1. A young girl has recovered well from the severe injuries she sustained in a motor vehicle accident 9 months ago, but because of some lingering nerve problems, she still has difficulty walking. She is balanced during the midstance phase but has difficulty bringing her limb forward to initiate movement. What nerve seems to be affected?
A. Superior gluteal
B. Inferior gluteal
C. Femoral
D. Obturator
E. Tibial
2. A young woman searching for driftwood walked several miles on the soft sandy beach of a Caribbean island. While walking on this uneven surface, the balance between inversion and eversion at her subtalar joint was maintained by the opposing actions of the fibularis longus and the
A. fibularis brevis
B. fibularis tertius
C. soleus
D. tibialis anterior
E. extensor digitorum longus
3. Structures at the knee that are not attached to the joint capsule include the
A. medial meniscus
B. medial collateral ligament
C. lateral collateral ligament
D. patellar retinacula
E. All of the above (A–D) are attached to the joint cavity.
4. A woman in her early 40s discovered a small lump at the top of her thigh that was later diagnosed as a femoral hernia. Where would this hernia be located?
A. Retroinguinal space
B. Femoral canal
C. Femoral sheath
D. Femoral ring
E. All of the above
5. An elderly woman shopping with her daughter fell in the mall parking lot. After examining the woman, the paramedics who responded to the call noted that the limb was pulled upward, and the hip was rotated laterally. They confided to the daughter that it appeared that the woman had fractured her femoral neck. Which of the following muscles would be responsible for the lateral (external) rotation?
A. Gluteus medius
B. Tensor of the fascia lata
C. Pectineus
D. Vastus lateralis
E. All of the above
6. The strongest and most supportive ligament of the hip joint is the
A. transverse ligament of the acetabulum
B. ligament of the head of the femur
C. pubofemoral ligament
D. ischiofemoral ligament
E. iliofemoral ligament
7. A young man running on the beach severely lacerated his foot when he accidentally stepped into a pit with broken glass left by late-night partygoers. Surgery was required to remove the glass fragments and treat the lacerations. You opt to use regional anesthesia, injecting anesthetic near each of the nerves that cross the ankle. Where would you anesthetize the sural nerve?
A. Anterior to the medial malleolus
B. Posterior to the medial malleolus
C. Posterior to the lateral malleolus
D. Anterior to the lateral malleolus
E. First web space
8. Sensation along the lateral side of the first toe is transmitted by branches of the
A. saphenous nerve
B. medial plantar nerve
C. deep fibular nerve
D. superficial fibular nerve
E. lateral plantar nerve
9. Superficial veins of the lower limb
A. lie deep to the fascia lata
B. include the great saphenous vein that terminates at the popliteal vein
C. include the small saphenous vein whose course runs anterior to the lateral malleolus
D. drain to deep veins via perforating veins
E. originate from the plantar venous arch on the sole
10. The dorsal pedal artery is a continuation of the
A. posterior tibial artery
B. fibular artery
C. anterior tibial artery
D. popliteal artery
E. inferior medial genicular artery
11. The deep plantar arch of the foot is an anastomosis between the dorsal pedal artery and the following structure on the sole of the foot:
A. Fibular artery
B. Lateral plantar artery
C. Plantar metatarsal arteries
D. Plantar digital arteries
E. Arcuate artery
12. An obese female patient suffers from peripheral edema (swelling of the legs) and large varicose veins in her leg. Which of the following might be coexisting symptoms related to her condition?
A. Incompetent valves in the great saphenous vein
B. Reversed flow in the perforating veins
C. Deep vein thrombosis
D. Thrombophlebitis
E. All of the above
13. “Footdrop” occurs when the plantar flexor muscles are unopposed. This condition may be caused by damage to which of the following nerves?
A. Superficial fibular
B. Deep fibular
C. Sural
D. Tibial
E. Medial plantar
14. As she was riding her bike home from her job as a camp counselor, Kristin was sideswiped by a large pickup trunk. She suffered multiple bruises, a fractured tibia, and a fractured pelvis. Several months later she still had an area of numbness on the medial side of her thigh and walked with a lateral swing to her gait. Which muscle was affected by her injury?
A. Gluteus medius
B. Gluteus maximus
C. Semimembranosus
D. Adductor longus
E. Rectus femoris
15. In anatomy laboratory you have just dissected the gluteal region of your cadaver. You are surprised to discover that in your cadaver the lateral component of the sciatic nerve passes through the piriformis muscle instead of inferior to it. Being a dedicated student, you investigate this further and find this anomaly can cause a piriformis syndrome in which the nerve is compressed by contraction of the muscle. What symptom might this particular patient have experienced?
A. Paresthesia (tingling) on the sole of the foot
B. Loss of knee flexion
C. Loss of knee extension
D. Footdrop
E. Sagging of the unsupported hip when walking
16. The adductor magnus muscle
A. extends and adducts the hip joint
B. is innervated by the femoral and obturator nerves
C. inserts on the linea aspera of the femur and adductor tubercle of the tibia
D. forms the anterior wall of the adductor canal
E. originates from the superior pubic ramus
17. Which muscle(s) of the lower limb is/are capable of producing flexion at one joint and extension at a second joint?
A. Semimembranosus
B. Rectus femoris
C. Lumbricals of foot
D. Long head of biceps femoris
E. All of the above (A–D)
18. During a street fight between two local gangs, one boy received a violent blow to the anterior knee that knocked him to the ground. In the emergency department, the physical exam of his knee revealed a positive posterior drawer sign. What structure appears to be injured?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Patellar ligament
D. Medial collateral ligament
E. Lateral collateral ligament
19. A single woman looking for adventure signed up for a walking tour of the Scottish highlands. She was unprepared for the effort that it required but kept up with the more experienced walkers. After a few days she began to experience extreme tenderness in her anterior leg deep to the ridge of the tibia. The tour guide had seen this in previous clients and suggested that her pain was due to shin splints. Her pain originated from overuse of the
A. extensor digitorum longus
B. extensor digitorum brevis
C. extensor hallucis longus
D. fibularis tertius
E. tibialis anterior
20. Which fibrous structure on the sole of the foot originates at the calcaneus and continues distally as digital fibrous sheaths?
A. Plantar aponeurosis
B. Plantar calcaneonavicular ligament
C. Long plantar ligament
D. Short plantar ligament
E. Deltoid ligament
21. A man was on a hunting trip with friends when he was accidentally shot in the midthigh. He bled profusely from his femoral artery until his friends applied constant pressure over the wound and drove him to a local emergency clinic. Although examination of the wound site in surgery revealed a badly torn femoral artery, the man continued to have distal pulses in his leg. What vessel arises proximal to the injury site and can provide collateral blood supply to the distal limb?
A. Medial circumflex femoral artery
B. Lateral circumflex femoral artery
C. Obturator artery
D. Descending genicular artery
E. Popliteal artery
22. An elderly woman slipped on a patch of ice in her driveway when she went to pick up the morning newspaper. Her neighbor witnessed the accident and called an ambulance. In the ER, X-rays revealed that she had fractured the neck of her femur. Her physician explained to her that avascular necrosis was a common complication of this injury in elderly women and convinced her to agree to a hip replacement. What vessel contributes most significantly to the blood supply of the hip joint?
A. Obturator
B. Superior gluteal
C. Inferior gluteal
D. Medial circumflex femoral
E. Lateral circumflex femoral
23. Which of the following spaces contain the femoral nerve?
A. Femoral sheath
B. Adductor hiatus
C. Popliteal fossa
D. Femoral canal
E. Retroinguinal space
24. The inferior gluteal nerve innervates the
A. gluteus maximus
B. gluteus medius
C. gluteus minimus
D. piriformis
E. All of the above
25. Which of the following muscles insert on the iliotibial tract?
A. Gluteus maximus
B. Gluteus medius
C. Gluteus minimus
D. Quadratus femoris
E. None of the above
26. Your 13-year-old son who studies martial arts is particularly flexible and is praised for his high kicks. After several weeks of training in preparation for an upcoming tournament, he complains of tenderness in his lower buttocks during practice and even when he sits on the hard stadium benches. As his pediatrician, how do you explain his problem?
A. Inflammation of the ischial tuberosity
B. Rupture of the obturator internus tendon from its insertion
C. Compression of the sciatic nerve in the gluteal region
D. Irritation of the tibial nerve in the thigh
E. Irritation of the inferior gluteal nerve
27. Which of the following muscles are involved in knee flexion?
A. Flexor hallucis longus
B. Soleus
C. Tibialis posterior
D. Biceps femoris
E. Rectus femoris
28. The lateral border of the femoral triangle is formed by the
A. tensor fasciae latae
B. femoral nerve
C. sartorius
D. adductor longus
E. rectus femoris
29. An 18-year-old marathon runner finished fourth in the Detroit marathon but limped away from the finish line. He had been suffering from excruciating pain on the sole of his foot and immediately sought advice from the medical volunteers. Following a thorough exam, the EMTs explained that the muscle tendons running through his tarsal tunnel had swollen and were compressing the nerve that accompanies them. What bones form the wall of this tunnel?
A. Navicular and talus
B. Cuboid and calcaneus
C. Talus and calcaneus
D. Medial malleolus of the tibia and calcaneus
E. Talus and base of the 1st metatarsal
30. An experienced 24-year-old backpacker has spent the last 4 months hiking the entire Appalachian trail. Although he has sturdy hiking boots, he often changes to the lightweight sneakers he brought as a backup. For the last few miles of the trek, he’s been experiencing shooting pain along the side of his foot at the apex of his medial arch. What structure is probably the cause of the pain?
A. Plantar calcaneonavicular (spring) ligament
B. Deltoid ligament
C. Posterior talofibular ligament
D. Superior extensor retinaculm
E. Tendon of fibularis longus
Answers and Explanations
1. C Forward movement at the beginning of the swing phase depends on the action of her hip flexors, particularly the rectus femoris, which is innervated by the femoral nerve (Sections 16.2, 16.4a, and 16.9).
A The superior gluteal nerve innervates the abductors of the hip. Damage to this nerve would cause a sagging of the hip on the contralateral side just before the midstance.
B The inferior gluteal nerve innervates the gluteus maximus. Injury to this nerve would affect the deceleration of the swing phase.
D Injury to the obturator nerve, which innervates the adductors of the hip, would cause an outward swing of the limb but would not inhibit acceleration of the thigh.
E The tibial nerve innervates the hamstring muscles of the posterior thigh, which are responsible for the deceleration at the end of the swing phase.
2. D The tibialis anterior and tibialis posterior are the strong inverters of the foot that counter the action of the fibularis longus and fibularis brevis (Section 16.8a).
A The fibularis brevis, in the lateral crural compartment, inserts on the base of the 5th metatarsal, which allows it to evert the foot.
B The fibularis tertius, a muscle of the anterior crural compartment, inserts on the base of the 5th metatarsal and everts the foot.
C The soleus, in the posterior crural compartment, plantar flexes the foot.
E The extensor digitorum, in the anterior crural compartment, everts the foot.
3. C The lateral (fibular) collateral ligament is an extracapsular ligament that extends from the lateral epicondyle of the femur to the head of the fibula and remains separate from the joint capsule of the knee (Section 16.5a).
A The medial and lateral menisci attach along their outer rims to the joint capsule.
B The medial (tibial) collateral ligament is a capsular ligament that extends from the medial epicondyle of the femur to the medial condyle and superior part of the medial tibia. It attaches to the joint capsule and to the medial meniscus.
D The patellar retinacula are fibrous expansions of the tendons of the quadriceps femoris muscle. They form the joint capsule on either side of the patella.
E Only the lateral (fibular) collateral ligament (C) is correct.
4. E A vascular compartment of the retroinguinal space contains the femoral sheath and the femoral canal. The femoral ring defines the upper edge of the femoral canal. A femoral hernia protrudes into the femoral canal (Section 16.4b).
A The retroinguinal space contains the femoral canal, the site of the femoral hernia. B through D are also correct (E).
B The femoral canal is a space within the femoral sheath that normally contains loose connective tissue, fat, and often a deep inguinal lymph node. A, C, and D are also correct (E).
C The femoral sheath contains the femoral vessels and the femoral canal. A, B, and D are also correct (E).
D The femoral ring defines the superior opening of the femoral canal. A, B, and C are also correct (E).
5. C The pectineus in the medial thigh compartment adducts and laterally rotates the hip (Sections 16.3 and 16.4a).
A The gluteus medius is an abductor of the hip.
B The tensor fascia lata abducts, flexes, and internally rotates the hip.
D The vastus lateralis extends the knee and has no influence over the hip joint.
E A, B, and D are incorrect.
6. E The iliofemoral ligament attaches proximally to the anterior inferior iliac spine and rim of the acetabulum and distally to the intertrochanteric line of the femur. It supports the hip joint during standing (Section 16.3).
A The transverse ligament completes the rim of the C-shaped acetabulum inferiorly.
B The ligament of the head of the femur attaches to the acetabulum within the joint but provides little support. A small artery runs within the ligament to the femoral head.
C The pubofemoral ligament runs laterally from the inferior aspect of the acetabular rim to merge with the iliofemoral ligament. It assists the iliofemoral ligament and limits abduction of the joint.
D The ischiofemoral ligament is the weakest of the three ligaments of the capsule. It arises from the ischial part of the acetabular rim and spirals anteriorly to insert on the femoral neck.
7. C The sural nerve innervates the lateral side of the foot and runs posterior to the lateral malleolus (Section 15.4d).
A The saphenous nerve runs anterior to the medial malleolus.
B The tibial nerve courses through the tarsal tunnel posterior to the medial malleolus.
D The superficial fibular nerve runs onto the dorsum of the foot anterior to the lateral malleolus.
E The deep fibular nerve accompanies the dorsal pedal artery onto the dorsum of the foot. It innervates the skin of the first web space.
8. C The deep fibular nerve, a branch of the common fibular nerve, supplies cutaneous innervation to the first web space, including the skin adjacent to the first and second digits. It also supplies motor innervation to the muscles of the anterior compartment of the leg (Section 15.4d).
A The saphenous nerve transmits sensation from the medial side of the foot.
B The medial plantar branch of the tibial nerve supplies cutaneous innervation to a large area of skin on the medial side of the foot and the medial three and a half digits.
D The superficial fibular nerve supplies cutaneous innervation to the dorsum of the foot.
E The lateral plantar branch supplies cutaneous innervation to the lateral foot and the lateral one and a half digits.
9. D Similar to superficial veins of the upper limb, superficial veins of the lower limb drain to deep veins via perforating veins (Section 15.4b).
A Superficial veins lie in the subcutaneous tissue, superficial to the deep fascia (fascia lata).
B The great saphenous vein pierces the fascia lata at the saphenous hiatus in the proximal thigh and terminates in the femoral vein.
C The small saphenous vein runs posterior to the lateral malleolus and superiorly to the popliteal fossa.
E The large superficial veins, the great and small saphenous veins, originate from the venous arch on the dorsum of the foot.
10. C The anterior tibial artery descends within the anterior crural compartment and emerges onto the dorsum of the foot as the dorsal pedal artery (Section 15.4a).
A The posterior tibial artery descends within posterior crural compartment and branches into the medial plantar and lateral plantar arteries that supply the sole of the foot.
B The fibular artery arises in the lateral part of the posterior leg and anastomoses with the anterior tibial artery to supply the ankle.
D The popliteal artery lies posterior to the knee. It gives rise to the genicular and tibial arteries.
E The inferior medial genicular artery is a branch of the popliteal artery and supplies blood to the patella and insertions of the sartorius, gracilis, and semitendinosus.
11. B The lateral plantar artery, similar to the ulnar artery in the hand, is the largest branch of the posterior tibial artery. It supplies the lateral side of the foot and forms the deep plantar arch with the dorsal pedal artery (Section 15.4a).
A The fibular artery supplies muscles in the posterior and lateral compartments of the leg and forms an anastomosis with the anterior tibial artery at the ankle, but it has no branches on the sole of the foot.
C The plantar metatarsal arteries arise from the deep plantar arch.
D Proper digital arteries arise from the plantar metatarsal arteries, which are branches of the deep plantar arch.
E The arcuate artery, a branch of the dorsal pedal artery, forms a loop on the dorsum of the foot and supplies the 2nd, 3rd, and 4th dorsal metatarsal arteries.
12. E Varicose, or dilated, veins can occur in conjunction with deep vein thromboses. When the deep veins are obstructed, the normal superficial-to-deep flow in the perforating veins reverses. With the increased volume, the superficial veins dilate, and their valves become incompetent. Thrombophlebitis, or venous inflammation, often occurs with thrombus formation (Section 15.4b).
A When venous valves are incompetent, upward flow is impeded, and blood pools in the veins. The resulting dilated veins are known as varicose veins. B through D are also correct (E).
B Superficial veins normally drain into the deep venous system through the perforating veins. If the deep veins are obstructed by thrombus, blood flows outward through the perforating veins into the superficial system, dilating the superficial veins. A, C, and D are also correct (E).
C When thrombus obstructs the deep veins of the leg, blood flows outward into the superficial veins, causing them to dilate. A, B, and D are also correct (E).
D Inflammation of veins can occur with thrombus formation. A through C are also correct (E).
13. B Footdrop is caused by an injury to the deep (or common) fibular nerve causing paralysis of the dorsiflexor muscles in the foot, leaving the plantar flexor muscles unopposed (Section 15.4d).
A Injury to the superficial fibular nerve will result in an inability to evert the foot and therefore an overall loss of balance and loss of sensation on the dorsum of the foot.
C Injury to the sural nerve will cause loss of sensation over the skin on the lateral side of the foot.
D Injury to the tibial nerve would cause paralysis of all of the muscles of the posterior thigh (except the short head of the biceps femoris) and posterior leg.
E Injury to the medial plantar nerve will cause paralysis of the muscles on the medial side of the foot and loss of sensation over a large area of skin on the medial side of the foot and the medial three and a half digits.
14. D A lateral swinging gait is caused by unopposed hip abduction, which occurs when the adductors are paralyzed. The obturator nerve innervates the adductor muscles of the thigh and can be injured by pelvic fractures. The area of numbness on the medial thigh also suggests an obturator nerve injury (Section 15.4d).
A The gluteus medius is an abductor of the hip. Injury to this muscle would result in a gluteal, or waddling, gait.
B The injury to the inferior gluteal nerve, which innervates the gluteus maximus, would impair extension of the hip but would not cause any sensory loss.
C Injury to the semimembranosus or its nerve, the tibial nerve, would impair hip extension, knee flexion, and sensation on the sole of the foot.
E Injury to the femoral nerve, which innervates the rectus femoris, would weaken flexion of the hip and extension of the knee. There would be a sensory loss from the anterior thigh and the medial side of the leg and foot.
15. D The common fibular nerve is the lateral component of the sciatic nerve. Compression will affect the dorsiflexors of the anterior leg compartment (through its deep fibular branch), resulting in footdrop (Sections 16.2 and 15.4d).
A Paresthesia on the sole of the foot would be a consequence of compression of the tibial nerve.
B The tibial nerve, the medial component of the sciatic nerve, innervates the hamstring muscles, which flex the knee. This action would remain intact.
C The knee extensors on the anterior thigh extend the knee and would not be affected by this anomaly.
E Sagging of the unsupported hip is characteristic of an injury to the superior gluteal nerve.
16. A The adductor magnus is the largest adductor of the hip but also works with the gluteus maximus to provide powerful extension of the hip joint (Section 16.4a).
B The adductor magnus has a dual innervation, the obturator and tibial nerves.
C The adductor magnus inserts entirely on the femur; the adductor tubercle is a feature on the distal femur.
D The adductor canal passes between the anterior and medial thigh compartments. The vastus medialis forms the anterior wall, and the adductor muscles form the posterior wall.
E The adductor magnus originates on the ischiopubic ramus, which includes the inferior pubic ramus and ischial ramus.
17. E Semimembranosus (A) produces flexion at the knee joint and extension at the hip joint. Rectus femoris (B) produces flexion at the hip joint and extension at the knee joint. The lumbricals of the foot (C) produce flexion of the metatarsophalangeal (MTP) joints of the 2nd to 5th toes and extension of the interphalangeal (IP) joints of the 2nd to 5th toes. The long head of the biceps femoris (D) produces extension of the hip joint and flexion of the knee joint (Sections 16.4a and 16.8c).
A Semimembranosus produces flexion at the knee joint and extension at the hip joint. B through D are also correct (E).
B Rectus femoris produces flexion at the hip joint and extension at the knee joint. A, C, and D are also correct (E).
C The lumbricals of the foot produce flexion of the MTP joints of the 2nd to 5th toes and extension of the IP joints of the 2nd to 5th toes. A, B, and D are also correct (E).
D The long head of the biceps femoris produces extension of the hip joint and flexion of the knee joint. A through C are also correct (E).
18. B The posterior displacement of the tibia is a positive posterior drawer sign that indicates an injury to the posterior cruciate ligament (Section 16.5a).
A Injury to the anterior cruciate ligament is recognized by the positive anterior drawer sign in which the tibia can be pulled anteriorly from under the femur.
C A positive drawer sign suggests anterior or posterior displacement of the tibia relative to the femur. Rupture of the patellar ligament destabilizes the knee joint but does not disrupt the alignment of the tibia and femur.
D Although the medial collateral ligament may be damaged by a forceful blow, it is not diagnosed by a posterior drawer sign.
E The lateral collateral ligament is unlikely to be damaged by a blow to the anterior knee and is not diagnosed by either anterior or posterior drawer signs.
19. E Shin splints are a result of inflammation of the tibialis anterior and small tears of the periosteum where the muscle attaches to the bone (Section 16.6b).
A The extensor digitorum originates from the head of the fibula, lateral condyle of the tibia, and interosseous membrane.
B The extensor digitorum brevis is an intrinsic muscle of the foot. It arises from the calcaneus.
C The extensor hallucis longus arises from the middle of the fibular shaft and the interosseous membrane.
D Fibularis tertius is a lateral muscle that arises from the distal fibula.
20. A The plantar aponeurosis is a thick fibrous band on the sole that is continuous with the deep fascia of the leg (Section 16.8c).
B The plantar calcaneonavicular ligament, or spring ligament, supports the head of the talus and maintains the medial side of the longitudinal arch of the foot.
C The long plantar ligament supports the lateral side of the longitudinal arch of the foot and extends from the calcaneus to the bases of the 1st, 2nd, and 3rd metatarsals.
D The short plantar ligament, or plantar calcaneocuboid ligament, supports the lateral arch of the foot.
E The deltoid ligament is a four-part ligament that supports the medial side of the ankle joint.
21. B The lateral circumflex femoral artery arises from the deep artery of the thigh in the proximal thigh. It supplies structures around the hip as well as a descending branch that anastomoses with the genicular arteries at the knee. Reverse flow in these branches could supply the popliteal artery and its branches in the leg (Section 15.4a).
A The medial circumflex femoral artery arises from the deep artery of the thigh and supplies the hip joint. It does not anastomose with the popliteal artery or other branches of the knee and leg.
C The obturator artery supplies the medial compartment of the thigh and does not anastomose with vessels of the leg.
D The descending genicular artery is a branch of the femoral artery, but it arises distal to the site of injury and therefore cannot provide collateral circulation.
E The popliteal artery anastomoses with the proximal femoral artery only through the lateral circumflex femoral artery.
22. D Although the medial and lateral circumflex femoral arteries and inferior gluteal artery anastomose around the hip, branches that supply the hip joint arise primarily from the medial circumflex femoral artery (Section 15.4a).
A The obturator artery supplies the medial thigh muscles and a small artery to the head of the femur. It is not a significant blood supply to the joint.
B The superior gluteal artery supplies muscles of the gluteal region but does not supply the hip joint.
C The inferior gluteal artery contributes to an anastomosis around the hip and primarily supplies muscles of the gluteal region.
E The lateral circumflex femoral artery anastomoses with the medial circumflex artery around the femoral neck, but it contributes less to the hip joint and more to the muscles of the lateral thigh.
23. E The femoral nerve enters the anterior thigh through the muscular compartment of the retroinguinal space. It branches immediately to innervate the muscles of the anterior thigh (Section 15.4d).
A The femoral sheath encloses only the femoral artery and vein.
B The femoral artery and vein pass through the adductor hiatus into the popliteal fossa.
C The popliteal fossa contains the tibial and common fibular nerves.
D The femoral canal lies medially within the femoral sheath and contains only loose connective tissue, fat, and lymph nodes.
24. A The inferior gluteal nerve innervates only the gluteus maximus muscle (Section 15.4d).
B The superior gluteal nerve innervates the gluteus medius and minimus and tensor of the fascia lata.
C The superior gluteal nerve innervates the gluteus medius and minimus and tensor of the fascia lata.
D The piriformis is innervated by the S1 and S2 branches of the sacral plexus.
E B, C, and D are incorrect
25. A The upper fibers of the gluteus maximus insert onto the iliotibial tract (Section 16.2).
B Gluteus medius inserts onto the lateral surface of the greater trochanter of the femur.
C Gluteus minimus inserts onto the anterolateral surface of the greater trochanter of the femur.
D Quadratus femoris inserts onto the intertrochanteric crest of the femur.
E Not applicable.
26. A The hamstring muscles originate at the ischial tuberosity and insert on the tibia and fibula. Repetitive stretching of these muscles over two joints (the flexed hip and extended knee) can irritate the site of origin (Section 16.4a).
B Pain from a tear at the insertion site of the obturator internus tendon would be focused over the greater trochanter of the femur.
C The sciatic nerve emerges from behind the piriformis muscle and can be compressed at this location. However, pain would reflect the sensory areas of the tibial and common fibular nerves, which include the anterolateral and posterior leg and the dorsum and lateral edge of the foot.
D Irritation of the tibial nerve would manifest as pain in the sole of the foot.
E The inferior gluteal nerve does not have a sensory component. Injury to the nerve would affect the gluteus maximus muscle and manifest as weakened extension and lateral rotation.
27. D The biceps femoris is one of the hamstring muscles (biceps femoris, semitendinosus, semimembranosus), which are the primary flexors of the knee (Section 16.4a).
A The flexor hallucis longus flexes the 1st digit and plantar flexes the foot.
B The soleus does not cross the knee joint and only plantar flexes the foot at the ankle.
C The tibialis posterior plantar flexes and inverts the foot.
E The rectus femoris extends the leg at the knee.
28. C The borders of the femoral triangle are the sartorius, adductor longus, and inguinal ligament (Section 16.4b).
A The tensor fasciae latae is the lateral boundary of the anterior thigh. The femoral triangle lies between the anterior and medial thigh compartments.
B The femoral nerve is one of the contents (lateral) of the femoral triangle but not a boundary.
D The adductor longus is the medial border of the triangle.
E The rectus femoris is lateral to the femoral triangle and lies inside the anterior compartment of the thigh.
29. D The tarsal tunnel is formed by the flexor retinaculum and its attachments to the calcaneus and medial malleolus of the tibia (Section 16.6b).
A The navicular and talus lie distal to the tarsal tunnel, and neither provide attachment for the flexor retinaculum, which forms the roof of the tunnel.
B The cuboid lies on the lateral side of the foot; the tarsal tunnel lies on the medial side of the ankle.
C The talus is not part of the tarsal tunnel.
E Neither the talus nor the 1st metatarsal is part of the tarsal tunnel.
30. A The plantar calcaneonavicular ligament supports the head of the talus, which forms the apex of the medial longitudinal arch (Section 16.8b).
B The deltoid ligament is the collateral ligament on the medial side of the ankle. It is not associated with the medial arch.
C The posterior talofibular ligament is part of the lateral ligament of the ankle and is not associated with the medial arch.
D The superior extensor retinaculum restrains the tendons on the dorsum of the foot (dorsiflexors).
E The tendon of the fibularis longus supports the transverse arch on the lateral side of the sole of the foot.