S1 Practice Questions For Lab Practical

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S1 Practice Questions For Lab Practical - Quiz


Questions and Answers
  • 1. 

    Mr. Johnson comes to your office complaining of loss of sensation to the lateral aspects of his thigh. Recalling your knowledge of anatomy and cutaneous nerves to that region, you determine that there is likely a lesion to the:

    • A.

      Anterior division, L2-L4

    • B.

      Posterior division, L2-L4

    • C.

      Posterior division, L2-L3

    • D.

      Posterior division, L3-L4

    • E.

      Anterior division, L2-L3

    Correct Answer
    C. Posterior division, L2-L3
    Explanation
    Lateral cutaneous nerve (from posterior division of L2-L3) supplies the lateral
    thigh, it is separate from the femoral nerve, unlike the anterior cutaneous branches
    of femoral nerve that supply the anterior thigh.

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  • 2. 

    The great saphenous vein is often used for coronary artery bypass graft surgery. The nerve that runs with a portion of this vein is vulnerable to injury when the vein is harvested surgically. What is the name of this nerve?

    • A.

      Sural nerve

    • B.

      Femoral nerve

    • C.

      Saphenous nerve

    • D.

      Obturator nerve

    • E.

      Tibial nerve

    Correct Answer
    C. Saphenous nerve
    Explanation
    Saphenous nerve, a terminal branch of femoral nerve, supplies cutaneous
    innervation to the medial leg. This nerve lies next to the great saphenous vein as it
    passes posteromedial to the knee, and may be damaged as the vein is harvested at
    this location.

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  • 3. 

    Your patient presents to the emergency room with a swollen, painful knee. You determine that the patient suffers from a dislocated patella. What muscle, when weakened, is unable to resist a lateral patella dislocation?

    • A.

      Vastus medialis

    • B.

      Vastus lateralis

    • C.

      Rectus femoris

    • D.

      Vastus intermedius

    • E.

      Popliteus

    Correct Answer
    A. Vastus medialis
    Explanation
    vastus medialis weakness may allow for lateral subluxation of the patella, which
    may lead to dislocation of the patella out of the patellar notch of the femur. This
    occurs because the Q-angle (quadriceps pull angle) is putting more lateral force on
    the patella (especially in females, who tend to have a greater Q-angle).

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  • 4. 

    Your patient has a spider bite on the right buttocks, within the superior medial quadrant. After three days, the bite becomes swollen and inflamed. What lymph nodes will be the first to receive the majority of the lymph from this infected bite?

    • A.

      Sacral

    • B.

      Superficial Inguinal, horizontal group

    • C.

      Superficial Inguinal, vertical group

    • D.

      Deep Inguinal

    • E.

      External Iliac

    Correct Answer
    B. Superficial Inguinal, horizontal group
    Explanation
    superficial inguinal, horizontal group

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  • 5. 

    What structure passes through a gap in the interosseous membrane of the leg?

    • A.

      Common Fibular Nerve

    • B.

      Posterior Tibial Artery

    • C.

      Anterior Tibial Artery

    • D.

      Fibular Artery

    • E.

      Tibial nerve

    Correct Answer
    C. Anterior Tibial Artery
    Explanation
    The popliteal artery divides into anterior and posterior tibial arteries. The anterior
    tibial artery passes through a gap at the superior end of the interosseous membrane
    to move to the anterior compartment of the leg, which it supplies.

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  • 6. 

    Your patient fractures the head of his fibula when he was side-swiped while playing hockey. He presents with footdrop and cutaneous sensory deficits. What area of skin is supplied by the deep fibular nerve?

    • A.

      Dorsum of foot including 1st interdigital cleft

    • B.

      Just dorsum of foot

    • C.

      1st interdigital cleft

    • D.

      Sole of foot

    • E.

      Heel of foot

    Correct Answer
    A. Dorsum of foot including 1st interdigital cleft
    Explanation
    Common fibular nerve runs posterior to the head of the fibula and wraps around
    the fibular neck, and so is prone to injury if a fracture occurs at this location. The
    deep fibular nerve supplies cutaneous innervation to the web of skin between the 1st
    and 2nd digits (1st interdigital cleft), while the superficial fibular nerve supplies the
    distal 1/3 of the lateral leg and the rest of the dorsum of the foot; thus, sensory
    deficits occurs across the entire dorsum of the foot including the web between 1st-2nd
    toes with a Common Fibular N. injury since this happened prior to the split into its
    two terminal branches.

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  • 7. 

    An elderly female complains of having trouble getting up from a chair. As you observe her in your exam room, you notice that she must use her upper limbs to help herself up from a seated position. What nerve is likely to have a lesion in this patient?

    • A.

      Nerve to Piriformis

    • B.

      Common Fibular Nerve

    • C.

      Superior Gluteal Nerve

    • D.

      Inferior Gluteal Nerve

    • E.

      Clunial Nerves

    Correct Answer
    D. Inferior Gluteal Nerve
    Explanation
    Inferior gluteal nerve supplies the gluteus maximus. This muscle extends the
    thigh, which is necessary to lift oneself from a seated position. The hamstring
    muscles are also extensors of the thigh (but the tibial n. is not an answer option
    here).

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  • 8. 

    Which muscle tendon exits the pelvic cavity through the lesser sciatic foramen?

    • A.

      Obturator Internus

    • B.

      Obturator Externus

    • C.

      Piriformis

    • D.

      Gluteus Minimus

    • E.

      Quadratus femoris

    Correct Answer
    A. Obturator Internus
    Explanation
    The muscle tendon that exits the pelvic cavity through the lesser sciatic foramen is the Obturator Internus. This muscle is located in the pelvic region and helps with the rotation of the hip joint. It passes through the lesser sciatic foramen, which is a small opening in the pelvis, to reach its insertion point on the femur.

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  • 9. 

    Which muscle, other than Quadratus Femoris, does the Nerve to Quadratus Femoris innervate?

    • A.

      None

    • B.

      Superior Gemellus

    • C.

      Inferior Gemellus

    • D.

      Obturator Internus

    • E.

      Piriformis

    Correct Answer
    C. Inferior Gemellus
    Explanation
    The Nerve to Quadratus Femoris innervates the Inferior Gemellus muscle.

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  • 10. 

    A 60-year-old male presents to the clinic with difficulty walking. You observe the patient’s right hip drops down when he stands on his left leg. What is the most likely location of the lesion?

    • A.

      Right Superior Gluteal Nerve

    • B.

      Right Inferior Gluteal Nerve

    • C.

      Left Superior Gluteal Nerve

    • D.

      Left Inferior Gluteal Nerve

    Correct Answer
    C. Left Superior Gluteal Nerve
    Explanation
    This patient has the Trendelenberg sign: his hip drops to the opposite side when
    he is balancing on one leg. The superior gluteal nerve innervates the gluteus medius
    and minimus muscles, which stabilize the pelvis during walking by abducting the
    thigh on the supporting (balancing) leg. The lesion always occurs on the side of the
    balancing leg, NOT the side to which the hip drops.

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  • 11. 

    Before Ned was a poor medical student he was filthy rich. He liked to flaunt it, so he carried copious amounts of cash in his wallet, which he kept in his back pocket. After prolonged sitting in the Annex, he developed Sciatica, which would resolve itself upon standing for a short while. In this case, what is the most likely cause of his symptoms?

    • A.

      Piriformis Syndrome

    • B.

      Herniated Disc in Lumbar Region

    • C.

      Cauda Equina Syndrome

    • D.

      Sectioned Sciatic Nerve

    • E.

      Tumor in the Greater Sciatic Foramen

    Correct Answer
    A. Piriformis Syndrome
    Explanation
    Sciatica refers to pain or paresthesia along the regions supplied of the sciatic
    nerve. Piriformis syndrome is a cause of sciatica when the sciatic nerve is
    compressed as it passes through or deep to the piriformis muscle. Sitting on a thick
    wallet can induce this syndrome by applying extra pressure on the piriformis muscle
    causing it to temporarily compress the nerve. The other causes could result in
    similar symptoms, but would not be relieved by standing up.

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  • 12. 

    What is the location of the common hamstring origin?

    • A.

      Greater Trochanter

    • B.

      Lesser Trochanter

    • C.

      Ischial Tuberosity

    • D.

      Inferior Pubic Ramus

    • E.

      Ischial Spine

    Correct Answer
    C. Ischial Tuberosity
    Explanation
    All posterior thigh muscles (except the short head of biceps femoris) originate on
    ischial tuberosity. This is one of the criteria that must be satisfied in order for a
    muscle to be considered a True Hamstring.

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  • 13. 

    What is the insertion of the Biceps Femoris muscle?

    • A.

      Tibial Head

    • B.

      Fibular Head

    • C.

      Medial Femoral Condyle

    • D.

      Lateral Femoral Condyle

    • E.

      Patella

    Correct Answer
    B. Fibular Head
    Explanation
    The biceps femoris inserts on the fibular head. The other hamstring muscles:
    semitendinosus inserts as part of pes anserinus on the proximal medial tibia, and
    semimembranous inserts on the medial condyle of tibia. These muscles act as
    ‘splints’ along both sides of the knee, and help stabilize the knee by resisting knee
    rotation.

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  • 14. 

    The femoral artery can be safely ligated proximal to the profunda femoris artery without compromising blood supply to thigh because of continued blood supply through which artery?

    • A.

      Inferior Gluteal

    • B.

      Medial Circumflex Femoral

    • C.

      Lateral Circumflex Femoral

    • D.

      1st Perforating branch of Profunda Femoris

    • E.

      Popliteal

    Correct Answer
    A. Inferior Gluteal
    Explanation
    Ligation of femoral artery proximal to profunda femoris is possible because of
    continued blood flow through inferior gluteal artery (a branch of internal iliac artery),
    which anastomoses with medial and lateral circumflex femoral arteries and the first
    perforating a. (branches of profunda femoris); blood can thus pass through this
    collateral network and return through the profunda femoris to the femoral a. distal to
    the ligature.

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  • 15. 

    A 4-year-old patient comes into your office for a routine checkup accompanied by his mother. At one point during the physical exam, you ask the boy to sit on the ground and then stand up. He succeeds without difficulty. Along with ruling out a potentially debilitating muscular disease, you have also correctly tested the proper functionality of which nerve acting on muscle(s) of the hip joint?

    • A.

      Common fibular branch of the sciatic nerve

    • B.

      Inferior gluteal nerve

    • C.

      Femoral nerve

    • D.

      Superior gluteal nerve

    • E.

      Nerve to the quadratus femoris

    Correct Answer
    B. Inferior gluteal nerve
    Explanation
    Gower's sign is when the patient walks their hands up their legs to stand rather
    than using their weakened gluteal and thigh muscles. The gluteus maximus is the
    primary muscle used for standing from a sitting position and is innervated by the
    inferior gluteal nerve.

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  • 16. 

    You are volunteering at a track tournament held at a local high school. One of the athletes has injured themselves during the hurdling competition. You do a quick assessment of the injured limb, and determine that the ischial tuberosity has been avulsed. Which muscle of the posterior thigh is not affected by this injury?

    • A.

      Semitendinosus

    • B.

      Long head of the biceps femoris

    • C.

      Semimembranosus

    • D.

      Short head of the biceps femoris

    Correct Answer
    D. Short head of the biceps femoris
    Explanation
    The short head of the biceps femoris has two distinct differences from the other
    posterior thigh muscles. First, it originates from the linea aspera of the femur, not the
    ischial tuberosity (thus, it is still functional in this patient). And second, the muscle is
    innervated by the common fibular nerve, not the tibial nerve. Because of this, short
    head of biceps femoris is not a true Hamstring.

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  • 17. 

    You decide to participate in the diabetic clinic hosted by Ross Emergency Medicine Association (REMA). You are instructed by the attending physician to check for a dorsalis pedis pulse. Where will you place your fingers in order to take this pulse, and what is the origin of this artery?

    • A.

      Medial to extensor hallucis longus tendon; posterior tibial artery.

    • B.

      Lateral to extensor digitorum longus tendon; anterior tibial artery.

    • C.

      Lateral to extensor hallucis longus tendon; anterior tibial artery.

    • D.

      Lateral to extensor hallucis longus tendon; posterior tibial artery.

    Correct Answer
    C. Lateral to extensor hallucis longus tendon; anterior tibial artery.
    Explanation
    Dorsalis pedis is a branch of the anterior tibial artery and it is palpable lateral to
    the tendon of the extensor hallucis longus, or between the tendons of extensor
    hallucis longus and extensor digitorum longus, especially with the foot held in
    dorsiflexion.

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  • 18. 

    For his Behavioral Science mandatory Personal Improvement Project, Ned decides his goal is to run a marathon. He hasn’t jogged since he arrived in Dominica 1 year ago. He runs 5 miles on the first day and develops pain and swelling in his leg. What is the root cause of his symptoms?

    • A.

      Repetitive microtrauma to Tibialis Anterior muscle

    • B.

      Repetitive microtrauma to Extensor Digitorum Longus

    • C.

      Common Fibular Nerve entrapment

    • D.

      Tibial Nerve entrapment

    • E.

      Repetitive microtrauma to Plantar Fascia

    Correct Answer
    A. Repetitive microtrauma to Tibialis Anterior muscle
    Explanation
    Ned suffers from ‘shin splints’. This is commonly due to microtears of the tibialis
    anterior muscle, usually from overuse in poorly conditioned individuals. This muscle
    is a strong dorsiflexor and inverter of the foot, both of which are required when you
    jog.

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  • 19. 

    Which muscle tendon passes inferior to the lateral malleolus and inserts at the plantar surface of the base of the first metatarsal?

    • A.

      Tibialis Anterior

    • B.

      Tibialis Posterior

    • C.

      Fibularis Longus

    • D.

      Fibularis Brevis

    • E.

      Fibularis Tertius

    Correct Answer
    C. Fibularis Longus
    Explanation
    Fibularis longus tendon has a long course posterior then inferior to the lateral
    malleolus (this acts like a pulley), then inserting on the 1st metatarsal plantar surface.

    Rate this question:

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  • Current Version
  • May 28, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 29, 2011
    Quiz Created by
    Chachelly
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