📝 Practice MCQs
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🎙️ Frequently Asked Viva Questions
Q1. Why is the upper outer quadrant of the gluteal region the safest site for intramuscular injection?
Answer: It avoids the sciatic nerve and major gluteal vessels while providing adequate muscle mass in the gluteus medius.
Q2. Why does injury to the superior gluteal nerve produce a positive Trendelenburg sign?
Answer: Paralysis of the gluteus medius and minimus prevents stabilization of the pelvis during single-leg stance, causing pelvic drop on the opposite side.
Q3. Why is the piriformis called the “key muscle” of the gluteal region?
Answer: It divides the greater sciatic foramen into supra- and infrapiriform compartments, determining the course of major nerves and vessels.
Q4. Why does piriformis syndrome produce sciatica-like pain?
Answer: Compression or irritation of the sciatic nerve by the piriformis causes pain radiating along the sciatic nerve distribution.
Q5. Why does the sciatic nerve normally escape injury during correctly administered gluteal injections?
Answer: The nerve runs in the inferomedial part of the buttock, away from the recommended superolateral injection site.
Q6. Why is the trochanteric anastomosis clinically more important than the cruciate anastomosis?
Answer: It provides the principal blood supply to the head and neck of the femur, preserving femoral head viability.
Q7. Why is the medial circumflex femoral artery the most important contributor to the blood supply of the femoral head?
Answer: Its ascending branches form the major retinacular arteries supplying the head and neck of the femur.
Q8. Why is the cruciate anastomosis functionally important after femoral artery occlusion?
Answer: It provides collateral circulation between the internal iliac and profunda femoris arterial systems.
Q9. Why does paralysis of the gluteus medius produce a waddling or lurching gait?
Answer: Patients shift the trunk toward the affected side to compensate for weak hip abductors and maintain balance.
Q10. Why does the gluteus maximus insert largely into the iliotibial tract rather than directly into the femur?
Answer: This enables efficient stabilization of both the hip and knee during standing, walking, and running.
Q11. Why is Nelaton’s line useful in diagnosing hip pathology?
Answer: Upward displacement of the greater trochanter above the line suggests femoral neck fracture, hip dislocation, or coxa vara.
Q12. Why does inflammation of the trochanteric bursa cause pain during walking or climbing stairs?
Answer: Repetitive friction between the gluteus maximus and greater trochanter irritates the inflamed bursa during hip movements.