Unit 1 Question Bank
Sourcing: items tagged TMU 2021–22 come from the real final paper
(Normal Human Structure 2, Grade 2019/2020 intake). Items tagged Slide come from TMU
Lecture 1. Items tagged Gray's are built from the textbook to cover examinable content
the paper has tested in other years. Nothing here is invented; answers are verifiable against
the cited page — check against the official marking scheme where one exists.
0 / 20 answered
1The lateral border of the femoral triangle is formed by the ( ).
Answer: C
The femoral triangle is bounded above by the inguinal ligament (its base),
laterally by the medial margin of sartorius, and medially by the medial margin of
adductor longus. Option B is the medial border, not lateral — the commonest slip. Pectineus forms
part of the floor, never a border.
Gray's 4e p.564 · TMU Slide 14
2Which branch of the lumbar plexus emerges from the medial border of psoas major? It is the ( ).
Answer: A
The obturator nerve is the one lumbar plexus branch that emerges
from the medial border of psoas major; it then runs into the pelvis and reaches the medial
compartment of the thigh through the obturator canal. The femoral nerve emerges from the
lateral border — that is the distractor being tested.
TMU 2021–22 final, Section II Q4 · Gray's 4e p.588
3Which structure is NOT contained within the femoral sheath?
Answer: D
The femoral sheath has three compartments holding the artery, the vein and the
lymphatics (the medial one being the femoral canal). The femoral nerve lies lateral to and
outside the sheath. It is a content of the femoral triangle but not of the
sheath — keep the two questions separate.
Gray's 4e p.565
4The great saphenous vein passes at the ankle ( ).
Answer: B
The great saphenous vein arises from the medial end of the dorsal venous arch and
crosses in front of the medial malleolus — a constant relationship that makes it the
target for an emergency venous cutdown. Option C describes the small saphenous vein, which runs
behind the lateral malleolus.
TMU Slide 10 · Gray's 4e p.560
5Contents of the adductor canal from anterior to posterior are ( ).
Answer: A
Front to back the canal holds saphenous nerve → femoral artery → femoral
vein. The nerve is the only one that leaves the canal to become superficial; the vessels
continue through the adductor hiatus and are renamed popliteal.
TMU Slide 18 · Gray's 4e p.564
6Which muscle of the medial compartment of the thigh is supplied by the femoral nerve?
Answer: C
Pectineus sits in the medial group by position but is innervated
by the femoral nerve. Every other option takes the obturator nerve. This exception is a favourite
single-mark question because it punishes rote group-learning.
Gray's 4e p.588
7The great saphenous vein terminates by draining into the femoral vein approximately ( ) below the inguinal ligament.
Answer: B
3–4 cm, where it pierces the saphenous opening in the fascia lata.
Do not confuse this with the 2–4 cm figure, which is where the deep femoral artery arises and
where the lateral femoral cutaneous nerve becomes superficial below the ASIS.
TMU Slide 10
8The lacuna vasorum transmits all of the following EXCEPT the ( ).
Answer: D
The vascular lacuna (medial to the iliopectineal arch) carries the femoral artery,
femoral vein and the femoral canal with its lymphatics. The femoral nerve passes through the
lacuna musculorum — the lateral compartment — together with iliopsoas and the lateral femoral
cutaneous nerve.
TMU Slide 16
9Which of the following is NOT a head of the quadriceps femoris?
Answer: C
Sartorius is a separate strap muscle of the anterior compartment,
not part of quadriceps. The four heads are rectus femoris and the three vasti — medialis, lateralis and
intermedius. Both sartorius and quadriceps take the femoral nerve, which is why the grouping is easy
to blur.
TMU Slide 13 · Gray's 4e p.583
10The femoral artery becomes the popliteal artery as it passes through the ( ).
Answer: A
The adductor hiatus is the gap in the lower attachment of adductor
magnus through which the femoral vessels reach the popliteal fossa and are renamed. The saphenous
opening transmits the great saphenous vein; the obturator canal transmits the obturator neurovascular
bundle; the femoral ring is the upper opening of the femoral canal.
Gray's 4e p.564, 588
11Which muscle has a dual nerve supply from both the obturator and the sciatic nerve?
Answer: D
Adductor magnus is a composite muscle: its adductor portion is
supplied by the obturator nerve, while its hamstring (ischiocondylar) portion takes the tibial division
of the sciatic nerve, reflecting its developmental origin from the posterior compartment.
Gray's 4e p.589
12A femoral hernia characteristically appears ( ) the pubic tubercle.
Answer: B
A femoral hernia descends through the femoral ring into the femoral canal, so it
emerges below and lateral to the pubic tubercle. An inguinal hernia appears above and
medial to it (option A) — this single relationship is how the two are told apart clinically.
Gray's 4e p.565
13Which structure passes through the saphenous opening of the fascia lata?
Answer: A
The saphenous opening exists precisely to let the great saphenous vein
leave the superficial fascia and join the femoral vein. The small saphenous vein pierces deep fascia in the
popliteal fossa instead; the saphenous nerve emerges from the adductor canal, not through this opening.
Gray's 4e p.564
14The floor of the femoral triangle is formed by the ( ).
Answer: C
Laterally the floor is iliopsoas descending from the abdomen;
medially it is pectineus and adductor longus. Option D describes the
roof — the fascia lata pierced by the saphenous opening.
Gray's 4e p.564
15The two muscles inserting into the iliotibial tract are the ( ).
Answer: B
Tensor fasciae latae anteriorly and most of gluteus
maximus posteriorly insert into the iliotibial tract. Acting through it they hold the knee
extended and stabilise the hip by resisting lateral displacement of the proximal femur.
Gray's 4e p.563
16Which nerve, if compressed near the anterior superior iliac spine, causes burning and numbness over the lateral thigh with NO muscle weakness?
Answer: D
This is meralgia paraesthetica. The lateral femoral cutaneous nerve
becomes superficial 2–4 cm below the ASIS and is purely sensory, so entrapment gives sensory symptoms
with no weakness. The femoral nerve would also cause quadriceps weakness and a lost knee jerk.
TMU Slide 12 · Gray's 4e p.563
17The deep femoral artery (profunda femoris) usually arises ( ) below the inguinal ligament.
Answer: A
2–4 cm below the inguinal ligament, arising from the posterolateral
aspect of the femoral artery. It is the main supply to the thigh musculature and, via its perforating
branches, to the posterior compartment.
TMU Slide 17
18Which structure is contained in the lacuna musculorum?
Answer: C
The muscular lacuna is the lateral compartment under the inguinal ligament and
transmits iliopsoas, the femoral nerve and the lateral femoral cutaneous nerve. All the
other options lie in the vascular lacuna, medial to the iliopectineal arch.
TMU Slide 16
19Which is NOT a tributary of the great saphenous vein near its termination?
Answer: D
The obturator vein is a deep vein draining to the internal iliac vein
through the obturator canal — it never joins the superficial saphenous system. The five true tributaries
are the superficial epigastric, superficial iliac circumflex, external pudendal, and the superficial
medial and lateral femoral veins.
TMU Slide 11
20During an adductor canal block for knee surgery, quadriceps power is largely preserved because the canal contains ( ).
Answer: B
By the time the femoral nerve's terminal branch reaches the adductor canal it is the
saphenous nerve, a purely sensory nerve supplying skin over the medial leg and foot. Motor
branches to quadriceps have already been given off higher, in the femoral triangle, so blocking here gives
analgesia while preserving the ability to straighten the knee and mobilise.
Gray's 4e p.564 · clinical application
1 Femoral triangle — TMU 2021–22, Section I Q3 · 3′+
A wedge-shaped depression at the junction of the anterior abdominal wall and the thigh.
Boundaries: base — the inguinal ligament; lateral — the medial margin of sartorius; medial — the medial margin of adductor longus; apex points inferiorly and continues as the adductor canal.
Floor: iliopsoas laterally, pectineus and adductor longus medially.
Roof: fascia lata, pierced by the saphenous opening.
Contents (lateral → medial): femoral nerve, femoral artery, femoral vein, lymphatics within the femoral canal. Gray's 4e pp.564–565
Boundaries: base — the inguinal ligament; lateral — the medial margin of sartorius; medial — the medial margin of adductor longus; apex points inferiorly and continues as the adductor canal.
Floor: iliopsoas laterally, pectineus and adductor longus medially.
Roof: fascia lata, pierced by the saphenous opening.
Contents (lateral → medial): femoral nerve, femoral artery, femoral vein, lymphatics within the femoral canal. Gray's 4e pp.564–565
2 Adductor canal (Hunter's canal) — 3′+
A triangular fascial tunnel in the medial third of the thigh running from the apex of the femoral triangle
to the adductor hiatus.
Boundaries: anterolaterally vastus medialis; posteriorly adductor longus above and adductor magnus below; roofed by a strong fibrous membrane covered by sartorius.
Contents (anterior → posterior): saphenous nerve, femoral artery, femoral vein.
The saphenous nerve leaves the canal to become cutaneous; the vessels continue through the adductor hiatus to become the popliteal vessels. TMU Slide 18 · Gray's 4e p.564
Boundaries: anterolaterally vastus medialis; posteriorly adductor longus above and adductor magnus below; roofed by a strong fibrous membrane covered by sartorius.
Contents (anterior → posterior): saphenous nerve, femoral artery, femoral vein.
The saphenous nerve leaves the canal to become cutaneous; the vessels continue through the adductor hiatus to become the popliteal vessels. TMU Slide 18 · Gray's 4e p.564
3 Lacuna vasorum (vascular lacuna) — 3′+
The medial of the two compartments beneath the inguinal ligament, separated from the lateral compartment by
the iliopectineal arch.
Boundaries: anteriorly the inguinal ligament; laterally the iliopectineal arch; medially the lacunar ligament; posteriorly the pecten pubis.
Contents: femoral artery, femoral vein, and the femoral canal containing lymphatics. TMU Slide 16
Boundaries: anteriorly the inguinal ligament; laterally the iliopectineal arch; medially the lacunar ligament; posteriorly the pecten pubis.
Contents: femoral artery, femoral vein, and the femoral canal containing lymphatics. TMU Slide 16
4 Lacuna musculorum (muscular lacuna) — 3′+
The lateral of the two compartments beneath the inguinal ligament.
Boundaries: anteriorly the inguinal ligament; laterally the ilium; medially the iliopectineal arch.
Contents: the iliopsoas muscle, the femoral nerve, and the lateral femoral cutaneous nerve. TMU Slide 16
Boundaries: anteriorly the inguinal ligament; laterally the ilium; medially the iliopectineal arch.
Contents: the iliopsoas muscle, the femoral nerve, and the lateral femoral cutaneous nerve. TMU Slide 16
5 Femoral sheath — 3′+
A funnel-shaped sleeve of fascia surrounding the femoral vessels below the inguinal ligament, formed by
downward prolongation of the transversalis fascia anteriorly and the iliac fascia posteriorly.
It is divided into three compartments: lateral — femoral artery; intermediate — femoral vein; medial — the femoral canal, containing lymphatics and fat.
Note: the femoral nerve lies lateral to and outside the sheath. Gray's 4e p.565
It is divided into three compartments: lateral — femoral artery; intermediate — femoral vein; medial — the femoral canal, containing lymphatics and fat.
Note: the femoral nerve lies lateral to and outside the sheath. Gray's 4e p.565
6 Femoral canal — 3′+
The most medial, conical compartment of the femoral sheath, about 1.25 cm long, containing lymphatic
vessels, a lymph node (of Cloquet) and fat.
Its upper opening is the femoral ring, bounded anteriorly by the inguinal ligament, posteriorly by the pecten pubis, medially by the lacunar ligament and laterally by the femoral vein.
Clinical significance: it is the route of a femoral hernia, which presents below and lateral to the pubic tubercle and strangulates readily because the ring is small and rigid. Gray's 4e pp.563, 565
Its upper opening is the femoral ring, bounded anteriorly by the inguinal ligament, posteriorly by the pecten pubis, medially by the lacunar ligament and laterally by the femoral vein.
Clinical significance: it is the route of a femoral hernia, which presents below and lateral to the pubic tubercle and strangulates readily because the ring is small and rigid. Gray's 4e pp.563, 565
7 Saphenous opening — 2′+
An oval aperture in the fascia lata just inferior to the medial end of the inguinal ligament, through which
the great saphenous vein passes from the superficial fascia to join the femoral vein.
Its margin is formed by the free medial edge of the fascia lata, which spirals around the lateral side of the great saphenous vein and passes medially beneath the femoral vein to attach to the pectineal line. Gray's 4e p.564
Its margin is formed by the free medial edge of the fascia lata, which spirals around the lateral side of the great saphenous vein and passes medially beneath the femoral vein to attach to the pectineal line. Gray's 4e p.564
8 Adductor hiatus — 2′+
An opening in the lower attachment of adductor magnus, between its adductor and hamstring portions, which
transmits the femoral artery and vein from the adductor canal into the popliteal fossa.
It marks the point at which the femoral vessels are renamed the popliteal vessels. Gray's 4e p.588
It marks the point at which the femoral vessels are renamed the popliteal vessels. Gray's 4e p.588
1
Please write down the muscle names of the thigh and their innervation.
10′
Real question — TMU 2021–22 final, Section III Q5.
Anterior group — femoral nerve
- Sartorius
- Quadriceps femoris: rectus femoris, vastus medialis, vastus lateralis, vastus intermedius
Medial group — obturator nerve
- Adductor longus, adductor brevis, gracilis
- Adductor magnus — obturator nerve (adductor part) + tibial division of sciatic nerve (hamstring part)
- Pectineus — femoral nerve (exception)
Posterior group — sciatic nerve
- Biceps femoris (long head — tibial division; short head — common fibular division)
- Semitendinosus, semimembranosus (tibial division)
Marking guide (10 marks):
Anterior group named correctly 2 · anterior nerve 1 · medial group named 2 · medial nerve 1 ·
posterior group named 2 · posterior nerve 1 · both exceptions stated (pectineus, adductor
magnus) 1.
Examiner note: candidates who list the three groups but omit the two exceptions typically cap at 8–9. State them explicitly.
Examiner note: candidates who list the three groups but omit the two exceptions typically cap at 8–9. State them explicitly.
2
Describe the boundaries and contents of the femoral triangle. What is its clinical importance?
8′
Boundaries
- Base (superior): inguinal ligament
- Lateral: medial margin of sartorius
- Medial: medial margin of adductor longus
- Apex: inferior, continuous with the adductor canal
- Floor: iliopsoas (lateral), pectineus and adductor longus (medial)
- Roof: fascia lata pierced by the saphenous opening
Contents — lateral to medial
- Femoral nerve (outside the femoral sheath)
- Femoral artery
- Femoral vein
- Lymphatics in the femoral canal
Mnemonic: NAVEL — Nerve, Artery, Vein, Empty space, Lymphatics.
Clinical importance
- Femoral artery palpation and puncture for angiography and endovascular access
- Femoral venous access — puncture just medial to the arterial pulse
- Femoral hernia emerges through the femoral canal, below and lateral to the pubic tubercle
- Femoral nerve block for anterior thigh and knee surgery
- Enlarged inguinal lymph nodes are palpated here
Marking guide (8 marks): boundaries 3 (base, lateral, medial) · floor 1 ·
contents in correct order 2 · clinical points, any two 2.
3
Describe the course and tributaries of the great saphenous vein. State its clinical applications.
7′
Course
- Begins at the medial end of the dorsal venous arch of the foot
- Passes in front of the medial malleolus
- Ascends the medial side of the leg, passing behind the medial condyle of the femur at the knee
- Ascends the medial side of the thigh
- Pierces the saphenous opening in the fascia lata and joins the femoral vein 3–4 cm below the inguinal ligament
Tributaries near the termination (5)
- Superficial epigastric vein
- Superficial iliac circumflex vein
- External pudendal vein
- Superficial medial femoral vein
- Superficial lateral femoral vein
Clinical applications
- Harvested as a graft for coronary artery bypass and peripheral arterial bypass
- Site of venous cutdown anterior to the medial malleolus in circulatory collapse
- The vein affected in varicose veins; ligated or ablated at the saphenofemoral junction
Marking guide (7 marks): origin 1 · malleolar relation 1 · termination with the 3–4 cm
figure 2 · five tributaries 2 (½ each, rounded) · one clinical application 1.
4
Describe the two compartments beneath the inguinal ligament and what each transmits.
6′
The space beneath the inguinal ligament is divided by the iliopectineal arch, a fascial band running from the inguinal ligament to the iliopubic eminence, into a lateral muscular compartment and a medial vascular compartment.
Lacuna musculorum (lateral)
- Boundaries: anteriorly inguinal ligament; laterally ilium; medially iliopectineal arch
- Contents: iliopsoas muscle, femoral nerve, lateral femoral cutaneous nerve
Lacuna vasorum (medial)
- Boundaries: anteriorly inguinal ligament; laterally iliopectineal arch; medially lacunar ligament; posteriorly pecten pubis
- Contents: femoral artery, femoral vein, femoral canal with lymphatics
Clinical note
The medial part of the vascular lacuna — the femoral ring — is the weak point through which a femoral hernia descends. A psoas abscess, by contrast, tracks down through the muscular lacuna along iliopsoas and points in the femoral triangle.
Marking guide (6 marks): naming the dividing iliopectineal arch 1 · muscular lacuna
boundaries 1 and contents 1.5 · vascular lacuna boundaries 1 and contents 1.5.
5
Describe the adductor canal — its boundaries, contents, and one clinical application.
6′
Position and extent
A triangular fascial tunnel in the middle third of the medial thigh, extending from the apex of the femoral triangle above to the adductor hiatus in adductor magnus below.
Boundaries
- Anterolateral wall: vastus medialis
- Posterior wall: adductor longus proximally, adductor magnus distally
- Roof: a strong fibrous membrane (subsartorial fascia) covered by sartorius
Contents — anterior to posterior
- Saphenous nerve
- Femoral artery
- Femoral vein
The nerve to vastus medialis also enters the upper part of the canal. The saphenous nerve exits to become cutaneous over the medial leg; the vessels pass through the adductor hiatus and are renamed popliteal.
Clinical application
The adductor canal block anaesthetises the saphenous nerve for medial knee analgesia while sparing the motor supply to quadriceps, allowing early mobilisation after knee arthroplasty. Historically, John Hunter ligated the femoral artery in this canal to treat popliteal aneurysm — hence "Hunter's canal".
Marking guide (6 marks): extent 1 · three boundaries 2 · three contents in correct order
2 · clinical application 1.