In the middle of a collegiate rugby tournament a player gets tackled
just as he is kicking the ball. He has all of his weight planted on his
left leg when another player clips him on one side of his knee. He falls
to the ground and clutches his knee in pain. When the team physician examines
the knee he is able to elicit abnormal side to side movement of the femur
on the tibia and abnormal forward motion of the tibia on the femur (anterior
drawer sign).
- The forward motion is caused by damage to which of the following ligaments:
- A) Oblique popliteal ligament
- B) Patellar ligament
- C) Anterior cruciate ligament
- D) Posterior cruciate ligament
- When diagnosing damage to the knee joint, it is important to look at
the three structures most often damaged. These three structures, otherwise
known as the "unhappy triad" include the:
- A) Medial meniscus, anterior cruciate ligamnet, tibial collateral ligament
- B) Lateral meniscus, posterior cruciate ligament, fibular collateral
ligament
- C) Lateral meniscus, oblique popliteal ligament, fibular collateral
ligament
- D) Oblique popliteal ligament, patellar ligament, anterior cruciate
ligament
The knee joint is a hinge-joint involving the articulation of the femur,
tibia, and patella. Since the femur and the tibia join at an angle, the
joint is mechanically weak. However, many ligaments and tendons help strengthen
and stabilize it.
- The tendons that strengthen and stabilize the knee joint on the lateral
side consist of all of the following except:
- A) Biceps femoris
- B) Gastrocnemius
- C) Iliotibial tract
- D) Soleus
- The tendons supporting the medial side of the knee joint include the
three which form the pes anserinus. Which one of the following four tendons
is not part of the pes anserinus:
- A) Semitendinosus
- B) Sartorius
- C) Gracilis
- D) Semimembranosus
A fourth year medical student did an elective working with the camp
pediatrician at a rural camp in northern Maine. One day when a young boy
came down with a high fever the pediatrican gave the child an intramuscular
injection. In his haste the physician plunged the needle into the medial
aspect of the boy's right gluteus maximus.
A few hours later the medical student observed the boy walking to his
cabin. He noticed that in addition to appearing lethargic, the boy was walking
in a strange manner. He seemed to be lifting his right foot unusually high
and letting it hang down while he walked. After examining the boy the medical
student realized that the boy's unusual gait was a result of his inability
to dorsiflex and evert his right foot.
- The medical student remembered that the nerve that innervates the muscles wich are directly
responsible for dorsiflexion and eversion of the foot
is the:
- A) Tibial nerve
- B) Deep peroneal (fibular) nerve
- C) Sciatic
- D) Common peroneal
- The muscles responsible for dorsiflexion of the foot include the:
- A) Tibialis Posterior
- B) Tibialis Anterior
- C)Extensor Digitorum Longus
- D) Two of the above. Both the Tibialis Anterior an dthe Extensor Digitorum Longus dorsiflex the foot
- Remembering the pediatrician's earlier IM injection into the boy and
considering the symptoms, the third year student determined that the damage
from the injection must have occurred to which nerve in the gluteal region:
- A) Obturator
- B) Superior gluteal
- C) Common peroneal portion o fthe sciatic
- D) Inferior gluteal
- The name for this clinical condition is:
- A) Obturator syndrome
- B) Gluteus medius limp
- C) Positive Trendelenberg sign
- D) Foot drop
On his 50th birthday a sedentary father of three makes a personal resolution
to exercise more and to lead a healthier lifestyle. The next day, eager
to begin his new training regime he gets up early and begins a three mile
jog. Less than one mile into the run, however, his leg muscles cramp and
he is forced to stop. Humbly, he walks home wincing with the pain of every
step.
The next day at his yearly exam the man tells his physician of the
pain in his legs upon exercise. The physician commends him for his initiative
but warns him to start exercising at a slower pace. He examines the man's
legs and notes tenderness along their anterior aspect. He tells the man
that the pain he is experiencing is most likely caused by the swelling
of his muscles upon experiencing unusual exertion. The swelling causes
compression of the blood vessels and subsequent lack of oxygen to the muscles.
- The muscles most likely to lose oxygen and cause this man's symptoms
(Anterior Compartment Syndrome) include all of the following except:
- A) Tibialis anterior
- B) Extensor digitorum longus
- C) Extensor hallicus brevis
- D) Extensor hallicus longus
- The blood supply might be compromised in which of the following arteries
due to Anterior Compartment Syndrome:
- A) Anterior tibeal
- B) Posterior tibeal
- C) Dorsal pedis artery
- D) Two of the above. Both the ANterior tibeal and the Dorsalis pedis artery might be compromised
- In order to check and see if the nerve travelling in the anterior compartment
is damaged the physician checks for sensory loss in:
- A) The area between the first and second toes
- B) The area along the dorsum of the foot
- C) The area along the lateral aspect of the fifth toe
- D) The area between the fourth and fifth toes
A propane tank explodes during a medical school 4th of July barbeque and sends metal
shrapnel into one of the dinner guests. A large piece of metal embeds itself in the
student's left thigh. The student is conscious but appears to be in shock and is bleeding
profusely from his femoral artery.
- The femoral artery travels within the adductor canal (Hunter's Canal) to reach the popliteal
fossa. Which of the following muscles forms the anterior lateral boundary of the canal?
- A) Vastus lateralis
- B) Sartorius
- C) Vastus medialis
- D) Adductor magnus
- Which of the following travel within the adductor canal?
- A) Femoral Vein
- B) Profunda Femoris Artery
- C) Profunda Femoris Vein
- D) Two of the above
- The proximal part of the femoral artery is enclosed within the femoral sheath, along with the
femoral vein. The femoral canal contains lymph vessels, connective tissue
and fat. In relation to the vein and artery the femoral canal:
- A) Is lateral to the femoral vein and medial to the femoral artery
- B) Is medial to the femoral vein and lateral to the femoral artery
- C) Is lateral to both the femoral vein and the femoral artery
- D) Is medial to both the femoral artery and the femoral vein