CCEP Extremity Anatomy 3 — Questions and Answers
Question 1: The dorsal scapular nerve innervates which muscles?
- Serratus anterior and subclavius
- Rhomboid major, rhomboid minor, and levator scapulae (Correct answer)
- Trapezius and sternocleidomastoid
- Supraspinatus and infraspinatus
Correct answer: Rhomboid major, rhomboid minor, and levator scapulae
The dorsal scapular nerve (C5) innervates the rhomboid major, rhomboid minor, and levator scapulae, retracting and rotating the scapula.
Question 2: At the hip, the zona orbicularis is best described as:
- A thickening of the iliofemoral ligament anteriorly
- Circular fibers of the hip joint capsule encircling the femoral neck (Correct answer)
- The attachment zone of the gluteus medius on the greater trochanter
- A bursa located between the iliotibial band and the greater trochanter
Correct answer: Circular fibers of the hip joint capsule encircling the femoral neck
The zona orbicularis consists of circular capsular fibers that form a collar around the femoral neck, helping to retain the femoral head in the acetabulum.
Question 3: The medial patellofemoral ligament (MPFL) originates from which bony landmark?
- Medial tibial plateau
- Medial femoral epicondyle
- Adductor tubercle (Correct answer)
- Medial condyle of the tibia
Correct answer: Adductor tubercle
The MPFL originates from the adductor tubercle region of the medial femoral condyle and inserts on the superomedial patella, acting as the primary restraint to lateral patellar displacement.
Question 4: Which intrinsic foot muscle is responsible for abducting the fifth toe?
- Abductor hallucis
- Flexor digiti minimi brevis
- Abductor digiti minimi (Correct answer)
- Dorsal interosseous IV
Correct answer: Abductor digiti minimi
The abductor digiti minimi originates from the calcaneal tuberosity and inserts on the base of the proximal phalanx of the fifth toe, abducting it.
Question 5: The thoracic outlet syndrome compresses which structures as they pass between the clavicle and first rib?
- Axillary artery and radial nerve only
- Brachial plexus and subclavian artery and/or vein (Correct answer)
- External jugular vein and phrenic nerve
- Musculocutaneous nerve and brachial artery
Correct answer: Brachial plexus and subclavian artery and/or vein
Thoracic outlet syndrome involves compression of the brachial plexus and/or subclavian vessels (artery and/or vein) as they traverse the costoclavicular space.
Question 6: Which structure forms the 'floor' of the carpal tunnel?
- Flexor retinaculum (transverse carpal ligament)
- Palmar aponeurosis
- Carpal bones (proximal and distal rows) (Correct answer)
- Pronator quadratus
Correct answer: Carpal bones (proximal and distal rows)
The floor (dorsal wall) of the carpal tunnel is formed by the concave arrangement of the carpal bones, while the roof is the flexor retinaculum.
Question 7: The obturator nerve (L2-L4) exits the pelvis through the obturator foramen and primarily innervates which muscle group?
- Hip abductors
- Hip flexors
- Hip adductors (Correct answer)
- Hip extensors
Correct answer: Hip adductors
The obturator nerve innervates the medial compartment hip adductors: adductor longus, adductor brevis, adductor magnus (adductor portion), gracilis, and obturator externus.
The dorsal scapular nerve innervates which muscles?