movement of the thumb would be most affected by the anesthetic?

opposition

What arterial vessel accompanies the deep branch of the ulnar nerve across the palm?

deep palmar arterial arch

The fourth dorsal interosseous muscle is innervated by the:

deep branch of the ulnar nerve

A student is rollerblading on the Diag and while trying to avoid a bicyclist falls heavily on his right wrist. After the fall he notes severe pain in the anatomical snuff box. Radiological studies reveal a fracture of the bone deep to the snuff box called the

scaphoid

A patient sustained multiple deep lacerations on the palm of his hand and anterior surface of his wrist. During examination, the physician put a piece of paper between adjacent surfaces of the patient's index and middle fingers and found him unable to squeeze them together with sufficient force to hold the paper. What muscles are being tested?

second dorsal and first palmar interosseous muscles

A patient sustained multiple deep lacerations on the palm of his hand and anterior surface of his wrist. During examination, the physician put a piece of paper between adjacent surfaces of the patient's index and middle fingers and found him unable to squeeze them together with sufficient force to hold the paper. The most specific nerve branch to the tested muscles is the:

deep branch of the ulnar nerve

Bleeding from a superficial cut in the middle of the palm of the hand near the proximal transverse crease comes mainly from what vessel?

superficial palmar arch

A deep puncture wound in the palmar surface of the little finger near the proximal IP joint might introduce infection into which synovial cavity:

ulnar bursa

In carpal tunnel syndrome, compression of the median nerve in the carpal tunnel affects which hand muscle?

flexor pollicis brevis

After suffering a cut deep to the hypothenar eminence, the patient is unable to hold a sheet of paper between the second and third digits. The nerve most likely injured was the:

deep ulnar

What movement of the thumb would be most affected by lesion of the median nerve in the cubital fossa:

flexion

structures within the carpal tunnel include:

radial bursa

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 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

A deep laceration, 2 cm in length, immediately posterior to the medial malleolus, may injure any of the following EXCEPT:

fibular artery

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

dorsalis pedis artery

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

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

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

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 the first and second toes

While walking barefoot on the beach 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

A medical student goes for a swim while on vacation 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

The lateral plantar nerve is a branch of which nerve?

tibial nerve

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

just lateral to the tendon of extensor hallucis longus

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

Along distance runner complained of swelling and pain of his shin (tibia). At physical examination, skin testino sho»ed 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

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?

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?

tibialis anterior

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

A patient has been diagnosed with bone cancer in the fibula that necessitates its removal. Which of the followoing muscles would be least affected following removal of the fibula?

flexor digitorum 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

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 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)

While water skiing following final exams, a medical student falls and twists her ankle. Her foot is forcibly everted, which could cause a sprain of which ligament?

deltoid

the radial nerve:

- supplies the muscles on the posterior aspect of the upper arm and forearm

- is the only nerve supplying the triceps muscle

the flexor digitorum profundus muscle:

- has an attachment to the ulna and not the radius

- can flex the distal, middle and proximal phalanges of the hand

if the ulnar nerve is cut at the elbow...

flexion at the metacarpophalangeal joints of the ring and little finger is lost if their interphalarlgeal joints are kept extended

If the median nerve is cut at the wrist...

the movement of opposition of the thumb is usually lost

With regard to movements of the medial four digits

- movement of the index finger in a radial direction is due to the first dorsal interosseous muscle

- flexion at the metacarpophalangeal joints while there is extension at the interphalangeal joints is due to the lumbrical muscles

the palmar aponeurosis

- is attached to the skin of the palm by fibrous septa

- is attached distally to the fibrous flexor sheaths

- protects the underlying tendons

- receives tendon of palmaris longus

the ulnar nerve:

- supplies the adductor pollicis muscle

- lies medial to the hook of the hamate

- supplies all the interossei muscles

If the median nerve is cut at the level of the elbow joint:

- there's usually a loss of opposition of the thumb

- there is a loss of flexion at the interphalangeal joint of the thumb

if the radial nerve is cut in the axilla

- the hand cannot be extended at the wrist

- the fingers cannot be extended at the metacarpophalangeal joints

- the flexed forearm cannot be actively extended at the elbow

the median nerve:

- arises by two roots, one from the lateral cord and the other from the medial cord of the brachial plexus

- is commonly the motor nerve to the abductor pollicis brevis muscle

in the hand...

- the second dorsal interosseous muscle pulls the middle finger in a radial direction

- the deep palmar arch is formed mainly by the radial artery

the radius has the...

- has the pronator teres muscle attached to its lateral border

- has the tendon of the abductor pollicis longus muscle on the lateral side of its styloid process

The flexor digitorum superficialis ( sublimis ) muscle

- has attachments to the humerus, radius and ulna

- is supplied only by the median nerve

- is superficial to the ulnar artery in the upper part of the forearm

The ulnar nerve:

- is deep to the triceps muscle in part of its course

- is posterior to the medial epicondyle of the humerus

- arises from the medial cord of the brachial plexus

- is medial to the ulnar artery in the forearm

- contains fibres which supply the skin of the medial part of the front of the palm of the hand

the median nerve:

- is lateral to the axillary vein in the axilla

- gives a branch to the elbow joint

the ulna has the flexor digitorum profundus muscle attached to

its allterior surface

the ulna has the flexor digitorum superficialis (sublimis) muscle attached to

the medial side of its coronoid process

the ulna may have the ....... attached to it

flexor pollicis longus muscle

the ulna has the....... attached to its posterior surface

abductor pollicis longus muscle

the ulna has the ........ muscle attached to it

flexor carpi ulnaris muscle

The semimembranosus muscle:

- is a flexor of the leg at the knee

- forms the upper medial boundary of the popliteal fossa

- is innervated by the medial popliteal (tibial) part of the sciatic nerve

- forms the oblique popliteal ligament of the knee joint

The longitudinal plantar (tarsal) arch is supported and maintained by the:

- tibialis anterior muscle

- peroneus longus muscle

- tibialis posterior muscle

- calcaneonavicular ligament

The peroneus longus muscle is:

- is paralyzed if the sciatic nerve is cut

- is paralyzed if the sciatic nerve is cut

- is an important muscle in maintaining the transverse arch of the foot

the soleus muscle is:

- is active while walking upstairs

- is active while walking downstairs

- is a plantar flexor of the foot at the ankle joint