SCID 242 - Quiz 5 - Gluteal And Thigh
Questions and Answers
- 1.
During recovery from a gunshot wound of the right pelvis, the patient notices a sway in his gait. When he lifts his left foot off of the ground, his pelvis dips down on the left side. The nerve that appears to have been injured is the: _________
- A.
Nerve to piriformis
- B.
Nerve to obturator internus
- C.
Sciatic nerve
- D.
Femoral nerve
- E.
Superior gluteal nerve
Correct Answer
E. Superior gluteal nerveExplanation
he superior gluteal nerve supplies gluteus minimus and medius--two muscles that are important abductors of the hip--as well as tensor fasciae latae. These muscles stabilize the pelvis when walking. The gluteus medius and minimus work in such a way that when you are standing on your right leg only, the muscles on the right side are supporting the left side of the pelvis. When you are standing on your left leg only, the muscles of the left side are supporting the right side of the pelvis. If a patient exhibits a characteristic hip drop on the uninjured side (in this case, the left side) while standing on the injured side (right), this is called Trendelenburg's sign. It occurs when the superior gluteal nerve--the nerve supply to the abductors of the thigh--is disrupted due to injury or disease.Rate this question:
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- 2.
If the head of the femur is dislocated postero-medially, compression of which nerve is likely to result?
- A.
Sciatic
- B.
Femoral
- C.
Obturator
- D.
Superior gluteal
- E.
Lumbosacral trunk
Correct Answer
A. SciaticExplanation
The sciatic nerve is closely related to the posterior hip joint, which makes this nerve very vulnerable in cases where the femur is dislocated postero-medially.Rate this question:
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- 3.
When the femur is fractured, the broken distal end often turns posteriorly to enter the popliteal fossa due to muscle traction. Because of its position deepest in the fossa, which structure is most vulnerable to laceration?
- A.
Common fibular n.
- B.
Lesser saphenous v.
- C.
Popliteal a.
- D.
Popliteal v.
- E.
Tibial n.
Correct Answer
C. Popliteal a.Explanation
The popliteal fossa contains the popliteal artery, popliteal vein, common fibular nerve, and tibial nerve. The popliteal artery is the deepest structure in the fossa--it lies on the posterior side of the knee joint. So, it is the structure that would be most likely to be lacerated by the broken distal end of the femur.Rate this question:
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- 4.
A fracture of the ischial tuberosity might be expected to most directly affect the muscles that produce which lower limb movement?
- A.
Abduction at the hip
- B.
Adduction at the hip
- C.
Extension at the knee
- D.
Flexion at the hip
- E.
Flexion at the knee
Correct Answer
E. Flexion at the kneeExplanation
The ischial tuberosity is the origin for the hamstrings muscles which are the muscles that allow for extension at the hip and flexion at the knee.Rate this question:
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- 5.
An elderly patient complains of difficulty in walking up stairs. Tests by her doctor reveal weakness in extension at her hip, but no change in hip flexion, or flexion or extension of the knee. Based upon these results, what muscle is most likely not functioning properly.
- A.
Adductor magnus
- B.
Gluteus maximus
- C.
Gluteus medius
- D.
Iliopsoas
- E.
Semitendinosus
Correct Answer
B. Gluteus maximusExplanation
Gluteus maximus is the most important muscle for powerfully extending the thigh. This is the muscle that is used for forceful extension at the hip joint, which is what you need to go up the stairs or to jump powerfully.Rate this question:
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- 6.
Weakness in climbing stairs or jumping would indicate a lesion of which nerve?
- A.
Superior gluteal
- B.
Inferior gluteal
- C.
Obturator
- D.
Femoral
- E.
Tibial
Correct Answer
B. Inferior glutealExplanation
The first thing that you want to do with this question is determine which muscle was impaired. Since the question specifies that there is a weakness when climbing steps or jumping, you should know that there is a problem with powerfully extending the hip. And that's what gluteus maximus does. The nerve to gluteus maximus, the inferior gluteal nerve, must be the nerve that was injured.Rate this question:
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- 7.
An elderly woman was found to have a hernial sac in the right femoral triangle and a marked weakness in adduction at the right hip joint. Which nerve was likely compressed by this herniation?
- A.
Femoral
- B.
Inferior gluteal
- C.
Obturator
- D.
Pudendal
- E.
Sciatic
Correct Answer
C. ObturatorExplanation
an injury to the femoral nerve would not cause problems with adduction. Instead, the patient would have problems extending her knee. The nerve which supplies the adductor compartment is the obturator nerve, so that must be the structure that was injured. Although the obturator nerve is not in the femoral triangle, it enters the thigh by passing through the obturator canal and under pectineus, part of the floor of the femoral triangle. So, it could be injured by an obturator hernia passing through the obturator canal.Rate this question:
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- 8.
If the femoral artery is occluded at the beginning of the adductor canal, which artery could help provide viability to the leg through collateral circulation?
- A.
Descending branch of the lateral circumflex femoral
- B.
Descending genicular
- C.
First perforating branch of the deep femoral
- D.
Medial circumflex femoral
- E.
Obturator
Correct Answer
A. Descending branch of the lateral circumflex femoralExplanation
The descending branch of the lateral circumflex femoral artery anastamoses with both the descending genicular branch of the femoral artery as well as the lateral superior genicular branch of the popliteal artery. These connections provide collateral circulation to the knee and leg.Rate this question:
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- 9.
A serious complication of fractures of the femoral neck is avascular necrosis of the femoral head. This usually results from rupture of which artery?
- A.
Acetabular branch of obturator
- B.
Deep circumflex iliac
- C.
Medial circumflex femoral
- D.
Descending branch of lateral circumflex femoral
- E.
Second perforating branch of lateral circumflex
Correct Answer
C. Medial circumflex femoralExplanation
It is important to remember that the medial circumflex femoral artery supplies blood to the femoral neck. During fractures of the femoral neck, this artery may be ruptured, and the femoral neck will be deprived of blood.Rate this question:
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- 10.
A patient with a tuberculous abscess (localized collection of pus) on the iliopsoas muscle in the femoral triangle presented impaired flexion of the thigh and extension of the leg. Which of the following nerves was likely involved?
- A.
Femoral
- B.
Inferior gluteal
- C.
Obturator
- D.
Sciatic
- E.
Superior gluteal
Correct Answer
A. FemoralExplanation
The quadriceps muscles, innervated by the femoral nerve, are the most important leg extensors. Rectus femoris, a component of the quads, is also a hip flexor. So, the patient's deficits, as well as the clinical history of an abscess in the femoral triangle, are consistent with an injury to the femoral nerve.Rate this question:
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- 11.
Childhood immunizations are sometimes given via intramuscular injections into the quadriceps muscles of the anterior thigh. At the mid-thigh level, a needle passing into the space deep to the sartorius muscle might pierce the femoral vessels as they lie in the: _________
- A.
Adductor canal
- B.
Adductor hiatus
- C.
Adductor triangle
- D.
Femoral canal
- E.
Femoral ring
Correct Answer
A. Adductor canalExplanation
Sartorius is the roof of the adductor canal. The femoral artery, femoral vein, saphenous nerve, and nerve to vastus medialis are all found in the adductor canal, deep to sartorius. So, if a needle pierced sartorius to enter the femoral vessels, the needle would be entering the adductor canal.Rate this question:
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- 12.
During a surgical procedure in which the lower abdominal wall has been opened, the retractor blades damaged a nerve lying between the iliacus and psoas major muscles. The patient has weakened hip flexion and an inability to extend the knee. What nerve has been compressed?
- A.
Obturator
- B.
Femoral
- C.
Sciatic
- D.
Tibial
- E.
Common fibular
Correct Answer
B. FemoralExplanation
The femoral nerve lies between the iliacus and psoas major muscles. So, if a surgeon pulls these muscles apart with a retractor, the femoral nerve can be easily injured.Rate this question:
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- 13.
Following surgical opening of the adductor canal, a patient experienced a loss of cutaneous sensation of the medial side of the leg. Which nerve was cut?
- A.
Ilioinguinal
- B.
Femoral
- C.
Obturator
- D.
Medial sural cutaneous
- E.
Saphenous
Correct Answer
E. SaphenousExplanation
The saphenous nerve is a branch of the femoral nerve. This nerve, and the nerve to vastus medialis, are the only nerves found in the adductor canal. So, it makes sense that one of these structures was injured. The saphenous nerve is a sensory nerve only; it supplies the skin on the medial side of the leg.Rate this question:
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Current Version
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Mar 18, 2023Quiz Edited by
ProProfs Editorial Team -
Oct 06, 2015Quiz Created by
Permphan
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