Lower Limb Anatomy MCQ Compilation

Question 1

Tensor fasciae latae is supplied by

Accepted Answer

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. ---

Question 2

Which structure is intrasynovial at the knee joint

Accepted Answer

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. ---

Question 3

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

Accepted Answer

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. ---

Question 4

Tibialis anterior

Accepted Answer

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. ---

Question 5

The adductor canal

Accepted Answer

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. ---

Question 6

The great saphenous vein

Accepted Answer

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. ---

Question 7

Regarding the femoral artery

Accepted Answer

The femoral vein is always on its medial side — 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. ---

Question 8

Gluteus maximus

Accepted Answer

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. ---

Question 9

Regarding the adductor compartment

Accepted Answer

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. ---

Question 10

Which vessel is NOT involved in the trochanteric anastomosis?

Accepted Answer

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. ---

Question 11

The sciatic nerve

Accepted Answer

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. ---

Question 12

Which is the odd one out?

Accepted Answer

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. ---

Question 13

Regarding the hamstring compartment

Accepted Answer

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. ---

Question 14

Regarding the popliteal vessels

Accepted Answer

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. ---

Question 15

At the knee joint

Accepted Answer

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. ---

Question 16

Regarding nerve supply of the lower limb

Accepted Answer

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). ---

Question 17

Regarding flexor digitorum longus

Accepted Answer

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. ---

Question 18

The following are branches of the femoral artery except

Accepted Answer

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. ---

Question 19

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

Accepted Answer

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. ---

Question 20

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

Accepted Answer

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. ---

Question 21

Cutaneous nerve supply of the thigh involves all but which of the following

Accepted Answer

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. ---

Question 22

The patellar plexus takes twigs from all but which of the following?

Accepted Answer

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. ---

Question 23

The inferior gluteal nerve supplies

Accepted Answer

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

Question 24

With respect to the posterior compartment of the leg, which is FALSE?

Accepted Answer

Plantaris arises from the lower part of the lateral supracondylar line and is absent in 10% — The small saphenous vein drains the LATERAL (not medial) side of the dorsal venous arch and lateral margin of the foot. The great saphenous drains the medial side. ---

Question 25

The myotome for plantar flexion of the great toe is

Accepted Answer

L3, 4 — Plantar flexion of the great toe (flexor hallucis longus) is primarily S1, S2. Remember: ankle plantarflexion is also S1, S2. ---

Question 26

With respect to the hip bone

Accepted Answer

The pelvic rim is formed by the iliac crest, tubercular area and pectineal line — A line through the highest points of the iliac crests (supracristal line) passes through the L4 vertebral spine - important landmark for lumbar puncture. ---

Question 27

Which of the following structures is NOT found in the adductor (subsartorial) canal?

Accepted Answer

Femoral artery — The femoral nerve divides in the femoral triangle and does NOT enter the adductor canal. The canal contains: femoral artery and vein, saphenous nerve, and nerve to vastus medialis. ---

Question 28

The surface markings of the sciatic nerve are from

Accepted Answer

The ischial tuberosity to the adductor tubercle of the medial femoral condyle — Sciatic nerve surface marking: from the midpoint between ischial tuberosity and greater trochanter, descending to the apex of the popliteal fossa (where it typically divides). ---

Question 29

The femoral canal

Accepted Answer

Is the lateral compartment of the femoral sheath — The femoral canal is the MEDIAL compartment of the femoral sheath, lying medial to the femoral vein. It normally contains lymphatics and the lymph node of Cloquet; it's the site of femoral hernias. ---

Question 30

Which is NOT true of the tendoachilles?

Accepted Answer

It inserts into the middle third of the posterior surface of the calcaneus — The Achilles tendon is NOT invested in a synovial sheath (unlike many other tendons). It has bursae associated with it but no true synovial sheath. ---

Question 31

Which of the following structures lies within the knee joint?

Accepted Answer

Patellar ligament — The tendon of popliteus is intracapsular (within the fibrous capsule), passing through the joint. The collateral ligaments and patellar structures are extracapsular. ---

Question 32

Following an injury to the leg, a patient is unable to dorsiflex their foot. Which nerve is most likely to be damaged?

Accepted Answer

The deep branch of the common peroneal nerve — The deep peroneal nerve supplies the anterior compartment muscles (tibialis anterior, extensor hallucis longus, extensor digitorum longus) which are responsible for dorsiflexion. ---

Question 33

With respect to peroneus longus

Accepted Answer

It inserts into the base of the 5th metatarsal — Peroneus longus is supplied by the superficial peroneal nerve (L5, S1). It inserts into the base of the 1st metatarsal and medial cuneiform (not 5th metatarsal - that's peroneus brevis). It arises from the fibula. ---

Question 34

The stability of the weightbearing flexed knee is maintained by

Accepted Answer

Anterior cruciate ligament — The posterior cruciate ligament (PCL) is the primary stabilizer of the flexed, weight-bearing knee. It prevents posterior displacement of the tibia on the femur when the knee is flexed. ---

Question 35

Regarding the femoral triangle

Accepted Answer

The lateral border of the adductor longus makes up its medial boundary — The great (long) saphenous vein pierces the cribriform fascia and joins the femoral vein within the femoral triangle at the saphenous opening. ---

Question 36

Inversion of the foot is performed by which pair of muscles?

Accepted Answer

Peroneus longus and peroneus brevis — Inversion is performed by tibialis anterior (dorsiflexion + inversion) and tibialis posterior (plantarflexion + inversion). Peroneus muscles cause eversion. ---

Question 37

The anterior tibial artery

Accepted Answer

Pierces the interosseous membrane — The anterior tibial artery lies lateral to tibialis anterior in the anterior compartment. It pierces the interosseous membrane to enter the anterior compartment from the posterior, and lies medial to the deep peroneal nerve. ---

Question 38

The suprapatellar bursa

Accepted Answer

Does not communicate with the knee joint — The suprapatellar bursa extends approximately 5cm (two finger breadths) above the patella, lying between the femur and quadriceps tendon. It communicates freely with the knee joint cavity. ---

Question 39

Which of the following does NOT apply to the popliteus muscle?

Accepted Answer

It inserts into the lateral meniscus of the knee joint — Popliteus FLEXES the knee and "unlocks" it by laterally rotating the femur on the fixed tibia (or medially rotating the tibia on the femur). It does NOT extend the knee. ---

Question 40

A 30 year old man presents with adenopathy of the medial group of superficial inguinal lymph nodes on the right side. Which of the following is the primary site resulting in this finding?

Accepted Answer

Right testis — Medial superficial inguinal nodes drain the perineum, including the lower anal canal, external genitalia (except testes), and lower vagina/urethra. Testes drain to para-aortic nodes. ---

Question 41

Regarding the popliteal fossa

Accepted Answer

The common peroneal nerve passes through the lateral part of the fossa — The common peroneal nerve runs along the lateral border of the popliteal fossa (following biceps femoris tendon). The fossa contains lymph nodes, and the popliteal artery is the deepest structure. ---

Question 42

Regarding the movements at the knee joint

Accepted Answer

Popliteus 'unlocks' the extended knee by producing medial rotation of the femur — In full extension, the knee is "locked" and no active rotation is possible. Rotation only occurs when the knee is flexed. Popliteus unlocks the knee by laterally rotating the femur (or medially rotating the tibia). ---

Question 43

The dorsalis pedis artery

Accepted Answer

Lies medial to the tendon of extensor hallucis longus — Dorsalis pedis passes into the sole through the first intermetatarsal space to join the lateral plantar artery, forming the deep plantar arch. It lies lateral to extensor hallucis longus and medial to the deep peroneal nerve. ---

Question 44

A 25 year old man is unable to plantar flex his foot. The most likely cause is damage to

Accepted Answer

The superficial peroneal nerve — The tibial nerve supplies all the plantarflexors (gastrocnemius, soleus, plantaris, tibialis posterior, flexor digitorum longus, flexor hallucis longus). Damage to this nerve would cause loss of plantarflexion. ---

Question 45

Which of the following is NOT a component of the second layer of the sole of the foot?

Accepted Answer

Tendon of flexor hallucis longus — The second layer consists of: flexor digitorum longus tendons, flexor hallucis longus tendon, quadratus plantae (flexor accessorius), and lumbricals. Abductor hallucis is in the first (superficial) layer. ---

Question 46

Which of the following structures does NOT pass through the greater sciatic foramen?

Accepted Answer

The sciatic nerve — The nerve to obturator externus is a branch of the obturator nerve and passes through the obturator foramen, NOT the greater sciatic foramen. All others pass through the greater sciatic foramen. ---

Question 47

The psoas muscle

Accepted Answer

Passes across the front of the capsule of the hip joint — Psoas major passes anterior to the hip joint capsule (separated by a bursa). It inserts into the lesser trochanter, is a hip flexor and weak lateral rotator, and is supplied by L1-3 nerve roots directly from the lumbar plexus. ---

Question 48

The femoral nerve

Accepted Answer

Is formed from the anterior divisions of the anterior primary rami of L2-4

Lower Limb Anatomy MCQ Compilation

Questions, Answers & Explanations