Chapter: Upper Limb Anatomy; Topic: Muscles of the Arm; Subtopic: Actions of Posterior Compartment Muscles
Keyword Definitions:
Anconeus: A small triangular muscle located at the posterolateral elbow assisting triceps in extension.
Elbow Extensors: Muscles primarily responsible for extension, mainly triceps brachii.
Accessory Muscles: Muscles that support but do not perform the primary action.
Posterior Arm Compartment: Contains triceps and anconeus, both innervated by radial nerve.
Stabilization Role: Anconeus helps stabilize the elbow joint during forearm movements.
1) Lead Question – 2016
What is the action of anconeus?
A) Primary elbow extensor
B) Assists extension of elbow
C) Wrist extension
D) Thumb abduction
Answer: B) Assists extension of elbow
Explanation: The anconeus muscle is a small, triangular muscle situated near the lateral epicondyle of the humerus. It contributes to elbow extension but is not the primary extensor; that role belongs to the triceps brachii. Instead, anconeus acts as a synergist assisting triceps in extension, stabilizing the elbow joint during pronation-supination, and helping in maintaining joint alignment. It does not contribute to wrist extension or thumb movements. Therefore, the correct answer is B.
2) Anconeus is innervated by–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: C) Radial nerve
Explanation: Anconeus receives motor supply from the radial nerve, similar to triceps, reinforcing its role in elbow extension. Thus, C is correct.
3) Primary extensor of the elbow is–
A) Brachialis
B) Triceps brachii
C) Anconeus
D) Biceps brachii
Answer: B) Triceps brachii
Explanation: Triceps is the main extensor of the elbow, with anconeus acting only as an accessory muscle. Thus, B is correct.
4) Anconeus contributes to which additional function?
A) Wrist flexion
B) Elbow joint stabilization
C) Thumb opposition
D) Shoulder internal rotation
Answer: B) Elbow joint stabilization
Explanation: Anconeus stabilizes the elbow during pronation-supination. Thus, B is correct.
5) Anconeus originates from–
A) Olecranon
B) Lateral epicondyle
C) Medial epicondyle
D) Radial tuberosity
Answer: B) Lateral epicondyle
Explanation: It arises from the posterior surface of the lateral epicondyle. Thus, B is correct.
6) A patient has weak elbow extension but normal triceps strength. Which muscle is likely affected?
A) Biceps
B) Brachialis
C) Anconeus
D) Supinator
Answer: C) Anconeus
Explanation: If triceps is intact but extension is weak in terminal range, anconeus involvement is suspected. Thus, C is correct.
7) Anconeus inserts on–
A) Coronoid process
B) Olecranon and upper ulna
C) Radial head
D) Ulnar styloid
Answer: B) Olecranon and upper ulna
Explanation: Anconeus fibers attach to lateral olecranon and posterior ulna. Thus, B is correct.
8) Which movement would remain unchanged if anconeus is paralyzed?
A) Elbow extension strength
B) Elbow stability
C) Wrist extension
D) Terminal locking of elbow
Answer: C) Wrist extension
Explanation: Wrist extension is radial-nerve mediated but unrelated to anconeus. Thus, C is correct.
9) Anconeus assists which muscle during extension?
A) Brachioradialis
B) Triceps brachii
C) Deltoid
D) Latissimus dorsi
Answer: B) Triceps brachii
Explanation: Anconeus works synergistically with triceps. Thus, B is correct.
10) Which nerve root contributes to anconeus innervation?
A) C5
B) C6
C) C8
D) T1
Answer: C) C8
Explanation: Radial nerve branches supplying anconeus commonly derive from C7–C8 fibers. Thus, C is correct.
11) Pain at the posterolateral elbow with resisted extension may indicate injury to–
A) Anconeus
B) Pronator teres
C) Palmaris longus
D) FCR
Answer: A) Anconeus
Explanation: Localized pain at lateral elbow with extension implicates anconeus strain. Thus, A is correct.
Chapter: Upper Limb Anatomy; Topic: Shoulder Girdle Muscles; Subtopic: Muscles Used in Climbing
Keyword Definitions:
Latissimus Dorsi: Large muscle of the back responsible for powerful extension, adduction, and internal rotation of the humerus.
Rhomboideus: Muscle that retracts and stabilizes the scapula.
Trapezius: Muscle responsible for elevation, rotation, and retraction of the scapula.
Levator Scapulae: Elevates scapula and assists in downward rotation.
Climbing Musculature: Combination of shoulder extensors and adductors enabling pulling movements.
1) Lead Question – 2016
Which muscle helps in climbing a tree?
A) Latissimus dorsi
B) Rhomboideus
C) Trapezius
D) Levator scapulae
Answer: A) Latissimus dorsi
Explanation: Latissimus dorsi is the principal muscle used during climbing because it produces powerful extension, adduction, and internal rotation of the humerus. These actions bring the body upward by pulling the trunk toward the upper limb. It also stabilizes the posterior axillary fold and contributes strongly during activities such as rowing, swimming, and climbing. Rhomboids and levator scapulae help stabilize the scapula, while trapezius aids in scapular motion but does not generate the primary pull required for climbing. Therefore, the correct answer is A.
2) Latissimus dorsi is innervated by–
A) Axillary nerve
B) Thoracodorsal nerve
C) Dorsal scapular nerve
D) Long thoracic nerve
Answer: B) Thoracodorsal nerve
Explanation: Thoracodorsal nerve (branch of posterior cord) supplies latissimus dorsi, enabling climbing actions. Thus, B is correct.
3) A patient unable to retract the scapula likely has dysfunction of–
A) Rhomboids
B) Latissimus dorsi
C) Pectoralis minor
D) Serratus anterior
Answer: A) Rhomboids
Explanation: Rhomboids retract and stabilize the scapula. Injury impairs retraction. Thus, A is correct.
4) Trapezius paralysis leads to–
A) Winged scapula
B) Loss of scapular elevation
C) Loss of humeral extension
D) Weak elbow flexion
Answer: B) Loss of scapular elevation
Explanation: Trapezius elevates and rotates scapula. Injury causes drooping. Thus, B is correct.
5) The primary muscle for overhead abduction beyond 90° is–
A) Deltoid
B) Latissimus dorsi
C) Trapezius
D) Rhomboids
Answer: C) Trapezius
Explanation: Trapezius upwardly rotates scapula during overhead abduction. Thus, C is correct.
6) Levator scapulae is supplied mainly by–
A) Spinal accessory nerve
B) Dorsal scapular nerve
C) Thoracodorsal nerve
D) Suprascapular nerve
Answer: B) Dorsal scapular nerve
Explanation: Levator scapulae receives dorsal scapular nerve with C3–C4. Thus, B is correct.
7) During climbing, the latissimus dorsi synergizes with–
A) Deltoid
B) Teres major
C) Supraspinatus
D) Infraspinatus
Answer: B) Teres major
Explanation: Teres major assists latissimus dorsi in extension and adduction. Thus, B is correct.
8) Loss of thoracodorsal nerve results in inability to–
A) Elevate scapula
B) Extend humerus
C) Externally rotate humerus
D) Initiate abduction
Answer: B) Extend humerus
Explanation: Thoracodorsal nerve innervates latissimus dorsi which extends humerus. Thus, B is correct.
9) A rock climber with difficulty pulling upward likely has weakness of–
A) Latissimus dorsi
B) Supraspinatus
C) Biceps brachii
D) Trapezius
Answer: A) Latissimus dorsi
Explanation: Pulling the trunk upward relies heavily on latissimus dorsi. Thus, A is correct.
10) Teres major inserts on–
A) Intertubercular groove (medial lip)
B) Greater tuberosity
C) Lesser tuberosity
D) Deltoid tuberosity
Answer: A) Intertubercular groove (medial lip)
Explanation: Teres major inserts on medial lip aiding extension and adduction. Thus, A is correct.
11) A patient with difficulty hiking body upward while holding overhead bars likely has injury to–
A) Radial nerve
B) Thoracodorsal nerve
C) Axillary nerve
D) Suprascapular nerve
Answer: B) Thoracodorsal nerve
Explanation: This nerve supplies latissimus dorsi, essential for climbing. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Forearm Arteries; Subtopic: Interosseous Arterial Branches
Keyword Definitions:
Common Interosseous Artery: A short branch of the ulnar artery dividing into anterior and posterior interosseous arteries.
Posterior Interosseous Artery: A deep forearm artery supplying extensor compartment structures.
Anterior Interosseous Artery: Companion artery to anterior interosseous nerve, supplying deep flexors.
Ulnar Artery: Major medial forearm artery giving rise to common interosseous artery.
Radial Recurrent Arteries: Branches participating in elbow anastomosis.
1) Lead Question – 2016
Posterior interosseous artery is a branch of?
A) Common interosseous artery
B) Radial artery
C) Median artery
D) Brachial artery
Answer: A) Common interosseous artery
Explanation: The common interosseous artery is a short trunk arising from the ulnar artery in the cubital fossa. It quickly divides into anterior and posterior interosseous arteries. The posterior interosseous artery passes through the interosseous membrane and enters the extensor compartment, supplying the posterior forearm muscles. It does not arise from the radial, median, or brachial arteries. Therefore, the correct answer is A. This artery plays an important role in collateral circulation around the wrist and elbow.
2) The common interosseous artery originates from–
A) Radial artery
B) Ulnar artery
C) Brachial artery
D) Deep brachial artery
Answer: B) Ulnar artery
Explanation: It arises just distal to the ulnar origin and divides into anterior and posterior interosseous arteries. Thus, B is correct.
3) Posterior interosseous artery supplies–
A) Flexor muscles
B) Extensor muscles
C) Brachialis
D) Palmar interossei
Answer: B) Extensor muscles
Explanation: It enters the posterior compartment to supply wrist and finger extensors. Thus, B is correct.
4) Posterior interosseous nerve accompanies which artery?
A) Median artery
B) Radial artery
C) Posterior interosseous artery
D) Anterior ulnar recurrent
Answer: C) Posterior interosseous artery
Explanation: The artery accompanies the nerve in the posterior compartment. Thus, C is correct.
5) The anterior interosseous artery runs with–
A) Median nerve
B) Anterior interosseous nerve
C) Radial nerve
D) Ulnar nerve
Answer: B) Anterior interosseous nerve
Explanation: Both structures course along the interosseous membrane. Thus, B is correct.
6) A patient with posterior compartment ischemia may have compromised–
A) Posterior interosseous artery
B) Radial recurrent artery
C) Ulnar collateral artery
D) Deep palmar arch
Answer: A) Posterior interosseous artery
Explanation: This artery is the major supply to extensor compartment. Thus, A is correct.
7) Which artery participates in the dorsal carpal arch?
A) Posterior interosseous artery
B) Princeps pollicis
C) Ulnar recurrent
D) Deep brachial
Answer: A) Posterior interosseous artery
Explanation: It joins with dorsal carpal branches of radial and ulnar arteries. Thus, A is correct.
8) The radial artery gives rise to which branch?
A) Anterior interosseous
B) Posterior interosseous
C) Radial recurrent
D) Inferior ulnar collateral
Answer: C) Radial recurrent
Explanation: Radial recurrent participates in elbow anastomosis. Thus, C is correct.
9) Median artery is a branch associated with–
A) Variants of ulnar artery
B) Variants of radial artery
C) Variants of axillary artery
D) Variants of brachial artery
Answer: A) Variants of ulnar artery
Explanation: The persistent median artery often arises from ulnar variants. Thus, A is correct.
10) Which artery gives nutrient branches to the radius?
A) Posterior interosseous
B) Anterior interosseous
C) Radial
D) Ulnar
Answer: B) Anterior interosseous
Explanation: Anterior interosseous artery sends nutrient branches to radius. Thus, B is correct.
11) A laceration in the extensor compartment mainly risks injury to–
A) Anterior interosseous artery
B) Posterior interosseous artery
C) Deep brachial artery
D) Superior ulnar collateral
Answer: B) Posterior interosseous artery
Explanation: This artery lies within the extensor compartment and is vulnerable in dorsal forearm trauma. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Clavicular Region; Subtopic: Muscles Protecting Neurovascular Structures
Keyword Definitions:
Subclavius: Small muscle beneath the clavicle protecting brachial plexus and subclavian vessels.
Brachial Plexus: Major nerve network supplying the upper limb, located inferior to clavicle.
Clavicle Fracture: Common injury where displaced fragments may threaten underlying structures.
Subclavian Vessels: Large artery and vein passing under clavicle.
Shoulder Girdle Muscles: Muscles stabilizing clavicle and scapula during upper limb motion.
1) Lead Question – 2016
Which muscle protects the brachial plexus in case of clavicle fractures?
A) Subclavius
B) Supraspinatus
C) Subscapularis
D) Teres minor
Answer: A) Subclavius
Explanation: The subclavius muscle lies directly beneath the clavicle, inserting onto its inferior surface. During clavicle fractures, especially mid-shaft injuries, the sharp bone fragments may threaten the brachial plexus and subclavian vessels below. The subclavius acts as a protective cushion, preventing direct damage. None of the other listed muscles lie in this position or serve this protective role. Supraspinatus is superior to the scapula, subscapularis lies on the anterior surface of the scapula, and teres minor is posterior. Thus, the correct answer is A.
2) Subclavius is innervated by–
A) Nerve to subclavius
B) Long thoracic nerve
C) Axillary nerve
D) Suprascapular nerve
Answer: A) Nerve to subclavius
Explanation: The muscle receives its supply from C5–C6 via the nerve to subclavius. Thus, A is correct.
3) Which vessel is most at risk in clavicular fractures?
A) Axillary artery
B) Subclavian artery
C) Radial artery
D) Ulnar artery
Answer: B) Subclavian artery
Explanation: The subclavian artery runs beneath the clavicle. Thus, B is correct.
4) Which structure runs posterior to the clavicle?
A) Brachial plexus
B) Cephalic vein
C) Median nerve
D) Basilic vein
Answer: A) Brachial plexus
Explanation: The trunks of the brachial plexus lie inferior and posterior to the clavicle. Thus, A is correct.
5) Subclavius stabilizes which joint?
A) AC joint
B) Sternoclavicular joint
C) Glenohumeral joint
D) Scapulothoracic joint
Answer: B) Sternoclavicular joint
Explanation: Subclavius anchors clavicle to first rib, stabilizing SC joint. Thus, B is correct.
6) A patient with clavicular fracture shows numbness in lateral arm. Which nerve root is likely affected?
A) C5
B) C8
C) T1
D) C7
Answer: A) C5
Explanation: Upper trunk compression affects C5, producing lateral arm sensory loss. Thus, A is correct.
7) Which muscle elevates the first rib along with sternocleidomastoid?
A) Subclavius
B) Scalenus anterior
C) Pectoralis minor
D) Trapezius
Answer: A) Subclavius
Explanation: Subclavius can assist in first rib stabilization or slight elevation. Thus, A is correct.
8) Clavicle fractures most commonly occur at–
A) Medial third
B) Middle third
C) Lateral third
D) Clavicular head
Answer: B) Middle third
Explanation: The middle third is structurally weakest. Thus, B is correct.
9) Subclavius inserts on the–
A) Clavicle (inferior surface)
B) First rib midpoint
C) Acromion
D) Coracoid process
Answer: A) Clavicle (inferior surface)
Explanation: It attaches to the subclavian groove. Thus, A is correct.
10) Which muscle depresses the clavicle?
A) Subclavius
B) Sternocleidomastoid
C) Supraspinatus
D) Levator scapulae
Answer: A) Subclavius
Explanation: Subclavius pulls clavicle downward and medially. Thus, A is correct.
11) Injury to subclavian vein may lead to–
A) Air embolism
B) Digital ischemia
C) Median nerve palsy
D) Horner syndrome
Answer: A) Air embolism
Explanation: Subclavian vein injury may suck in air under negative pressure, causing embolism. Thus, A is correct.
Chapter: Upper Limb Anatomy; Topic: Arterial Supply of Hand; Subtopic: Deep Palmar Arch
Keyword Definitions:
Deep Palmar Arch: Main arterial arch of palm located deep to flexor tendons.
Radial Artery: Major contributor to deep palmar arch.
Ulnar Artery: Contributes minor branch to deep arch but mainly forms superficial palmar arch.
Perforating Branches: Arterial branches connecting deep arch to dorsal metacarpal arteries.
Anastomosis: Vascular connection between deep and superficial palmar arches ensuring collateral circulation.
1) Lead Question – 2016
Which of the following is true about deep palmar arch?
A) Mainly formed by the radial artery
B) Ulnar artery has no contribution to it
C) It gives off 5 perforating branches
D) It does not anastomose with the superficial palmar arch
Answer: A) Mainly formed by the radial artery
Explanation: The deep palmar arch lies deep in the palm and is primarily formed by the terminal portion of the radial artery. The ulnar artery contributes a smaller deep branch joining the arch. It gives off three perforating branches, not five, which connect with dorsal metacarpal arteries. It also anastomoses with the superficial palmar arch via communicating branches, ensuring collateral blood flow to the digits. Hence, the correct statement is that the deep palmar arch is mainly formed by the radial artery.
2) The superficial palmar arch is mainly formed by–
A) Radial artery
B) Ulnar artery
C) Deep brachial artery
D) Anterior interosseous artery
Answer: B) Ulnar artery
Explanation: The ulnar artery is the major contributor to the superficial palmar arch, with radial artery giving a smaller contribution. Thus, B is correct.
3) The deep branch of ulnar artery passes with which nerve?
A) Median nerve
B) Deep branch of ulnar nerve
C) Superficial radial nerve
D) Posterior interosseous nerve
Answer: B) Deep branch of ulnar nerve
Explanation: Both structures pass between hypothenar muscles to join the deep palmar arch. Thus, B is correct.
4) Which artery forms the princeps pollicis artery?
A) Ulnar artery
B) Radial artery
C) Deep palmar arch
D) Superficial palmar arch
Answer: B) Radial artery
Explanation: Radial artery gives the main supply to the thumb via princeps pollicis. Thus, B is correct.
5) Deep palmar arch lies at the level of–
A) Distal transverse crease
B) Proximal transverse crease
C) Heads of metacarpals
D) Bases of metacarpals
Answer: D) Bases of metacarpals
Explanation: It lies deep and proximal at the level of metacarpal bases. Thus, D is correct.
6) A penetrating injury to the first web space may damage–
A) Superficial palmar arch
B) Deep palmar arch
C) Ulnar artery
D) Palmar interossei
Answer: B) Deep palmar arch
Explanation: The deep arch crosses the bases of metacarpals including the first web space. Thus, B is correct.
7) Dorsal metacarpal arteries arise from–
A) Deep palmar arch
B) Superficial palmar arch
C) Dorsal carpal arch
D) Radial recurrent artery
Answer: C) Dorsal carpal arch
Explanation: Dorsal carpal arch supplies dorsal metacarpal arteries. Thus, C is correct.
8) Palmar metacarpal arteries arise from–
A) Deep palmar arch
B) Superficial palmar arch
C) Radial recurrent
D) Ulnar recurrent
Answer: A) Deep palmar arch
Explanation: Palmar metacarpal arteries originate from deep arch and join common digital arteries. Thus, A is correct.
9) Which branch connects deep and superficial arches?
A) Perforating branches
B) Communicating branch
C) Recurrent branch
D) Nutrient branch
Answer: B) Communicating branch
Explanation: The communicating branch ensures anastomosis between arches. Thus, B is correct.
10) Radial artery enters the palm by passing between–
A) Flexor digitorum tendons
B) Heads of first dorsal interosseous
C) ADM and FDM
D) Lumbricals
Answer: B) Heads of first dorsal interosseous
Explanation: It passes dorsally then through the first interosseous space to enter palm. Thus, B is correct.
11) Deep palmar arch supplies primarily–
A) Skin of palm
B) Extensor tendons
C) Phalanges
D) Interossei and deep hand muscles
Answer: D) Interossei and deep hand muscles
Explanation: Deep arch supplies intrinsic deep muscles including interossei and adductor pollicis. Thus, D is correct.
Chapter: Upper Limb Anatomy; Topic: Scapula – Palpable Landmarks; Subtopic: Coracoid Process & Surface Anatomy
Keyword Definitions:
Coracoid Process: An anterior projection of scapula palpable in infraclavicular fossa.
Spine of Scapula: A posterior ridge dividing supraspinous and infraspinous fossae.
Infraclavicular Fossa: Depression below clavicle bounded by deltoid and pectoralis major.
Scapular Landmarks: Anatomical points used for clinical palpation and muscle attachment.
Anterior Scapular Palpation: Palpation of coracoid process through deltopectoral groove.
1) Lead Question – 2016
Which part of scapula can be palpated in the infraclavicular fossa?
A) Coracoid process
B) Spine of scapula
C) Inferior angle
D) Supraspinous fossa
Answer: A) Coracoid process
Explanation: The coracoid process is a hook-like projection of the scapula that lies anteriorly and can be easily felt in the infraclavicular fossa, specifically within the deltopectoral groove. It serves as an attachment for pectoralis minor, short head of biceps, and coracobrachialis. The spine of scapula and supraspinous fossa are posterior structures and cannot be palpated anteriorly. The inferior angle is located posteroinferiorly. Hence, the only structure palpable in the infraclavicular region is the coracoid process, making option A correct.
2) The coracoid process gives attachment to–
A) Supraspinatus
B) Pectoralis minor
C) Teres major
D) Infraspinatus
Answer: B) Pectoralis minor
Explanation: Pectoralis minor originates from ribs 3–5 and inserts on coracoid process. Thus, B is correct.
3) The structure passing through the deltopectoral groove is–
A) Cephalic vein
B) Basilic vein
C) Subclavian artery
D) Thoracoacromial nerve
Answer: A) Cephalic vein
Explanation: Cephalic vein runs in deltopectoral groove close to coracoid. Thus, A is correct.
4) A surgeon palpates coracoid process to locate origin of–
A) Long head of biceps
B) Short head of biceps
C) Triceps lateral head
D) Trapezius
Answer: B) Short head of biceps
Explanation: Short head arises from coracoid process. Thus, B is correct.
5) Which artery lies close to coracoid process during procedures?
A) Thoracoacromial artery
B) Axillary artery
C) Radial artery
D) Ulnar artery
Answer: B) Axillary artery
Explanation: Axillary artery passes inferior to coracoid, clinically important. Thus, B is correct.
6) The inferior angle of scapula is located at vertebral level–
A) T1
B) T7
C) T12
D) L1
Answer: B) T7
Explanation: Inferior angle aligns with T7 spinous process. Thus, B is correct.
7) Supraspinous fossa contains–
A) Subscapularis
B) Supraspinatus
C) Infraspinatus
D) Teres minor
Answer: B) Supraspinatus
Explanation: Supraspinatus lies above the spine in supraspinous fossa. Thus, B is correct.
8) Axillary nerve can be palpated near–
A) Coracoid process
B) Surgical neck of humerus
C) Manubrium
D) Medial epicondyle
Answer: B) Surgical neck of humerus
Explanation: It winds around surgical neck with posterior circumflex humeral artery. Thus, B is correct.
9) A patient with shoulder trauma has tenderness at coracoid. Likely injured muscle is–
A) Pectoralis minor
B) Teres major
C) Deltoid
D) Supraspinatus
Answer: A) Pectoralis minor
Explanation: Pectoralis minor inserts on coracoid and is involved in anterior shoulder trauma. Thus, A is correct.
10) The coracoclavicular ligament attaches coracoid to–
A) Manubrium
B) Clavicle
C) Scapular spine
D) Humerus
Answer: B) Clavicle
Explanation: It stabilizes AC joint via conoid and trapezoid parts. Thus, B is correct.
11) The coracoacromial arch prevents–
A) Inferior migration of humeral head
B) Superior migration of humeral head
C) Rotation of scapula
D) Medial humeral shift
Answer: B) Superior migration of humeral head
Explanation: Arch formed by coracoid + acromion + ligament acts as superior restraint. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Forearm Muscles; Subtopic: Wrist Flexors – Insertions
Keyword Definitions:
Flexor Carpi Radialis (FCR): A wrist flexor and radial deviator inserting on bases of 2nd & 3rd metacarpals.
Metacarpal Base: Proximal part of metacarpal bone where several forearm muscles insert.
Radial Deviation: Movement of wrist toward thumb side produced by FCR.
Common Flexor Origin: Medial epicondyle giving rise to superficial flexors including FCR.
Carpal Bones: Eight small bones of wrist not involved in FCR insertion.
1) Lead Question – 2016
Flexor carpi radialis inserts into?
A) Base of 5th metatarsal
B) Base of 2nd and 3rd metacarpal
C) Scaphoid and trapezium
D) Capitate and hamate
Answer: B) Base of 2nd and 3rd metacarpal
Explanation: Flexor carpi radialis originates from the medial epicondyle of the humerus and travels along the anterior forearm. It inserts primarily on the base of the 2nd metacarpal with occasional slips to the 3rd metacarpal. This insertion enables it to flex the wrist and produce radial deviation. It does not insert on carpal bones like scaphoid or trapezium, nor on the 5th metatarsal, which belongs to the lower limb. Therefore, the correct answer is B.
2) Flexor carpi ulnaris inserts into–
A) Pisiform
B) Trapezoid
C) 2nd metacarpal
D) Capitate
Answer: A) Pisiform
Explanation: FCU inserts into pisiform and via ligaments to hamate and 5th metacarpal. Thus, A is correct.
3) FCR is innervated by–
A) Ulnar nerve
B) Median nerve
C) Radial nerve
D) Axillary nerve
Answer: B) Median nerve
Explanation: FCR is a median-nerve–supplied forearm flexor. Thus, B is correct.
4) The major action of FCR is–
A) Wrist flexion and radial deviation
B) Wrist extension
C) Finger abduction
D) Thumb extension
Answer: A) Wrist flexion and radial deviation
Explanation: FCR flexes wrist and pulls it radially. Thus, A is correct.
5) Which structure passes through FCR tunnel in flexor retinaculum?
A) FCR tendon
B) Median nerve
C) Ulnar nerve
D) FDP tendon
Answer: A) FCR tendon
Explanation: FCR has a separate fibro-osseous tunnel lateral to carpal tunnel. Thus, A is correct.
6) Pain over 2nd metacarpal base with wrist flexion suggests strain of–
A) FCU
B) FCR
C) ECRB
D) EPL
Answer: B) FCR
Explanation: FCR inserts on 2nd/3rd metacarpal; strain causes pain there. Thus, B is correct.
7) FCR originates from–
A) Lateral epicondyle
B) Medial epicondyle
C) Radius
D) Ulna
Answer: B) Medial epicondyle
Explanation: All superficial forearm flexors arise from medial epicondyle. Thus, B is correct.
8) FCR tendon is used for tendon transfer in–
A) Radial nerve palsy
B) Median nerve palsy
C) Ulnar nerve palsy
D) Axillary nerve palsy
Answer: A) Radial nerve palsy
Explanation: FCR can be transferred to restore wrist extension. Thus, A is correct.
9) The artery running close to FCR tendon at wrist is–
A) Ulnar artery
B) Radial artery
C) Anterior interosseous
D) Posterior interosseous
Answer: B) Radial artery
Explanation: Radial artery lies just lateral to FCR tendon, used for pulse palpation. Thus, B is correct.
10) The flexor retinaculum attaches laterally to–
A) Pisiform
B) Hook of hamate
C) Scaphoid tubercle
D) Ulna
Answer: C) Scaphoid tubercle
Explanation: Lateral attachments include scaphoid and trapezium. Thus, C is correct.
11) Wrist flexion is strongest when combined with–
A) Ulnar deviation
B) Radial deviation
C) Supination
D) Pronation
Answer: A) Ulnar deviation
Explanation: FCU is strongest flexor; combining ulnar deviation increases flexion force. Thus, A is correct.
Chapter: Lower Limb Anatomy; Topic: Tibia – Surface Anatomy & Attachments;
Subtopic: Lateral Tibial Condyle
Keyword Definitions:
Lateral Tibial Condyle: Upper lateral expanded part of tibia receiving attachments such as iliotibial tract.
Iliotibial Tract (ITT): Thickened fascia lata band inserting on Gerdy’s tubercle of lateral tibia.
Gerdy's Tubercle: Prominent area on lateral condyle where ITT inserts.
Ligamentum Patellae: Continuation of quadriceps tendon inserting on tibial tuberosity.
Collateral Ligaments: Medial and lateral stabilizing ligaments attached to tibia and femur.
1) Lead Question – 2016
What is true about lateral tibial condyle?
A) Iliotibial tract is attached to the lateral condyle of tibia
B) Ligamentum patellae inserts on it
C) Medial collateral ligament is attached to it
D) Semimembranosus is attached to it
Answer: A) Iliotibial tract is attached to the lateral condyle of tibia
Explanation: The lateral tibial condyle bears a prominent area called Gerdy’s tubercle where the iliotibial tract inserts. This attachment helps stabilize the lateral knee during movement. Ligamentum patellae does not attach here; instead, it inserts on the tibial tuberosity located anteriorly. Medial collateral ligament attaches to the medial condyle, not the lateral one. Semimembranosus inserts on the posteromedial aspect of tibia, not on the lateral condyle. Hence, the only correct statement regarding the lateral tibial condyle is that it receives the iliotibial tract.
2) The tibial tuberosity is the insertion of–
A) Semitendinosus
B) Ligamentum patellae
C) Sartorius
D) IT band
Answer: B) Ligamentum patellae
Explanation: Ligamentum patellae continues from the patella to insert on tibial tuberosity. Thus, B is correct.
3) Gerdy’s tubercle receives attachment of–
A) Tensor fascia lata
B) Sartorius
C) Gracilis
D) Semimembranosus
Answer: A) Tensor fascia lata
Explanation: TFL inserts via iliotibial tract onto Gerdy’s tubercle. Thus, A is correct.
4) Medial condyle of tibia gives insertion to–
A) Semimembranosus
B) Biceps femoris
C) IT band
D) Popliteus
Answer: A) Semimembranosus
Explanation: Semimembranosus inserts on posteromedial tibia. Thus, A is correct.
5) Popliteus inserts on–
A) Posterior tibia above soleal line
B) Lateral tibial condyle
C) Medial tibial condyle
D) Intercondylar eminence
Answer: A) Posterior tibia above soleal line
Explanation: Popliteus unlocks knee and inserts above the soleal line. Thus, A is correct.
6) A patient with lateral knee pain likely has inflammation of–
A) IT band at Gerdy's tubercle
B) Pes anserinus
C) Sartorius insertion
D) Popliteus tendon
Answer: A) IT band at Gerdy's tubercle
Explanation: Lateral knee pain is classic for IT band syndrome. Thus, A is correct.
7) The lateral condyle of tibia articulates with–
A) Medial femoral condyle
B) Lateral femoral condyle
C) Patella
D) Fibular head
Answer: B) Lateral femoral condyle
Explanation: Knee joint articulation pairs same-sided condyles. Thus, B is correct.
8) Fibular collateral ligament attaches to–
A) Tibia
B) Fibular head
C) Medial tibial condyle
D) Patella
Answer: B) Fibular head
Explanation: LCL spans from lateral femoral epicondyle to fibular head. Thus, B is correct.
9) Pes anserinus is formed by–
A) Sartorius, gracilis, semitendinosus
B) ITB, TFL, biceps femoris
C) Gastrocnemius heads
D) Popliteus, soleus, plantaris
Answer: A) Sartorius, gracilis, semitendinosus
Explanation: These three muscles form the goose-foot insertion. Thus, A is correct.
10) The intercondylar eminence is important for attachment of–
A) CL ligaments
B) Cruciate ligaments
C) Hamstrings
D) IT band
Answer: B) Cruciate ligaments
Explanation: ACL and PCL attach here. Thus, B is correct.
11) Injury to lateral condyle may affect–
A) IT band stability
B) Semimembranosus
C) Pes anserinus
D) MCL
Answer: A) IT band stability
Explanation: ITB insertion lies on lateral tibial condyle; trauma affects stability. Thus, A is correct.
Chapter: Lower Limb Neuroanatomy; Topic: Lumbosacral Myotomes; Subtopic: Motor Supply to Dorsiflexors of Foot
Keyword Definitions:
Extensor Hallucis Longus (EHL): Muscle extending great toe and assisting ankle dorsiflexion.
L5 Nerve Root: Major root supplying muscles responsible for dorsiflexion and toe extension.
Myotome: Group of muscles supplied predominantly by a single spinal nerve root.
Foot Drop: Weakness of ankle dorsiflexors often due to L5 root or peroneal nerve lesions.
Deep Peroneal Nerve: Peripheral nerve carrying L4–L5 fibers to EHL.
1) Lead Question – 2016
Weakness of extensor hallucis longus is due to which nerve root mainly?
A) L5
B) L4
C) S1
D) S2
Answer: A) L5
Explanation: Extensor hallucis longus is the key muscle tested for the L5 myotome. It extends the great toe and is innervated mainly by L5 fibers carried through the deep peroneal nerve. Weakness of EHL is commonly seen in L5 radiculopathy, disc herniation at L4–L5, or deep peroneal nerve neuropathy. L4 contributes mainly to quadriceps and ankle inversion, while S1 supplies plantarflexors. Thus, the muscle most strongly associated with the L5 root is EHL, making option A correct.
2) The primary action of extensor hallucis longus is–
A) Plantarflexion
B) Extension of great toe
C) Foot eversion
D) Knee extension
Answer: B) Extension of great toe
Explanation: EHL extends great toe and aids dorsiflexion. Thus, B is correct.
3) L5 radiculopathy typically presents with–
A) Loss of ankle jerk
B) Weak EHL
C) Weak plantarflexion
D) Sensory loss over heel
Answer: B) Weak EHL
Explanation: L5 is best tested by EHL strength. Thus, B is correct.
4) Deep peroneal nerve supplies all except–
A) Tibialis anterior
B) Extensor hallucis longus
C) Extensor digitorum longus
D) Fibularis longus
Answer: D) Fibularis longus
Explanation: Fibularis longus is superficial peroneal nerve supply. Thus, D is correct.
5) A patient with herniation at L4–L5 will commonly show–
A) Loss of knee jerk
B) Foot drop
C) Loss of ankle jerk
D) Weak quadriceps
Answer: B) Foot drop
Explanation: L5 compression leads to dorsiflexor weakness. Thus, B is correct.
6) Sensory loss in L5 lesion is found over–
A) Medial malleolus
B) Lateral foot
C) Dorsum of foot and great toe
D) Posterior thigh
Answer: C) Dorsum of foot and great toe
Explanation: L5 dermatome covers dorsum of foot and hallux. Thus, C is correct.
7) Extensor digitorum longus is supplied mainly by–
A) L3
B) L4
C) L5
D) S1
Answer: C) L5
Explanation: EDL shares L5 dominance like EHL. Thus, C is correct.
8) S1 root lesion most strongly affects–
A) EHL
B) Gastrocnemius
C) Tibialis anterior
D) EDL
Answer: B) Gastrocnemius
Explanation: S1 is key for plantarflexion and Achilles reflex. Thus, B is correct.
9) Weak dorsiflexion of ankle is seen in–
A) Tibial neuropathy
B) L5 radiculopathy
C) S2 lesion
D) Femoral neuropathy
Answer: B) L5 radiculopathy
Explanation: Dorsiflexors share L5 fibers; radiculopathy weakens them. Thus, B is correct.
10) A positive heel-walk test indicates–
A) L4 lesion
B) L5 weakness
C) S1 lesion
D) L3 lesion
Answer: B) L5 weakness
Explanation: Heel-walking tests dorsiflexors supplied mainly by L5. Thus, B is correct.
11) Compression of common peroneal nerve affects–
A) Plantarflexors
B) Everters and dorsiflexors
C) Hip flexors
D) Knee extensors
Answer: B) Everters and dorsiflexors
Explanation: Common peroneal nerve injury weakens L5-dominant dorsiflexors and everters. Thus, B is correct.
Chapter: Lower Limb Anatomy; Topic: Foot Arches; Subtopic: Medial & Lateral Longitudinal Arches
Keyword Definitions:
Medial Longitudinal Arch: Higher arch of foot supported by spring ligament and intrinsic muscles.
Lateral Longitudinal Arch: Flatter arch supported mainly by plantar fascia and muscle tendons.
Plantar Fascia: Thick fibrous structure forming primary support for both arches.
Spring Ligament: Supports medial arch only, connecting calcaneus to navicular.
Intrinsic Foot Muscles: Small muscles contributing to arch stabilization.
1) Lead Question – 2016
Which of the following is common between the medial and lateral plantar arch?
A) Flexor Digitorum Brevis
B) Plantar Fascia
C) Spring Ligament
D) Deltoid Ligament
Answer: B) Plantar Fascia
Explanation: The plantar fascia, also called the plantar aponeurosis, is a strong fibrous structure extending from the calcaneus to the toes. It provides essential static support to both the medial and lateral longitudinal arches by maintaining tension during weight-bearing. Flexor digitorum brevis contributes mainly to the medial arch. Spring ligament supports only the medial arch by holding the talar head. Deltoid ligament stabilizes the ankle joint and does not participate in arch maintenance. Therefore, the only structure common to both medial and lateral arches is the plantar fascia.
2) The spring ligament connects:
A) Talus to calcaneus
B) Calcaneus to navicular
C) Cuboid to navicular
D) Talus to navicular
Answer: B) Calcaneus to navicular
Explanation: The spring ligament forms the key static support of medial arch. Thus, B is correct.
3) Primary dynamic support of the medial arch is from–
A) Tibialis posterior
B) Fibularis brevis
C) Tibialis anterior
D) Gastrocnemius
Answer: A) Tibialis posterior
Explanation: Tibialis posterior maintains medial arch height. Thus, A is correct.
4) Lateral arch mainly receives support from–
A) Flexor hallucis longus
B) Fibularis longus
C) Tibialis anterior
D) Soleus
Answer: B) Fibularis longus
Explanation: Fibularis longus tendon forms sling under the foot supporting lateral arch. Thus, B is correct.
5) A patient with flat foot likely has dysfunction of–
A) Tibialis posterior
B) Fibularis brevis
C) Flexor digitorum longus
D) Gastrocnemius
Answer: A) Tibialis posterior
Explanation: Posterior tibial tendon failure leads to arch collapse. Thus, A is correct.
6) Plantar aponeurosis originates from–
A) Metatarsal heads
B) Calcaneal tuberosity
C) Navicular
D) Talus
Answer: B) Calcaneal tuberosity
Explanation: It arises from calcaneus and extends to toes supporting both arches. Thus, B is correct.
7) Medial arch bones include all except–
A) Talus
B) Navicular
C) Cuboid
D) Cuneiforms
Answer: C) Cuboid
Explanation: Cuboid belongs to lateral arch. Thus, C is correct.
8) Lateral arch includes–
A) Talus
B) Cuboid
C) Navicular
D) All cuneiforms
Answer: B) Cuboid
Explanation: Cuboid and calcaneus form the lateral arch. Thus, B is correct.
9) Failure of plantar fascia results in–
A) Cavus foot
B) Flattened arches
C) Ankle valgus
D) Toe deformities only
Answer: B) Flattened arches
Explanation: Plantar fascia is essential for both arches; rupture causes collapse. Thus, B is correct.
10) Weight transfer during stance passes mainly through–
A) Cuboid
B) Talus
C) Navicular
D) Sesamoids
Answer: B) Talus
Explanation: Talus receives body weight and transmits to arches. Thus, B is correct.
11) In pes cavus, which structure is typically tight?
A) Tibialis posterior
B) Plantar fascia
C) Spring ligament
D) ACL
Answer: B) Plantar fascia
Explanation: Excessive arch height is linked with tight plantar fascia. Thus, B is correct.