CCEP Extremity Anatomy 4 — Questions and Answers
Question 1: The 'terrible triad' injury of the elbow involves disruption of which three structures?
- Medial collateral ligament, coronoid process, radial head
- Lateral collateral ligament, coronoid process, radial head (Correct answer)
- Medial collateral ligament, olecranon, radial head
- Annular ligament, coronoid, capitellum
Correct answer: Lateral collateral ligament, coronoid process, radial head
The terrible triad of the elbow consists of posterior dislocation with fractures of both the coronoid process and the radial head, plus lateral collateral ligament disruption.
Question 2: Which muscle of the rotator cuff has its primary action as internal rotation of the humerus?
- Supraspinatus
- Infraspinatus
- Subscapularis (Correct answer)
- Teres minor
Correct answer: Subscapularis
The subscapularis is the only rotator cuff muscle that internally rotates the humerus; it also adducts and assists in stabilizing the humeral head anteriorly.
Question 3: The deep peroneal nerve supplies motor innervation to the anterior compartment of the leg and terminates by providing sensation to which area of the foot?
- Entire dorsum of the foot
- Plantar surface of the hallux
- First web space (between hallux and second toe) (Correct answer)
- Lateral border of the foot
Correct answer: First web space (between hallux and second toe)
The terminal sensory branch of the deep peroneal nerve provides sensation to the first dorsal web space between the great and second toes.
Question 4: Which of the following ligaments is the PRIMARY restraint to valgus stress at the elbow?
- Radial collateral ligament
- Annular ligament
- Anterior bundle of the medial (ulnar) collateral ligament (Correct answer)
- Interosseous membrane
Correct answer: Anterior bundle of the medial (ulnar) collateral ligament
The anterior bundle of the medial (ulnar) collateral ligament is the primary static restraint to valgus stress at the elbow, particularly between 30° and 120° of flexion.
Question 5: The plantar fascia originates from the:
- Navicular tuberosity
- Medial process of the calcaneal tuberosity (Correct answer)
- Base of the fifth metatarsal
- Sustentaculum tali
Correct answer: Medial process of the calcaneal tuberosity
The plantar fascia (plantar aponeurosis) originates primarily from the medial process of the calcaneal tuberosity and fans distally to insert at the proximal phalanges.
Question 6: The Lisfranc ligament connects which two bones?
- Navicular to first cuneiform
- First cuneiform to second metatarsal base (Correct answer)
- Cuboid to fourth metatarsal base
- Second to third metatarsal bases
Correct answer: First cuneiform to second metatarsal base
The Lisfranc ligament is a strong interosseous ligament running from the lateral aspect of the medial cuneiform to the medial base of the second metatarsal.
Question 7: The sesamoid bones of the hallux are embedded within which tendon and located on the plantar surface of the first metatarsal head?
- Flexor hallucis longus
- Flexor hallucis brevis (Correct answer)
- Abductor hallucis
- Peroneus longus
Correct answer: Flexor hallucis brevis
The medial and lateral sesamoids of the hallux are embedded within the two heads of the flexor hallucis brevis and articulate with the plantar surface of the first metatarsal head.
CCEP Extremity Anatomy 4
The 'terrible triad' injury of the elbow involves disruption of which three structures?