GROSS ANATOMY

SELF-EVALUATION EXAM - LOWER LIMB

By O.W. Henson, Jr., Ph.D.

University of North Carolina at Chapel Hill

Mark each of the following True (T) or False (F)

Pertaining to the bony processes of the coxal bone:

_____ 1. the greater part of the iliac crest provides an area for the origin of the gluteus maximus muscle.

_____ 2. the spine of the ischium is an attachment point for the sacrospinous ligament.

_____ 3. the tuberosity of the ischium is a point of origin for the hamstring muscles.

_____ 4. the anterior inferior iliac spine is one of the points of origin of the rectus femoris muscle.

The gluteus maximus muscle:

_____ 5. is innervated by the inferior gluteal nerve.

_____ 6. is attached partly into the iliotibial band.

_____ 7. is an important internal rotator of the thigh.

_____ 8. is an extensor of the thigh.

The greater sciatic foramen:

_____ 9. is largely bounded by the ilium, ischium, sacrum, and sacrospinous ligaments.

_____10. extends on the coxal bone from the posterior superior iliac spine to the ischial spine.

_____11. transmits the piriformis and coccygeus muscles.

_____12. transmits only those vessels and nerves destined for the buttock, posterior thigh, and leg.

The obturator externus differs from the obturator internus in that it:

_____ l3. takes its origin from the obturator membrane.

_____ 14. inserts into the trochanteric fossa.

_____ 15. is supplied by the obturator nerve.

_____ 16. is an external rotator of the thigh.

If the left inferior gluteal nerve were severed where it emerges from the pelvis, one would expect:

_____ 17. loss of cutaneous sensation over the inferior portion of the buttock.

_____ 18. weakness and clumsiness is standing up from a sitting position.

_____ l9. weakness in externally (laterally) rotating the thigh.

_____ 20. conspicuous tilting of the pelvis when walking.

Cutaneous nerves of the thigh include branches of the following nerves of the lumbar plexus:

_____ 2l. posterior femoral cutaneous nerve.

_____ 22. genitofemoral nerve.

_____ 23. lateral femoral cutaneous nerve.

_____ 24. femoral nerve.

The femoral triangle:

_____ 25. is bounded by the inguinal ligament, the sartorius muscle, and the adductor longus muscle.

_____ 26. contains the femoral nerve, artery, and vein.

_____ 27. has as its floor the iliopsoas, pectineus, and adductor magnus muscles.

_____ 28. may contain a femoral hernia.

In the case of a femoral hernia:

_____ 29. the hernial sac lies just lateral to the femoral vein.

_____ 30. the viscus enters via the femoral ring.

_____ 31. the saphenous hiatus may permit it to escape from behind the fascia lata.

_____ 32. the hernial sac passes posterior to the inguinal ligament.

Contents of the femoral sheath typically include:

_____ 33. femoral artery.
_____ 34. lymph nodes and vessels.
_____ 35. femoral vein.
_____ 36. femoral nerve.

Contributing to flexion of the thigh and usually innervated by the femoral nerve are the:

_____ 37. i1iopsoas.

_____ 38. sartorius.

_____ 39. adductor brevis.

_____ 40. pectineus.

All four heads of the quadriceps femoris:

_____ 4l. pass over only one joint.

_____ 42. serve to extend the leg.

_____ 43. are innervated by the femoral nerve.

_____ 44. are in close contact with the femur for most of their length.

The deep femoral artery usually:

_____ 45. gives rise to the medial femoral circumflex artery which is especially important because it supplies the head of the femur..

_____ 46. has a lateral femoral circumflex branch with supplies the greater trochanter of the femur.

_____ 47. is accompanied by the nerve to the vastus medialis.

_____ 48. gives rise to branches that supply the hamstring muscles.

Lateral (external) rotators of the thigh include the:

_____ 49. quadratus femoris, innervated by the sciatic n.

_____ 50. obturator internus, innervated by the obturator nerve.

_____ 51. iliopsoas, innervated by the femoral nerve and branches from the lumbar plexus.

_____ 52. gluteus maximus, innervated by the superior gluteal n.

Of the muscles listed below, those which do not contribute to lateral rotation of the thigh are the :

_____ 53. tensor fasciae latae.

_____ 54. sartorius.
_____ 55. gluteus maximus.
_____ 56. obturator internus.
_____ 57. obturator externus.

The femoral artery:

_____ 58. lies within the femoral canal.

_____ 59. lies within the subsartorial (adductor) canal.

_____ 60. passes through the adductor hiatus and becomes the popliteal artery.

_____ 61. is accompanied in part of its course by the saphenous nerve.

The adductor canal is bounded by the:

_____ 62. fascia deep to the sartorius.

_____ 63. adductor longus.
_____ 64. vastus lateralis.
_____ 65. vastus medialis.

The arteries usually supplying the neck and head of the femur include the:

_____ 66. inferior gluteal artery.
_____ 67. artery of the ligament of the head.
_____ 68. medial femoral circumflex artery.
_____ 69. lateral femoral circumflex artery.

Stabilization of the hip or sacroiliac joints is accomplished by:

_____ 70. iliofemoral ligaments which limit flexion.

_____ 7l. ischiofemoral ligaments which become taut in extension

_____ 72. iliolumbar ligaments which lock the auricular facets into those of the sacrum.

_____ 73. sacrospinous ligament which limits posterior rotation of the inferior portion of the sacrum.

Stability of the locked knee during standing is contributed to by:

_____ 74. the line of gravity being anterior to the axis of the knee joint.

_____ 75. tonic contraction of the quadriceps femoris.

_____ 76. tautness of almost all ligaments of the knee joint.

_____ 77. tonic contraction of the triceps surae.

The popliteal fossa:

_____ 78. is the space behind the knee, bounded laterally by the biceps femoris and the lateral head of the gastrocnemius and medially by the semimembranosus, semitendinosus and the medial head of the gastrocneumius muscles.

_____ 79. contains the common peroneal and tibial nerves.

_____ 80. contains the popliteal artery which gives rise to all of the arteries that usually supply the knee joint.

_____ 81. contains the popliteal vein, usually located superficial to both the popliteal artery and tibial n.

With regard to the knee joint:

_____ 82. the medial meniscus is more firmly fixed in placed than the lateral meniscus.

_____ 83. the plantaris muscle has a portion which attaches to the lateral meniscus.

_____ 84. the suprapatellar bursa is an extension of the infrapatellar bursa.

_____ 85. three bones articulate to form the knee joint.

Muscles in the anterior compartment of the leg:

_____ 86. are all supplied exclusively by the deep peroneal nerve.

_____ 87. are supplied by the anterior tibial artery

_____ 88. are all capable of dorsiflexing the foot.

_____ 89. include both invertors and evertors of the foot.

The tibia has:

_____ 90. a tuberosity on its anterior surface for the insertion of the quadriceps muscle by way of the ligamentum patellae.

_____ 91. an intercondylar area, the anterior portion of which provides an attachment point for the anterior cruciate ligament.

_____ 92. an articular surface for the patella.

_____ 93. a medial surface which is largely subcutaneous.

On the distal end of the tibia are grooves for the:

_____ 94. flexor hallucis longus.

_____ 95. flexor digitorum longus.

_____ 96. tibialis posterior.

_____ 97. tibialis anterior.

The interosseous membrane of the leg:

_____ 98. unites the tibia and fibula.

_____ 99. separates the gastrocnemius and soleus from all the other muscles of the leg.

____100. serves as one attachment for the tibialis posterior muscle.

____101. through an opening at the top, permits passage of the anterior tibial vessels.

The fibula:

____102. has a head which provides an attachment area for the tendon of the biceps femoris and the fibular collateral ligament.

____103. provides an attachment area for the peroneus longus, brevis, and tertius.

____104. participates in the formation of the knee joint.

____105. participates in the formation of the ankle joint.

Of the following muscles, those which cannot contribute to plantar flexion of the foot at the talocrural joint are the:

____ 106. tibialis posterior.

____ 107. peroneus brevis.

____ 108. peroneus longus.

____ 109. flexor digitorum brevis.

____ 110. flexor digitorum longus.

Nerves supplying the skin of the foot include the:

_____ 111. deep peroneal nerve.

_____ 112. sural nerve.

_____ 113. saphenous nerve.

_____ 114. superficial peroneal nerve.

The dorsalis pedis artery usually:

_____ 115. is a continuation of the anterior tibial artery on the dorsum of the foot.

_____ 116. gives rise to the arcuate artery which, in turn, sends branches to the medial and lateral sides of all of the toes.

_____ 117. gives rise to a deep plantar artery that, in turn, sends branches to all of the toes.

_____ 118. gives rise to branches that supply the ankle joint.

Structures passing through or deep to the flexor retinaculum at the ankle include the:

_____ 119. posterior tibial artery.

_____ 120. tibialis posterior.

_____ 121. flexor hallucis brevis.

_____ 122. flexor digitorum longus.

Passing beneath the inferior extensor retinaculum are tendons of the:

_____ 123. tibialis posterior.

_____ 124. extensor digitorum longus.

_____ 125. peroneus tertius.

_____ 126. peroneus brevis.

The medial cuneiform bone:

_____ 127.articulates posteriorly with the navicular, anteriorly with the first metatarsal, and laterally with the second metatarsal and intermediate cuneiform.

_____ 128.is the keystone of the medial longitudinal arch of the foot.

_____ 129.provides a portion of the insertion of both the tibialis anterior and tibialis posterior muscles.

Muscles taking origin from the dorsum of the foot are the:

_____ 130. extensor hallucis brevis.

_____ 131. peroneus tertius.

_____ 132. extensor digitorum brevis.

_____ 133. flexor hallucis brevis.

The following muscles of the foot are innervated by the lateral plantar nerve:

_____ 134. adductor hallucis.

_____ 135. abductor hallucis.

_____ 136. flexor digitorum brevis.

_____ 137. abductor digiti minimi.

_____ 138. all of the interossei.

_____ 139. some of the lumbricals.

The plantar calcaneonavicular ligament:

_____140. is also called the “spring” ligament.

_____141. is attached to the medial surface of the ankle bones.

_____142. aids in the support of the arch of the foot.

_____143. is in intimate contact with the tibia.

The plantar arterial arch has connections directly with the:

_____ 144. metatarsal arteries.

_____ 145. lateral plantar artery.

_____ 146. superficial branch of the medial plantar artery.

_____ 147. perforating branches to the dorsum of the foot.

If the femoral nerve were severed immediately below the inguinal ligament, one would expect:

_____ 148. inability to flex the thigh.

_____ 149. inability to extend the leg.

_____ 150. some loss of cutaneous sensibility over much of the mid-anterior thigh.

_____ 151. some loss of cutaneous sensibility over the medial side of the leg.

The femoral nerve:

_____ 152. reaches the thigh by passing under the inguinal ligament.

_____ 153. supplies the more anterior muscles of the thigh.

_____ 154. typically arises from spinal nerves L2, 3, and 4.

_____ 155. supplies nothing but skin below the knee.

The obturator nerve:

_____156. arises from the second, third, and fourth lumbar segments of the spinal cord.

_____157. emerges along the medial side of the psoas major, then passes along the medial surface of the obturator internus muscle to reach the obturator canal.

_____158. provides motor innervation to adductor muscles of the thigh.

_____159. usually provides cutaneous innervation to a portion of the medial side of the thigh.

_____160. enters the thigh through the obturator canal, accompanied by the obturator artery and vein.

_____161. supplies the obturator internus muscle.

_____162. sends a branch to the knee joint.

Severing the third lumbar nerve would affect fibers of the:

_____ 163. lateral cutaneous nerve of the thigh.

_____ 164. femoral nerve.

_____ 165. obturator nerve.

_____ 166. tibial nerve.

_____ 167. peroneal nerve.

_____ 168. superior gluteal nerve.

The innervation of blood vessels of the lower limb includes the:

_____ 169. preganglionic fibers from sacral nerves.

_____ 170. postganglionic fibers from the sacral sympathetic trunk.

_____ 171. preganglionic fibers in the hypogastric nerves.

_____ 172. postganglionic fibers in the femoral, obturator and sciatic nerves.

If the tibial nerve were severed high in the popliteal space, one would expect:

_____ 173. inability to flex the toes.

_____ 174. greatly weakened plantar flexion of the foot.

_____ 175. loss of cutaneous sensibility over almost all of the plantar skin.

_____ 176. diminution of sensibility over the lateral side of the foot.

If the common peroneal nerve were severed at its origin in the popliteal space you would predict:

_____ 177. loss of plantar flexion of the foot and toes.

_____ 178. inability to invert the foot.

_____ 179. sensory loss over the dorsum of the foot.

_____ 180. sensory loss over the medial side of the leg.

The superior gluteal nerve:

_____ 181. passes out of the pelvis just superior to the piriformis muscle.

_____ 182. is accompanied for much of its route by the superior gluteal artery.

_____ 183. ramifies between the gluteus maximus and gluteus medius.

_____ 184. usually contains fibers of the fourth and fifth lumbar and the first sacral nerve.

The deep peroneal nerve supplies the:

_____ 185. tibialis anterior.

_____ 186. peroneus brevis.

_____ 187. peroneus tertius.

_____ 188. extensor digitorum longus.

A lesion of the inferior gluteal nerve would be evident because the subject would:

_____ 189. drop the pelvis on the unsupported side on walking.

_____ 190. have great difficultly in forceful extension of the thigh as in standing up from a sitting position.

_____ 191. be unable to abduct the thigh.

_____ 192. carry the lower limb in a permanently flexed position.

Taking origin from the tibia and innervated by the tibial nerve are the:

_____ 193. flexor digitorum longus.

_____ 194. tibialis anterior.

_____ 195. gastrocnemius.

_____ 196. tibia1is posterior.

The calcaneus has:

_____ 197. an oblique groove for the tendon of the peroneus longus.

_____ 198. a palpable sustentaculum tali on its lateral surface.

_____ 199. a major weight-bearing surface.

_____ 200. a large tuberosity for the insertion of the triceps surae muscle.

The medial cuneiform bone has:

_____ 201. a lateral surface which receives the tendon of the peroneus longus.

_____ 202. a plantar surface which receives the tendon of the tibialis posterior.

_____ 203. a medial surface which receives the tendon of the tibialis anterior muscle.

_____ 204. an articular surface for the navicular.

SELF-EVALATION EXAM - LOWER LIMB

KEY

The following questions are True (T) :

2. 6l. 113. 163.
3. 62. 114. 164.
4. 63 115. 165.
5. 65. 117. 170.
6. 66. 118. 172.
8 67 119 173
9. 68. 120. 174

175.
14. 69. 122. 176.
15 71. 124. 179.
18. 72. 125. 181.
19. 73. 127. 182.
22. 74. 129. 184.
23. 76. 130. 185.
24. 78. 132. 187.
25. 79. 134. 188.
26. 82. 137. 190.
28. 85. 138. 193.
30. 86. 139. 196.
31. 87. 140. 197.
32. 88. 142. 199.
33 89 144 200

34. 90. 145. 201.
35. 91. 147. 202.
37. 93 149. 203.
38. 94 150. 204.
40. 95. 151.
42. 96. 152.

153.
43. 98. 154.
45. 100. 155.
46. 101. 156.
48. 102. 157.
51. 103. 158.
53 105. 159
59. 109. 160.
60. 111 162.
112.