Gross Anatomy Questions That Should be Answerable After November 13, 2015
1. Name the ligament(s) that help prevent the following:
(a) upward displacement of the caudal sacrum during standing
(b) the tibia from sliding anteriorly on the femoral condyles
(c) abduction (excessive eversion) of the ankle
(d) adduction of the knee
(e) axial rotation at the knee
(f) flat foot
2. Describe with reference to anatomy, the basis for anterior tibial compartment syndrome.
What muscles are located in the anterior tibial compartment?
What nerve and artery in located in the anterior tibial compartment?
3. For each of the muscles listed below, name the nerve that supplies its motor innervation (name specific branch if
appropriate):
c) peroneus brevis ___________________________
4. What muscles are located in the anterior tibial compartment?
What nerve(s) supplies(y) these muscles?
What sensory test could you perform to determine whether this(ese) nerve(s) has(ve) been damaged?
What motor test could you perform to determine whether this(ese) nerve(s) has(ve) been damaged?
What artery supplies the anterior tibial compartment?
Where would you feel for a pulse to determine whether blood was flowing through this artery?
5. Where would you feel for a pulse in the dorsalis pedis artery?
The dorsalis pedis artery is most commonly a branch of what other artery?
6. What role does the triceps surae play during walking?
How might a person’s gait change if it was paralyzed?
7. While walking across campus, you notice a man walking in an unusual way. He appears to allow his right knee to
extend completely at heel-strike, then leans forward slightly during the first half of right limb support phase. What is
the most likely explanation for his unusual gait?
Explain your answer:
8. What role do the muscles of the anterior tibial compartment play in normal gait?
If a person had suffered damage to the nerve that innervates them, how might he or she alter their gait?
9. A Trendelenburg sign is an indication of damage to what nerve?
Describe the two main components of a Trendelenburg gait and briefly explain why they occur.
10. Label the t1-weighted MRI shown below.
(be specific)
11. Following recovery from an anterior dislocation of his left hip, a man is only able to go up and down stairs one step
(i.e, tread) at the time. When going up he leads with his right lower limb, but going down he leads with this left.
What nerve(s) and muscle(s) have been damaged?
What, if any, alternation of normal gait might this individual display?
12. A woman suffered a pelvic fracture in an automobile accident. In a follow-up exam she displayed a positive
Trendelenburg sign when standing on her right limb.
(a) Describe the appearance of this sign
(b) What has been damaged?
13. A “hip” fracture most commonly involves an injury at what specific site?
Explain in anatomical terms why it is often necessary to perform hip replacement surgery after an initial attempt at
internal fixation.
14. The following are descriptions of gait disorders. In each case, name the nerve that is most likely to be damaged and
the muscle(s) whose paralysis is causing the symptoms. Explain why the patient is displaying his or her unusual
gait.
(a) During walking, the patient allows his right knee to extend completely at heel-strike, then he leans forward ever
so slightly during the first half of right limb support phase.
Nerve and muscle(s):
Explanation:
(b) During walking, the patient takes short steps with her left limb, ending stance phase before the limb extends past
vertical.
Nerve and muscle(s):
Explanation:
(c) During walking, the patient’s right thigh and knee seem to flex more than usual during swing phase, and swing
phase ends with right forefoot touching the ground before the heel.
Nerve and muscle(s):
Explanation:
15, Explain with particular reference to anatomy why fractures of the neck of the femur are associated with a significant
incidence of death of the femoral head.
16. Label this oblique axial t1-weighted MRI section near the ankle. The plane of the section is shown
in the small image.
17. A young man makes a New Year's resolution to exercise more, and on the first day goes for a two mile run. The next
day he experiences discomfort over the anterolateral side of his left lower leg. Nonetheless, he pushes himself to run
more every day trying to ignore the pain, but eventually he is forced to quit. Now he and his friends notice that he
walks "funny", and his mother wonders why he wears down the heels of his right shoes but not the left.
What condition has he likely developed?
What do the muscles named above contribute to normal walking?
Describe what is "funny" about the way he walks.
18. Not wearing her seatbelt because it will wrinkle her dress, a woman is ejected from her car when it is struck by
another at an intersection. She suffers serious injuries including a fracture across her left ilium. After the fracture has
healed, she has a peculiar gait in which every time she steps on her left foot her trunk “lurches to the left” and her
right hip “drops”.
What nerve(s) and muscle(s) have been damaged?
Explain why she is experiencing her symptoms.
19. M. C. takes the advice of someone she respects and decides to study anatomy while sitting on the toilet rather than
going to lecture. However, she notices that after each bout of studying, she feels paresthesias (pins and needles) in
her left foot, and she walks as if she has no control over many the muscles of her left lower limb. Explain why she’d
be better off going to lecture.
20. For each of the muscles listed below, name the nerve that supplies its motor innervation (name specific branch if
appropriate):
a) flexor digiti quinti brevis ____________________________
b) abductor hallucis ________________________
21. The following structures are found in the plantar region of the foot. Place an “X” beside those structures that are
important in maintaining the arch of the foot during quiet standing.
_____ long plantar ligament
_____ flexor hallucis brevis
_____ quadratus plantae
_____ spring ligament
_____ flexor digitorum brevis
_____ short plantar ligament
_____ plantar aponeurosis
_____ tendon of peroneus longus
_____ pedal lumbricals
_____ plantar interossei
22. Ligaments at joints typically limit and/or prevent certain motions. For each of the ligaments listed, name one motion
that it limits.
a) iliofemoral ligament
c) lateral collateral ligament (at knee)
b) sacrotuberous ligament
d) deltoid ligament
23. Wanting to show off his new sports car, a man picks up his brother to take him for a ride. Neither bothers to wear a
seat belt. They are involved in a head-on collision in which the brother’s left lower leg is shoved against the dash
board. What soft tissue structure(s) at this knee is(are) likely to have been injured?
Describe a test that his physician could perform do determine if such an injury had occurred:
24. What role do the gluteus medius and gluteus minimus play during human walking?
Describe the gait of a person who has suffered damage to the above named nerve on the left side.
25. What nerve innervates the triceps surae (gastrocnemius and soleus)?
When are these muscles active during a step cycle of walking, and what role are they playing?
How might a patient who had suffered paralysis to the triceps surae compensate for their loss during walking?
26. In order to remove a pelvic tumor the surgeon finds it necessary to retract the patient’s right psoas major for a
prolonged period of time. Following the surgery, the patient reports numbness over the front of his right thigh.
What is the likely cause of this numbness?
After recovering from the surgery the numbness persists and the patient initially has some difficulty walking and can
only take one step at a time on a stairway. Paralysis of what muscle(s) account(s) for these difficulties?
After a few weeks the patient finds it is no longer difficult to walk, although he still has to take one step at a time on a
stairway. Will there be anything unusual about this individual’s gait?
If so, describe his gait. If not, leave blank.
27. A high school quarterback is injured when he is surprised by a tackle around his knees that forces his left lower leg
into abduction. What two soft tissue structure at this knee are the most likely to have been injured?
28. Standard treatment of a femoral neck fracture in a young person is by screws and/or plates. Explain with reference to
anatomy why this often fails and it becomes necessary to perform a hip replacement.
29. Match the following list of ligaments with the motions that they are designed to help limit or restrict (there may be
more than one correct answer, and answers can be used more than once):
_____ plantar aponeurosis
_____ long plantar ligament
_____ anterior cruciate ligament
_____ lateral collateral ligament of the knee
_____ iliofemoral ligament
_____ deltoid ligament
_____ plantar calcaneonavicular (spring)
ligament
A. adduction of the lower leg at the knee
B. rotation of the lower leg at the knee
C. hyperextension of the lower leg at the knee
D. hyperflexion of the lower leg at the knee
E. adduction of the foot at the ankle
F. abduction of the foot at the ankle
G. hyperflexion of the thigh at the hip
H. hyperextension of the thigh at the hip
I. fallen arches
J. hyperflexion of the lateral four toes at their MTP joints
30. Is this CT scan of a right or a left knee?
How can you tell?
Explain with reference to human lower limb anatomy why the asymmetry
you identified above exists:
31. Presented below is a series of eight axial T1 MR images of the pelvis and thigh. Every unit increase in the image
number represents a 7 mm inferior shift of the section. Identify the structures (A - W) to which lines are drawn.