1. A multiple choice quiz assessing knowledge of musculoskeletal and nervous system anatomy and physiology. Questions cover topics like muscle structure, nerve damage presentations, bone fractures, and joint motions. 2. An 18-year-old girl presented with severe right knee pain and abnormal anterior displacement of the tibia, indicating damage to the anterior cruciate ligament. 3. Loss of dorsiflexion and eversion of the foot after trauma to the neck of the fibula with complete sensory loss on the dorsum of the foot points to damage of the deep peroneal nerve.

1. NEB Step-1 Formative Assessment of Locomotion
Prof. Saeed Shafi
SMC/SFLT
1. Sarcomere is a portion of myofibril between two:
a. I Bands
b. A Bands
c. Z Discs
d. H Bands
e. Myosin
2. A patient comes to an OPD with progressive muscle weakness,
drooping of eyelids and early fatigueability. An autoimmune
disorder is diagnosed, which most likely is:

2. a. Tetanus
b. Myasthenia Gravis
c. Tetany
d. Polio myelitis
e. Tetanization
3. A 16 years old football player suffered a fracture to the right tibia.
After his lower leg has been in a cast for eight weeks, he is surprised
to find out that his right gastrocnemius muscle is significantly
smaller in circumference than it was before the fracture. What is the
most likely explanation?
a. decreased number of muscle fibers
b. decreased blood flow to the muscle
c. decreased number of myofibrils
d. increase in glycolytic activity in muscle
e. progressive denervation of muscle fibers
4. An elderly woman with osteoporosis is taken to emergency
department following a fall. One of her legs appeared shortened and
externally rotated. Which part of femur is fractured according to her
presentation?
a. Head
b. Neck
c. Greater trochanter
d. Lesser trochanter
e. Upper shaft
5. To assess the power of quadriceps femoris, a patient is asked to
extend the knee against resistance. Biceps femoris by opposing this
action, acts as:
a. Synergist
b. Fixator
c. Agonist

3. d. Antagonist
e. Prime mover
6. Abduction-adduction of the hip indicates hip motion in which body
plane?
a. Sagittal plane
b. Coronal plane
c. Horizontal plane
d. Vertical plane
e. Transverse plane
7. In carpal tunnel syndrome the patient exhibits the sparing of which
one of the following thumb movements:
a. Abduction
b. Adduction
c. Extension
d. Flexion
e. Opposition
8. An 18 year old girl came to ER with severe pain in right knee due to
injury during a football match. On examination there was an
abnormal anterior displacement of tibia. Which one of the following
ligaments is damaged in her case?
a. Posterior cruciate
b. Medial collateral
c. Anterior cruciate
d. Lateral collateral
e. Patellar
9. An 18 years old female presented with atrophy of thenar eminence
but no sensory loss. The nerve most likely damaged is:
a. Median
b. Ulnar
c. Radial

4. d. Musculocutaneous
e. Axillary
10. A patient comes to OPD with loss of dorsiflexion and eversion
of foot after trauma to the neck of ipsilateral fibula. Examination
revealed complete sensory loss on dorsum of foot. Damage to which
of the following nerves is responsible for this presentation :
a. Common peroneal
b. Superficial peroneal
c. Deep peroneal
d. Sural
e. Sciatic
11. A university student had avascular necrosis of femoral head
following a fracture which interfered with one of the following
anastomosis:
a. Gluteal
b. Iliac
c. Cruciate
d. Trochanteric
e. Hamstring
12. A 10 years old young boy fell while playing football and got
fracture dislocation of surgical neck of the humerus. One of the
following nerves will be damaged as a result of this injury?
a. Axillary
b. Radial
c. Ulnar
d. Musculocutaneous
e. Median
13. A 40 years old lady underwent mastectomy and axillary
clearance. A month later her physician noticed prominent medial
border of the scapula and inability to perform pushing and punching

5. movements. Injury to which of the following nerves is responsible
for these features?
a. Medial Pectoral
b. Lateral pectoral
c. Axillary
d. Long thoracic
e. Thoraco dorsal
14. An 18 year old boy received a knife wound on medial side of
cubital fossa. Which of the following structures is MOST likely to be
injured?
a. Radial nerve
b. Biceps brachii tendon
c. Brachial artery
d. Median nerve
e. Ulnar nerve
15. Arterial anastomosis in shoulder occurs between suprascapular
artery and one of the following arteries?
a. Anterior circumflex humeral
b. Circumflex scapular
c. Dorsal scapular
d. Thoracodorsal
e. Transverse cervical
16. Which of the following is not a direct branch of the axillary
artery?
a. Anterior circumflex humeral
b. Posterior circumflex humeral
c. Thoracoacromial
d. Thoracodorsal
e. Subscapular

6. 17. A severely dehydrated 10 years old boy brought to emergency in
shock. Doctor on duty was unable to find any vein in upper limb.
Which one of the following veins is most suitable for IV access?
a. Femoral
b. Great saphenous
c. Small saphenous
d. Dorsal venous arch
e. Popliteal
18. A middle aged lady presented with a lump in right breast. On
examination it was hard, mobile and painless situated in the upper
outer quadrant. The group of axillary lymph nodes involved in her
case is:
a. Anterior
b. Posterior
c. Apical
d. Lateral
e. Medial
19. A housemaid while mopping fell down on wet floor on hand and
was unable to adduct the wrist. Which one of the following muscles
is most likely to be damaged?
a. Flexor digitorum superficialis
b. Flexor digitorum profundus
c. Adductor policis
d. Flexor carpi ulnaris
e. Flexor digiti minimi
20. A 27 years old cricketer with a history of blunt trauma to arm
was seen by a doctor in AIMS. He was asked to abduct the arm. He
could start the movement but could not bring the arm to shoulder
height. This is due to injury of one of the following nerves:
a. Median
b. Ulnar

7. c. Radial
d. Musculocutaneous
e. Axillary
21. Hemivertebra is responsible for which one of the following
spinal curvatures?
a. Kyphosis
b. Scoliosis
c. Lordosis
d. Kyphoscoliosis
e. Ptosis
22. An injury to one of the following nerves will impair
sensations over the supero-medial aspect of knee?
a. Sural
b. Saphenous
c. Femoral
d. Obturator
e. Superficial peroneal
23. During insertion of an IV cannula in the median cubital vein, the
patient suddenly developed numbness on the radial side of the
forearm. Which nerve was injured?
a. Lateral antebrachial cutaneous
b. Medial antebrachial cutaneous
c. Musculocutaneous
d. Posterior antebrachial cutaneous
e. Superficial radial nerve
24. A Turkish Aid worker during earthquake relief in AJK-Pakistan
got a deep incised wound just beneath the lateral malleolus. Which
movements will be most affected?
a.Plantar flexion and inversion
b.Plantar flexion and eversion
c.Dorsiflexion and inversion

8. d.Dosriflexion and eversion
e.Plantar flexion and lateral rotation
25. A Cubin RESCUE worker got his right lower limb trapped
under falling rocks during earthquake relief work. Two months later,
the attending physician noticed his right foot drop and diminished
sensation on the lateral aspect of ipsilateral leg and the dorsum of the
foot, with marginal sparing. He was unable to dorsiflex his right
foot. The nerve most likely injured in this case is:
a. Sciatic
b. Tibial
c. Common peroneal
d. Deep peroneal
e. Superficial peroneal
26. Which muscle is involved in plantar flexion of the ankle joint
during raising of the heel?
a. Popliteus
b. Hamstrings
c. Gastrocnemius
d. Tibialis anterior
e. Plantaris
27. A needle biopsy of the sural nerve resulted in the formation of a
Hematoma. Which of the following vessels lies adjacent to the sural
nerve that was accidentally injured in this case?
a. Posterior Tibial A.
b. Anterior Tibial A.
c. Greater Saphenous V.
d. Small Saphenous V.
e. Peroneal A.
28. In the process of escaping from eminent danger, the heroine of
a jungle movie punctured the skin on the medial side of her wrist

9. with a spiny bush. Next day, an inflamation was seen spreading up
the medial side of her arm, along a large cutaneous vein extending
from the dorsum of her hand to the medial side of her arm. The vein
involved is:
a. Basilic
b. Brachial
c. Cephalic
d. Median Cubital
e. Ulnar
29. Loss of sensation from the tip of the index finger is indicative of
injury to which nerve?
a. Radial
b. Median
c. Ulnar
d. Musculocutaneous
e. Medial antebrachial cutaneous
30. A person riding a mountain bike on a rustic trail hits a rut. The
fork of the bike breaks and the person is thrown into a tree, severely
fracturing the upper end of his humerus. During the repair the
surgeon ties off the artery traveling through the quadrangular space
to stop the hemorrhage. Which artery did he ligate?
a. dorsal scapular
b. posterior circumflex humeral
c. circumflex scapular
d. subscapular
e. suprascapular
31. A person sustains a left brachial plexus injury in an autorikshaw
accident. After initial recovery the patient has normal scapular
contour and diapgragmatic breathing. He can’t initiate abduction of
shoulder. However, if the affected arm is helped through the first 15

10. degrees of abduction, the patient can fully abduct the arm. Where
would you expect the site of injury?
a. Axillary nerve
b. Posterior cord
c. Roots of plexus
d. Superior trunk
e. Suprascapular nerve
32. A patient with a diabetic ulcer in the anterior midline of the
ankle region experienced loss of cutaneous sensation on the dorsal
surface of the foot. Which nerve was most likely damaged?
a. Saphenous
b. Sural
c. Sural communicating
d. Deep Peroneal
e. Superficial Peroneal
33. Following a car accident, patient received a deep laceration on
medial side of right knee and numbness along medial side of right
leg and foot. He has no motor loss. The nerve which appears to
have been injured is:
a. Saphenous
b. Sural
c. Sural communicating
d. Deep Peroneal
e. Superficial Peroneal
34. Articular cartilage differs from non-articular hyaline cartilage
by the absence of :
a.Perichondrium
b.Collagen fibers
c.Glycosaminoglycans
d.Chondrocytes
e. Basophilic matrix

11. 35. An elderly man complained of pain in his shoulder when he
brought his forearm and hand behind his back while dressing. It was
determined that the pain was caused by stretching of the lateral
rotators of his arm during this motion. Which muscle was most
likely involved?
a. Infraspinatus
b. Latissimus dorsi
c. Subscapularis
d. Supraspinatus
e. Teres major
36. Which one of the followings does not contribute to the rotator
cuff of shoulder joint?
a. Infraspinatus
b. Subscapularis
c. Supraspinatus
d. teres major
e. teres minor
37. A soldier developed "fallen arches" from marching with a heavy
pack in boots that lacked arch support. The ligament that normally
supports the head of the talus and is primarily responsible for
holding up the medial longitudinal arch of the foot is the:
a. Calcaneometatarsal
b. Deltoid
c. long plantar
d. short plantar
e. Spring
38. The interosseous membrane between the radius and ulna is the
uniting structure in a type of fibrous joint classified as a:
a. Suture
b. Symphysis
c. Synchondrosis
d. Syndesmosis

12. e. Synostosis
39. If the second part of the axillary artery was interrupted,
collateral blood flow could pass from branches of the thyrocervical
trunk into which artery?
a. Anterior humeral circumflex
b. Circumflex scapular
c. Deep brachial
d. Posterior humeral circumflex
e. Thoracoacromial
40. In a fracture of the midshaft of the humerus, which artery is
most likely to be injured?
a. Subscapular
b. Posterior circumflex humeral
c. Radial recurrent
d. Deep brachial
e. Circumflex scapular
41. The axillary nerve arises directly from which part of the brachial
plexus?
a. inferior trunk
b. lateral cord
c. medial cord
d. middle trunk
e. posterior cord
42. Saeed Ajmal lost sensation from the tip of his little finger
during spin bowling. Injury to which nerve is responsible for his
presentation?
a. Radial
b. Median
c. Ulnar
d. Musculocutaneous
e. Medial antebrachial cutaneous

13. 43. A patient is given intramuscular injection on the upper medial
quadrant of the buttock by a trainee Nurse. This may injure one of
the following nerves:
a. Superior gluteal
b. Inferior gluteal
c. Sciatic
d. Pudendal
e. Posterior cutaneous nerve of thigh
44. During a basketball game, the center of the team went up for a
rebound and when coming down, his foot landed on the foot of
another player, sharply everting it. He limped off the floor, having
severely sprained the medial side of her ankle. Which ligament was
injured?
a. Calcaneofibular
b. Deltoid
c. Short plantar ligament
d. Plantar calcaneonavicular
e. Tibial collateral ligament
45. While walking to class on an icy winter morning, a student slips
and falls on her outstretched hand. The intense pain forces her to go
to the emergency room. After X-rays of her wrist are taken, the
attending doctor says," You were lucky, there is no Colles' or
scaphoid fractures, but you have dislocated the middle carpal bone of
the proximal row." Which bone was dislocated?
a. Capitate
b. Lunate
c. Scaphoid
d. Trapezoid
e. Triquetrum
46. A two year old child refused to take her nap. Her mother tightly
holds her left hand and pulled her to the bedroom. Refusing to go

14. further, the child suddenly attempts to jerk away and then sits down
screaming and holding her left elbow. In an attempt to calm her
down her mother offers her a cookie, but she cannot supinate her left
hand to receive it. Which joint is dislocated in this case?
a. glenohumeral
b. humero-ulnar
c. humero-radial
d. proximal radio-ulnar
e. distal radio-ulnar
52. Limb buds become visible from the ventrolateral body wall at the
end of which week of gestation?
a) 4th
b) 5th
c) 6th
d) 7th
e) 8th
53. Digital rays in Hand plates are clearly visible towards the end of
which week of gestation?
a) 4th
b) 5th
c) 6th
d) 7th
e) 8th
54. Regarding rotation of limbs during fetal life:
a) Upper limb rotates 90 degree medially and lower limb rotates 90
degree laterally
b) Upper limb rotates 90degree laterally
c) Lower limb rotates 90degree medially
d) Upper limb rotates 90degree laterally and lower limb rotates
90degree medially
e) Both upper & lower limbs rotate 1800

15. 55. Partial absence of limbs is called:
a) Amelia
b) Meromelia
c) Phocomelia
d) Micromelia
e) Quadrimelia
56. Abnormal cleft between 2nd
and 4th
metacarpal bone and soft tissues
is called;
a. Syndactyly
b. Polydactly
c. Brachydactly
d. Osteogenesis imperfacta
e. Lobster claw hand
57. In lower limb blood pressure is measured from which of the
following artery:
a. Internal Pudendal
b. Popliteal
c. Femoral
d. Obturator
e. Dorsalis pedis
58. After a nerve injury at wrist, patient developed weakness in
touching the thumb with the index finger of the same side. Paralysis of
which muscle is responsible for this presentation?
a. Adductor pollicis
b. Abductor pollicis brevis
c. Flexor pollicis brevis
d. Flexor pollicis longus
e. Opponens pollicis
59. Which of the following muscles is the most powerful supinator of
the forearm when the elbow joint is flexed?
a. Supinator

16. b. Brachioradialis
c. Brachialis
d. Supraspinatus
e. Biceps brachii
60. In knee jerk, afferent impulse travels in one of the following nerves:
a. Femoral
b. Tibial
c. Obturator
d. Sciatic
e. Common peroneal
61. With regard to the anatomy of the femoral triangle, progressing
from medial to lateral which of the following is the most correct?
a. Femoral nerve, femoral artery, femoral vein
b. Femoral artery, femoral nerve, femoral vein
c. Femoral vein, femoral artery, femoral nerve
d. Femoral nerve, femoral vein, femoral artery
e. Femoral artery, femoral vein, femoral nerve
62. Endomysium surrounds:
a. Muscle fiber
b. Muscle fascicles
c. Myofibrils
d. Entire muscle
e. Muscle group
63. In coronary artery bypass grafting (CABG), which of the following
vein is most commonly used:
a. Accessory saphenous.
b. Popliteal
c. Great saphenous
d. Small saphenous

17. e. Femoral
64. The collagen fibers present in fibrocartilage are:
a. Type I
b. Type II
c. Type III
d. Type IV
e. Type V
65. Muscle which flexes both the hip and knee is:
a. Rectus femoris
b. Semitendinosus
c. Biceps femoris
d. Sartorius
e. Popliteus
66. A middle aged person presented with tingling and burning sensation
over anterolateral aspect of thigh. There is no history of trauma.
Entrapment of one of the following nerves is responsible for these
symptoms:
a. Ilioinguinal
b. Iliohypogastric
c. Genitofemoral
d. Femoral
e. Lateral femoral cutaneous
67. The most important muscle involved in maintaining the curvature of
the transverse arch of the foot is:
a. Adductor hallucis
b. Flexor accesorius
c. Peroneus longus
d. Tibialis anterior
e. Tibialis posterior

18. 68. Regarding collagen in human body:
a. Type II collagen is the most abundant
b. Is made up of four polypeptide chains
c. Glycine is the least amino acid found in collagen
d. Each polypeptide chain has about 1000 amino acid residues
e. Is a conjugate protein.
69. A skeletal muscle was stimulated to produce an isotonic
contraction. Significant muscle shortening was observed. Which
part of the sarcomere would retain a constant length during this
type of muscle contraction?
a. A band
b. Distance between adjacent Z disks
c. Distance from Z disk to M line
d. Distance between adjacent M lines
e. I band
72. The Principal mechanism leading to ovulation is:
a. Raised intrafollicular pressure.
b. Contraction of smooth muscles in theca externa.
c. Enzymatic digestion of follicular wall.
d. Raised level of FSH.
e. Completion of first meiotic division of primary oocyte.
73. Primary sex is determined at the time of :
a) Gametogenesis
b) Implantation
c) Neurulation
d) Ovulation
e) Fertilization

19. 74. One of the following is responsible for transport of female
gamete to the site of fertilization:
a) Uterine contractions
b) Tubal peristalsis
c) Stereocilia of fallopian tube
d) Tubal muscosal enzymes
e) Chemotaxis by sperms
75. Most frequent site for ectopic pregnancy is
a) Ampulla of Uterine tube
b) Abdominal Peritoneum
c) Ovaries
d) Cervix
e) Rectouterine pouch
76. The process of trilaminar germ disc formation is?
a) Neurulation
b) Gastrulation
c) Implantation
d) Morphogernesis
e) Angiogenesis
77. A new born baby had abnormal facial features. The doctor
suspected the patient to have Down Syndrome. What will be the test
of the choice to confirm his impression?
a) Karyotype
b) DNA hybridization
c) PCR
d) Peripheral blood film examination
e) Blood glucose