Chapter: Anatomy
Topic: Lower Limb
Subtopic: Blood Supply of Femur
Keyword Definitions:
Femoral Head: The upper rounded part of the femur that fits into the acetabulum of the hip bone.
Medial Circumflex Femoral Artery: A branch of the profunda femoris artery supplying the femoral head and neck.
Lateral Circumflex Femoral Artery: Supplies mainly the anterior and lateral aspects of thigh muscles.
Artery of Ligamentum Teres: A small artery supplying minor part of the femoral head in adults.
Avascular Necrosis: Death of bone tissue due to loss of blood supply, commonly affecting femoral head.
Lead Question - 2013
Main blood supply to the head and neck of femur comes from
a) Lateral circumflex femoral artery
b) Medial circumflex femoral artery
c) Artery of ligamentum teres
d) Popliteal artery
Explanation: The main blood supply to the head and neck of femur is from the medial circumflex femoral artery, which provides retinacular branches around the femoral neck. The lateral circumflex and ligamentum teres arteries give minor contributions. The correct answer is b) Medial circumflex femoral artery.
Guessed Question 2
Which artery is most commonly injured in fracture of the femoral neck?
a) Popliteal artery
b) Medial circumflex femoral artery
c) Lateral circumflex femoral artery
d) Femoral artery
Explanation: In fracture of the femoral neck, the medial circumflex femoral artery is commonly injured, leading to avascular necrosis of the femoral head. Its retinacular branches are particularly vulnerable. The correct answer is b) Medial circumflex femoral artery.
Guessed Question 3
Which artery provides a significant blood supply to the femoral head in children?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Artery of ligamentum teres
d) Obturator artery
Explanation: In children, the artery of ligamentum teres (a branch of the obturator artery) significantly contributes to the femoral head blood supply. This diminishes with age. The correct answer is c) Artery of ligamentum teres.
Guessed Question 4
Avascular necrosis of femoral head is most likely due to injury of which artery?
a) Medial circumflex femoral artery
b) Popliteal artery
c) Lateral circumflex femoral artery
d) Profunda femoris artery
Explanation: Damage to the medial circumflex femoral artery is the main cause of avascular necrosis of the femoral head. Its retinacular branches are crucial for blood supply. The correct answer is a) Medial circumflex femoral artery.
Guessed Question 5
During hip dislocation, which artery is at maximum risk of damage?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Inferior gluteal artery
d) Internal pudendal artery
Explanation: Posterior dislocation of the hip may disrupt the medial circumflex femoral artery, compromising femoral head vascularity. This can lead to avascular necrosis. The correct answer is a) Medial circumflex femoral artery.
Guessed Question 6
Artery of ligamentum teres is a branch of which artery?
a) Obturator artery
b) Profunda femoris artery
c) Femoral artery
d) Internal iliac artery
Explanation: The artery of ligamentum teres is usually a branch of the obturator artery. It passes through the ligament of head of femur to supply a minor part of the femoral head. The correct answer is a) Obturator artery.
Guessed Question 7
Which artery predominantly supplies the greater trochanter of femur?
a) Lateral circumflex femoral artery
b) Medial circumflex femoral artery
c) Popliteal artery
d) Artery of ligamentum teres
Explanation: The lateral circumflex femoral artery provides branches to the greater trochanter and anterior thigh region, while medial circumflex mainly supplies the head and neck. The correct answer is a) Lateral circumflex femoral artery.
Guessed Question 8
Profunda femoris artery gives rise to which important arteries supplying femur?
a) Medial and lateral circumflex femoral arteries
b) Obturator artery
c) Inferior gluteal artery
d) Superior gluteal artery
Explanation: Profunda femoris artery, the deep artery of thigh, gives rise to medial and lateral circumflex femoral arteries. These are vital for femoral head and surrounding structures. The correct answer is a) Medial and lateral circumflex femoral arteries.
Guessed Question 9
Which condition is most likely after untreated femoral neck fracture due to arterial compromise?
a) Osteoarthritis
b) Avascular necrosis
c) Osteomyelitis
d) Chondrosarcoma
Explanation: If femoral neck fractures compromise blood supply from the medial circumflex femoral artery, avascular necrosis of the femoral head may develop. The correct answer is b) Avascular necrosis.
Guessed Question 10
Retinacular arteries are branches of which artery?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Femoral artery
d) Popliteal artery
Explanation: Retinacular arteries arise from the medial circumflex femoral artery and travel along the femoral neck to supply the head. These are crucial in maintaining bone viability. The correct answer is a) Medial circumflex femoral artery.
Guessed Question 11
In slipped capital femoral epiphysis, compromised blood supply is mainly from?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Obturator artery
d) Popliteal artery
Explanation: Slipped capital femoral epiphysis (SCFE) endangers the blood supply to femoral head, especially through retinacular branches of the medial circumflex femoral artery. The correct answer is a) Medial circumflex femoral artery.
Chapter: Anatomy
Topic: Lower Limb
Subtopic: Femur and its Landmarks
Keyword Definitions:
Linea Aspera: A prominent longitudinal ridge on the posterior surface of femur giving attachment to muscles and intermuscular septa.
Gluteal Tuberosity: A roughened area lateral to linea aspera for gluteus maximus insertion.
Adductor Tubercle: Projection on medial epicondyle of femur for adductor magnus insertion.
Popliteal Surface: Smooth triangular area above femoral condyles posteriorly.
Clinical Relevance: Fractures near linea aspera may affect attachment of thigh muscles causing displacement.
Lead Question - 2013
True about linea aspera?
a) Forms lateral border of femur
b) Forms medial border of femur
c) Continues as gluteal tuberosity
d) None of the above
Explanation: Linea aspera is a vertical ridge on the posterior surface of femur, not on its medial or lateral border. Superiorly, it diverges into the gluteal tuberosity laterally and pectineal line medially. Thus, the correct answer is c) Continues as gluteal tuberosity.
Guessed Question 2
Linea aspera provides attachment to which major thigh muscles?
a) Vastus lateralis and vastus medialis
b) Gluteus minimus and sartorius
c) Biceps femoris and adductor magnus
d) Tensor fascia lata and rectus femoris
Explanation: Linea aspera serves as an important attachment site for thigh muscles like adductor magnus, adductor longus, and short head of biceps femoris. It also anchors intermuscular septa. The correct answer is c) Biceps femoris and adductor magnus.
Guessed Question 3
Which clinical consequence is likely if a femoral shaft fracture involves the linea aspera?
a) Loss of hip abduction
b) Loss of knee extension
c) Muscle displacement due to adductors and hamstrings
d) Loss of ankle dorsiflexion
Explanation: Fractures involving the linea aspera can cause displacement due to strong pull of attached muscles like adductors and hamstrings. This alters alignment of the femur. The correct answer is c) Muscle displacement due to adductors and hamstrings.
Guessed Question 4
Which structure is found between the medial and lateral lips of the linea aspera?
a) Nutrient foramen
b) Trochlear groove
c) Adductor tubercle
d) Intercondylar notch
Explanation: The nutrient foramen of the femur is commonly located near or on the linea aspera between its medial and lateral lips, providing vascular entry to the femoral shaft. The correct answer is a) Nutrient foramen.
Guessed Question 5
The upper lateral prolongation of linea aspera forms which structure?
a) Gluteal tuberosity
b) Pectineal line
c) Supracondylar ridge
d) Greater trochanter
Explanation: The linea aspera continues superiorly as the gluteal tuberosity laterally and as the pectineal line medially. These provide important muscular attachments. The correct answer is a) Gluteal tuberosity.
Guessed Question 6
The lower end of linea aspera diverges into which structures?
a) Medial and lateral supracondylar lines
b) Intercondylar fossa
c) Patellar surface
d) Popliteal surface
Explanation: Inferiorly, the linea aspera splits into medial and lateral supracondylar lines, which border the triangular popliteal surface of the femur. The correct answer is a) Medial and lateral supracondylar lines.
Guessed Question 7
Which artery passes near linea aspera and may be injured in fractures?
a) Profunda femoris artery
b) Popliteal artery
c) Obturator artery
d) Medial circumflex femoral artery
Explanation: The profunda femoris artery and its perforating branches run close to the linea aspera. They can be damaged in femoral shaft fractures, leading to hemorrhage. The correct answer is a) Profunda femoris artery.
Guessed Question 8
Which intermuscular septum is attached to the linea aspera?
a) Lateral and medial intermuscular septa
b) Posterior intermuscular septum
c) Anterior intermuscular septum
d) Obturator membrane
Explanation: The medial and lateral intermuscular septa of thigh are attached to linea aspera. They separate the anterior, medial, and posterior thigh compartments. The correct answer is a) Lateral and medial intermuscular septa.
Guessed Question 9
In radiographs, which feature helps identify the posterior aspect of the femur?
a) Patellar surface
b) Linea aspera
c) Greater trochanter
d) Lesser trochanter
Explanation: Linea aspera is a posterior landmark of femur and helps differentiate anterior from posterior surfaces on radiographs. The correct answer is b) Linea aspera.
Guessed Question 10
Which muscle inserts along the gluteal tuberosity, a continuation of the linea aspera?
a) Gluteus maximus
b) Vastus lateralis
c) Sartorius
d) Pectineus
Explanation: The gluteus maximus muscle inserts partly into the gluteal tuberosity, which is a lateral continuation of the linea aspera. This is a key insertion site for powerful hip extension. The correct answer is a) Gluteus maximus.
Guessed Question 11
Popliteal surface of femur lies just below the bifurcation of linea aspera into?
a) Medial and lateral supracondylar lines
b) Intercondylar fossa
c) Greater trochanter
d) Adductor tubercle
Explanation: The popliteal surface lies inferior to the bifurcation of linea aspera into medial and lateral supracondylar lines, forming a triangular area above condyles. The correct answer is a) Medial and lateral supracondylar lines.
Chapter: Anatomy
Topic: Lower Limb
Subtopic: Greater Trochanter and Muscle Attachments
Keyword Definitions:
Greater Trochanter: A large projection on the lateral upper part of the femur serving as a major muscle attachment site.
Gluteus Medius: Muscle originating from the outer surface of ilium, inserted into the lateral surface of greater trochanter; chief abductor of hip.
Gluteus Minimus: Smallest gluteal muscle, inserted into the anterior surface of greater trochanter.
Piriformis: Muscle from sacrum inserted on the superior border of greater trochanter; external rotator of hip.
Gluteus Maximus: Largest gluteal muscle inserted mainly into gluteal tuberosity and iliotibial tract.
Clinical Relevance: Trendelenburg sign occurs when gluteus medius/minimus are weak or damaged.
Lead Question - 2013
Muscle attached to lateral surface of greater trochanter -
a) Gluteus maximus
b) Gluteus medius
c) Gluteus minimus
d) Piriformis
Explanation: The gluteus medius inserts into the lateral surface of the greater trochanter. Gluteus minimus attaches to its anterior surface, and piriformis to its superior border. Gluteus maximus does not insert here. The correct answer is b) Gluteus medius.
Guessed Question 2
Which muscle attaches to the anterior surface of greater trochanter?
a) Gluteus medius
b) Gluteus minimus
c) Piriformis
d) Quadratus femoris
Explanation: Gluteus minimus inserts into the anterior surface of the greater trochanter and works with gluteus medius to abduct and medially rotate the thigh. The correct answer is b) Gluteus minimus.
Guessed Question 3
Piriformis inserts into which part of the greater trochanter?
a) Inferior border
b) Superior border
c) Lateral surface
d) Posterior surface
Explanation: Piriformis muscle, arising from anterior sacrum, inserts into the superior border of the greater trochanter and is an important landmark for gluteal neurovascular structures. The correct answer is b) Superior border.
Guessed Question 4
Damage to the superior gluteal nerve affects which muscle attached to greater trochanter?
a) Gluteus medius
b) Piriformis
c) Quadratus femoris
d) Obturator externus
Explanation: The superior gluteal nerve supplies gluteus medius and minimus. Damage causes Trendelenburg gait due to failure of pelvic stabilization during walking. The correct answer is a) Gluteus medius.
Guessed Question 5
Trendelenburg sign results from paralysis of which muscle?
a) Gluteus medius
b) Gluteus maximus
c) Piriformis
d) Iliopsoas
Explanation: Trendelenburg sign occurs when gluteus medius and minimus (hip abductors inserting on greater trochanter) are weak or paralyzed, leading to pelvic drop on the opposite side. The correct answer is a) Gluteus medius.
Guessed Question 6
A patient with injection injury in gluteal region develops pelvic tilt. Most likely nerve involved?
a) Superior gluteal nerve
b) Inferior gluteal nerve
c) Obturator nerve
d) Sciatic nerve
Explanation: Superior gluteal nerve injury paralyzes gluteus medius and minimus, both attached to the greater trochanter, causing pelvic drop and Trendelenburg gait. The correct answer is a) Superior gluteal nerve.
Guessed Question 7
Which muscle attaching to greater trochanter helps in medial rotation of the hip?
a) Gluteus minimus
b) Piriformis
c) Quadratus femoris
d) Obturator externus
Explanation: Gluteus minimus assists in medial rotation of the thigh at the hip joint, apart from abduction. It inserts on the anterior surface of greater trochanter. The correct answer is a) Gluteus minimus.
Guessed Question 8
In posterior hip dislocation, which muscle attached to greater trochanter is often injured?
a) Piriformis
b) Gluteus medius
c) Quadratus femoris
d) Gluteus maximus
Explanation: In posterior hip dislocation, piriformis and gluteus medius, both attached to greater trochanter, are vulnerable to stretching and tearing due to displacement of femoral head. The correct answer is a) Piriformis.
Guessed Question 9
Which bony prominence serves as an important landmark for intramuscular injections in gluteal region?
a) Greater trochanter
b) Lesser trochanter
c) Ischial spine
d) Iliac crest
Explanation: Greater trochanter is used along with iliac crest to identify safe upper outer quadrant for intramuscular injections in gluteal region, avoiding sciatic nerve. The correct answer is a) Greater trochanter.
Guessed Question 10
Which muscle attaching to greater trochanter is primarily an external rotator of hip?
a) Piriformis
b) Gluteus medius
c) Gluteus minimus
d) Tensor fascia lata
Explanation: Piriformis is primarily an external rotator of the hip joint. It attaches to the superior border of the greater trochanter and is clinically important in piriformis syndrome. The correct answer is a) Piriformis.
Guessed Question 11
Superior gluteal artery damage would compromise blood supply to which muscle attached to greater trochanter?
a) Gluteus medius
b) Piriformis
c) Adductor magnus
d) Quadriceps femoris
Explanation: Superior gluteal artery supplies gluteus medius and minimus, both attached to greater trochanter. Injury reduces blood supply and weakens hip abduction. The correct answer is a) Gluteus medius.
Chapter: Anatomy
Topic: Pelvis and Perineum
Subtopic: Sacrotuberous Ligament and Related Structures
Keyword Definitions:
Sacrotuberous Ligament: Strong ligament connecting sacrum to ischial tuberosity, stabilizing the sacroiliac joint.
Perforating Cutaneous Nerve: Small branch of sacral plexus that pierces sacrotuberous ligament to supply buttock skin.
Posterior Femoral Cutaneous Nerve: Nerve supplying posterior thigh and gluteal skin, passing beneath gluteus maximus.
Sciatic Nerve: Largest nerve of the body, leaves pelvis via greater sciatic foramen below piriformis.
Superior Gluteal Nerve: Nerve passing through greater sciatic foramen above piriformis to supply gluteus medius, minimus, and tensor fascia lata.
Clinical Relevance: Injury to sacrotuberous ligament region can cause entrapment neuropathy or gluteal pain syndromes.
Lead Question - 2013
Sacrotuberous ligament is pierced by
a) Perforating cutaneous nerve
b) Posterior femoral cutaneous
c) Superior gluteal nerve
d) Sciatic nerve
Explanation: The sacrotuberous ligament is pierced only by the perforating cutaneous nerve, which arises from the sacral plexus and supplies the medial gluteal region skin. Other nerves pass through sciatic foramina. The correct answer is a) Perforating cutaneous nerve.
Guessed Question 2
Which ligament forms the lower boundary of the lesser sciatic foramen?
a) Sacrospinous ligament
b) Sacrotuberous ligament
c) Inguinal ligament
d) Obturator membrane
Explanation: The sacrotuberous ligament extends from sacrum to ischial tuberosity, forming the lower boundary of lesser sciatic foramen. The sacrospinous ligament forms its upper boundary. The correct answer is b) Sacrotuberous ligament.
Guessed Question 3
Which nerve passes below the piriformis through the greater sciatic foramen?
a) Sciatic nerve
b) Superior gluteal nerve
c) Obturator nerve
d) Femoral nerve
Explanation: The sciatic nerve passes through the greater sciatic foramen below piriformis, running deep to gluteus maximus. Compression here may cause sciatica. The correct answer is a) Sciatic nerve.
Guessed Question 4
Which ligament along with sacrospinous converts sciatic notch into foramen?
a) Sacrotuberous ligament
b) Iliofemoral ligament
c) Pubofemoral ligament
d) Ischiofemoral ligament
Explanation: Sacrotuberous and sacrospinous ligaments transform greater and lesser sciatic notches into foramina through which pelvic nerves and vessels pass. The correct answer is a) Sacrotuberous ligament.
Guessed Question 5
In piriformis syndrome, which nerve is compressed as it passes beneath piriformis?
a) Sciatic nerve
b) Pudendal nerve
c) Posterior femoral cutaneous nerve
d) Inferior gluteal nerve
Explanation: In piriformis syndrome, the sciatic nerve gets compressed as it passes below piriformis, producing pain radiating to posterior thigh and leg. The correct answer is a) Sciatic nerve.
Guessed Question 6
Which nerve leaves pelvis through the lesser sciatic foramen?
a) Pudendal nerve
b) Superior gluteal nerve
c) Posterior femoral cutaneous nerve
d) Sciatic nerve
Explanation: The pudendal nerve exits through greater sciatic foramen, hooks around ischial spine and sacrospinous ligament, and re-enters through lesser sciatic foramen into the perineum. The correct answer is a) Pudendal nerve.
Guessed Question 7
Which structure passes between sacrotuberous and sacrospinous ligaments?
a) Pudendal nerve
b) Obturator nerve
c) Femoral nerve
d) Genitofemoral nerve
Explanation: Pudendal nerve, internal pudendal vessels, and nerve to obturator internus pass between sacrospinous and sacrotuberous ligaments to enter lesser sciatic foramen. The correct answer is a) Pudendal nerve.
Guessed Question 8
Damage to superior gluteal nerve affects which function?
a) Hip abduction
b) Hip extension
c) Hip adduction
d) Knee flexion
Explanation: Superior gluteal nerve supplies gluteus medius and minimus. Damage weakens hip abduction and causes positive Trendelenburg sign due to failure of pelvic support. The correct answer is a) Hip abduction.
Guessed Question 9
Which ligament resists posterior rotation of sacrum?
a) Sacrotuberous ligament
b) Anterior sacroiliac ligament
c) Iliofemoral ligament
d) Inguinal ligament
Explanation: Sacrotuberous ligament helps resist posterior rotation of sacrum at sacroiliac joint, stabilizing pelvis against body weight. The correct answer is a) Sacrotuberous ligament.
Guessed Question 10
Which nerve supplies posterior thigh skin but does not pierce sacrotuberous ligament?
a) Posterior femoral cutaneous nerve
b) Perforating cutaneous nerve
c) Obturator nerve
d) Pudendal nerve
Explanation: Posterior femoral cutaneous nerve passes below gluteus maximus to supply posterior thigh skin but does not pierce sacrotuberous ligament. The correct answer is a) Posterior femoral cutaneous nerve.
Guessed Question 11
Entrapment of perforating cutaneous nerve causes pain in which region?
a) Medial gluteal region
b) Posterior thigh
c) Perineum
d) Lateral leg
Explanation: The perforating cutaneous nerve, piercing sacrotuberous ligament, supplies medial gluteal region. Entrapment or irritation causes localized gluteal pain. The correct answer is a) Medial gluteal region.
Chapter: Anatomy
Topic: Lower Limb Vessels
Subtopic: Branches of Femoral Artery
Keyword Definitions:
Superficial External Pudendal Artery: Small branch of femoral artery supplying skin of lower abdomen and external genitalia.
Femoral Artery: Continuation of external iliac artery after passing beneath inguinal ligament, major artery of thigh.
External Iliac Artery: Artery that continues as femoral artery after crossing inguinal ligament.
Internal Iliac Artery: Branch of common iliac artery supplying pelvis, gluteal region, and perineum.
Great Saphenous Vein: Longest superficial vein of body, often used for bypass grafts, runs close to femoral artery branches.
Clinical Relevance: Injury to femoral artery or its branches in groin may cause hemorrhage or ischemia of genital region.
Lead Question - 2013
The superficial external pudendal artery is a branch of?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Aorta
Explanation: The superficial external pudendal artery arises from the femoral artery near the femoral triangle. It crosses the spermatic cord or round ligament to supply skin of external genitalia. The correct answer is a) Femoral artery.
Guessed Question 2
The profunda femoris artery is a direct branch of?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Popliteal artery
Explanation: Profunda femoris artery, also called deep artery of thigh, arises from femoral artery in femoral triangle. It supplies deep muscles of thigh and gives perforating branches. The correct answer is a) Femoral artery.
Guessed Question 3
Which artery supplies blood to the head and neck of femur in adults?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Obturator artery
d) Superior gluteal artery
Explanation: Medial circumflex femoral artery provides retinacular branches that supply femoral head and neck in adults. Obturator artery is important in children. The correct answer is a) Medial circumflex femoral artery.
Guessed Question 4
A patient with pelvic fracture injures internal pudendal artery. Which region is mainly affected?
a) Perineum
b) Anterior thigh
c) Lateral leg
d) Lower abdomen
Explanation: Internal pudendal artery, branch of internal iliac, supplies perineum including external genitalia, anal canal, and associated muscles. Its injury leads to perineal bleeding. The correct answer is a) Perineum.
Guessed Question 5
Which branch of femoral artery is commonly used for coronary bypass graft harvesting?
a) Great saphenous vein (vein, not artery)
b) Profunda femoris artery
c) Superficial epigastric artery
d) Superficial circumflex iliac artery
Explanation: The great saphenous vein, closely related to femoral artery branches, is harvested for coronary artery bypass surgery. Among arteries, superficial branches are too small for grafts. The correct answer is a) Great saphenous vein (though a vein, it is clinically relevant).
Guessed Question 6
A stab wound just below inguinal ligament injures femoral artery. Which immediate complication is expected?
a) Profuse bleeding and thigh ischemia
b) Perineal ischemia
c) Pelvic organ necrosis
d) Renal ischemia
Explanation: Femoral artery is main arterial supply of lower limb. Injury below inguinal ligament causes profuse bleeding and acute ischemia of thigh and leg. The correct answer is a) Profuse bleeding and thigh ischemia.
Guessed Question 7
Which artery accompanies the saphenous nerve in adductor canal?
a) Femoral artery
b) Popliteal artery
c) Profunda femoris artery
d) Obturator artery
Explanation: The femoral artery and saphenous nerve run together in adductor canal. Femoral artery continues through adductor hiatus to become popliteal artery. The correct answer is a) Femoral artery.
Guessed Question 8
Which artery gives rise to superficial epigastric artery?
a) Femoral artery
b) Internal iliac artery
c) External iliac artery
d) Inferior epigastric artery
Explanation: The superficial epigastric artery arises from femoral artery just below inguinal ligament, supplying lower anterior abdominal wall skin. The correct answer is a) Femoral artery.
Guessed Question 9
In case of occlusion of femoral artery just distal to inguinal ligament, which artery helps collateral circulation?
a) Inferior gluteal artery
b) Superior epigastric artery
c) Internal pudendal artery
d) Posterior tibial artery
Explanation: Inferior gluteal artery, branch of internal iliac, anastomoses with profunda femoris branches, providing collateral supply when femoral artery is blocked. The correct answer is a) Inferior gluteal artery.
Guessed Question 10
A patient presents with scrotal skin ischemia after groin trauma. Which artery is most likely injured?
a) Superficial external pudendal artery
b) Deep femoral artery
c) Internal pudendal artery
d) Superficial circumflex iliac artery
Explanation: Superficial external pudendal artery supplies skin of scrotum or labia majora. Injury leads to ischemia and necrosis of external genital skin. The correct answer is a) Superficial external pudendal artery.
Guessed Question 11
Which artery is palpated at femoral pulse just below inguinal ligament?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Profunda femoris artery
Explanation: Femoral artery lies just below inguinal ligament at mid-inguinal point, between anterior superior iliac spine and pubic symphysis. It is the site for femoral pulse palpation and catheter insertion. The correct answer is a) Femoral artery.
Chapter: Anatomy
Topic: Lower Limb Vessels
Subtopic: Branches of Femoral Artery
Keyword Definitions:
Superficial External Pudendal Artery: Small branch of femoral artery supplying skin of lower abdomen and external genitalia.
Femoral Artery: Continuation of external iliac artery after passing beneath inguinal ligament, major artery of thigh.
External Iliac Artery: Artery that continues as femoral artery after crossing inguinal ligament.
Internal Iliac Artery: Branch of common iliac artery supplying pelvis, gluteal region, and perineum.
Great Saphenous Vein: Longest superficial vein of body, often used for bypass grafts, runs close to femoral artery branches.
Clinical Relevance: Injury to femoral artery or its branches in groin may cause hemorrhage or ischemia of genital region.
Lead Question - 2013
The superficial external pudendal artery is a branch of?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Aorta
Explanation: The superficial external pudendal artery arises from the femoral artery near the femoral triangle. It crosses the spermatic cord or round ligament to supply skin of external genitalia. The correct answer is a) Femoral artery.
Guessed Question 2
The profunda femoris artery is a direct branch of?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Popliteal artery
Explanation: Profunda femoris artery, also called deep artery of thigh, arises from femoral artery in femoral triangle. It supplies deep muscles of thigh and gives perforating branches. The correct answer is a) Femoral artery.
Guessed Question 3
Which artery supplies blood to the head and neck of femur in adults?
a) Medial circumflex femoral artery
b) Lateral circumflex femoral artery
c) Obturator artery
d) Superior gluteal artery
Explanation: Medial circumflex femoral artery provides retinacular branches that supply femoral head and neck in adults. Obturator artery is important in children. The correct answer is a) Medial circumflex femoral artery.
Guessed Question 4
A patient with pelvic fracture injures internal pudendal artery. Which region is mainly affected?
a) Perineum
b) Anterior thigh
c) Lateral leg
d) Lower abdomen
Explanation: Internal pudendal artery, branch of internal iliac, supplies perineum including external genitalia, anal canal, and associated muscles. Its injury leads to perineal bleeding. The correct answer is a) Perineum.
Guessed Question 5
Which branch of femoral artery is commonly used for coronary bypass graft harvesting?
a) Great saphenous vein (vein, not artery)
b) Profunda femoris artery
c) Superficial epigastric artery
d) Superficial circumflex iliac artery
Explanation: The great saphenous vein, closely related to femoral artery branches, is harvested for coronary artery bypass surgery. Among arteries, superficial branches are too small for grafts. The correct answer is a) Great saphenous vein (though a vein, it is clinically relevant).
Guessed Question 6
A stab wound just below inguinal ligament injures femoral artery. Which immediate complication is expected?
a) Profuse bleeding and thigh ischemia
b) Perineal ischemia
c) Pelvic organ necrosis
d) Renal ischemia
Explanation: Femoral artery is main arterial supply of lower limb. Injury below inguinal ligament causes profuse bleeding and acute ischemia of thigh and leg. The correct answer is a) Profuse bleeding and thigh ischemia.
Guessed Question 7
Which artery accompanies the saphenous nerve in adductor canal?
a) Femoral artery
b) Popliteal artery
c) Profunda femoris artery
d) Obturator artery
Explanation: The femoral artery and saphenous nerve run together in adductor canal. Femoral artery continues through adductor hiatus to become popliteal artery. The correct answer is a) Femoral artery.
Guessed Question 8
Which artery gives rise to superficial epigastric artery?
a) Femoral artery
b) Internal iliac artery
c) External iliac artery
d) Inferior epigastric artery
Explanation: The superficial epigastric artery arises from femoral artery just below inguinal ligament, supplying lower anterior abdominal wall skin. The correct answer is a) Femoral artery.
Guessed Question 9
In case of occlusion of femoral artery just distal to inguinal ligament, which artery helps collateral circulation?
a) Inferior gluteal artery
b) Superior epigastric artery
c) Internal pudendal artery
d) Posterior tibial artery
Explanation: Inferior gluteal artery, branch of internal iliac, anastomoses with profunda femoris branches, providing collateral supply when femoral artery is blocked. The correct answer is a) Inferior gluteal artery.
Guessed Question 10
A patient presents with scrotal skin ischemia after groin trauma. Which artery is most likely injured?
a) Superficial external pudendal artery
b) Deep femoral artery
c) Internal pudendal artery
d) Superficial circumflex iliac artery
Explanation: Superficial external pudendal artery supplies skin of scrotum or labia majora. Injury leads to ischemia and necrosis of external genital skin. The correct answer is a) Superficial external pudendal artery.
Guessed Question 11
Which artery is palpated at femoral pulse just below inguinal ligament?
a) Femoral artery
b) External iliac artery
c) Internal iliac artery
d) Profunda femoris artery
Explanation: Femoral artery lies just below inguinal ligament at mid-inguinal point, between anterior superior iliac spine and pubic symphysis. It is the site for femoral pulse palpation and catheter insertion. The correct answer is a) Femoral artery.
Keyword Definitions
• Lymph nodes – Small immune structures filtering lymphatic fluid.
• Superficial inguinal lymph nodes – Drain superficial structures of lower limb, external genitalia, and lower abdominal wall.
• Deep inguinal nodes – Located beneath fascia lata, drain deep lymphatics of lower limb.
• External iliac nodes – Drain lymph from pelvic organs and deep inguinal nodes.
• Internal iliac nodes – Drain pelvic viscera, perineum, and gluteal region.
• Great toe lymphatics – Superficial drainage follows great saphenous vein to superficial inguinal nodes.
• Popliteal lymph nodes – Located behind knee, drain deep tissues of leg.
• Clinical correlation – Swelling in groin may indicate infection or malignancy in drainage territory.
• Saphenous vein – Long superficial vein of leg, associated with superficial lymphatics.
• Sentinel lymph node – First node to receive lymph from cancer site, important in oncology.
Chapter: Anatomy / Lower Limb
Topic: Lymphatic Drainage
Subtopic: Drainage of Foot and Great Toe
Lead Question – 2013
Skin and fascia of great toe drains into?
a) Superficial inguinal lymph nodes
b) External iliac nodes
c) Internal iliac nodes
d) Deep inguinal nodes
Explanation: The superficial lymphatics of the great toe accompany the great saphenous vein and drain primarily into the superficial inguinal lymph nodes. Deep lymphatics, however, drain into deep inguinal and external iliac nodes. Correct answer: Superficial inguinal lymph nodes.
Guessed Questions for NEET PG
1) Lymph from the glans penis drains into?
a) Superficial inguinal nodes
b) Deep inguinal nodes
c) External iliac nodes
d) Internal iliac nodes
Explanation: Lymph from the glans penis and clitoris drains into deep inguinal lymph nodes (node of Cloquet). This clinical correlation is important in genitourinary cancers. Correct answer: Deep inguinal nodes.
2) Infection at the lateral side of the foot drains initially into?
a) Popliteal nodes
b) Superficial inguinal nodes
c) Deep inguinal nodes
d) External iliac nodes
Explanation: Lymphatics from the lateral foot follow the small saphenous vein and drain into popliteal lymph nodes before reaching deeper nodes. Correct answer: Popliteal nodes.
3) Which lymph nodes are involved in carcinoma of the anal canal below pectinate line?
a) Internal iliac nodes
b) External iliac nodes
c) Superficial inguinal nodes
d) Para-aortic nodes
Explanation: The anal canal below the pectinate line drains into superficial inguinal nodes, explaining why inguinal swelling may be an early sign of malignancy. Correct answer: Superficial inguinal nodes.
4) The node of Cloquet is located in?
a) Femoral ring
b) Adductor canal
c) Inguinal ligament
d) Popliteal fossa
Explanation: The node of Cloquet is the highest deep inguinal lymph node, located in the femoral canal, and communicates with external iliac nodes. Correct answer: Femoral ring.
5) Which lymph nodes drain the uterus near the round ligament?
a) Internal iliac nodes
b) Para-aortic nodes
c) Superficial inguinal nodes
d) External iliac nodes
Explanation: Lymphatics from the uterus near the round ligament follow the ligament to reach the superficial inguinal nodes. Correct answer: Superficial inguinal nodes.
6) Which is the sentinel node in carcinoma of the cervix?
a) Internal iliac nodes
b) External iliac nodes
c) Superficial inguinal nodes
d) Para-aortic nodes
Explanation: The primary lymphatic drainage of cervix is to the internal iliac and sacral nodes, making them sentinel nodes for carcinoma cervix. Correct answer: Internal iliac nodes.
7) Enlargement of which nodes may indicate infection in the great toe?
a) Deep inguinal nodes
b) Superficial inguinal nodes
c) External iliac nodes
d) Para-aortic nodes
Explanation: Infection of great toe skin or fascia drains to superficial inguinal nodes, which enlarge clinically. Correct answer: Superficial inguinal nodes.
8) Popliteal lymph nodes drain all except?
a) Lateral side of sole
b) Heel region
c) Lateral border of foot
d) Medial side of great toe
Explanation: The medial side of great toe drains into superficial inguinal nodes, not popliteal nodes. Correct answer: Medial side of great toe.
9) Lymphatic obstruction in the femoral canal primarily affects?
a) Deep inguinal nodes
b) Superficial inguinal nodes
c) Popliteal nodes
d) Internal iliac nodes
Explanation: The femoral canal contains the node of Cloquet, which is part of deep inguinal lymphatic drainage. Obstruction here causes lower limb lymphedema. Correct answer: Deep inguinal nodes.
10) Which lymph nodes are first affected in carcinoma of the testis?
a) Superficial inguinal nodes
b) Deep inguinal nodes
c) Para-aortic nodes
d) External iliac nodes
Explanation: Testicular lymphatics follow gonadal vessels and drain into para-aortic (lumbar) nodes, not inguinal nodes. Correct answer: Para-aortic nodes.
Keyword Definitions
• Ossification center – Specific area where bone formation begins.
• Primary ossification center – Appears before birth, usually in diaphysis of long bones.
• Secondary ossification center – Appears after birth, mostly at epiphyses.
• Epiphysis – End part of long bone, separated by growth plate.
• Growth plate (physis) – Cartilaginous zone responsible for bone lengthening.
• Femur – Longest bone in the body, crucial for weight bearing.
• Lower end of femur – Includes medial and lateral condyles, important for knee joint stability.
• Clinical correlation – Injuries near growth plate may cause deformity in children.
• Fusion of ossification centers – Indicates skeletal maturity, useful in forensic medicine.
• Pathology – Delay in ossification may suggest rickets or endocrinological disorders.
Chapter: Anatomy / Lower Limb
Topic: Ossification of Femur
Subtopic: Lower End of Femur
Lead Question – 2013
Lower end of femur is ossified from how many ossification centers?
a) 1
b) 2
c) 3
d) 4
Explanation: The lower end of femur is ossified from a single secondary ossification center, which appears at birth and is the largest epiphyseal center in the body. It helps determine gestational age in newborn radiographs. Correct answer: 1.
Guessed Questions for NEET PG
1) The first secondary ossification center to appear in the body is?
a) Head of femur
b) Lower end of femur
c) Upper end of tibia
d) Calcaneus
Explanation: The lower end of femur and upper end of tibia are the earliest secondary ossification centers, both appearing at birth. These are crucial in neonatal skeletal age estimation. Correct answer: Lower end of femur.
2) Which ossification center is used to determine fetal maturity in X-rays?
a) Upper end of humerus
b) Lower end of femur
c) Upper end of fibula
d) Clavicle
Explanation: The presence of the ossification center in the lower end of femur indicates intrauterine maturity after 36 weeks of gestation. Correct answer: Lower end of femur.
3) The lower end of femur fuses with shaft at what age?
a) 12 years
b) 16 years
c) 20 years
d) 25 years
Explanation: Fusion of the lower end of femur with diaphysis occurs around 20 years of age, making it a reliable marker for skeletal maturity in forensic medicine. Correct answer: 20 years.
4) Which epiphysis is the largest secondary ossification center?
a) Proximal humerus
b) Distal femur
c) Proximal tibia
d) Iliac crest
Explanation: The distal femoral epiphysis is the largest secondary ossification center, covering the condylar region. It plays a crucial role in knee growth. Correct answer: Distal femur.
5) In rickets, which ossification center shows delayed appearance?
a) Lower end of femur
b) Upper end of tibia
c) Distal radius
d) All of the above
Explanation: Rickets causes generalized delay in appearance of secondary ossification centers, including lower femur, tibia, and wrist bones. Correct answer: All of the above.
6) The ossification center at the head of femur appears at?
a) Birth
b) 1 year
c) 3 months
d) 6 years
Explanation: The head of femur ossification center appears at around 1 year of age, useful in pediatric radiology. Correct answer: 1 year.
7) Which bone has both membranous and cartilaginous ossification?
a) Femur
b) Clavicle
c) Tibia
d) Radius
Explanation: The clavicle develops from both intramembranous and endochondral ossification, unlike femur which is purely cartilaginous in origin. Correct answer: Clavicle.
8) A neonate with no ossification center at lower femur is likely?
a) Term baby
b) Preterm baby
c) Post-term baby
d) Growth restricted baby only
Explanation: Absence of ossification center at the lower femur suggests prematurity (
9) Which of the following is true about epiphyseal injuries in femur?
a) Common in adults
b) Affect growth potential
c) Do not cause deformity
d) Heals without complications
Explanation: Epiphyseal injuries in the distal femur can affect growth and cause angular deformities due to damage of growth plate. Correct answer: Affect growth potential.
10) The nutrient artery of femur enters from?
a) Upper end
b) Middle third posterior surface
c) Lower end
d) Anterior surface
Explanation: The nutrient artery enters the shaft of femur from the middle third on its posterior surface, directed towards the knee ("to the elbow I go, from the knee I flee"). Correct answer: Middle third posterior surface.
Keyword Definitions
• Hip flexion – Movement decreasing the angle between thigh and trunk.
• Iliopsoas – Primary hip flexor formed by psoas major and iliacus; inserts on lesser trochanter.
• Psoas major – Lumbar-origin muscle (T12–L5) flexing hip; innervated by L1–L3 (direct branches).
• Iliacus – Iliac fossa muscle joining psoas; femoral nerve (L2–L3).
• Rectus femoris – Biarticular quadriceps head; flexes hip, extends knee; origin AIIS.
• Sartorius – ASIS origin; flexes, abducts, laterally rotates hip; flexes knee.
• Tensor fasciae latae (TFL) – Assists hip flexion/abduction; superior gluteal nerve (L4–S1).
• Femoral nerve – L2–L4 nerve to anterior thigh flexors/extensors.
• Thomas test – Assesses fixed flexion deformity of hip/iliopsoas contracture.
• Psoas sign – Pain with resisted hip flexion/extension of hip suggesting psoas irritation (e.g., retrocecal appendicitis).
Chapter: Anatomy / Lower Limb
Topic: Muscles of the Hip
Subtopic: Flexors of the Hip Joint
Lead Question – 2013
Muscle causing flexion of hip ?
a) Biceps femoris
b) Psoas major
c) Gluteus maximus
d) TFL
Explanation: The prime mover for hip flexion is iliopsoas; among options, psoas major is the principal flexor. TFL assists but is not the main flexor. Biceps femoris mainly extends hip and flexes knee; gluteus maximus extends hip. Correct answer: Psoas major.
Guessed Questions for NEET PG
1) Primary insertion site of the main hip flexor complex is?
a) Greater trochanter
b) Lesser trochanter
c) Intertrochanteric line
d) Iliac crest
Explanation: Iliopsoas (psoas major + iliacus) inserts onto the lesser trochanter of the femur via a common tendon, providing a powerful flexion vector across the hip with some external rotation. Correct answer: Lesser trochanter.
2) Nerve supply of iliacus is via?
a) Obturator nerve
b) Femoral nerve
c) Sciatic nerve
d) Superior gluteal nerve
Explanation: Iliacus is innervated by the femoral nerve (L2–L3). In contrast, psoas major receives direct branches from the lumbar plexus (L1–L3). Understanding dual innervation patterns aids clinical localization of weakness. Correct answer: Femoral nerve.
3) A footballer with pain on resisted straight-leg raise; MRI shows AIIS avulsion. Weakness likely in?
a) Hip extension
b) Hip flexion
c) Knee flexion
d) Hip adduction
Explanation: AIIS avulsion implicates rectus femoris origin. Rectus femoris flexes the hip and extends the knee; acute injury produces painful/weak hip flexion on straight-leg raise. Correct answer: Hip flexion.
4) Thomas test detects contracture of which muscle group?
a) Hip abductors
b) Hip extensors
c) Hip flexors (iliopsoas)
d) Hip adductors
Explanation: Thomas test identifies fixed flexion deformity due to tightness/contracture of iliopsoas. The contralateral hip is maximally flexed; lumbar lordosis flattens; a rising contralateral thigh indicates flexor contracture. Correct answer: Hip flexors (iliopsoas).
5) Which muscle is NOT a primary hip flexor?
a) Sartorius
b) Pectineus
c) Gluteus medius
d) Rectus femoris
Explanation: Gluteus medius chiefly abducts and stabilizes pelvis; it is not a hip flexor. Sartorius and rectus femoris flex the hip; pectineus mainly adducts but contributes to flexion. Correct answer: Gluteus medius.
6) Superior gluteal nerve injury most reduces which assisting action at hip?
a) Flexion by TFL
b) Extension by gluteus maximus
c) Adduction by gracilis
d) External rotation by piriformis
Explanation: Superior gluteal nerve (L4–S1) supplies TFL, gluteus medius, and minimus. Injury impairs abduction and internal rotation and reduces TFL-assisted hip flexion. Correct answer: Flexion by TFL.
7) In femoral nerve palsy, which combined movement is most impaired?
a) Hip flexion with knee extension
b) Hip extension with knee flexion
c) Hip adduction with knee flexion
d) Hip abduction with knee extension
Explanation: Femoral nerve supplies iliacus and quadriceps (including rectus femoris). Palsy weakens hip flexion and abolishes knee extension, impairing sit-to-stand and stair climbing. Correct answer: Hip flexion with knee extension.
8) A patient with retrocecal appendicitis has pain on passive extension of right hip. Irritation involves?
a) Gluteus maximus
b) Psoas major
c) Adductor magnus
d) Obturator externus
Explanation: The psoas sign indicates psoas major irritation; stretching the inflamed muscle by hip extension elicits pain. This localizes retroperitoneal inflammation near the psoas. Correct answer: Psoas major.
9) Which root value chiefly powers hip flexion during straight-leg raise?
a) L1
b) L2–L3
c) L4–L5
d) S1–S2
Explanation: Hip flexion strength correlates with L2–L3 myotomes (iliopsoas). Testing resisted hip flexion helps localize radiculopathy to upper lumbar roots. Correct answer: L2–L3.
10) A sprinter has pain at ASIS with weakness in crossing legs. Most likely muscle injured?
a) Sartorius
b) Rectus femoris
c) Pectineus
d) Iliopsoas
Explanation: Sartorius originates at ASIS and flexes, abducts, and laterally rotates the hip—used to cross legs (“tailor’s muscle”). ASIS tenderness with these deficits suggests sartorius strain/avulsion. Correct answer: Sartorius.
Keyword Definitions
• Sacral promontory – The anterior projecting edge of the first sacral vertebra, used as an anatomical landmark.
• Aortic bifurcation – Occurs at the level of L4 vertebra, below the sacral promontory.
• Inferior mesenteric artery (IMA) – Arises from the abdominal aorta at L3, supplying the hindgut.
• Superior mesenteric artery (SMA) – Arises at L1, supplying the midgut.
• Presacral nerve – Autonomic plexus lying anterior to sacrum, not directly related to sacral promontory.
• Pelvic inlet – Boundary between abdominal and pelvic cavities, sacral promontory forms its posterior margin.
• True pelvis – Space below the pelvic brim, relevant for obstetric diameters.
• Obstetric conjugate – Distance from sacral promontory to pubic symphysis, important in labor assessment.
• Ureter crossing – Ureters cross pelvic brim near bifurcation of common iliac arteries close to sacral promontory.
• Clinical relevance – Used in obstetrics, surgery, and radiology as a key anatomical reference.
Chapter: Anatomy / Abdomen & Pelvis
Topic: Landmarks in Pelvis
Subtopic: Sacral Promontory and Related Structures
Lead Question – 2013
Sacral promontory is the landmark for
a) Origin of superior mesenteric artery
b) Termination of presacral nerve
c) Origin of inferior mesenteric artery
d) None of the above
Explanation: The sacral promontory marks the posterior boundary of the pelvic inlet. It is not the landmark for SMA (L1) or IMA (L3). Presacral nerve plexus lies anterior to sacrum but termination is not at the promontory. Correct answer: None of the above.
Guessed Questions for NEET PG
1) The sacral promontory contributes to measurement of which pelvic diameter?
a) Transverse diameter
b) Obstetric conjugate
c) Interspinous diameter
d) Diagonal conjugate
Explanation: The obstetric conjugate runs from the sacral promontory to the superior margin of the pubic symphysis, critical for assessing childbirth feasibility. Diagonal conjugate is measured clinically but relates to the same point. Correct answer: Obstetric conjugate.
2) The level of bifurcation of the abdominal aorta is?
a) L1
b) L2
c) L3
d) L4
Explanation: The abdominal aorta bifurcates into common iliac arteries at L4, slightly below the sacral promontory, an important landmark for surgeons and interventional radiologists. Correct answer: L4.
3) A surgeon during pelvic surgery uses sacral promontory to identify?
a) Start of rectum
b) Pelvic brim
c) Common iliac bifurcation
d) Superior mesenteric artery
Explanation: The sacral promontory is a key landmark forming the posterior boundary of the pelvic brim, helping orient pelvic surgery and dissection. Correct answer: Pelvic brim.
4) Inferior mesenteric artery arises at which vertebral level?
a) L1
b) L2
c) L3
d) L4
Explanation: The IMA arises at the level of L3, supplying descending colon, sigmoid, and upper rectum. It does not originate at the sacral promontory level. Correct answer: L3.
5) During obstetric assessment, the diagonal conjugate is measured from?
a) Sacral promontory to inferior pubic symphysis
b) Coccyx to pubic symphysis
c) Sacral promontory to ischial spine
d) Pubic tubercle to ischial tuberosity
Explanation: The diagonal conjugate is measured from the sacral promontory to the inferior border of the pubic symphysis, used clinically to estimate true conjugate. Correct answer: Sacral promontory to inferior pubic symphysis.
6) Which artery lies closest to the sacral promontory?
a) Inferior mesenteric artery
b) Middle sacral artery
c) Superior mesenteric artery
d) Internal iliac artery
Explanation: The middle sacral artery descends anterior to sacrum from near the aortic bifurcation and is closely related to the sacral promontory. Correct answer: Middle sacral artery.
7) In pelvic brim, the sacral promontory forms?
a) Anterior boundary
b) Posterior boundary
c) Lateral boundary
d) Inferior boundary
Explanation: The sacral promontory forms the posterior boundary of the pelvic brim, while the pubic symphysis forms the anterior limit. Correct answer: Posterior boundary.
8) Which clinical test involves palpating sacral promontory per vaginum?
a) Bimanual examination
b) Pelvic outlet test
c) Assessment of diagonal conjugate
d) Assessment of transverse diameter
Explanation: In gynecological examination, diagonal conjugate is estimated by palpating sacral promontory and measuring distance to pubic symphysis. Correct answer: Assessment of diagonal conjugate.
9) In pregnancy, an obstetric conjugate a) Cephalopelvic disproportion
b) Sacralization of lumbar vertebra
c) Lordosis
d) Normal pelvis
Explanation: Obstetric conjugate shorter than 10 cm indicates reduced pelvic inlet, leading to cephalopelvic disproportion and labor complications. Correct answer: Cephalopelvic disproportion.
10) Which nerve plexus lies just anterior to sacral promontory?
a) Lumbar plexus
b) Presacral plexus
c) Pudendal plexus
d) Coccygeal plexus
Explanation: The presacral (hypogastric) plexus lies anterior to sacrum and sacral promontory, providing autonomic supply to pelvic organs. Correct answer: Presacral plexus.