Lower Limb Anatomy MCQ Compilation – 180 MCQs | Kenya MBChB

180 Year 1: Anatomy exam questions on Lower Limb Anatomy MCQ Compilation for medical students. Includes MCQs, answers, explanations and written questions. Sampl

This MCQ set contains 180 questions on Lower Limb Anatomy MCQ Compilation in the Year 1: Anatomy unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: Tensor fasciae latae is supplied by:

  1. A. Anterior division of femoral nerve
  2. B. Superior gluteal nerve
  3. C. Nerve to vastus lateralis
  4. D. Inferior gluteal nerve
  5. E. Lateral femoral cutaneous nerve

Correct answer: B – Superior gluteal nerve

Tensor fasciae latae is innervated by the superior gluteal nerve (L4, L5, S1). This nerve emerges from the pelvis through the greater sciatic foramen above the piriformis muscle and supplies tensor fasciae latae, gluteus medius, and gluteus minimus.

Q2: Which structure is intrasynovial at the knee joint:

  1. A. Oblique popliteal ligament
  2. B. Tendon of popliteus
  3. C. Medial and lateral menisci
  4. D. Anterior cruciate ligament
  5. E. None of the above

Correct answer: E – None of the above

While the cruciate ligaments and tendon of popliteus are intracapsular (inside the fibrous capsule), they are actually extrasynovial as they are covered by synovial membrane. The menisci are also intracapsular but not truly intrasynovial.

Q3: The 'screw-home' movement in extension of the knee joint begins with tightening of the:

  1. A. Anterior cruciate ligament
  2. B. Oblique popliteal ligament
  3. C. Medial collateral ligament
  4. D. Lateral collateral ligament
  5. E. Posterior cruciate ligament

Correct answer: A – Anterior cruciate ligament

The screw-home mechanism involves automatic lateral rotation of the tibia on the femur during the last 20-30 degrees of extension. This is initiated by tightening of the anterior cruciate ligament, which causes the tibia to rotate laterally to achieve full extension and "lock" the knee.

Q4: Tibialis anterior:

  1. A. Is supplied by the tibial nerve
  2. B. Inserts into the second metatarsal bone
  3. C. Is pierced by the posterior tibial artery
  4. D. Tendon perforates the superior extensor retinaculum
  5. E. Does not arise from the interosseous membrane

Correct answer: D – Tendon perforates the superior extensor retinaculum

The tendon of tibialis anterior passes through the superior extensor retinaculum at the ankle. It is supplied by the deep peroneal nerve (not tibial), inserts into the medial cuneiform and base of the first metatarsal, and arises from the lateral tibia and interosseous membrane.

Q5: The adductor canal:

  1. A. Contains the femoral artery and nerve
  2. B. Ends distally in the adductor longus hiatus
  3. C. Contains no muscular nerves
  4. D. Has adductor longus forming the root
  5. E. Always has the femoral artery lying between the saphenous nerve and the femoral vein

Correct answer: E – Always has the femoral artery lying between the saphenous nerve and the femoral vein

In the adductor canal (Hunter's canal), the femoral artery is positioned between the saphenous nerve (laterally) and the femoral vein (medially/posteriorly). The canal contains the femoral vessels, saphenous nerve, and nerve to vastus medialis, and ends at the adductor hiatus in adductor magnus.

Q6: The great saphenous vein:

  1. A. Joins the femoral vein above the inguinal ligament
  2. B. Begins as the upward continuation of the lateral marginal vein of the foot
  3. C. Travels with the saphenous nerve along its course
  4. D. Runs behind the medial malleolus
  5. E. Enters the femoral vein on its anteromedial side

Correct answer: E – Enters the femoral vein on its anteromedial side

The great saphenous vein pierces the cribriform fascia and enters the femoral vein on its anteromedial aspect below the inguinal ligament. It begins from the medial end of the dorsal venous arch, passes anterior (not posterior) to the medial malleolus, and is only accompanied by the saphenous nerve in the lower leg.

Q7: Regarding the femoral artery:

  1. A. Adductor magnus lies between it and the profunda femoris artery
  2. B. The profunda femoris vein lies behind the profunda femoris artery
  3. C. Profunda femoris artery arises from its posterior surface
  4. D. The lateral circumflex femoral artery separates the superficial and deep branches of the femoral nerve
  5. E. The femoral vein is always on its medial side

Correct answer: D – The lateral circumflex femoral artery separates the superficial and deep branches of the femoral nerve

The lateral circumflex femoral artery, a branch of the profunda femoris, passes laterally between the divisions of the femoral nerve, separating the superficial and deep branches. The profunda femoris arises from the posterolateral aspect of the femoral artery.

Q8: Gluteus maximus:

  1. A. Forms the gluteal fold
  2. B. Has four bursae beneath it
  3. C. Has blood supply solely from the inferior gluteal artery
  4. D. Is the chief control of hip flexion
  5. E. Has 50% of fibres inserting into the gluteal tuberosity

Correct answer: D – Is the chief control of hip flexion

Gluteus maximus is the chief EXTENSOR (not flexor) of the hip, particularly important when rising from sitting, climbing stairs, and running. It receives blood from both superior and inferior gluteal arteries, and the majority of its fibers insert into the iliotibial tract rather than the gluteal tuberosity.

Q9: Regarding the adductor compartment:

  1. A. Adductor magnus lies between the anterior and posterior divisions of the obturator nerve
  2. B. Adductor longus inserts into the upper two thirds of the linea aspera of the femur
  3. C. The hamstring part of adductor magnus is supplied by the tibial part of the sciatic nerve
  4. D. The medial intermuscular septum separates the adductor compartment from the posterior compartment
  5. E. Obturator externus medially rotates the hip

Correct answer: C – The hamstring part of adductor magnus is supplied by the tibial part of the sciatic nerve

Adductor magnus is a composite muscle. The adductor portion is supplied by the obturator nerve, while the hamstring (ischiocondylar) portion is supplied by the tibial division of the sciatic nerve. This dual innervation reflects its dual embryological origin.

Q10: Which vessel is NOT involved in the trochanteric anastomosis?

  1. A. Superior gluteal artery
  2. B. Obturator artery
  3. C. Lateral circumflex femoral artery
  4. D. Medial circumflex femoral artery
  5. E. Inferior gluteal artery

Correct answer: B – Obturator artery

The trochanteric anastomosis around the greater trochanter involves branches from the superior and inferior gluteal arteries, medial and lateral circumflex femoral arteries, but NOT the obturator artery. This anastomosis provides collateral circulation to the hip region.

Q11: The sciatic nerve:

  1. A. Lies deep to the posterior femoral cutaneous nerve
  2. B. Passes down over obturator internus, quadratus femoris and piriformis
  3. C. Tibial and common peroneal components separate behind the hip joint
  4. D. In the buttock it lies midway between the greater trochanter and pubic tuberosity
  5. E. Is derived from L3, 4, 5, S1, 2

Correct answer: A – Lies deep to the posterior femoral cutaneous nerve

The sciatic nerve lies deep (anterior) to the posterior femoral cutaneous nerve in the gluteal region. It emerges below (not over) piriformis, is derived from L4, L5, S1, S2, S3, and typically divides into tibial and common peroneal components in the lower thigh.

Q12: Which is the odd one out?

  1. A. Sciatic nerve
  2. B. Nerve to obturator internus
  3. C. Superior gluteal nerve
  4. D. Pudendal nerve
  5. E. Posterior femoral cutaneous nerve

Correct answer: C – Superior gluteal nerve

The superior gluteal nerve is the only structure that emerges ABOVE piriformis through the greater sciatic foramen. All the other structures (sciatic nerve, nerve to obturator internus, pudendal nerve, and posterior femoral cutaneous nerve) emerge BELOW piriformis.

Q13: Regarding the hamstring compartment:

  1. A. The cutaneous nerve supply is from the posterior circumflex femoral nerve
  2. B. Ischial fibres of adductor magnus degenerate to form the tibial collateral ligament
  3. C. Semitendinosus lies deep to semimembranosus
  4. D. The oblique popliteal ligament is an expansion of biceps femoris
  5. E. The long head of biceps arises from the lateral facet of the ischial tuberosity

Correct answer: B – Ischial fibres of adductor magnus degenerate to form the tibial collateral ligament

The hamstring part of adductor magnus has some fibers that insert as a tendon onto the adductor tubercle, and phylogenetically these fibers are related to the medial (tibial) collateral ligament. The oblique popliteal ligament is an expansion of semimembranosus, not biceps femoris.

Q14: Regarding the popliteal vessels:

  1. A. The tibial nerve lies between the popliteal artery and vein
  2. B. The sural arteries supply soleus
  3. C. The middle genicular artery supplies the cruciate ligaments
  4. D. Lymph nodes lie alongside the popliteal artery
  5. E. The popliteal artery enters the fossa on the lateral side of the femur

Correct answer: C – The middle genicular artery supplies the cruciate ligaments

The middle genicular artery is a small branch that pierces the posterior capsule of the knee joint to supply the cruciate ligaments and synovial membrane. The popliteal vein lies between the artery and tibial nerve (artery is deepest), and the popliteal artery enters on the medial side.

Q15: At the knee joint:

  1. A. The fibular collateral ligament is attached to the lateral meniscus and joint capsule
  2. B. There are three main gaps in the joint capsule
  3. C. The tibial collateral ligament is tight in flexion
  4. D. The posterior cruciate ligament is attached to the lateral condyle of the femur
  5. E. The cruciate ligaments are sensitive and the menisci are not

Correct answer: E – The cruciate ligaments are sensitive and the menisci are not

The cruciate ligaments are richly innervated and sensitive to pain and proprioception. The menisci have nerve supply only at their peripheral attachments, with the central portions being relatively avascular and aneural. The fibular collateral ligament is NOT attached to the lateral meniscus.

Q16: Regarding nerve supply of the lower limb:

  1. A. Superficial peroneal nerve supplies the muscles in the anterior compartment of the leg
  2. B. The cruciate ligaments are supplied by the tibial nerve
  3. C. The obturator nerve supplies obturator internus muscle
  4. D. The sciatic nerve does not make contact with bone
  5. E. The tibial part of the sciatic nerve is the sole supply to muscles in the hamstring compartment

Correct answer: B – The cruciate ligaments are supplied by the tibial nerve

The cruciate ligaments receive innervation from branches of the tibial nerve (part of the articular branch supply to the knee joint). The anterior compartment is supplied by the deep peroneal nerve, and obturator internus is supplied by the nerve to obturator internus (not the obturator nerve).

Q17: Regarding flexor digitorum longus:

  1. A. Its four tendons divide under the flexor retinaculum
  2. B. It arises from the tibia and interosseous membrane only
  3. C. The medial two tendons receive a strong slip from the tendon of flexor hallucis longus
  4. D. The tendons have no flexor sheaths
  5. E. It inserts into the bases of the middle phalanges

Correct answer: C – The medial two tendons receive a strong slip from the tendon of flexor hallucis longus

In the sole of the foot, the tendon of flexor hallucis longus sends a strong slip to join the medial two tendons of flexor digitorum longus. The four tendons divide in the sole (not under the retinaculum), and they insert into the bases of the distal (not middle) phalanges.

Q18: The following are branches of the femoral artery except:

  1. A. Superficial circumflex iliac artery
  2. B. Superficial epigastric artery
  3. C. Superficial external pudendal artery
  4. D. Deep external pudendal artery
  5. E. Middle genicular artery

Correct answer: E – Middle genicular artery

The middle genicular artery is a branch of the popliteal artery (not the femoral artery). It pierces the posterior capsule of the knee to supply the cruciate ligaments. The superficial branches and deep external pudendal artery are all direct branches of the femoral artery.

Q19: The following cutaneous nerves of the thigh are derived in part from the second lumbar nerve except:

  1. A. Ilioinguinal
  2. B. Medial femoral cutaneous nerve
  3. C. Obturator nerve
  4. D. Lateral femoral cutaneous nerve
  5. E. Genitofemoral nerve

Correct answer: A – Ilioinguinal

The ilioinguinal nerve arises from L1 only. The medial femoral cutaneous (L2-L3), obturator (L2-L4), lateral femoral cutaneous (L2-L3), and genitofemoral (L1-L2) nerves all have contributions from L2.

Q20: Which of the following, regarding the great saphenous vein, is INCORRECT?

  1. A. It is the longest vein in the body
  2. B. It passes behind the medial malleolus
  3. C. At the knee, it lies a hand's breadth behind the medial border of the patella
  4. D. The saphenous opening lies about 3cm below and lateral to the pubic tubercle
  5. E. The deep external pudendal artery runs medially behind the saphenous vein near its termination

Correct answer: B – It passes behind the medial malleolus

The great saphenous vein passes ANTERIOR (in front of) the medial malleolus, not behind it. All other statements are correct. The vein ascends on the medial aspect of the leg and thigh.

Q21: Question 1 Cutaneous nerve supply of the thigh involves all but which of the following:

  1. A. The intermediate femoral cutaneous nerve
  2. B. The obturator nerve
  3. C. The genital branch of the genitofemoral nerve
  4. D. The ilioinguinal nerve
  5. E. The posterior cutaneous nerves of the thigh

Correct answer: A – The intermediate femoral cutaneous nerve

The genital branch of the genitofemoral nerve supplies the scrotum/labia majora and cremaster muscle, NOT the thigh skin. All others provide cutaneous innervation to the thigh.

Q22: Question 2 The patellar plexus takes twigs from all but which of the following?

  1. A. Infrapatellar branch of the common peroneal nerve
  2. B. Medial femoral cutaneous nerve
  3. C. Lateral femoral cutaneous nerve
  4. D. Intermediate femoral cutaneous nerve
  5. E. Infrapatellar branch of the saphenous nerve

Correct answer: A – Infrapatellar branch of the common peroneal nerve

The patellar plexus receives contributions from saphenous nerve, medial, intermediate, and lateral femoral cutaneous nerves. There is NO infrapatellar branch from the common peroneal nerve.

Q23: Question 3 The inferior gluteal nerve supplies:

  1. A. Gluteus maximus
  2. B. Gluteus medius
  3. C. Gluteus minimus
  4. D. All of the above
  5. E. None of the above

Correct answer: A – Gluteus maximus

Inferior gluteal nerve (L5, S1, S2) supplies ONLY gluteus maximus. Gluteus medius and minimus are supplied by the superior gluteal nerve.

Q24: Question 4 Within the buttock:

  1. A. The pudendal nerve emerges beneath piriformis, turns around the back of the sacrospinous ligament and passes between the sacrotuberous and sacrospinou
  2. B. The internal pudendal artery can be compressed against the base of the ischial tuberosity
  3. C. The sciatic nerve (L4, 5, S1) emerges from below piriformis muscle more laterally than the inferior gluteal and pudendal nerves and vessels
  4. D. The posterior femoral cutaneous nerve lies medially to the sciatic nerve
  5. E. The cruciate anastomosis provides the main source of blood for the supply of the head of femur

Correct answer: A – The pudendal nerve emerges beneath piriformis, turns around the back of the sacrospinous ligament and passes between the sacrotuberous and sacrospinou

Pudendal nerve exits below piriformis, hooks around the sacrospinous ligament, and re-enters pelvis through lesser sciatic foramen. The sciatic nerve is L4-S3 (not just L4,5,S1).

Q25: Question 5 With respect to the ligaments around the knee joint:

  1. A. The fibular collateral ligament blends with the capsule and is attached to the lateral meniscus
  2. B. The tibial collateral ligament blends posteriorly with the capsule and is attached to the medial meniscus
  3. C. The oblique popliteal ligament is an expansion from the tendon of semitendinosus that blends with the capsule posteriorly
  4. D. The posterior cruciate ligament runs from anterior tibial plateau to the posteromedial aspect of the lateral femoral condyle
  5. E. The transverse ligament runs posteriorly between menisci

Correct answer: A – The fibular collateral ligament blends with the capsule and is attached to the lateral meniscus

The tibial (medial) collateral ligament is firmly attached to the medial meniscus and joint capsule. The fibular collateral ligament is NOT attached to the lateral meniscus. Oblique popliteal ligament is from semimembranosus.

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