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Lab 6— Anterior, Medial—Thigh & Leg 1 1. Fracture of This Structure

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Lab 6— Anterior, Medial—Thigh & Leg 1 1. Fracture of This Structure Lab 6— Anterior, Medial—Thigh & Leg Skeletal—Questions 1 of 1 1. Fracture of this structure would most likely cause weakness in ad- duction, flexion, and extension of the thigh. 2. A 20-year-old man developed foot drop following a fracture in the leg. What is the most likely site of the frac- ture? A. Upper tibia B. Upper fibula C. Lower tibia D. Lower fibula E. Middle tibia 3. A 71-year-old grandmother fell half way down the basement stairs while carrying a laundry basket after dinner. She didn’t lose con- sciousness, but sat at the bottom of the stairs gathering her wits and the scattered laundry. She didn’t think she had broken any bones as she could move all her limbs. Her husband, who had heard the noise and came to check on her, helped her stand up. It was then that she felt a slight pain in her left hip when she placed weight on it. She limped about for the rest of the day. The next morning her husband brought her into your family practice office where you could clearly see that she walked with her pelvis tilted as if her left leg was slightly shorter. She still had left hip pain. You order a plain film of the left femur from hip to knee expecting to find which of the following? A. Femoral neck fracture with compression B. Femoral neck fracture with complete displacement C. A spiral fracture of the femoral shaft D. A transverse supracondylar fracture E. An intercondylar fracture 1 Lab 6— Anterior, Medial—Thigh & Leg Skeletal—Answers 1. Answer A. (1) The adductor tubercle is fractured. The adductor magnus inserts on the adductor tubercle on the femur and functions to adduct, flex, and extend the thigh. 2. Answer B. (2) One of the most frequently injured nerves in the body is the common peroneal nerve as it crosses the head of the fibula. This nerve gives rise to the deep fibular nerve which innervates the dorsiflexors in the anterior compartment of the leg - tibialis anterior, extensor digitorum longus, and extensor hallucis longus - thus causing foot drop. 3. Answer A. (7) Fractures of the femoral neck, com- monly called “hip fractures” are extremely common in old- er women as a consequence of osteoporosis. Since the woman was still able to bear some weight on her leg it is very unlikely that she had complete displacement of the femoral neck (answer b), rather a compression fracture with the fall. None of the symptoms are consistent with fracture in either the shaft (answer c) or distal portion (answers d and e) of the femur. 2 Lab 6— Anterior, Medial—Thigh & Leg Ligaments — Questions 1 of 1 1. A 20-year-old college student receives a severe blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula. If the lateral (fibular) col- lateral ligament is torn by this fracture, which of the follow- ing conditions may occur? A. Abnormal passive abduction of the extended leg B. Abnormal passive adduction of the extended leg C. Anterior displacement of the femur on the tibia D. Posterior displacement of the femur on the tibia E. Maximal flexion of the leg 3 Lab 6— Anterior, Medial—Thigh & Leg Ligament — Answers 1. Answer B. (1) The lateral (fibular) collateral liga- ment prevents adduction at the knee. Therefore, a torn lateral collateral ligament can be recognized by abnormal passive adduction of the extended leg. Abnormal passive abduction of the extended leg may occur when the medial (tibial) collateral ligament is torn. The anterior cruciate ligament prevents posterior displacement of the femur on the tibia; the posterior cruciate ligament prevents anterior displacement of the femur on the tibia. In addition, the posterior cruciate ligament is taut when the knee is fully flexed. 4 Lab 6— Anterior, Medial—Thigh & Leg Muscles; Tendons — Questions 1 of 3 1. A 14-year-old male severs his right leg just below the 4. A 21-year-old man was involved in a motorcycle acci- hip in a motorcycle accident involving a guardrail. You are dent, resulting in destruction of the groove in the lower attempting to reattach the limb. As you complete the reat- surface of the cuboid bone. Which of the following muscle tachment of the muscles, you reflect up the structure of tendons is most likely damaged? the muscle that you are sewing. The rectus femoris of the A. Flexor hallucis longus quadriceps group is an example of which type of muscle? B. Peroneus brevis C. Peroneus longus A. Unipennate D. Tibialis anterior B. Bipennate E. Tibialis posterior C. Multipennate D. Parallel E. Convergent 2. Which tendons insert on the first metatarsal bone? 5. A 52-year-old woman slipped and fell and now com- A. Flexor hallucis longus and extensor hallucis longus plains of being unable to extend her leg at the knee joint. B. Peroneus longus and tibialis anterior Which of the following muscles was paralyzed as a result C. Peroneus longus and tibialis posterior of this accident? D. Flexor hallucis longus and tibialis anterior A. Semitendinosus E. Peroneus brevis and tibialis anterior B. Sartorius C. Gracilis D. Quadriceps femoris E. Biceps femoris 3. A rupture of the tendon superior to which lettered site 6. A patient experiences weakness in dorsiflexing and or structure in the following radiograph below would most inverting the foot. Which of the following muscles is dam- likely cause an inability to extend the knee joint? aged? A. Peroneus longus B. Peroneus brevis C. Tibialis anterior D. Extensor digitorum longus E. Peroneus tertius 3. 7. A patient experiences paralysis of the muscle that origi- nates from the femur and contributes directly to the stabil- ity of the knee joint. Which of the following muscles is in- volved? A. Vastus lateralis B. Semimembranosus C. Sartorius D. Biceps femoris (long head) E. Rectus femoris 5 Lab 6— Anterior, Medial—Thigh & Leg Muscles; Tendons — Answers 1. Answer B. (2) A unipennate muscle has its fascicle 4. Answer C. (1) The groove in the lower surface of arranged in one direction. The vastus lateralis is an exam- the cuboid bone is occupied by the tendon of the pe- ple of an unipennate muscle. This type of muscle gener- roneus longus muscle. The flexor hallucis longus tendon ates considerable force, but relatively slowly. The fasci- occupies a groove on the posterior surface of the body of cles of the rectus femoris are arranged in a bipennate the talus and a groove on the inferior surface of the calca- arrangement. This type of arrangement affords the mus- neus during its course. The tibialis posterior muscle ten- cle an increase in power while limiting its length of con- don occupies the medial malleolar groove of the tibia. traction. Most muscles in the body have a multipennate Other muscle tendons are not in the groove of the tarsal fascicle arrangement. These muscles have intermediate bones. strength and range of motion. Muscles with parallel fasci- cles, such as the biceps brachii, have greater range of contraction, but limited strength. Convergent fascicles are seen in postural muscles and have great strength of con- traction with limited range of contraction. 2. Answer B. (2) Peroneus longus and tibialis anterior 5. Answer D. (2) The quadriceps femoris muscle in- is the correct answer. Tibialis anterior is the main dorsi- cludes the rectus femoris muscle and the vastus medialis, flexor of the ankle, and also assists with foot inversion. It intermedialis, and lateralis muscles. They extend the leg is located on the anterior aspect of the leg. Its tendon de- at the knee joint. The semitendinosus, semimembra- scends over the front of the ankle, and continues over the nosus, and biceps femoris muscles (the hamstrings) ex- dorsum of the foot onto the medial side. There it inserts tend the thigh and flex the leg. The sartorius and gracilis on the medial cuneiform and first metatarsal. muscles can flex the thigh and the leg. Peroneus longus and peroneus brevis are the main evert- ors of the foot, and also assist with plantar flexion of the ankle. They are located on the lateral side of the leg. Their tendons descend together on the lateral side of the ankle, passing behind the lateral malleolus, and continu- ing forward along the lateral surface of the calcaneus. Peroneus brevis inserts on the tuberosity of the fifth meta- tarsal. Peroneus longus crosses the cuboid bone, travels in a groove on the cuboid's plantar surface, and continues 6. Answer C. (1) The tibialis anterior can dorsiflex and medially across the sole of the foot to insert on the medial invert the foot. The peroneus longus and brevis muscles cuneiform and first metatarsal. can plantar flex and evert the foot, the peroneus tertius can dorsiflex and evert the foot, and the extensor digi- torum longus can dorsiflex the foot and extend the toes. 3. The Answer is C. (1) The quadriceps tendon is rup- 7. Answer A. (1) The vastus lateralis muscles arise tured. The quadriceps muscle is a powerful knee extensor from the femur and all the other muscles originate from used in climbing, running, jumping, and rising from a seat- the hip (coxal) bone. The biceps femoris inserts on the ed position. fibula, and other muscles insert on the tibia; thus, all of them contribute to the stability of the knee joint. 6 Lab 6— Anterior, Medial—Thigh & Leg Muscles; Tendons — Questions 2 of 3 8. A 24-year-old woman presents to her physician with 12.
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