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Introduction Review Questions Completion Questions Select the phrase that best completes each statement. 1. A patient who is standing in the anatomic position is (a) facing laterally. (b) has the palms of the hands directed medially. (c) has the ankles several inches apart. (d) is standing on his or her toes. (e) has the upper limbs by the sides of the trunk. Answer 1. E 2. A patient is performing the movement of flexion of the hip joint when she (a) moves the lower limb away from the midline in the coronal plane. (b) moves the lower limb posteriorly in the paramedian plane. (c) moves the lower limb anteriorly in the paramedian plane. (d) rotates the lower limb so that the anterior surface faces medially. (e) moves the lower limb toward the median sagittal plane. Answer 2. C Matching Questions Match each structure listed below with a structure or occurrence with which it is most closely associated. Each lettered answer may be used more than once. 3. Superficial fascia 4. Deep fascia 5. Skeletal muscle (a) Divides up interior of limbs into compartments (b) Adipose tissue (c) Tendon spindles (d) None of the above Answer 3. B 4. A 5. C For each joint listed below, indicate with which type of movement it is associated. 6. Sternoclavicular joint 7. Superior radioulnar joint 8. Ankle joint (a) Flexion (b) Gliding (c) Both A and B (d) Neither A nor B Answer 6. B 7. D 8. A For each joint listed below, give the most appropriate classification. 9. Joints between vertebral bodies 10. Inferior tibiofibular joint 11. Sutures between bones of vault of skull 12. Wrist joint (a) Synovial joint (b) Cartilaginous (c) Fibrous (d) None of the above Answer 9. B 10. C 11. C 12. A For each type of synovial joint listed below, give an appropriate example from the list of joints. 13. Hinge joint 14. Condyloid joint 15. Ball-and-socket joint 16. Saddle joint (a) Metacarpophalangeal joint of index finger (b) Shoulder joint (c) Wrist joint (d) Carpometacarpal joint of the thumb (e) None of the above Answer 13. E 14. A 15. B 16. D For each type of muscle action listed below, select the most appropriate definition. 17. Prime mover 18. Fixator 19. Synergist 20. Antagonist (a) A muscle that contracts isometrically to stabilize the origin of another muscle (b) A muscle that opposes the action of a flexor muscle (c) A muscle that is chiefly responsible for a particular movement (d) A muscle that prevents unwanted movements in an intermediate joint so that another muscle can cross that joint and act primarily on a distal joint (e) A muscle that opposes the action of a prime mover Answer 17. C 18. A 19. D 20. E For each type of blood vessel listed below, select an appropriate definition. 21. Arteriole 22. Portal vein 23. Anatomic end artery 24. Venule (a) A vessel that connects two capillary beds (b) A vessel whose terminal branches do not anastomose with branches or arteries supplying adjacent areas (c) A vessel that connects large veins to capillaries (d) An artery <0.1 mm in diameter (e) A thin-walled vessel that has an irregular cross diameter Answer 21. D 22. A 23. B 24. C For each of the lymphatic structures listed below, select an appropriate structure or function. 25. Lymph capillary 26. Thoracic duct 27. Right lymphatic duct 28. Lymph node (a) Present in the central nervous system (b) Drains lymph directly from the tissues (c) Contains lymphatic tissue and has both afferent and efferent vessels (d) Drains lymph from the right side of the head and neck, the right upper limb, and the right side of the thorax (e) Drains lymph from the right side of the abdomen Answer 25. B 26. E 27. D 28. C Multiple-Choice Questions Directions: Read the case histories and select the best answer to the question following them. The surgical notes of a patient state that she had a right infraumbilical paramedian incision through the skin of the anterior abdominal wall. 29. Where exactly was this incision made? (a) In the midline below the umbilicus (b) In the midline above the umbilicus (c) To the right of the midline above the umbilicus (d) To the right of the midline below the umbilicus (e) Just below the xiphoid process in the midline Answer 29. D After an attack of pericapsulitis of the left shoulder joint, a patient finds that a particular movement of the joint is restricted. 30. Which of the joint movements is restricted and by how much? (a) Abduction is limited to 30آ°. (b) Lateral rotation is limited to 45آ°. (c) Medial rotation is limited to 55آ°. (d) Flexion is limited to 90آ°. (e) Extension is limited to 45آ°. Answer 30. A The Thorax: Thoracic Wall Review Questions Multiple-Choice Questions Select the best answer for each question. 1. The following statements concerning structures in the intercostal space are correct except which? (a) The anterior intercostal arteries of the upper six intercostal spaces are branches of the internal thoracic artery. (b) The intercostal nerves travel forward in an intercostal space between the internal intercostal and innermost intercostal muscles. (c) The intercostal blood vessels and nerves are positioned in the order of vein, nerve, and artery from superior to inferior in a subcostal groove. (d) The lower five intercostal nerves supply sensory innervation to the skin of the lateral thoracic and anterior abdominal walls. (e) The posterior intercostal veins drain backward into the azygos and hemiazygos veins. Answer 1. C. The order from superior to inferior is intercostal vein, artery, and nerve. 2. The following statements concerning the diaphragm are correct except which? (a) The right crus provides a muscular sling around the esophagus and possibly prevents regurgitation of stomach contents into the esophagus. (b) On contraction, the diaphragm raises the intra- abdominal pressure and assists in the return of the venous blood to the right atrium of the heart. (c) The level of the diaphragm is higher in the recumbent position than in the standing position. (d) On contraction, the central tendon descends, reducing the intrathoracic pressure. (e) The esophagus passes through the diaphragm at the level of the eighth thoracic vertebra. Answer 2. E. The esophagus passes through the diaphragm at the level of the 10th thoracic vertebra. 3. The following statements concerning the intercostal nerves are correct except which? (a) They provide motor innervation to the peripheral parts of the diaphragm. (b) They provide motor innervation to the intercostal muscles. (c) They provide sensory innervation to the costal parietal pleura. (d) They contain sympathetic fibers to innervate the vascular smooth muscle. (e) The 7th to the 11th intercostal nerves provide sensory innervation to the parietal peritoneum. Answer 3. A. They provide sensory innervation to the pleura and peritoneum covering the peripheral parts of the diaphragm. 4. To pass a needle into the pleural space (cavity) in the midaxillary line, the following structures will have to be pierced except which? (a) Internal intercostal muscle (b) Levatores costarum (c) External intercostal muscle (d) Parietal pleura (e) Innermost intercostal muscle Answer 4. B. The levator costarum is located on the back away from the area involved. 5. The following statements concerning the thoracic outlet (anatomic inlet) are true except which? (a) The manubrium sterni form the anterior border. (b) On each side, the lower trunk of the brachial plexus and the subclavian artery emerge through the outlet and pass laterally over the surface of the first rib. (c) The body of the seventh cervical vertebra forms the posterior boundary. (d) The first ribs form the lateral boundaries. (e) The esophagus and trachea pass through the outlet. Answer 5. C. The body of the first thoracic vertebra forms the posterior boundary. 6. The following statements concerning the thoracic wall are correct except which? (a) The trachea bifurcates opposite the manubriosternal joint (angle of Louis) in the midrespiratory position. (b) The arch of the aorta lies behind the body of the sternum. (c) The apex beat of the heart can normally be felt in the left intercostal space about 3.5 in. (9 cm) from the midline. (d) The lower margin of the right lung on full inspiration could extend down in the midclavicular line to the eighth costal cartilage. (e) All intercostal nerves are derived from the anterior rami of thoracic spinal nerves. Answer 6. B. The arch of the aorta lies behind the manubrium sterni. Completion Questions Select the phrase that best completes each statement. 7. Clinicians define the thoracic outlet as (a) the lower opening in the thoracic cage. (b) the gap between the crura of the diaphragm. (c) the esophageal opening in the diaphragm. (d) the upper opening in the thoracic cage. (e) the gap between the sternal and costal origins of the diaphragm. Answer 7. D 8. The costal margin is formed by (a) the 6th, 8th, and 10th ribs. (b) the inner margins of the 1st ribs. (c) the edge of the xiphoid process. (d) the costal cartilages of the 7th, 8th, 9th, and 10th ribs. (e) the costal cartilages of the 7th to the 10th ribs and the ends of the cartilages of the 11th and 12th ribs. Answer 8. E 9. The lower margin of the left lung in midrespiration crosses (a) the 6th, 8th, and 10th ribs. (b) the 7th, 8th, and 9th ribs. (c) the 10th, 11th, and 12th ribs. (d) the 8th rib only. (e) the 6th, 11th, and 12th ribs. Answer 9. A 10. The suprapleural membrane is attached laterally to the margins of (a) the 1st rib. (b) the 6th, 8th, and 10th ribs. (c) the manubriosternal junction. (d) the 2nd rib. (e) the xiphoid cartilage. Answer 10. A 11. The mammary gland in the young adult female overlies (a) the 1st to the 5th ribs. (b) the 2nd to the 6th ribs. (c) the 1st and 2nd ribs. (d) the 2nd and 3rd ribs. (e) the 4th to the 6th ribs. Answer 11. B 12. The parietal pleura (a) is sensitive only to the sensation of stretch. (b) is separated from the pleural space by endothoracic fascia. (c) is sensitive to the sensations of pain and touch. (d) receives its sensory innervation from the autonomic nervous system. (e) is formed from splanchnopleuric mesoderm. Answer 12. C Fill-in-the-Blank Questions Fill in the blank with the best answer. 13. The thoracic duct passes through the ________ opening in the diaphragm. 14. The superior epigastric artery passes through the ________ opening in the diaphragm. 15. The right phrenic nerve passes through the ________ opening in the diaphragm. 16. The left vagus nerve passes through the ________ opening in the diaphragm. (a) aortic (b) esophageal (c) caval (d) none of the above Answer 13. A 14. D. The superior epigastric artery enters the anterior abdominal wall between the sternal and the costal origins of the diaphragm. 15. C 16. B 17. The aortic opening in the diaphragm lies at the level of the ________ thoracic vertebra. 18. The xiphisternal joint lies at the level of the ________ thoracic vertebra. 19. The caval opening in the diaphragm lies at the level of the ________ thoracic vertebra. (a) 10th (b) 12th (c) 8th (d) 9th (e) 7th Answer 17. B 18. D 19. C The Thorax: Thoracic Cavity Review Questions Multiple-Choice Questions Select the best answer for each question. 1. The following statements concerning the trachea are true except which? (a) It lies anterior to the esophagus in the superior mediastinum. (b) In deep inspiration, the carina may descend as far as the level of the sixth thoracic vertebra. (c) The left principal bronchus is wider than the right principal bronchus. (d) The arch of the aorta lies on its anterior and left sides in the superior mediastinum. (e) The sensory innervation of the mucous membrane lining the trachea is derived from branches of the vagi and the recurrent laryngeal nerves. Answer 1. C. The right principal bronchus is wider than the left. This is clearly seen in the normal posteroanterior bronchogram shown in Figure 3-54. 2. The following statements concerning the root of the right lung are true except which? (a) The right phrenic nerve passes anterior to the lung root. (b) The azygos vein arches over the superior margin of the lung root. (c) The right pulmonary artery lies posterior to the principal bronchus. (d) The right vagus nerve passes posterior to the lung root. (e) The vessels and nerves forming the lung root are enclosed by a cuff of pleura. Answer 2. C. The right pulmonary artery lies anterior to the principal bronchus. 3. The following statements concerning the right lung are true except which? (a) It possesses a horizontal and an oblique fissure. (b) Its covering of visceral pleura is sensitive to pain and temperature. (c) The lymph from the substance of the lung reaches the hilum by the superficial and deep lymphatic plexuses. (d) The pulmonary ligament permits the vessels and nerves of the lung root to move during the movements of respiration. (e) The bronchial veins drain into the azygos and hemiazygos veins. Answer 3. B. The visceral pleura is innervated by sympathetic and vagal afferent fibers via the pulmonary plexus and is not sensitive to pain and temperature, but it is sensitive to the sensation of stretch. 4. The anterior surface of the heart is formed by the following structures except which? (a) Right ventricle (b) Right atrium (c) Left ventricle (d) Left atrium (e) Right auricle Answer 4. D. The left atrium lies behind the heart. 5. In a posteroanterior radiograph of the thorax, the following structures form the left margin of the heart shadow except which? (a) Left auricle (b) Pulmonary trunk (c) Arch of aorta (d) Left ventricle (e) Superior vena cava Answer 5. E 6. All of the following statements concerning the esophagus are correct except which? (a) It receives an arterial blood supply from both the descending thoracic aorta and the left gastric artery. (b) It is constricted by the presence of the left principal bronchus. (c) It crosses from right to left posterior to the descending aorta. (d) It pierces the diaphragm, with the left vagus on its anterior surface and the right vagus on its posterior surface. (e) It joins the stomach about 16 in. (41 cm) from the incisor teeth. Answer 6. C. The esophagus crosses from right to left anterior to the descending aorta. 7. All of the following statements concerning the mediastinum are correct except which? (a) The mediastinum forms a partition between the two pleural spaces (cavities). (b) The mediastinal pleura demarcates the lateral boundaries of the mediastinum. (c) The heart occupies the middle mediastinum. (d) Should air enter the left pleural cavity, the structures forming the mediastinum are deflected to the right. (e) The anterior boundary of the mediastinum extends to a lower level than the posterior boundary. Answer 7. E. The anterior boundary of the mediastinum extends down to the xiphisternal joint anteriorly—that is, to the level of the ninth thoracic vertebral body. The posterior boundary extends down farther, to the level of the 12th thoracic vertebra. 8. All of the following statements regarding the conducting system of the heart are true except which? (a) The impulse for cardiac contraction spontaneously begins in the sinuatrial node. (b) The atrioventricular bundle is the sole pathway for conduction of the waves of contraction between the atria and the ventricles. (c) The sinuatrial node is frequently supplied by the right and left coronary arteries. (d) The sympathetic nerves to the heart slow the rate of discharge from the sinuatrial node. (e) The atrioventricular bundle descends behind the septal cusp of the tricuspid valve. Answer 8. D. The sympathetic nerves to the heart increase the rate of discharge from the sinuatrial node. 9. All of the following statements regarding the mechanics of inspiration are true except which? (a) The diaphragm is the most important muscle of inspiration. (b) The suprapleural membrane can be raised. (c) The sternum moves anteriorly. (d) The ribs are raised superiorly. (e) The tone of the muscles of the anterior abdominal wall is diminished. Answer 9. B. The suprapleural membrane is composed of fibrous tissue and is attached to the transverse process of the seventh cervical vertebra; it cannot be raised during inspiration. 10. The following statements concerning the lungs are correct except which? (a) Inhaled foreign bodies most frequently enter the right lung. (b) The left lung is in direct contact with the arch of the aorta and the descending thoracic aorta. (c) There are no lymph nodes within the lungs. (d) The structure of the lungs receives its blood supply from the bronchial arteries. (e) The costodiaphragmatic recesses are lined with parietal pleura. Answer 10. C 11. The following statements concerning the blood supply to the heart are correct except which? (a) The coronary arteries are branches of the ascending aorta. (b) The right coronary artery supplies both the right atrium and the right ventricle. (c) The circumflex branch of the left coronary artery descends in the anterior interventricular groove and passes around the apex of the heart. (d) Arrhythmias (abnormal heart beats) can occur after occlusion of a coronary artery. (e) Coronary arteries can be classified as functional end arteries. Answer 11. C. The circumflex branch of the left coronary artery winds around the left margin of the heart in the atrioventricular groove. 12. The following statements concerning the bronchopulmonary segments are correct except which? (a) The veins are intersegmental. (b) The segments are separated by connective tissue septa. (c) The arteries are intrasegmental. (d) Each segment is supplied by a secondary bronchus. (e) Each pyramid-shaped segment has its base pointing toward the lung surface. Answer 12. D. Each segment of the lung is supplied by a segmental bronchus. Completion Questions Match each structure listed below with the region in which it is found. Each lettered answer may be used more than once. 13. Coronary sinus (opening) 14. Moderator band 15. Anulus ovalis 16. Right pulmonary veins (openings) (a) Left atrium (b) Right ventricle (c) Right atrium (d) Left ventricle (e) Right auricle Answer 13. C 14. B 15. C 16. A The Upper limb Review Questions Multiple-Choice Questions Select the best answer for each question. 1. The following structures pass posterior to the flexor retinaculum except which? (a) Flexor digitorum superficialis tendons (b) Median nerve (c) Flexor pollicis longus tendon (d) Ulnar nerve (e) Anterior interosseous nerve Answer 1. D. The ulnar nerve passes superficial to the flexor retinaculum just lateral to the pisiform bone. 2. The following tendons are inserted into the base of the proximal phalanx of the thumb except which? (a) Extensor pollicis brevis (b) Abductor pollicis longus (c) Oblique head of adductor pollicis (d) Flexor pollicis brevis (e) First palmar interosseous Answer 2. B. The abductor pollicis longus is inserted into the base of the first metacarpal bone. 3. The following muscles abduct the hand at the wrist joint except which? (a) Flexor carpi radialis (b) Abductor pollicis longus (c) Extensor carpi radialis longus (d) Extensor digiti minimi (e) Extensor pollicis longus Answer 3. D. The extensor digiti minimi extends the metacarpophalangeal joint of the little finger and adducts the hand at the wrist joint. 4. The following bones form the proximal row of carpal bones except which? (a) Lunate (b) Pisiform (c) Scaphoid (d) Triquetral (e) Trapezium Answer 4. E. The trapezium is in the distal row of carpal bones. 5. The tendons of the following muscles form the rotator cuff except which? (a) Teres minor (b) Supraspinatus (c) Subscapularis (d) Teres major (e) Infraspinatus Answer 5. D. The teres major tendon is inserted into the medial lip of the bicipital groove of the humerus. 6. The quadrangular space is bounded by the following structures except which? (a) Surgical neck of the humerus (b) Long head of triceps (c) Deltoid (d) Teres major (e) Teres minor Answer 6. C 7. The radial nerve gives off the following branches in the posterior compartment of the arm except which? (a) Lateral head of the triceps (b) Lower lateral cutaneous nerve of the arm (c) Medial head of the triceps (d) Brachioradialis (e) Anconeus Answer 7. D. The branch from the radial nerve to the brachioradialis muscle leaves the nerve after it has left the posterior compartment of the arm by piercing the lateral intermuscular septum. 8. All the following statements concerning the brachial plexus are correct except which? (a) The roots C8 and T1 join to form the lower trunk. (b) The cords are named according to their position relative to the first part of the axillary artery. (c) The nerve that innervates the levator scapulae is a branch of the upper trunk. (d) The roots, trunks, and divisions are not located in the axilla. (e) No nerves originate as branches from the individual divisions of the brachial plexus. Answer 8. B. The cords are named according to their relative position to the second part of the axillary artery as it lies behind the pectoralis minor muscle. 9. The anterior fascial compartment of the forearm contains the following arteries except which? (a) Brachial (b) Anterior interosseous (c) Radial (d) Ulnar (e) Profunda Answer 9. E. The profunda artery runs through the posterior fascial compartment of the arm accompanied by the radial nerve. 10. The boundaries of the anatomic snuffbox include the following except which? (a) Abductor pollicis brevis (b) Extensor pollicis longus (c) Extensor pollicis brevis (d) Abductor pollicis longus Answer 10. A. The abductor pollicis brevis is a muscle of the thenar eminence and is not near the anatomic snuffbox. 11. The following structures are attached to the greater tuberosity of the humerus except which? (a) Supraspinatus muscle (b) Coracohumeral ligament (c) Teres minor muscle (d) Infraspinatus muscle (e) Subscapularis muscle Answer 11. E. The subscapularis muscle is inserted into the lesser tuberosity of the humerus. 12. The following structures form the boundaries to the superior entrance into the axilla except which? (a) Clavicle (b) Coracoid process (c) Upper border of the scapula (d) Outer border of the first rib Answer 12. B 13. The carpal tunnel contains the following important structures except which? (a) Flexor pollicis longus tendon (b) Flexor digitorum profundus tendons (c) Median nerve (d) Flexor carpi radialis tendon (e) Flexor digitorum superficialis tendons Answer 13. D. The flexor carpi radialis tendon enters the palm through a split in the flexor retinaculum in a groove on the trapezium. Completion Questions Select the phrase that best completes each statement. 14. Hyperextension of the proximal phalanges of the little and ring fingers (i.e., claw hand) can result from damage to the ________ nerve. (a) ulnar (b) axillary (c) radial (d) median (e) anterior interosseous Answer 14. A. The ulnar nerve supplies the lumbrical and interossei muscles, which normally flex the proximal phalanges and extend the middle and distal phalanges of the little and ring fingers. 15. Wrist drop can result from damage to the ________ nerve. (a) median (b) ulnar (c) radial (d) anterior interosseous (e) axillary Answer 15. C. see page 537 and Figure 9-103. 16. An inability to oppose the thumb to the little finger can result from damage to the ________ nerve. (a) anterior interosseous (b) posterior interosseous (c) radial (d) ulnar (e) median Answer 16. E. The opponens pollicis muscle, which is responsible for pulling the thumb medially and forward across the palm so that the palmar surface of the tip of the thumb may come into contact with the palmar surface of the tips of the other fingers, is supplied by the median nerve. 17. The sensory innervation of the nail bed of the index finger is the (a) median nerve. (b) radial nerve. (c) dorsal cutaneous branch of the ulnar nerve. (d) superficial branch of the ulnar nerve. (e) palmar cutaneous branch of the ulnar nerve. Answer 17. A 18. The sensory innervation of the medial side of the palm is the (a) radial nerve. (b) palmar cutaneous branch of the ulnar nerve. (c) dorsal cutaneous branch of the ulnar nerve. (d) median nerve. (e) superficial branch of the ulnar nerve. Answer 18. B 19. The sensory innervation of the dorsal surface of the root of the thumb is the (a) median nerve. (b) radial nerve. (c) superficial branch of the ulnar nerve. (d) dorsal cutaneous branch of the ulnar nerve. (e) posterior interosseous nerve. Answer 19. B 20. The sensory innervation of the medial side of the palmar aspect of the ring finger is the (a) radial nerve. (b) posterior interosseous nerve. (c) dorsal cutaneous branch of the ulnar nerve. (d) median nerve. (e) superficial branch of the ulnar nerve. Answer 20. E 21. The musculocutaneous nerve originates from the ________ of the brachial plexus. (a) posterior cord (b) lateral cord (c) both medial and lateral cords (d) upper trunk (e) medial cord Answer 21. B 22. The suprascapular nerve originates from the ________ of the brachial plexus. (a) medial cord (b) lower trunk (c) posterior cord (d) lateral cord (e) upper trunk Answer 22. E 23. The median nerve originates from the ________ of the brachial plexus. (a) medial and lateral cords (b) medial cord (c) posterior cord (d) upper and lower trunk (e) lateral cord Answer 23. A 24. The thoracodorsal nerve originates from the ________ of the brachial plexus. (a) lateral cord (b) posterior cord (c) medial cord (d) medial and posterior cords (e) lower trunk Answer 24. B 25. The axillary nerve originates from the ________ of the brachial plexus. (a) posterior cord (b) middle trunk (c) lateral cord (d) lower trunk (e) medial cord Answer 25. A 26. The lymph from the upper lateral quadrant of the breast drains mainly into the (a) lateral axillary nodes (b) internal thoracic nodes (c) posterior axillary nodes (d) anterior axillary nodes (e) deltopectoral group of nodes Answer 26. D 27. The medial collateral ligament of the elbow joint is closely related to the (a) brachial artery (b) radial nerve (c) ulnar nerve (d) basilic vein (e) ulnar artery Answer 27. C The Lower Limb Review Questions Multiple-Choice Questions Select the best answer for each question. 1. Which of the following nerves innervates at least one muscle that acts on both the hip and knee joints? (a) Ilioinguinal nerve (b) Femoral nerve (c) Saphenous nerve (d) Common peroneal nerve (e) Superficial peroneal nerve Answer 1. B. The femoral nerve innervates the rectus femoris muscle. 2. In walking, the hip bone of the suspended leg is raised by which of the following muscles acting on the supported side of the body? (a) Gluteus maximus (b) Obturator internus (c) Gluteus medius (d) Obturator externus (e) Quadratus femoris Answer 2. C. The gluteus medius muscle acts with the gluteus minimus muscle to raise the pelvis on the opposite side. 3. Which of the following muscles is a flexor of the thigh? (a) Superior gemellus (b) Adductor longus (c) Gracilis (d) Psoas (e) Obturator internus Answer 3. D 4. Which of the following muscles dorsiflexes the foot at the ankle joint? (a) Peroneus longus (b) Extensor digitorum brevis (c) Tibialis posterior (d) Extensor hallucis brevis (e) Tibialis anterior Answer 4. E Completion Questions Select the phrase that best completes each statement. 5. A femoral hernia descends through the femoral canal, and the neck of the sac lies (a) below and lateral to the pubic tubercle. (b) above and medial to the pubic tubercle. (c) at the saphenous opening. (d) in the obturator canal. (e) lateral to the iliacus muscle. Answer 5. A 6. The peroneal artery is a branch of the (a) anterior tibial artery. (b) popliteal artery. (c) posterior tibial artery. (d) arcuate artery. (e) lateral plantar artery. Answer 6. C 7. Unlocking of the knee joint to permit flexion is caused by the action of the (a) vastus medialis muscle. (b) articularis genu muscle. (c) gastrocnemius muscle. (d) biceps femoris muscle. (e) popliteus muscle. Answer 7. E. The rotatory action of the popliteus muscle slackens the ligaments of the extended knee joint, thus permitting flexion to take place. 8. In the adult, the chief arterial supply to the head of the femur is from the (a) superior circumflex iliac artery. (b) obturator artery. (c) branches from the medial and lateral circumflex femoral arteries. (d) deep external pudendal artery. (e) inferior gluteal artery. Answer 8. C. Since the epiphyseal plate is no longer present in the neck of the femur, branches from the medial and lateral circumflex femoral arteries can ascend through the femoral neck to the head of the femur. 9. The lymph drainage of the skin covering the ball of the big toe is into the (a) vertical group of superficial inguinal nodes. (b) popliteal nodes. (c) horizontal group of superficial inguinal nodes. (d) axillary nodes. (e) internal iliac nodes. Answer 9. A. The lymphatic vessels follow the course of the great saphenous vein. 10. The lymph drainage of the skin covering the medial side of the knee joint is into the (a) popliteal nodes. (b) internal iliac nodes. (c) vertical group of superficial inguinal nodes. (d) horizontal group of superficial inguinal nodes. (e) obturator nodes. Answer 10. C 11. The lymph drainage of the skin of the buttock is into the (a) axillary nodes. (b) superior gluteal nodes. (c) vertical group of superficial inguinal nodes. (d) horizontal group of superficial inguinal nodes. (e) internal iliac nodes. Answer 11. D 12. The lymph drainage of the skin of the calf is into the (a) vertical group of superficial inguinal nodes. (b) internal iliac nodes. (c) horizontal group of superficial inguinal nodes. (d) popliteal nodes. (e) obturator nodes. Answer 12. D. The lymphatic vessels follow the course of the small saphenous vein. 13. Hyperextension of the hip joint is prevented by the (a) obturator internus tendon. (b) ischiofemoral ligament. (c) tensor fascia latae muscle. (d) iliotibial tract. (e) ligamentum teres. Answer 13. B Fill-in-the-Blank Questions Fill in the blank with the best answer. 14. The ________ prevents dislocation of the femur backward at the knee joint. (a) posterior cruciate ligament (b) anterior cruciate ligament (c) medial collateral ligament (d) lateral collateral ligament (e) tendon of the popliteus muscle Answer 14. B 15. The ________ prevents abduction of the tibia at the knee joint. (a) posterior cruciate ligament (b) anterior cruciate ligament (c) lateral collateral ligament (d) lateral meniscus (e) medial collateral ligament Answer 15. E 16. The ________ is attached to the head of the fibula. (a) lateral meniscus (b) lateral collateral ligament (c) anterior cruciate ligament (d) posterior cruciate ligament (e) medial meniscus Answer 16. B Multiple-Choice Questions Select the best answer for each question. 17. The calcaneum participates in the formation of which arch(es) of the foot? (a) Medial longitudinal arch only (b) Medial and lateral longitudinal arches (c) Transverse arch only (d) Medial longitudinal and transverse arches (e) Lateral longitudinal and transverse arches Answer 17. B 18. The talus participates in the formation of which arch(es) of the foot? (a) Transverse arch only (b) Lateral longitudinal arch only (c) Medial longitudinal arch only (d) Medial and lateral longitudinal arches (e) Transverse and medial longitudinal arches Answer 18. C 19. The cuboid participates in the formation of which arch(es) of the foot? (a) Medial longitudinal arch only (b) Lateral longitudinal arch only (c) Transverse arch only (d) Medial longitudinal and transverse arches (e) Lateral longitudinal and transverse arches Answer 19. E 20. The sesamoid bones under the head of the first metatarsal bone participate in the formation of which arch(es) of the foot? (a) Lateral longitudinal arch only (b) Medial longitudinal arch only (c) Medial longitudinal and transverse arches (d) Transverse arch only (e) Lateral longitudinal and transverse arches Answer 20. B 21. The following statements concerning the dorsalis pedis artery are correct except which? (a) It is a continuation of the anterior tibial artery. (b) It enters the sole of the foot by passing between the two heads of the first dorsal interosseous muscle. (c) It can be palpated on the foot between the tendons of tibialis anterior and the extensor hallucis longus muscles. (d) It joins the lateral plantar artery. (e) On its lateral side lies the terminal part of the deep peroneal nerve. Answer 21. C. The dorsalis pedis artery can be palpated on the dorsum of the foot as it lies between the tendons of the extensor hallucis longus and the most medial tendon of the extensor digitorum longus muscle; it can also be palpated midway between the medial and lateral malleoli on the front of the ankle. 22. The following structures contribute to the boundaries of the popliteal fossa except which? (a) The semimembranosus muscle (b) The plantaris (c) The biceps femoris muscle (d) The medial head of the gastrocnemius muscle (e) The soleus Answer 22. E 23. The following structures pass through the greater sciatic foramen except which? (a) The superior gluteal artery (b) The sciatic nerve (c) The obturator internus tendon (d) The pudendal nerve (e) The inferior gluteal vein Answer 23. C 24. The femoral ring is bounded by the following structures except which? (a) The femoral vein (b) The lacunar ligament (c) The superior ramus of the pubis (d) The femoral artery (e) The inguinal ligament Answer 24. D 25. The following structures pass through the subsartorial canal except which? (a) The posterior division of the obturator nerve (b) The nerve to vastus lateralis (c) The femoral artery (d) The saphenous nerve (e) The femoral vein Answer 25. B 26. The floor of the femoral triangle is formed by the following muscles except which? (a) The pectineus (b) The adductor longus (c) The iliacus (d) The psoas (e) The adductor brevis Answer 26. E 27. The following statements concerning the ankle joint are correct except which? (a) It is strengthened by the deltoid (medial collateral) ligament. (b) It is a hinge joint. (c) It is formed by the articulation of the talus and the distal ends of the tibia and the fibula. (d) It is most stable in the fully plantar-flexed position. (e) It is a synovial joint. Answer 27. D 28. The foot is inverted by the following muscles except which? (a) The tibialis anterior (b) The extensor hallucis longus (c) The extensor digitorum longus (d) The peroneus tertius (e) The tibialis posterior Answer 28. D