Bones of the Lower Limb MCQs

The femoral head is the most proximal portion of the femur and is supported by the femoral neck. It articulates with the acetabulum of the pelvis. The femoral head is nearly spherical (two-thirds) but has a medial depression known as the fovea capitis femoris that serves as an attachment point for the ligamentum teres. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Lower Limb, Page number - 554

Perforating veins are anastamosing channels that shunt blood from the superficial veins to deep veins. These perforating veins have valves to ensure that blood only flows in the superficial to deep direction. If these valves fail, blood will back up in the superficial veins, causing valves to fail in the superficial veins, too. Then, the veins become varicose. Venae commitantes are special veins, usually paired, that accompany deep arteries in the limbs. They surround arteries in an irregular branching network that creates a vascular sheet around the arteries. The veins in the lower limb that are most likely to become varicose are the greater and lesser saphenous veins and their tributaries. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Lower Limb, Page number - 569

Flexor digitorum longus is the most medial muscle in the deep posterior compartment of the leg. This means that it takes origin from the middle half of the posterior surface of the tibia and is not attached to the fibula in any way. Biceps femoris inserts on the head of the fibula and the lateral condyle of the tibia. Extensor digitorum longus is a muscle on the lateral side of the anterior compartment of the leg. This means that it takes origin from the fibula, and would be affected by its removal. Flexor hallucis longus is the most lateral muscle in the posterior compartment, so it originates from the fibula, too. Finally, fibularis (peroneus) longus and brevis, the two muscles of the lateral compartment, both take origin from the fibula. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Lower Limb, Page number: 599

Ans. B i.e. Medial cuneiform Medial collateral ligament (deltoid ligament) attaches to the medial malleolus of the tibia and the navicular, talus, and calcaneus bones. This ligament prevents medial distraction (eversion) and excessive range of motion. It is subdivided into four parts: Tibionavicular part attaches the margin of the plantar calcaneonavicular ligament (spring ligament). Tibiocalcaneal part attaches to the sustentaculum tali of the calcaneus bone. Posterior tibiotalar part attaches to the medial side and medial tubercle of the talus. Anterior tibiotalar part attaches to the medial surface of the talus.

Answer- A. Multiple screw fixation Placement of multiple screws across the fractured femoral neck is the treatment of choice for femoral neck fractures, and may be performed following either closed or open reduction using a standard lateral approach or a more limited percutaneous technique. 1235. Talus is supplied by a) Anterior tibial artery b) Posterior tibial artery c) Dorsal pedis artery d) All Correct Answer - D Answer- D. All Extraosseous blood supply

Ans. C i.e. Femoral head Osteochondritis Perthes disease: - Osteochondritis of femoral head - Adduction is unaffected - IOC for Perthes disease: MRI Osteochondritis of lunate: Kienbock's disease Osteochondritis of tibial tubercle: OschGood's Schlatter's disease Osteochondritis of calcaneum: Sever's disease

The given clinical scenario and the renal angle tenderness are suggestive of acute pyelonephritis. The renal angle is formed by the lower border of the 12th rib and the lateral border of the erector spinae. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Abdomen, Page number - 135

Pes cavus is a foot condition characterised by an unusually high medial longitudinal arch. It can appear in early life and become symptomatic with increasing age. Due to the higher arch, the ability to shock absorb during walking is diminished and an increased degree of stress is placed on the ball and heel of the foot. Consequently, symptoms will generally include pain in the foot, which can radiate to the ankle, leg, thigh and hip. This pain is transmitted up the lower limb from the foot due to the unusually high stress placed on the hindfoot during the heel strike of the gait cycle. Causes of pes cavus can be idiopathic, hereditary, due to an underlying congenital foot problem such as club foot, or secondary to neuromuscular damage such as in poliomyelitis. Reference: Textbook of Gray's Anatomy for students, 3rd Edition, Lower Limb, Page number - 667