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SAQs
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ANATOMY
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SAQs
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ANATOMY
VG Sawant MS (Anatomy)Professor and Head
Department of Anatomy
Padmashree Dr DY Patil Medical College
Nerul, Navi Mumbai, Maharashtra, IndiaFormer Professor of Anatomy
Terna Medical College
Navi Mumbai, Maharashtra, India
Grant Medical College, Mumbai, Maharashtra, India
Third Edition
JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD.
New Delhi Panama City • London • Dhaka • Kathmandu
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Jaypee Brothers Medical Publishers (P) Ltd.
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd.4838/24, Ansari Road, Daryaganj
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© 2013, Jaypee Brothers Medical Publishers
All rights reserved. No part of this book may be reproduced in any form orby any means without the prior permission of the publisher.
Inquiries for bulk sales may be solicited at: [email protected]
This book has been published in good faith that the contents provided bythe author contained herein are original, and is intended for educational
purposes only. While every effort is made to ensure accuracy ofinformation, the publisher and the author specifically disclaim any damage,
liability, or loss incurred, directly or indirectly, from the use or application
of any of the contents of this work. If not specifically stated, all figuresand tables are courtesy of the author. Where appropriate, the readers
should consult with a specialist or contact the manufacturer of the drug ordevice.
SAQs in Anatomy
First Edition: 2003
Second Edition: 2005
Reprint: 2009
Third Edition: 2013
ISBN 978-93-5025-180-5
Typeset at JPBMP typesetting unit
Printed at
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Inc.City of Knowledge, Bld. 237, Clayton
Panama City, Panama
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Dedicated to
My Parents
Wife Rekha
Daughter KshittjaSon Viresh
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Preface to the Third Edition
I have great pleasure in presenting the third edition
of this book.
I am thankful to all the students for theirresponse to the second edition of the book.
In the third edition, about 130 new SAQs,
especially in Brain and Genetics Section have been
added.
It is pleasure to thank all those who have written
letters of encouragement and have made useful
suggestions. Suggestions and comments are
welcome from teachers and students. I also wish
to thank Mr Tarun Duneja (Director-Publishing)
and Mr KK Raman (Production Manager),
M/s Jaypee Brothers Medical Publishers (P) Ltd,
New Delhi, India, for their help to publish the book.
I would also like to thank Mr Chandra Shekhar
Gawde and Mr Ramesh Krishnamachari of
M/s Jaypee Brothers Medical Publisher (P) Ltd,
Mumbai branch, India, for their help.
VG Sawant
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Preface to the First Edition
The changing trend in evaluation, i.e. from essaytype questions to objective type questions isadapted by Medical Council of India (MCI) and mostof the medical universi-ties. Objective type of questioning gives equal opportunity to all studentsand covers wider syllabus.
Short answer questions (SAQs) are objective typeof questions which require answer in words or inshorter manner. SAQs are useful in measuring
learning outcomes in the lower and middle levelcognitive domains, i.e. knowledge comprehension,application and analysis. Therefore, in a medicalcurriculum, where a student is required to be wellaware of facts of life, disease and treatment, theSAQs can become a helpful tool to test their learningoutcome.
While framing a SAQ, one should remember thefollowing things:1. Use simple language2. Use any one of the following formats:
a. Question type.b. Enumerate the structures.c. Definition type.
d. Draw and label the diagram.e. Reasoning type.f. Comparison between two.
3. Do not ask SAQ in one or two words like a titleof short note, i.e. biceps brachii.This is a wrong SAQ as it is neither in questionformat nor in any one of formats which are
mentioned here. The student does not knowwhat specific answer he has to write. Instead,the SAQ on the same topic can be framed inthe following way:a. Specify the joints at which biceps brachii
acts.b. What are the movements produced by biceps
brachii at these joints?4. Avoid use of negative beginning.
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The SAQs are asked in theory examination for2 marks. So, the answers should be written inshortest manner (in some of the clinically-orientedSAQs, answers are little lengthy for understandingpurpose, but students can write in shortestmanner).
The SAQs included in this book, besides being
asked in theory examination, are also mostfrequently asked in viva voce during practicals. Inaddition, answers to these SAQs will also help thestudents to answer MCQs on the same topic.
Though this book is essentially for under-graduate students, it can be useful for the studentspreparing for postgraduate entrance examination.
Constructive suggestions, healthy criticism andcomments to improve this book are welcome from
Anatomy teachers and students.I thank Mr Tarun Duneja (Director-Publishing),
M/s Jaypee Brothers Medical Publishers (P) Ltd,
New Delhi, India, for his help to publish the book.
VG Sawant
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Contents
1. General Anatomy ......................................1
2. Superior Extremity ................................17
3. Inferior Extremity .................................. 37
4. Thorax........................................................ 53
5. Abdomen ................................................... 67
6. Head, Face and Neck...............................97
7. Brain ........................................................ 134
8. Histology ................................................. 157
9. Embryology ............................................ 184
10. Genetics ................................................... 210
11. Radiology ................................................ 222
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GENERAL ANATOMY 1
Q. 1. Define anatomical position of the body.
What are supine and prone positions of
the body?
Ans. Anatomical position—The body is erect, the
eyes look straight to the front, the upper limbs
hang by the side of the trunk with the palms
directed forwards and the lower limbs are
parallel with the toes pointing forwards. Supine position—Lying down position with the
face directed upwards.
Prone position—Lying down position with the
face directed downwards.
Q. 2. Give examples of three classes of levers
in the body.
Ans. I class lever—Triceps bringing about extension
at the elbow joint
R
E ↑ ∆F
II class lever—Rising on the toes.
↑
E RD
F
III class lever—Biceps bringing about flexion
at the elbow joint.
↑ ∆ E R
F
Q. 3. What is superficial fascia? Mention its two
functions.
Ans. Superficial fascia is a general coating of the
body beneath the skin made up of loose areolartissue with varying amount of fat.
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Functions:
1. It facilitates movement of the skin.
2. Conserves body heat.
Q. 4. What is deep fascia? Mention its two
functions.
Ans. Deep fascia is a fibrous sheet which invests
the body beneath the superficial fascia and is
devoid of fat. Functions:
1. Keeps the underlying structures in position.
2. Provides extra surface for attachment of
muscles.
Q. 5. Give any four modifications of deep fascia.
Ans. 1. Aponeurosis.
2. Retinaculum.3. Bursa.
4. Capsules of joint.
5. Sheaths around arteries—carotid sheath.
Q. 6. Give functions of articular capsule.
Ans. 1. It binds the articular bones together.
2. It supports the synovial membrane on the
inner surface.
3. Due to numerous sensory nerves supplying
capsule, it acts as a ‘watch’ dog by producing
reflex contraction of muscles thus protec-
ting the joint.
Q.7. Give functions of synovial membrane.
Ans. 1. The synovial fluid secrected by the syno- vial membrane provides nutrition to the
articular cartilage.
2. It liberates hyaluronic acid which main-
tains viscosity of the fluid.
3. It removes particulate matters and worn
out cartilage cells by the phagocytic activity.
Q. 8. Define terms origin and insertion of amuscle.
Ans. 1. Origin of a muscle—It is the proximal
attachment of a muscle, which is relatively
fixed during its contraction.
2. Insertion of a muscle—it is the distal
attachment of a muscle, which is relatively
movable during its contraction.
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General Anatomy 3
Q. 9. What is isotonic or concentric action of a
muscle? Give one example. Ans. Isotonic—Iso-means same. Tone of the muscle
remains same. Length of the muscle is reduced
by 1/3 or more during contraction and toneremains same.
Example—lifting a load by contraction of biceps and brachialis at the elbow joint.
Q. 10. What is isometric contraction of a muscle?Give one example.
Ans. Isometric—Iso-means same, metric-means
length. Length of the muscle remains same.During isometric contraction, the tension is
same as load and length of the muscle doesnot change.
Example—holding the arm outstretched.Q. 11. What is excentric action or paying out of a
muscle? Give one example. Ans. In excentric action the tension is less than the
load and the muscle lengthens while active
thus paying out gradually to control the speedand force of a movement in the direction
opposite to that normally produced by themuscle when it is shortening.
Example—lowering the arm to the side.
Q. 12. Give peculiarities of sesamoid bones.
Ans. 1. Develop in the tendon of a muscle
2. Ossify after birth3. Devoid of periosteum
4. Absence of Haversian system.
Q. 13. Give classification of cartilaginous joints
mention one example of each. Ans. 1. Primary cartilaginous joint-
the bones are connected by hyaline carti-lage and the joint is temporary.
Example—Spheno-occipital joint.
2. Secondary cartilaginous joint-united by a disc of fibrocartilage
Example—Symphysis pubis.
Q. 14. What are the swing and the shunt compo-
nents of a muscle? Ans. A swing component of a muscle produces
angular movement of the joint.
A shunt component of a muscle tends to draw
the bones along the shaft towards the jointand compress the articular surface.
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Q. 15. What is bursa? Give its function.
Ans. A bursa is a closed sac of synovial membrane
containing a capillary film of synovial fluid
lying between two mobiles but tightly opposed
surfaces.
A bursa reduces friction between two mobiles
but tightly opposing surfaces permit complete
freedom of movement within limited range.
Q. 16. Name any four types of normal bursae.
Ans. 1. Subcutaneous 2. Submuscular
3. Subfascial 4. Subtendinous
5. Communicating 6. Noncommunicating.
Q. 17. Name any four adventitious bursae.
Ans. 1. Student’s elbow
2. Porter’s shoulder3. Housemaid’s knee
4. Clergyman’s knee
5. Weaver’s bottom
6. Bunion
Q. 18. Give examples of sesamoid bones.
Ans. 1. Patella
2. Pisiform3. Two segamoid bones beneath the head of
Ist metatarsal in flexor hallucis brevis
4. Fabella in the lateral head of gastrocne-
mius
5. Rider’s bone in the Adductor longus.
Q. 19. What is active insufficiency of a muscle?
Give one example. Ans. When a tendon of muscle crosses several joints
it cannot work with efficiency at all joints
simultaneously. This is called as active insuffi-
ciency of a muscle. As Flexor digitorum, pro-
foundus crosses wrist metacorpophalangeal
interphalangeal joints, the fingers cannot be
fully flexed when the wrist is also flexed.Q. 20. What is closed-packed and loose-packed
position of a joint? Give one example.
Ans. A. Closed-packed position—when the joint
surfaces become completely congruent, their
area of contact is maximal and they are
tightly compressed, no further movement
is possible, e.g. knee-full extension,shoulder-abduction and lateral rotation.
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General Anatomy 5
B. Loose-packed position—when the joint
surfaces are not congruent, i.e. least packed
position.
For example, knee-semiflexion, shoulder-
semiabduction.
Q. 21. Define posture. Name any two postural
muscles.
Ans. Posture is defined as the relation of the seg-
ments of the body, i.e. head, trunk and limbs
to each other.
Postural muscles-soleus, gastrocnemius
quadriceps femoris, gluteus maximus erector
spinac.
Q. 22. Specify the line of gravity and centre of
gravity in standing position. Ans. The line of gravity passes anterior to the ankle
and knee joints, posterior to the hip joints,
behind the lumbar vertebrae, anterior to the
thoracic and lower cervical vertebrae and
through dens of the axis vertebra.
The centre of gravity in standing position lies
2-3 cm in front of the first sacral vertebra.
Q. 23. Name the synovial joints in which articular
surfaces are covered by white fibro-
cartilage.
Ans. 1. Sternoclavicular joint
2. Acromioclavicular joint
3. Temporomandibular joint.
Q. 24. Name intra-articular structures. Ans. Tendons—
1. Long head of biceps brachii
2. Popliteus
Cartilages—Intra-articular disc of TM and
sternoclavicular joints, menisci, labrum
glenoidule labrum acetabulum.
Ligaments—Cruciate ligaments of knee joint Fat—Haversion pad of fat.
Q. 25. Enumerate membranocartilaginous
bones.
Ans. 1. Clavicle
2. Occipital
3. Temporal
4. Mandible5. Sphenoid.
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Q. 26. Give functions of bones.
Ans. 1. They give shape and support to the body2. They provide surfaces for the attachment
of muscles, tendons and ligaments
3. They form joints where movements takeplace
4. Protection of viscera like lungs, heart brainspinal cord
5. Bone marrow manufactures blood cells6. Bones store body calcium and phosphorus.
Q. 27. Enumerate the factors which limit the
movements of a joint. Ans. 1. Reflex contraction of antagonistic muscles.
2. Approximation of soft parts3. Tension of the ligaments
4. Stimulation of mechanoreceptors in arti-cular tissue.
Q. 28. Name different types of sutural joints.
Ans. 1. Serrate 2. Denticulate3. Squamous 4. Limbous
5. Plane 6. Schindylesis
Q. 29. Name different types of epiphysis giving
one example of each. Ans. 1. Pressure epiphysis—head of femur
2. Traction epiphysis—trochanter of femur
3. Compound epiphysis (Pressure + trac-tion)—ischial tuberosity
4. Composite epiphysis—upper end of
humerus
5. Atavistic epiphysis—coracoid process of scapula6. Aberrant epiphysis—at the bases of
metacarpal bones.
Q. 30. Name uniaxial synovial joints giving oneexample of each.
Ans. 1. Hinge joint—elbow joint
2. Pivot joint—superior radioulnar joint.Q. 31. Name biaxial synovial joints giving one
example of each.
Ans. 1. Condylar joint—temporomandibular joint
2. Ellipsoid joint—wrist joint.
Q. 32. Name multiaxial synovial joints giving one
example of each.
Ans. 1. Saddle joint—first carpometacarpal joint2. Ball and socket joint—shoulder joint.
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General Anatomy 7
Q. 33. Give any four examples of skeletal mus-
cles with parallel fasciculi.
Ans. 1. Quadrilateral—thyrohyoid
2. Straplike—sartorius
3. Straplike with tendinous intersections—
Rectus abdominis
4. Fusiform—biceps brachii.
Q. 34. Give any four examples of skeletal mus-cles with oblique fasciculi.
Ans. 1. Triangular—Temporalis.
2. Unipennate—flexor pollicis longus
3. Bipennate—rectus femoris
4. Multipennate—deltoid
5. Circumpennate—Tibialis anterior.
Q. 35. Give any four characteristics of synovial joint.
Ans. 1. The articular ends are covered by articular
hyaline cartilage.
2. The joint is covered by joint capsule
3. The inner aspect of joint capsule and intra-
capsular non-articular parts of the bone are
covered by synovial membrane4. The joint cavity contains synovial fluid
secreted by synovial membrane
5. The joint is strengthened by ligaments
6. Some degree of movement is always pos-
sible.
Q. 36. Name the arteries supplying a long bone. Ans. 1. Nutrient artery
2. Epiphyseal artery
3. Metaphyseal arteries
4. Periosteal arteries.
Q. 37. Give morphological classification of
bones.
Ans. 1. Long bones2. Short bones
3. Flat bones
4. Irregular bones
5. Pneumatic bones
6. Sesamoid bones
7. Accessory bones.
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Q. 38. Give developmental classification of
bones mentioning one example each.
Ans. 1. Membranous bones—parietal
2. Cartilaginous bones—humerus
3. Membranocartilaginous bones-clavicle,
mandible.
Q. 39. Define a bone. Give its two functions.
Ans. A bone is highly vascular, constantly changing,mineralized living connective tissue.
Functions:
1. Gives shape and support to the body
2. Provides surface for the attachment of
muscles and tendons.
Q. 40. Give medicolegal importance of bones.
Ans. 1. Estimation of age2. Estimation of sex
3. Estimation of height
4. Cause of death.
Q. 41. Enumerate the areas of the body where
lymph capillaries are absent.
Ans. Epidermis, cornea, articular hyaline cartilage,
splenic pulp, bone marrow, liver lobule, brain,spinal cord.
Q. 42. Name the areas of the body where seb-
aceous glands do not open into hair folli-
cle but open directly on the skin surface.
Ans. Lips, nipple and areola of breast, tarsal glands
of the eyelids, glans penis, inner surface of pre-puce, labia minora.
Q. 43. Name the areas of the body where sweat
glands are absent.
Ans. Nipple, inner surface of prepuce, labia minora,
glans penis, glans clitoris, margins of lips, nail
bed.
Q. 44. Name the areas of the body where apo-
crine sweat glands are present.
Ans. Axilla, prepuce, scrotum, monspubis, labia
minora, areola of the breast and perianal
regions.
Q. 45. Enumerate the areas of the body where
fat is absent in the superficial fascia. Ans. Eyelids, external ear, penis, scrotum.
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General Anatomy 9
Q. 46. Name the structures present in the
superficial fascia. Ans. Cutaneous nerves and vessels, lymph nodes,
deeply situated sweat glands, mammary
glands, subcutaneous muscles in the face, neck
and scrotum.
Q. 47. Name any of the four end arteries in the
body.
Ans. 1. Central artery of retina
2. Arteries of spleen, kidney, lung
3. Central branches cerebral arteries
4. Vasa recti of small intestine.
Q. 48. Give examples of actual anterial anasto-
mosis.
Ans. 1. Palmar arches
2. Plantar arches
3. Circle of willis
4. Labial branches of facial arteries
5. Intestinal arcades
6. Uterine and ovarian arteries.
Q. 49. Name the organs where portal systems of
vessels are found. Ans. 1. Liver 2. Pituitary
3. Kidney 4. Suprarenal.
Q. 50. Name the areas where capillaries are
absent.
Ans. 1. Epidermis
2. Hair
3. Nails4. Articular hyaline cartilage
5. Cornea.
Q. 51. Classify nerve cells according to polarity
giving example of each.
Ans. 1. Unipolar—mesencephalic nucleus of
trigeminal nerve.
2. Bipolar—olfactory cells of nasal mucosa3. Psuedounipolar—Dorsal root ganglia
4. Multipolar—most of the neurones in the
body.
Q. 52. Enumerate the sites where smooth
muscles are present.
Ans. 1. Iris
2. All blood vessels3. Pulmonary tree
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4. Walls of gastrointestinal tract from the
lower portion of the esophagus to theinternal anal sphincter
5. Walls and tubes of genitourinary tract
6. Piloerector muscles.
Q. 53. What is a dermatome? Give its clinical
importance.
Ans. The area of skin supplied by one spinal nerve
is called a dermatome. The area of sensoryloss of the skin following injuries of the spinal
cord or of the nerve roots can be determined by
examining the dermatomes for touch, pain, and
temperature.
Q. 54. Enumerate the curvatures of the verteb-
ral column and mention the age at which
they develop. Ans. A. Primary curvatures-concave anteriorly
thoracic and sacral appear before birth.
B. Secondary curvatures-convex anteriorly
1. Cervical-3 to 4 months when the child
starts holding its neck
2. Lumbar-6 to 9 months when the child
starts sitting (according to some authorsabout 1 year i.e. when the child starts
standing).
Q. 55. Enumerate the abnormal curvatures of
the vertebral column.
Ans. A. Kyphosis-exaggerated thoracic curvature
B. Scoliosis-lateral bending
C. Kyphoscoliosis-Kyphosis + scoliosisD. Lordosis-exaggerated lumbar curvature.
Q. 56. Define a joint. Enumerate three main
varieties of joints.
Ans. A joint is a junction between two or more bones
or cartilage with or without movement.
Structural classification
a. Fibrous jointsb. Cartilaginous joints
c. Synovial joints.
Q. 57. Mention the dermatomes at the following
levels.
1. Sternal angle 2. Xiphoid process
3. Umbilicus 4. Pubis.
Ans. 1. Sternal angle-T22. Xiphoid process-T7
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General Anatomy 11
3. Umbilicus-T10
4. Pubis-L1
Q. 58. Draw and label a typical synovial joint.
Q. 59. Enumerate the functions of the inter-
vertebral discs.
Ans. 1. They form secondary cartilaginous joints
2. They give shape to the vertebral column.3. They act as shock absorbers
4. They take part in weight transmission
5. Because of their elasticity they allow slight
movements of vertebral bodies on each
other.
Q.60. Draw and label a diagram showing
distribution of a typical spinal nerve. Ans. Typical spinal nerve.
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Q.61. Give functional classification of blood
vessels. Mention one example of each.
Ans. 1. Conducting vessel – Aorta (Elastic Artery)
2. Distributing vessel – Brachial (Muscular
Artery)
3. Resistance vessel – Arteriole
4. Exchange vessel – Capillary
5. Capacitance vessel – Vein
Q.62. What are venae comitants? What are their
functions?
Ans. Below the knee and the elbow joints most of
the deep veins are arranged in pairs along the
sides of the arteries, which are called as venae
comitants.
Functions1. Venae comitants help in the return of blood
towards the heart by the transmitted
pulsations of the arteries.
2. They help in countercurrent heat exchange
between arteries and veins.
Q.63. Enumerate the valve less veins.
Ans. 1. Venae Cavae2. Hepatic
3. Ovarian
4. Renal
5. Spinal
6. Cerebral
7. Umbilical
8. Pulmonary9. Emissary
10. Veins having less than 2 mm diameter.
Q.64. What are cavernous tissues? Name any
three cavernous tissues.
Ans. Cavernous tissues are blood filled spaces lined
by endothelium and surrounded by trabeculae
containing smooth muscle fibres. Arterioles
and venules open directly into these spaces.
Cavernous tissues
1. Erectile tissue of penis
2. Erectile tissue of clitoris
3. Nasal mucous membrane
4. Cavernous sinus
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General Anatomy 13
Q.65. Give differences between red and white
muscles fibres.
Ans. Red Muscles White Muscles
1. They are red in 1. They are paler
colour due to more in colour due to
myoglobin and less myoglobin
rich capillary and poor capillary
plexus around plexus around
each muscles each musclefiber. fiber.
2. They show slow 2. They show fast
tonic contraction. phasic contraction.
3. They are rich in 3. They are poor in
mitochondria and mitochondria but
oxidative enzymes. rich in glycolytic
enzymes.4. They have less 4. They have more
cross striations cross striations and
more sarcoplasm. less sarcoplasm.
5. As they show 5. As they show
well developed anaerobic
aerobic metabo- metabolism,
lism, they are they are quite
highly resistant easily fatigued.to fatigue.
Q.66. Enumerate tortuous arteries in the body
Ans. 1. Facial 2. Occipital
3. Splenic 4. Uterine
5. Nutrient
Q.67. Enumerate the surfaces of the bodywithout hair.
Ans. 1. Palms
2. Soles
3. Glans penis
4. Labia minora
5. Umbilicus
6. Inner surface of labia majoraQ.68. Name the arteries formed by fusion of
other arteries.
Ans. 1. Basilar artery – vertebral arteries
2. Anterior spinal artery – anterior spinal
branches of vertebral arteries.
3. Azygous arteries of vagina – branches of
uterine and vaginal arteries.
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Q.69. Enumerate hyaline cartilages.
Ans. 1. Articular
2. Thyroid
3. Cricoid
4. Tracheal rings
5. Costal
6. Nasal
7. Bronchial
8. Lower part of arytenoid
Q.70. Enumerate elastic cartilages.
Ans. 1. Cartilage of epiglottis
2. Cartilage of pinna
3. Corniculate
4. Cuneiform
5. Apex of arytenoid
6. Cartilage of auditory tube7. Cartilage of external acoustic meatus.
Q.71. Enumerate fibrocartilages.
Ans. 1. Intervertebral disc
2. Inter-pubic disc
3. Articular discs of temporomandibular,
sternoclavicular, and inferior radioulnar
joints
4. Labrum glenoidale and acetabulare
5. Mensci of knee joint
Q.72. A skeletal muscle is sometimes referred
to as voluntary muscle. However, it is an
unsatisfactory term. Explain.
Ans. The skeletal muscle is sometimes referred to
as voluntary muscle because the movements
in which it participates are often initiated
under conscious control. However, this is an
unsatisfactory term since it is involved in
many movements – breathing, blinking,
swallowing and the actions of muscles of the
perineum and the middle ear are examples—
that are usually or exclusively driven at anunconscious level.
Q.73. What are synergists? Give one example.
Ans. When the prime movers cross more than one
joint, the undesired actions at the proximal
joints are prevented by certain muscles called
as synergists. During making a tight fist the
flexor digitorum superficialis and profundus
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General Anatomy 15
flex the fingers. The wrist joint is fixed in slight
extension by extensors of wrist. These are
called as synergists.
Q.74. Define terms (a) Prime mover (b) Anta-
gonist. Give one example of each.
Ans. a. Prime mover—When a muscle is a chief
muscle or a member of a chief group of
muscles in producing a particular move-
ment is called a prime mover. Brachials is
a prime mover in the movement of flexion
of the elbow joint.
b. Antagonist—The muscle which opposes the
action of the prime mover is called the
antagonist. The treeps brachii opposes the
action of brachialis in flexing the elbow
joint. Antagonist actually help the primemover by active controlled relaxation due
to recprocal innervation.
Q.75. Mention the factors maintaining stability
of joints.
Ans. 1. Bony configuration
2. Ligaments
3. Tone of the muscles
4. Atmospheric pressure
Q.76. Mention functions of articular discs.
Ans. 1. Divide the joint cavity
2. Lubrication
3. Prevent wear and tear of the articular
cartilage
4. The upper compartment shows gliding
movement and lower compartment shows
angular movements.
Q.77. Why the shaft of a long bone is hollow?
Ans. The hollow shaft of the long bone confers high
strength in bending, minimizes bone mass and
increases the speed of the movement.Q.78. Name the skeletal muscles with no bony
attachments.
Ans. Frontalis, bulbospongiosus, risorius, palmaris
brevis, intrinsic muscles of the tongue,
subcutaneous part of external anal sphincter.
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16 SAQs in Anatomy
Q.79. Name unpaired muscles in the body.
Ans. Diaphragm, trachealis, posterior cri-
coarytenoid, external urethral sphincter, in-
ternal anal sphincter.
Q.80. Name elastic ligaments in the body.
Ans. Ligamentum nuchae, ligamentum flavam,
spring ligament.
Q.81. Name commonly ruptured tendons in thebody.
Ans. Tendon of quadriceps femoris, tendocalcaneus,
biceps brachii, supraspinatus, external
pollicius longus.
Q.82. Name the prevertebral muscles.
Ans. Longus capitis, longus colli, scalenus anterior,
medius and posterior, psoas major, quadratuslumborum, piriformis.
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SUPERIOR E XTREMITY 2
Q. 1. Name the nerves arising from the roots
and trunks of brachial plexus. Ans. A. Branches of roots
1. Long thoracic (Nerve to serratus ante-rior)
2. Dorsal scapular
B. Branches of upper trunk
1. Suprascapular nerve C5, C62. Nerve to subclavius C5, C6
Q. 2. Name the branches of medial cord of
brachial plexus.
Ans. 1. Medial pectoral C8, T12. Medial root of median C8, T13. Ulnar C7, C8, T1
4. Medial cutaneous nerve of arm C8, T15. Medial cutaneous nerve of forearm C8,T1.
Q. 3. Name the branches of lateral cord of
brachial plexus.
Ans. 1. Lateral pectoral C5, C6, C72. Musculocutaneous C5, C6, C73. Lateral root of median nerve C5,C6, C7.
Q. 4. Name the branches of posterior cord of
brachial plexus.
Ans. 1. Upper subscapular C5, C62. Lower subscapular C5, C63. Nerve to Latissimus dorsi C6, C7, C84. Axillary C5, C65. Radial C5, C6, C7, C8, T1
Q. 5. Name the branches of axillary artery.
Ans. I part—Superior thoracic
II part—
1. Acromio-thoracic artery
2. Lateral-thoracic artery.
III part—
1. Subscapular
2. Anterior circumflex humeral artery 3. Posterior circumflex humeral artery.
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Q. 6. Name the branches of brachial artery.
Ans. 1. Profunda brachii2. Superior ulnar collateral
3. Inferior ulnar collateral
4. Nutrient artery to humerus5. Muscular branches
6. Radial7. Ulnar.
Q. 7. Name the arteries taking part in the ana-stomosis around the scapula.
Ans. A. Around body of scapula
1. Suprascapular artery (branch of thyro-cervical trunk)
2. Deep branch of transverse cervical artery3. Circumflex scapular (branch of subscap-
ular).B. Anastomoses over the acromial process
1. Acromial branch of thoraco-acromial
artery.2. Acromial branch of suprascapular
artery3. Acromial branch of posterior circumflex
humeral artery.
Q. 8. Name the arteries taking part in the
anastomosis around elbow joint.
Ans. A. In front of lateral epicondyle1. Anterior descending
2. Radial recurrent.B. Behind lateral epicondyle
1. Posterior descending
2. Interosseous recurrent.C. In front of medial epicondyle.
1. Inferior ulnar collateral2. Anterior ulnar recurrent.
D. Behind medial epicondyle1. Superior ulnar collateral
2. Posterior ulnar recurrent.
E. Just above olecrenon fossa. A branch from posterior descending anasto-
mosis with branch from inferior ulnar col-lateral.
Q. 9. Give the boundaries and contents of quadrangular space.
Ans. Boundaries: Superior:
1. Subscapularis in front
2. Capsule of shoulder joint
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Superior Extremity 19
3. Teres minor behind.
Medial:—Long head of triceps
Lateral:—Surgical neck of humerus
Inferior:—Teres major.
Contents:
1. Axillary nerve
2. Posterior circumflex humeral artery.
Q. 10. Give boundaries and structures passing through upper triangular space.
Ans. Boundaries
Medial—Teres minor
Lateral—Long head of triceps
Inferior—Teres major
Contents: Circumflex scapular artery.
Q. 11. Give boundaries and structures passing through lower triangular space.
Ans. Boundaries
Superior—Teres major
Medial—Long head of triceps
Lateral—Medial border of humerus
Contents:
1. Radial nerve2. Profunda brachii vessels.
Q. 12. Give boundaries of cubital fossa.
Ans. a. Laterally—medial border of brachio-
radialis
b. Medially—lateral border of pronator teres
c. Base—is directed upwards represented by
an imaginary line joining epicondyles of thehumerus.
d. Apex—directed downwards, formed by
meeting point of lateral and medial
boundaries
Floor:
i. Brachialis
ii. Supinator muscles.
Q. 13. Give contents of cubital fossa.
Ans. 1. Median nerve
2. Termination of brachial artery and begin-
ning of radial and ulnar arteries
3. Tendon of biceps with bicipital aponeurosis
4. Radial nerve between the brachioradialis
and extensor carpi radialis longus.
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Q. 14. Name the branches of axillary nerve.
Ans. A. Muscular1. Deltoid
2. Teres minor.
B. Cutaneous—Upper lateral cutaneous nerveof arm
C. Articular—shoulder jointD. Vascular—To posterior circumflex humeral
artery.Q. 15. Name the branches of musculocutaneous
nerve.
Ans. A. Musculari. Bisceps brachii
ii. Brachialisiii. Coracobrachialis
B. Cutaneous—Lateral cutaneous nerve of forearm.
Q. 16. Name the branches of median nerve in
the forearm and palm. Ans. A. Forearm—
1. Muscular
i. Pronator teres
ii. Flexor carpi radialisiii. Palmaris longus
iv. Flexor digitorum superficialis
2. Anterior Interosseous
i. Flexor pollicis longus
ii. Pronator quadratusiii. Lateral half of flexor digitorum pro-
fundusIt supplies distal radioulnar andwrist joint.
3. Palmar cutaneous branch
4. Articular branch
i. Elbow joint
ii. Superior radioulnar joint.
5. Vascular: radial and ulnar artery.
6. Communicating branch to ulnar nerve.B. Palm: Muscular: Abductor pollicis brevis
Flexor pollicis brevis Apponens pollicis
Ist and 2nd lumbrical
Cutaneous: lateral 3½ digits.
Q. 17. Name the branches of ulnar nerve in the
forearm and palm. Ans. A. Forearm: Muscular
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Superior Extremity 21
i. Flexor carpi ulnaris
ii. Medial half of flexor digitorum profun-
dus.
Cutaneous: Palmar cutaneous branch
Dorsal cutaneous branch
Articular: Elbow joint.
B. Palm: Muscular:
i. Palmaris brevis
ii. Flexor digiti minimiiii. Abductor digiti minimi
iv. Apponens digiti minimi
v. Medial two lumbricals (3rd and 4th
lumbricals)
vi. Palmar and dorsal interossei
vii. Adductor pollicis.
Cutaneous: Medial 1½ fingers Articular: Wrist joint.
Q. 18. Name the branches of radial nerve.
Ans. Muscular
i. Before entering the spiral groove, long and
medial heads of triceps
ii. In the spiral groove, lateral, medial head of
triceps and anconeousiii. Below radial groove in front of arm Brachi-
alis, Brachioradialis and Extensor carpi
radialis longus.
Cutaneous:
i. Above radial groove, posterior cutaneous
nerve of arm.
ii. In the radial groove, lower lateral cutaneousnerve of arm and posterior cutaneous nerve
of forearm.
Articular branch: Elbow joint.
Q. 19. Name the branches of posterior interos-
seous nerve.
Ans. Muscular
i. Supinatorii. Extensor carpi radialis brevis
iii. Extensor digitorum
iv. Extensor digiti minimi
v. Extensor carpi ulnaris
vi. Abductor pollicis longus
vii. Extensor pollicis brevis
viii. Extensor pollicis longus and indices. Articular: Wrist and distal radioulnar joint.
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Q. 20. Name different types of grips of hand.
Ans. 1. Power grip2. Precision grip
3. Hook grip
4. Power + precision grip
5. Complex manipulation.
Q. 21. Name the muscles inserted in the dorsal
digital expansion.
Ans. 1. Extensor digitorum
2. Palmar Interossei
3. Dorsal Interossei
4. Lumbricals
Q. 22. Name the rotator cuff muscles.
Ans. 1. Subscapularis 2. Supraspinatus
3. Infraspinatus 4. Teres minor
Q. 23. Name the structures passing through
bicipital groove.
Ans. 1. Tendon of long head of biceps brachii
2. Synovial sheath of above tendon
3. Ascending branch of anterior circumflex
humeral artery.
Q. 24. Give functions of interosseous membrane. Ans. 1. Binds radius and ulna (syndesmosis joint)
2. Provides attachment to muscles
3. Separates flexor and extensor compart-
ments
4. Takes part in weight transmission from
radius to ulna.
Q. 25. What is carpal tunnel? Name the struc-tures passing through it.
Ans. It is an osseofibrous tunnel formed by flexor
retinaculum and carpal bones. Structures
passing through carpal tunnel are:
1. Flexor digitorum superficialis
2. Flexor digitorum profundus
3. Tendon of flexor pollicis longus
4. Median nerve5. Radial and ulnar bursae.
Q. 26. Name the structure passing in front of the
flexor retinaculum.
Ans. 1. Tendon of palmaris longus.
2. Palmar cutaneous branch of median nerve.
3. Palmar cutaneous branch of ulnar nerve
4. Ulnar nerve5. Ulnar artery.
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Superior Extremity 23
Q. 27. Enumerate the structures piercing clavi-
pectoral fascia.
Ans. 1. Lateral pectoral nerve.
2. Thoracoacromial vessels (artery and vein)
3. Cephalic vein
4. Lymphatics (from breast and pectoral
region to apical axillary lymph nodes).
Q. 28. Name the muscles producing pronation. Ans. 1. Pronator teres
2. Pronator quadratus
3. Flexor carpi radialis assisted by
4. Palmaris longus.
Q. 29. Define Pronation and Supination.
Ans. Pronation: The head of the radius rotates
within annular ligament, and the lower end of radius rotates forwards, medially across the
lower end of ulna and the palm faces poste-
riorly.
Supination: It is reverse of pronation. The head
of the radius rotates within the annular
ligament and the lower end of radius rotates
laterally and backwards regaining its originalposition lateral to ulna and the palm faces
anteriorly.
Q. 30. Enumerate the movements of pectoral or
shoulder girdle.
Ans. 1. Elevation 2. Depression
3. Protraction 4. Retraction
5. Forward rotation 6. Backward rotation.
Q. 31. Name the joints of the shoulder girdle.
What type of joints are they?
Ans. Shoulder girdle consists of
1. Sternoclavicular joint—saddle joint
2. Acromioclavicular joint—plane synovial
joint.
Q. 32. Enumerate movements at the shoulder
joint.
Ans. 1. Flexion 2. Extension
3. Adduction 4. Abduction
5. Medial rotation 6. Lateral rotation
7. Circumduction.
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Q. 33. Analyse briefly the abduction at the
shoulder.
Ans. Abduction takes place partly at the shoulder
joint and partly at the shoulder girdle. The
humerus and the scapula move in the ratio of
2:1. Throughout abduction, for every 15°
elevation, 10° occurs at the shoulder joint and
5° are due to movements scapula.
Q. 34. Name the muscles involved in the abduc-
tion of shoulder.
Ans. Ist 15° supraspinatus
15 to 90° Acromial fibres of deltoid
Above 90° Upper and lower fibres of Trapezius
with lower 5 digitations of serratus anterior.
Q. 35. Enumerate movements produced at themetacarpophalangeal joint and muscles
causing them.
Ans. 1. Flexion—Interossei and Lumbricals
2. Extension—Extensors of fingers
3. Adduction—Palmar interossei
4. Abduction—Dorsal interossei.
Q. 36. Give nerve supply and actions of lumbri-cals of hand.
Ans. The 1st and 2nd lumbricals are supplied by
the median nerve
The 3rd and 4th lumbricals are supplied by
the ulnar nerve
Actions—Lumbricals flex the metacarpo-
phalangeal joints and extend the interpha-langeal joint of the digit into which they are
inserted.
Q. 37. Specify the joints at which biceps brachii
acts. Name the movements produced at
these joints.
Ans. Biceps brachii acts at shoulder joint and elbow
joint
Shoulder joint—Flexion
Elbow joint—Flexion
Powerful supination in mid flexed position.
Q. 38. Enumerate the palmar spaces.
Ans. 1. Pulp spaces of the fingers
2. The digital synovial sheaths3. The ulnar bursa
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Superior Extremity 25
4. The radial bursa
5. The midpalmar space6. The thenar space
Q. 39. Give boundaries of triangle of auscul-
tation. Give its clinical importance.
Ans. Boundaries of triangle of auscultation.
Below—upper border of Latissimus dorsi
Medially—lateral border of trapezius
Laterally—medial border of scapula
Floor—6th intercostal space and rhomboideus
major.
By the use of stethoscope breath sounds can
be heard better in the triangle of auscultation
as compared to the remaining part of the back
which is covered by thick musculature.
Q. 40. Specify the nerve supply and actions of
lumbricals. Which position the hand will
adopt due to their paralysis.
Ans. Medial two lumbricals—ulnar nerve
Lateral two lumbricals—median nerve
Actions: lumbricals produce flexion at the
metacarpopharyngeal joints and extension at
the interphalangeal joints.Paralysis of lumbricals produces claw hand in
which there is hyperextension at the meta-
carpophalangeal joints and flexion at the
interphalangeal joints.
Q. 41. Give boundaries of the axilla.
Ans. Apex—Anteriorly–clavicle
Posteriorly–superior border of scapulaMedially–outer border of 1st rib
Base—Skin and fascia
Anterior wall
i. Pectoralis major
ii. Clavipectoral fasica enclosing pectoralis
minor and subclavius
Posterior wall—subcapularis above teresmajor and Latissimus dorsi below
Lateral wall—Coracobrachialis and short head
of biceps brachii. Upper part of shaft of
humerus.
Q. 42. Enumerate contents of the axilla.
Ans. Contents of the axilla:
1. Axillary artery and its branches2. Axillary vein and its tributaries
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26 SAQs in Anatomy
3. Axillary lymph nodes and associated
lymphatics
4. Infraclavicular part of brachial plexus
5. The long thoracic and intercostobrachial
nerves
6. Axillary fat and areolar tissue.
Q. 43. What is anatomical snuff box? Give
boundaries of anatomical snuff box. Ans. It is a skin depression that lies distal to the
styloid process of the radius.
Boundaries—medially-tendon of extensor
pollicis longus.
Laterally–tendons of abductor pollicis longus
and extensor pollicis brevis
Q. 44. Give clinical findings in injury to mediannerve at the elbow.
Ans. Clinical findings in injuries to median nerve
at the elbow:
The forearm is kept in the supine position
wrist flexion is weak and is accompanied by
adduction. No flexion is possible at the inter-
phalangeal joints of the index and middlefingers. The muscles of the thenar eminence
are paralyzed and wasted, so that the
eminence is flattened. The thumb is laterally
rotated and adducted. The hand looks flat-
tened and apelike. Sensory—There is loss of
skin sensation of the lateral half of the palm
of the hand and palmar aspect of the lateral
three and half fingers and the skin is warmerand drier than normal.
Q. 45. What is carpal tunnel syndrome?
Ans. Carpal tunnel syndrome is produced by comp-
ression of median nerve in the carpal tunnel.
It consists of burning pain or ‘pins and needles’
along the distribution of the median nerve to
the lateral three and half fingers and weak-
ness of thenar muscles.
Q. 46. Give the clinical findings in injury to the
radial nerve in axilla.
Ans. In injury to the radial in axilla, the patient is
unable to extend the elbow joint, the wrist
joint, and the fingers. Wrist drop or flexion of the wrist occurs.
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Superior Extremity 27
There is a small loss of skin sensations down
the posterior surface of the lower part of the
arm and down a strip on the back of the
forearm. There is also a variable area of sen-
sory loss on the lateral part of the dorsum of
the hand and dorsal surface of the roots of the
lateral three and half fingers.
Q.47. What is Erb’s paralysis? Give clinicalfindings of Erb’s paralysis.
Ans. Injury to the upper trunk (mainly C5 partly
C6) of brachial plexus causes Erb’s paralysis.
The deformity is known as policeman’s tip
hand or porter’s tip hand. The upper limb
hangs limply by the side, medially rotated and
adducted forearm extended and pronated.
There is loss of sensation along the lateral
side of the arm.
Q. 48. What is Klumpke’s paralysis? Give clinical
findings of Klumpke’s paralysis.
Ans. Injury to the lower trunk (mainly T1 partly C8)
of brachial plexus causes Klumpke’s paralysis.
The deformity is known as clawhand. There ishyperextension at the metacarpophalangeal
joints and flexion of the interphalangeal joints.
There is cutaneous anesthesia and analgesia
in a narrow zone along the ulnar border of the
forearm and hand.
Q. 49. What is Dupuytren’s contracture? Which
structures are involved in Dupuytren’scontracture and what is the position
taken up by them?
Ans. Dupuytren’s contracture is localised thicken-
ing and contracture of Palmar aponeurosis.
It starts near root of the ring finger, flexing it
at metacarpophalangeal joint and later
involving little finger in the same manner. Inlong-standing cases there is flexion at the
proximal interphalangeal joints.
Q. 50. What is Volkmann’s ischemic contrac-
ture? Involvement of which structure
causes this contracture? Which muscles
are mainly affected?
Ans. Volkmann’s ischemic contracture is a contrac-ture of muscles of the foreman following
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28 SAQs in Anatomy
fractures of the lower end of the humerus or
fractures of the radius and ulna.
Localised segment of brachial artery goes into
spasm reducing the arterial flow to the flexor
and extensor muscles so they undergo ischae-
mic necrosis.
Flexor muscles are longer than the extensor
muscles and they are, therefore, the ones
mainly affected.
Q. 51. Give clinical findings in injury to the ulnar
nerve at elbow.
Ans. The hand assumes characteristic claw defor-
mity (man en griff).
Motor—Flexion at the wrist joint will result
in abduction. Medial border of the front of forearm will show flattening.
The patient is unable to adduct or abduct
fingers. It is impossible to adduct the thumb.
The metacorpophalangeal joint becomes
hyper extended. Interphalangeal joints of the
4th and 5th fingers are flexed and wasting of
the hypothenar eminence.
Sensory loss of skin sensations over anterior
and posterior surfaces of the medial third of
the hand and medial one and half fingers.
Vasomotor—The skin areas involved in sen-
sory loss are warmer and drier than normal.
Q. 52. Give clinical findings in injury to ulnar
nerve at the wrist. What is ulnar paradox? Ans. Clinical findings in injury to the ulnar nerve
at the wrist—
Flattening of the hypothenar eminence. Meta-
carpophalangeal joints are hyperextend. Inter-
phalangeal joints of the 4th and 5th fingers
are markedly flexed.
Usually higher the lesion more obvious is thedeformity, but in injury to ulnar nerve at the
wrist joint flexor digitorum profundus is not
involved which actively produces marked
flexion at the interphalangeal joints of the 4th
and 5th fingers as compared to that produced
due to injury to ulnar nerve at the elbow. This
is called as ulnar paradox.
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Superior Extremity 29
Q. 53. Name any four structural changes at the
middle of the arm. Ans. 1. Cross-sectional changes of the humeral
shaft from upper cylindrical to lower tri-
angular
2. Median nerve crosses the front of brachial
artery from lateral to medial
3. Entry of radial nerve and profunda brachii
into spiral groove4. Basilic vein pierces deep fascia.
Q. 54. Name the bones to which flexor retina-
culum of superior extremity is attached.
Ans. 1. Scaphoid. 2. Pisiform
3. Hook of hamate 4. Trapezium.
Q. 55. Give functions of palmar aponeurosis.
Ans. 1. Provides firm attachment to the overlying
skin to improve grips
2. Protects palmar vessels and nerves and
prevents flexor tendons from bowstringing
3. Provides origin to the palmaris brevis
4. Palmar septa attached to aponeurosis sub-
divide palm into potential spaces.
Q. 56. The movements of thumb, test radial,
median and ulnar nerves. Explain.
Ans. The flexion of the thumb is brought about by
flexor pollicis brevis and flexor pollicis longus
which are supplied by median nerve.
The extension of the thumb is brought about
by extensor pollicis longus, extensor pollicis
brevis and abductor pollicis longus which aresupplied by radial nerve.
The adduction of thumb is brought about by
adductor pollicis which is supplied by ulnar
nerve.
Q. 57. List the groups of axillary lymph nodes.
What does the anterior group drain?
Ans. Axillary lymph nodes1. Anterior
2. Posterior
3. Lateral
4. Central
5. Apical
The anterior group of axillary lymph nodes
drain about 75% of lymphatics from the mam-mary gland.
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Q. 58. Enumerate the factors which maintain
the stability of the shoulder joint. Ans. 1. Coracoacromial arch
2. Rotator cuff muscles
3. Glenoid labrum4. Long head of biceps brachii
5. Long head of triceps brachii.
Q. 59. Sternoclavicular joint is synovial, saddle,
compound, and complex joint. Explain.
Ans. Sternoclavicular joint:
A. Synovial—The joint cavity is lined by syno-
vial membrane
B. Saddle—The medial end of clavicle has
concavo-convex shape and the clavicular
notch of manubrium sterni also has
concavo-convex shape.C. Compound—Three elements taking part in
joint, i.e. medial end of clavicle clavicular
notch of manubrium sterni and Ist costal
cartilage
D. Complex—Intra-articular disc divides
joint cavity.
Q.60. Enumerate the muscles of thenareminence and specify their nerve supply.
Ans. The abductor pollicis brevis, the flexor pollicis
brevis and the oppones pollicis form the thenar
eminence. All these muscles are supplied by
the median nerve.
Q.61. Name the movements of the wrist joint
and the muscles producing them.
Ans. 1. Flexion – Flexor carpi radialis, flexor carpi
ulnaris, palmaris longus
2. Extension – Extensor carpi radialis longus,
extensor carpi radialis brevis, extensor
carpi ulnaris
3. Abduction – Flexor carpi radialis, extensor
carpi radialis longus and brevis, abductorpollicis, longus
4. Adduction – Flexor carpi ulnaris, extensor
carpi ulnaris.
Q.62. Give venous drainage of the breast.
Mention its applied importance.
Ans. Veins form a plexus beneath the areola. From
this plexus the veins radiate to the periphery
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Superior Extremity 31
and drain into the axillary, internal thoracic
and intercostals veins.
The veins draining the breast communicate
with the vertebral venous plexus. Through
these communications breast cancer can
spread to the vertebrae and to the brain.
Q.63. Specify the boundaries of the mid palmar
space.
Ans. The mid palmar space is bounded by
1. Anteriorly – palmar aponeurosis
2. Posteriorly – 3rd, 4th, 5th metacarpals and
the fascia covering the interossei of the 3rd
and 4th space and the medial part of the
transverse head of the adductor pollicis
3. Medially – medial palmar septum
4. Laterally – intermediate palmar septum
Q.64. Specify the contents of the mid palmar
space.
Ans. The mid palmar space contains
1. The flexor tendons of 3rd, 4th and 5th
fingers.
2. 2nd, 3rd and 4th lumbrical muscles
3. Superficial palmar arch
4. The digital nerves and vessels of the medial
three and half fingers.
Q.65. Enumerate the arteries supplying the
breast.
Ans. 1. Lateral thoracic, superior thoracic and
acromiothoracic branches of the axillary
artery.
2. Internal thoracic – perforating branches to
the 2nd, 3rd and 4th intercostal spaces.
3. Lateral branches of 2nd, 3rd and 4th
intercostal arteries.
Q.66. What is superficial palmar arch? Which
arteries take part in its formation? Ans. Superficial palmar arch is important
anastomoses between the ulnar and radial
arteries.
Superficial palmar arch is formed as the direct
continuation of the ulnar artery beyond the
flexor retinaculum (i.e. by the superficial
palmar branch). On the lateral side the arch
is completed by one of the following branches
of the radial artery –
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1. Superficial palmar branch
2. The radialis indicis
3. The princeps pollicis
Q.67. Specify boundaries of the thenar space.
Ans. The thenar space is bounded by
1. Anteriorly – palmar aponeurosis
2. Posteriorly – fascia covering the transverse
head of the adductor pollicis and first dorsal
interosseous muscle.
3. Medially – intermediate palmar septum
4. Laterally – lateral palmar septum.
Q.68. What is rotator cuff? What is its function?
Ans. Rotator cuff is musculotendinous cuff formed
by the flattened tendons of the subscapularis,
supraspinatus, infraspinatus, teres minorwhich blend with the capsule of the shoulder
joint.
The cuff gives strength to the capsule of the
shoulder joint all around except inferiorly.
Q.69. Specify the contents of the thenar space.
Ans. The thenar space contains
1. The tendon of the flexor pollicis longus withits synovial sheath
2. The flexor tendon of the index finger
3. The first lumbrical muscle
4. The palmar digital vessels and nerves of
the lateral side of the index finger and of
the thumb.
Q.70. Enumerate branches of the radial artery. Ans. Branches of radial artery.
1. Muscular
2. Radial recurrent branch
3. Palmar carpal branch
4. Superficial palmar branch
5. First dorsal metacarpal artery
6. Radialis indicis7. Princeps pollicis
Q.71. Enumerate branches of the ulnar artery.
Ans. Branches of the ulnar artery
1. Muscular
2. Anterior and posterior ulnar recurrent
branches
3. Palmar and dorsal carpal branches
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Superior Extremity 33
4. Common interosseous artery
5. Superficial palmar branch (which is themain continuation of the artery)
6. Deep palmar branch
Q.72. Give lymphatic drainage of the breast. Ans. A. Lymphatics draining the parenchyma of the
breast and skin of areola and nipple.
75% Drain into axillary nodes. Majority to
anterior axillary group and few to posteriorgroup → central → apical → supraclavi-cular nodes.
20% Parasternal nodes (internal mam-
mary)5% Posterior Intercostal Nodes
From deep surface of the breast through
pectoralis major and clavipectoral fasciato the apical nodes.
B. From overlying skin excluding areola and
nipple.
From outer part – axillary nodesFrom upper part – supraclavicular nodes
From inner part – parasternal (bilateral)From lower part – sub peritoneal, sub-
diaphragmatic
Q.73. What is Mallet finger?
Ans. Mallet finger (cricket or baseball finger) results
from the distal interphalangeal jointssuddenly being forced into extreme
(hyperflexion). This avulses the attachmentof the terminal tendon of the extensor
digitorum from the base of the distal phalanx. As a result the patient is unable to extend the
distal interphalangeal joint.
Q.74. What is tennis elbow? Ans. Tennis elbow or elbow tendinitis is painful
musculoskeletal condition that may followrepetitive forceful pronation and supination
of the forearm. It is characterized by pain andpoint tenderness at or just distal to the lateral
epicondyle of the humerus and appears to be
resulting from premature degeneration of thecommon extensor attachment of the
superficial extensor muscles of the forearm.The pain is aggravated by activities that put
tension on the common extensor tendon. It is
commonly seen in tennis and golf players and
those using screwdrivers and shoveling snow.
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Q.75. What is painful arc syndrome? How it is
caused?
Ans. Painful arc syndrome or subacromial bursitis
or supraspinatus tendinitis is characterised
by pain between 60 and 120 degrees of
abduction of the shoulder.
During abduction of the shoulder joint the
supraspinatus tendon is exposed to friction
against the acromion. Normally the amountof friction is reduced to minimum by sub-
acromial bursa.
Degenerative changes in the bursa followed
by degenerative changes in the supraspinatus
tendon, which may extend into other tendons
of the rotator cuff cause this syndrome.
Q.76. Give clinical findings in injury to theaxillary nerve. How it is damaged?
Ans. Damage to the axillary nerve results in
paralysis of the deltoid and teres minor
muscles. There is loss of power of abduction of
the shoulder joint and rounded contour of the
shoulder is lost. There is sensory loss over the
lower half of the deltoid.The axillary nerve may be damaged by
dislocation of the shoulder or by the fracture
of the surgical neck of the humerus.
Q.77. Give clinical findings that in injury to the
musculocutaneous nerve.
Ans. Injury to the musculocutaneous nerve leads to
paralysis of the biceps brachi and coraco-brachialis and the brachialis muscle is
weakened (as it is also supplied by radial
nerve). There is sensory loss along the lateral
side of the forearm.
Q.78. Give any four characteristics of the
clavicle.
Ans. 1. It is the first bone to ossify in the body2. It ossifies from two primary and one
secondary center
3. It is the only long bone placed horizontally
in the body
4. Though it is a long bone it ossifies in
membrane (According to some authorities–
partly membrane, partly cartilage).5. The shaft is curved
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Superior Extremity 35
6. It is subcutaneous
7. It is pierced by nerves (supraclavicular).
8. Its articular ends are covered by fibro-
cartilage
9. It has no medullary cavity
10. It is the only link between upper limb and
axial skeleton
11. It is commonly fractured at the junction of
medial 2/3 and lateraly 1/312. It acts like a strut.
Q.79. Give differences between metacarpals
and metatarsals.
Ans. Metacarpals
1. The head is rounded, larger than the base
and is directed below
2. The shaft is of uniform thickness3. The dorsal surface of the shaft has an
elongated flat triangular area
4. The base is irregular
Metatarsals
1. The head is flattened from side to side,
smaller than the base and is directed in
front2. The shaft trapers distally
3. The dorsal surface of the shaft uniformly
convex
4. The base is set obliquerly and projects
backwards and laterally
Q.80. Name the muscles having double nerve
supply and mention the nerves supplying them.
Ans. 1. Pectoralis major—Medial and lateral pec-
toral nerves
2. Brachialis—Musculocutaneous and radial
nerves
3. Flexor digitorium profundus—Median and
ulnar nerves.
Q. 81. Which is the only bone having three types
of epiphyses?
Ans. Scapula is the only bone having three types of
epiphyses
a. Glenoid- Pressure
b. Acromion- Traction
c. Coracoid process- Atavistic
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Q.82. Why clavicle is fractured commonly at the
junction of medial two-third and lateral
one-third?
Ans. Junction of medial two-third and lateral one
third of clavicle is a weak point due to
a. Medial two-third is cylindrical and lateral
one-third is flattened making this point
weak.
b. Two curves of the clavicle meet at this pointc. This junction is devoid of muscular
attachment.
d. Two primay centers appear quite close to
each other at this junction.
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INFERIOR E XTREMITY 3
Q. 1. Enumerate the branches of the femoral
nerve.
Ans. Branches of femoral nerve (L2, 3, 4)
A. Anterior division
a. Muscular–sartorius
b. Cutaneous–medial and intermediate
Cutaneous nerve of thigh
B. Posterior divisiona. Muscular-rectus femoris vastus
medialis, lateralis and intermedius,
anticularis genu
b. Cutaneous-saphenous
c. Articular- knee joint and hip joint.
Q. 2. Enumerate branches of the sciatic nerve.
Ans. A. Articular—Hip jointB. Muscular—
1. Tibial part of sciatic—semitendinosus,
semimembranous, long head of biceps
femoris, ischial head of adductor mag-
nus
2. Common, peroneal part—short head of
biceps femoris.C. Terminal-tibial and common peroneal.
Q. 3. Enumerate branches of the tibial nerve.
Ans. A. Muscular—gastrocnemius, soleus, planta-
ris, popliteus, tibilalis posterior, flexor-
digitorum longus, flexor hallucis longus.
B. Genicular—Superior medial genicular
–Inferior medial genicular–Middle genicular
C. Cutaneous—sural, medial calcanean
D. Articular—ankle joint
E. Terminal—Medial and lateral plantar
Q. 4. Enumerate branches of deep peroneal
nerve.
Ans. A. Muscular—Tibialis anterior, extensorhallucis longus, extensor digitorum longus,
extensor digitorum brevis, peroneus tertius.
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B. Cutaneous branch supplies adjacent sides
of 1st and 2nd toes.
C. Articular-ankle joint, tarsal joint, and tar-
sometatarsal and metatarsophalangeal
joints of the big toe.
Q. 5. Enumerate tributaries of great saphanous
vein.
Ans. 1. Medial marginal vein2. Posterior arch vein
3. Anterior leg vein
4. Few veins from calf which communicate
with the small saphenous vein.
5. Anterolateral vein
6. Posteromedial vein
7. Superficial epigastric8. Superficial circumflex iliac
9. Superficial external pudendal
10. Deep external pudendal.
Q. 6 Give boundaries of Popliteal fossa.
Ans. Superolaterally—tendon of biceps femoris
Superomedially—semitendinosus and semi-
membranosus.
Inferolaterally—Lateral head of gastrocen-
mius and plantaris
Inferomedially—medial head of gastrocne-
mius
Roof—popliteal fascia
Floor—popliteal surface of femur, capsule of
knee joint, oblique popliteal ligament, poste-
rior part of upper end of tibia, fascia covering
popliteus muscle.
Q. 7. Enumerate contents of popliteal fossa.
Ans. 1. Popliteal artery and its branches
2. Popliteal vein and its tributaries
3. Tibial nerve4. Common peroneal nerve
5. Termination of small saphenous vein
6. Posterior cutaneous nerves of thigh
7. Genicular branch of obturator nerve
8. Popliteal lymph nodes
9. Fat
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Inferior Extremity 39
Q. 8. Why the medial meniscus is damaged
more frequently than the lateral menis-
cus?
Ans. The tibial collateral ligament is firmly
attached to the medial meniscus, which
restricts its mobility. During sudden locking
of the knee joint, as in kicking the football, the
medial meniscus is subjected to sudden grind-
ing force and gets torn.The lateral meniscus is less frequently
damaged because it is not attached to the
fibular collateral ligament and the tendon of
the popliteus which sends few of its fibres to
the lateral meniscus pulls it into more favour-
able position.
Q. 9. Give the clinical findings in an injury tothe common peroneal nerve.
Ans. Common peroneal nerve may be severed
during fracture of the fibular neck.
It results in the paralysis of all the muscles in
the anterior and lateral compartment of the
leg (dorsiflexors of the ankle and evertors of
foot). The loss of dorsiflexion of the ankle andeversion of foot causes foot drop. The foot drops
and the toes drag on the floor while walking.
Q. 10. Give functions of menisci of the knee joint.
Ans. 1. Menisci increase the concavity of the tibial
condyles for better adaptation with femoral
condyles
2. They serve as shock absorbers3. They act as swabs to lubricate the joint
cavity
4. Because of their nerve supply they have an
additional sensory function for better
stability of the knee joint.
Q. 11. Name the muscles under cover of Gluteus
maximus. Ans. 1. Gluteus medius.
2. Gluteus minimus.
3. Reflected head of rectus femoris.
4. Piriformis.
5. Obturator internus with 2 gemelli.
6. Quadratus femoris.
7. Obturator externus.
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8. Origin of 4 hamstrings from ischial tubero-
sity9. Insertion of the upper (Pubic) fibres of
adductor magnus.
Q. 12. Name the vessels under cover of Gluteus
maximus.
Ans. 1. Superior gluteal vessels
2. Inferior gluteal vessels
3. Internal pudendal vessels
4. Trochanteric anastomosis
5. Cruciate anastomosis
6. First perforating artery.
Q. 13. Name the nerves under cover of Gluteus
maximus.
Ans. 1. Superior gluteal
2. Inferior gluteal
3. Sciatic
4. Posterior cutaneous nerve of thigh
5. Nerve to quadratus fernoris
6. Pudendal nerve
7. Nerve to obturator internus
8. Perforating cutaneous nerves.
Q. 14. Name the structure passing through the
Greater sciatic foramen.
Ans. A. Piriformis
B. Structures passing above the piriformis
i. Superior gluteal nerve
ii. Superior gluteal vessels
C. Structures passing below the piriformis are
i. Inferior gluteal nerveii. Inferior gluteal vessels
iii. Sciatic nerve
iv. Posterior cutaneous nerve of thigh
v. Nerve to quadratus femoris
vi. Pudendal nerve
vii. Internal pudendal vessels
viii. Nerve to obturator internus.
Q. 15. Name the structures passing through the
lesser sciatic foramen.
Ans. 1. Tendon of obturator internus
2. Pudendal nerve
3. Internal pudendal vessels
4. Nerve to obturator internus. The upper and
lower parts of the foramen are filled up bythe origin of two gemelli muscles.
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Inferior Extremity 41
Q. 16. What are the boundaries of the femoral
triangle?
Ans. Boundaries of the femoral triangle
Laterally: Medial border of sartorius
Medially: Medial border of adductor longus
Base: Formed by the inguinal ligament
Apex: Point where medial and lateral
borders meet
Floor: Iliacus, psoas major, pectineus,adductor longus
Roof: Fascia lata
Q. 17. Name the contents of the femoral trian-
gle.
Ans. 1. Femoral artery and its branches
2. Femoral vein and its tributaries
3. Femoral sheath4. Femoral nerve
5. Nerve to pectineus
6. Femoral branch of genitofemoral nerve
7. Lateral cutaneous nerve of thigh
8. Deep inguinal lymph nodes.
Q. 18. Name the intra-articular structures of theknee joint.
Ans. 1. Medial and lateral menisci
2. Anterior and posterior cruciate ligaments
3. Tendon of popliteus
4. Intra-articular pad of fat.
Q. 19. Name the bones forming the medial and
lateral longitudinal arches of foot. Ans. Bones forming the medial longitudinal arch
are:
1. Medial half of the calcanium
2. Talus
3. Navicular
4. Three cuneiforms
5. First three metatarsals
Bones forming lateral longitudinal arch are:
1. Lateral part of calcanium
2. Cuboid
3. Fourth and fifth metatarsals.
Q. 20. Name the branches of the obturator nerve.
Ans. Branches of the obturator nerve:
A. Anterior division—a. Muscular—
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42 SAQs in Anatomy
i. Pectineus
ii. Adductor longus
iii. Gracilis
iv. Adductor brevis.
b. Cutaneous—Branch to sub-sartorial
plexus
c. Articular- Hip joint.
B. Posterior division—
a. Muscular—i. Obturator externus
ii. Adductor magnus
iii. Adductor brevis, if not supplied by
anterior division.
b. Articular—knee joint.
Q. 21. Name the hamstring muscles.
Ans. 1. Semitendinosus
2. Semimembranous
3. Long head of biceps femoris
4. Ischial head of adductor magnus.
Q. 22. What is femoral sheath? What are its
contents?
Ans. The femoral sheath is a funnel- shaped sleeveof fascia enclosing the upper three to four cms.
of the femoral vessels. It is formed by down-
ward extension of the abdominal fascia i.e.the
anterior wall of the sheath is formed by fascia
transversalis and the posterior wall by the
fascia iliaca.
Contents of the femoral sheath:
a. Lateral compartment-1) femoral artery and
femoral branch of genitofemoral nerve.
b. Intermediate compartment-femoral vein.
c. Medial compartment-(femoral canal)
lymph node of cloquet, lymphatics and areo-
lar tissue.
Q. 23. Enumerate branches of femoral artery. Ans. 1. Superficial epigastric
2. Superficial circumflex iliac
3. Superficial external pudendal
4. Deep external pudendal
5. Muscular branches
6. Profunda femoris
7. Descending genicular
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Inferior Extremity 43
Q. 24. Enumerate branches of popliteal artery.
Ans. 1. Cutaneous-skin of the back of the leg
2. Muscular branches
3. Superior medial genicular
4. Superior lateral genicular
5. Inferior medial genicular
6. Inferior lateral genicular
7. Middle genicular
Q. 25. Trace the pathway a cardiac catheter
takes when introduced into femoral artery
up to left ventricle of the heart.
Ans. Femoral artery—external iliac artery—
common iliac artery—abdominal aorta—
thoracic aorta—arch of aorta—left ventricle
of the heart.Q. 26. Trace the pathway a cardiac catheter
takes when introduced into femoral vein,
up to right atrium of the heart.
Ans. Femoral vein—external iliac vein—common
iliac vein—inferior vena cava—right atrium
of the heart.
Q. 27. Enumerate the arteries which anasto-
mose at the anterior superior iliac spine.
Ans. 1. Superficial circumflex iliac artery
2. Deep circumflex iliac artery
3. Deep branch of superior gluteal artery
4. Ascending branch of lateral circumflex
femoral artery.Q. 28. Specify the pathway of the femoral hernia.
Ans. The hernial sac first passes downward through
the femoral canal then forwards through the
saphenous opening and finally upwards along
the superficial epigastric and superficial
circumflex iliac vessels.
Q. 29. Enumerate the coverings of the complete
femoral hernia.
Ans. 1. Peritoneum of the hernial sac
2. Femoral septum
3. Anterior wall of femoral sheath
4. Cribriform fascia
5. Superficial fascia and skin.
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Q. 30. Specify the type, of ankle joint. Enume-
rate the bones taking part in the ankle
joint. In which position is the ankle most
stable? In which position is the ankle least
stable?
Ans. The ankle joint is a hinge variety of synovial
joint.
The bones taking part in the ankle joint are
lower end of tibia with its medial malleolus of fibula and lateral malleolus and body of talus.
The ankle joint is most stable in dorsiflexed
position and least stable in planter flexed
position.
Q. 31. What is porta pedis? Name the structures
passing through it.
Ans. Porta means gate, pedis means foot. Theinterval between the flexor retinaculum and
the calcaneus forms the main gate of the sole
hence it is called as porta pedis.
The structures passing through the Porta pedis
are:
1. Tibialis posterior tendon
2. Flexor digitorum longus tendon3. Posterior tibial artery with a pair of venae
comitants
4. Tibial nerve
5. Flexor hallucis longus tendon.
Q. 32. Give functions of plantar aponeurosis.
Ans. 1. It maintains the longitudinal arches of foot
acting as tie beam.2. It provides origin to the superficial groups
of plantar muscles.
3. It protects plantar vessels and nerves from
compression.
Q. 33. What type of epiphysis is ischial tubero-
sity and what are the structures attached
to it? Ans. Ischial tuberosity is a compound type of
epiphysis—pressure and traction.
Structures attached to it are:
1. Superolateral area—Semimembranosus
2. Inferomedial area—
a. Semitendinosus
b. Long head of biceps femoris3. Inferolateral area—adductor magnus
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Inferior Extremity 45
4. Sharp medial margin—attachment to
sacrotuberous ligament.5. Lateral border—ischiofemoral ligament.
Q. 34. What are the peculiarities of fibula and
why does it not obey the law of ossifica-tion?
Ans. The fibula violates the law of ossificationbecause the secondary centre which appears
first does not fuse last. The reasons for this violation are:1. The secondary centre appears first in the
lower end because it is a pressure epiphy-sis.
2. The upper epiphysis fuses last because thisis the growing end of the bone.
Peculiarities of fibula are:1. Does not take part in knee joint formation.2. Does not take part in weight transmission
3. Does not obey the law of ossification4. Decalcified fibula can be knoted.
Q. 35. Enumerate structures piercing the femo-
ral sheath.
Ans. 1. Femoral branch of genitofemoral nerve.2. Superficial epigastric, superficial circum-flex iliac and superficial external pudendal
branches of femoral artery3. Great saphenous vein.
Q. 36. Enumerate structure passing through
saphenous opening.
Ans. 1. Great saphenous vein2. Superficial external pudendal and super-ficial epigastric arteries.
3. Few lymph vessels connecting the super-
ficial and deep inguinal lymph nodes.4. Few branches of medial femoral cutaneous
nerve.
Q. 37. Enumerate the structures piercing theoblique popliteal ligament. Ans. Middle genicular vessels, middle genicular
nerve, genicular branch of the posterior
division of obturator nerve.
Q. 38. What is conjunct and adjunct, medial and
lateral rotations at the knee joint?
Ans. Conjunct rotation takes place automaticallyduring extension-flexion movements of the
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joint duc to geometry of the articular surfaces
and tension of the ligaments. Its range isabout 20°. Adjunct rotation takes place in
semiflexed knee by the active contraction of
muscles and its range varies between 50° and70°.
Q. 39. Name any four of arteries taking part inthe anastomoses around the knee joint.
Ans. The arteries taking part in the anastomosesaround the knee joint:1. Five genicular branches of popliteal artery
2. The descending genicular branch of femoralartery
3. The descending branch of lateral circum-flex femoral artery
4. Two recurrent branches of anterior tibialartery.
Q. 40. Name the ligaments of the hip joint. Why
iliofemoral ligament is the strongestligament?
Ans. The ligaments of the hip joint are:
1. The fibrous capsule
2. The iliofemoral ligament3. The pubofemoral ligament4. The ischiofemoral ligament
5. The ligament of the head of the femur6. The acetabular labrum
7. The transverse acetabular ligament
The iliofemoral ligament is one of the strongestligaments because it prevents the trunk from
falling backwards in the standing posture.
Q. 41. What is inversion? Name two inverters of
the foot.
Ans. Inversion is a movement in which the medialborder of the foot is elevated, so that the sole
faces medially. Inverters of the foot are:1. Tibialis anterior
2. Tibialis posterior.
Q. 42. What is eversion? Name two evertors of
the foot. What is the axis of inversion and
eversion? Ans. Eversion is a movement in which the lateral
border of the foot is elevated so that the solefaces laterally. Evertors of foot are:
1. Peroneus longus2. Peroneus brevis
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Inferior Extremity 47
Axis of inversion and eversion is oblique axis
which runs forwards, upwards and medially,
passing from the back of the calcaneum
through the sinus tarsi to emerge at the
superomedial aspect of the neck of the talus.
Q. 43. Name the contents of adductor canal.
Ans. Contents of adductor canal are:
1. Femoral artery
2. Femoral vein
3. The saphenous nerve
4. The nerve to vastus medialis
Q. 44. Name any four bursae around the knee
joint.
Ans. Bursae around the knee joint are:
1. Subcutaneous prepatellar bursa2. Subcutaneous infrapatellar bursa
3. Deep infrapatellar bursa
4. Suprapatellar bursa.
Q. 45. What is fascia lata? Mention its modifica-
tion.
Ans. The fascia lata is a tough fibrous sheath that
envelops the whole of the thigh like a sleeve.Its two modifications are:
1. Iliotibial tract
2. Cribriform fascia.
Q. 46. Specify root value of tibial part of sciatic
nerve and name any two muscles supplied
by it in the thigh?
Ans. The root value of tibial part of sciatic nerve isL4,5, and 1,2,3The muscles supplied by the Tibial part of
sciatic nerve are semimembranosus, semi-
tendinosus and the long head of biceps femoris.
Q. 47. Give boundaries of femoral ring. Why
femoral hernia is more common in
females? Ans. Femoral ring is bounded
Anteriorly by—Inguinal ligament
Posteriorly by—Pectineus and its covering
fascia
Medially by—Concave margin of the lacunar
ligament
Laterally by—septum separating it fromfemoral vein.
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Inferior Extremity 49
Ans. 1. Gluteus maximus (extensor of the hip)
2. Quadriceps femoris (extensor of the knee)
3. Gastrocnemius
4. Soleus
Q. 52. Give characteristics of the hamstring
muscles.
Ans. 1. They take origin from the ischial tuberosity.
2. They are inserted beyond the knee joint tothe tibia, fibula or both bones.
3. They are supplied by the tibial division of
the sciatic nerve.
4. They act as flexors of knee joint and
extensors of hip joint.
Q. 53. What is reverse muscular action? Explain
with a suitable example. Ans. During muscular contraction when the
proximal end of a muscle (origin) moves
towards the distal end (insertion). It is called
as reverse muscular action.
The distal end (insertion) of the muscles of
lower limb move only when the feet are off the
ground, i.e. action from above but when thefeet are supporting the body weight the
muscles act in reverse (from below) i.e.
proximal end moves (origin) towards the distal
end. This is typically seen while rising up from
sitting posture and in going upstairs.
Q. 54. What is oblique popliteal ligament? Which
blood vessel and nerve pierce it? Namestructures supplied by the vessel and the
nerve.
Ans. Oblique popliteal ligament is an expansion
from the tendon of the semimembranosus
muscle. The middle genicular vessels and
nerve pierce it. Middle genicular vessels and
nerve supply cruciate ligaments and synovial
membrane of the knee joint.
Q. 55. Name the structures which are
represented by the following ligaments.
1. Tibial collateral ligament
2. Fibular collateral ligament
3. Long plantar ligament
4. Plantar aponeurosis
(plantar flexors of the
ankle)}
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Ans. 1. Tibial collateral ligament – degenerated
tendon of adductor mag