LOWER LIMBS STUDY CASES

Question 1

A 27-year-old patient exhibits a loss of skin
sensation and paralysis of muscles on the plantar
aspect of the medial side of the foot. Which
of the following nerves is most likely damaged?

Answer 1

Tibial

Question 2

A patient with a deep knife wound in the
buttock walks with a waddling gait that is characterized
by the pelvis falling toward one side
at each step. Which of the following nerves is
damaged?

Answer 2

Superior Gluteal nerve

Question 3

A patient is unable to prevent anterior displacement
of the femur on the tibia when the
knee is flexed. Which of the following ligaments
is most likely damaged?

Answer 3

Posterior cruiciate

Question 4

A 41-year-old man was involved in a fight and
felt weakness in extending the knee joint. On examination,
he was diagnosed with a lesion of the
femoral nerve. Which of the following symptoms
would be a result of this nerve damage?

Answer 4

Paralysis on VASTUS LATERALIS MUSCLE

Question 5

A 47-year-old woman is unable to invert
her foot after she stumbled on her driveway.
Which of the following nerves are most likely
injured?

Answer 5

DEEP Peroneal & tibia

Question 6

A 22-year-old patient is unable to “unlock”
the knee joint to permit flexion of the leg.
Which of the following muscles is most likely
damaged?

Answer 6

Popliteus

Question 7

A patient presents with sensory loss on adjacent
sides of the great and second toes and
impaired dorsiflexion of the foot. These signs
probably indicate damage to which of the
following nerves?

Answer 7

DEEP Peroneal

Question 8

A motorcyclist falls from his bike in an accident
and gets a deep gash that severs the superficial
peroneal nerve near its origin. Which of
the following muscles is paralyzed?

Answer 8

Peroneus longus

Question 9

A 67-year-old patient has been given a
course of antibiotics by gluteal intramuscular
injections after a major abdominal surgery.
To avoid damaging the sciatic nerve during an
injection, the needle should be inserted into
which of the following areas?

Answer 9

Upper lateral quadrant of the gluteal region.

Question 10

A 20-year-old patient cannot flex and medially
rotate the thigh while running and climbing.
Which of the following muscles is most
likely damaged?

Answer 10

Tensor fasciae latae

Question 11

A 21-year-old man was involved in a motorcycle
accident, resulting in destruction of the
groove in the lower surface of the cuboid bone.
Which of the following muscle tendons is most
likely damaged?

Answer 11

Flexor hallucis longus

Question 12

A construction worker falls feet first from a
roof. He sustains a fracture of the groove on the
undersurface of the sustentaculum tali of the
calcaneus bone. Which of the following muscle
tendons is most likely torn?

Answer 12

Flexor hallucis brevis.

Question 13

A thoracic surgeon is going to collect a portion
of the greater saphenous vein for coronary
bypass surgery. He has observed that this vein
runs

Answer 13

Superficial to the fascia lata of the thigh

Question 14

A 52-year-old woman slipped and fell
and now complains of being unable to extend
her leg at the knee joint. Which of the following
muscles was paralyzed as a result of this
accident?

Answer 14

Quadricep femoris

Question 15

A patient experiences weakness in dorsiflexing
and inverting the foot. Which of the following
muscles is damaged?

Answer 15

Tibialis anterior

Question 16

Questions 16 to 20: A 62-year-old woman slips
and falls on the bathroom floor. As a result, she
has a posterior dislocation of the hip joint and a
fracture of the neck of the femur.

Answer 16

OHK

Question 17

16. Rupture of the ligamentum teres capitis
    femoris may lead to damage to a branch of
    which of the following arteries?

Answer 17

Obturator

Question 18

17. Fracture of the neck of the femur results in
    avascular necrosis of the femoral head, probably
    resulting from lack of blood supply from
    which of the following arteries?

Answer 18

Mdial femoral circumflex

Question 19

18.If the acetabulum is fractured at its posterosuperior
margin by dislocation of the hip
joint, which of the following bones could be
involved?

Answer 19

ILIUM

Question 20

19. The woman experiences weakness when
    abducting and medially rotating the thigh after
    this accident. Which of the following muscles is
    most likely damaged?

Answer 20

Gluteus minimus

Question 21

20. The woman undergoes hip surgery. If all of
    the arteries that are part of the cruciate anastomosis
    of the upper thigh are ligated, which of
    the following arteries maintains blood flow?

Answer 21

Superior Gluteal

Question 22

A 34-year-old woman sustains a deep cut
on the dorsum of the foot just distal to her ankle
joint by a falling kitchen knife. A physician in
the emergency department has ligated the dorsalis
pedis artery proximal to the injured area.
Which of the following conditions most likely
occurs as a result of the injury?

Answer 22

Reduction of blood flow in the medial tarsal artery.

Question 23

A patient experiences paralysis of the
muscle that originates from the femur and contributes
directly to the stability of the knee joint.
Which of the following muscles is involved?

Answer 23

Vastus lateralis

Question 24

A patient is involved in a motorcycle wreck
that results in avulsion of the skin over the anterolateral
leg and ankle. Which of the following
structures is most likely destroyed with this type
of injury?

Answer 24

Superficial peroneal nerve

Question 25

A knife wound penetrates the superficial vein that terminates in the popliteal vein. Bleeding occurs from which of the following vessels?

Answer 25

LESSER saphenous vein

Question 26

A 10-year-old boy falls from a tree house. The resultant heavy compression of the sole of his foot against the ground caused a fracture of the head of the talus. Which of the following structures is unable to function normally?

Answer 26

MEDIAL longitudinal arch

Question 27

A 24-year-old woman complains of weakness when she extends her thigh and rotates it laterally. Which of the following muscles is paralyzed?

Answer 27

Gluteus Maximus

Question 28

A patient with hereditary blood clotting problems presents with pain in the back of her knee. An arteriograph reveals a blood clot in the popliteal artery at its proximal end. Which of the following arteries will allow blood to reach the foot?

Answer 28

Lateral circumflex femoral

Question 29

A 72-year-old woman complains of a cramplike pain in her thigh and leg. She was diagnosed as having a severe intermittent claudication. Following surgery, an infection was found in the adductor canal, damaging the enclosed structures. Which of the following structures remains intact

Answer 29

Great saphenous vein

Question 30

A basketball player was hit in the thigh by an opponent’s knee. Which of the following arteries is likely to compress and cause ischemia because of the bruise and damage to the extensor muscles of the leg?

Answer 30

Anterior tibia

Question 31

An elderly woman fell at home and fractured the greater trochanter of her femur. Which of the following muscles would continue to function normally?

Answer 31

Gluteus Maximus.

Question 32

Questions 31 to 35: A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula.

Answer 32

OHK

Question 33

31.Which of the following nerves is damaged?

Answer 33

Common peroneal

Question 34

32. After injury to this nerve, which of the following | muscles could be paralyzed?

Answer 34

Extensor hallucis longus

Question 35

33. If the lateral (fibular) collateral ligament is torn by this fracture, which of the following conditions may occur?

Answer 35

Abnormal passive adduction of the extended leg

Question 36

34. Which of the following arteries could also | be damaged by this fracture?

Answer 36

Anterior Tibial

Question 37

35. Which of the following conditions would | occur from this fracture?

Answer 37

Anterior tibial compartments syndrome

Question 38

36. A construction worker is hit on the leg with a concrete block and is subsequently unable to plantar flex and invert his foot. Which of the following muscles is most likely damaged?

Answer 38

Tibialis posterior

Question 39

37. The obturator nerve and the sciatic (tibial portion) nerve of a 15-year-old boy are transected as a result of a motorcycle accident. This injury would result in complete paralysis of which of the following muscles?

Answer 39

ADDuctor magnus

Question 40

38. A 24-year-old woman presents to her physician with weakness in flexing the hip joint and extending the knee joint. Which muscle is most likely involved in this scenario?

Answer 40

Rectus Femoris

Question 41

39. A 17-year-old boy was stabbed during a gang fight, resulting in the transection of the obturator nerve. Which of the following muscles is completely paralyzed?

Answer 41

ADDUctor longus

Question 42

40. A 32-year-old carpenter fell from the roof. The lateral longitudinal arch of his foot was flattened from fracture and displacement of the keystone for the arch. Which of the following bones is damaged?

Answer 42

Cuboid bone

Question 43

While playing football, a 19-year-old college student receives a twisting injury to his knee when being tackled from the lateral side. Which of the following conditions most likely has occurred?

Answer 43

Ruptured fibular collateral ligament

Question 44

A patient has weakness when flexing both her thigh and leg. Which of the following muscles is most likely injured?

Answer 44

Sartorius

Question 45

A 35-year-old man has difficulty in dorsiflexing the foot. Which of the following muscles is most likely damaged?

Answer 45

Tibialis anterior

Question 46

An injury to the leg of a golfer results in loss of the ability to invert the foot. Which of the following muscles is most likely paralyzed?

Answer 46

Tibialis posterior

Question 47

An orthopedic surgeon ligates the posterior tibial artery at its origin. Which of the following arteries has no blood flow immediately after the ligation?

Answer 47

Peroneal

Question 48

Before knee surgery, a surgeon ligates arteries participating in the anastomosis around the knee joint. Which of the following arteries is most likely spared?

Answer 48

Saphenous branch of the descending genicular

Question 49

A 25-year-old gladiator sustains a penetrating injury that severs the superficial peroneal nerve. This will most likely cause paralysis of which of the following muscles?

Answer 49

Peroneus brevis

Question 50

A patient presents with a thrombosis in the popliteal vein. This thrombosis most likely causes reduction of blood flow in which of the following veins?

Answer 50

Femoral

Question 51

A 21-year-old tennis player comes to an emergency room and complains of pain in the knee joint. On examination, he has an infection inside the knee joint capsule but outside the synovial cavity. Which of the following structures is preserved from this infection?

Answer 51

Lateral collateral ligament

Question 52

A 14-year-old gymnastic silver medalist falls from the parallel bar and complains of pains from the knee and ankle joints. On physical examination, her physician found that the muscle responsible for flexing the leg at the knee joint and plantar flexing the foot is severely weakened. Which of the following muscles involved in both movements was most likely damaged in this accident?

Answer 52

Grastrocnemius

Question 53

28-year-old basketball player falls while rebounding and is unable to run and jump. On physical examination, he has pain and weakness when extending his thigh and flexing his leg. Which muscle involved in both movements is most likely injured?

Answer 53

Semitendinosus

Question 54

52-year-old woman comes to an orthopedic surgeon complaining of an uncomfortable feeling in her knee and ankle joints. After a thorough examination, she is diagnosed as having arthritis with mild discomfort with passive movements. The muscles acting at the ankle joint appear normal with good strength. Which muscle can both dorsiflex and invert her foot?

Answer 54

Extensor hallucis longus