Lower limb: venous drainage: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Lower limb: venous drainage

Sample item

A 55-year-old woman has long-standing varicose veins and a pigmented ulcer above the medial malleolus. Duplex shows reflux in the perforating veins of the calf. How do incompetent perforators produce the changes?

ADeep vein valves block all venous return from the legBHigh pressure from the deep veins is transmitted into the superficial veinsCSuperficial vein blood flows normally but is obstructed in the femoral arteryDLymphatic blockage raises the pressure in the great saphenous vein

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. High pressure from the deep veins is transmitted into the superficial veins

Perforating veins normally carry blood from superficial to deep veins, guarded by valves, particularly during calf muscle contraction. When the valves fail, the high pressure generated by the calf pump is transmitted to the superficial veins and skin, causing varicosities, pigmentation and ulceration around the medial malleolus.

Option by option

A. Deep vein valves block all venous return from the leg
Competent valves enforce one-way flow and do not stop venous return; the duplex finding here is reflux, not obstruction.
B. High pressure from the deep veins is transmitted into the superficial veins (correct)
Correct. Reflux through incompetent valves exposes superficial veins and skin to deep venous pressure.
C. Superficial vein blood flows normally but is obstructed in the femoral artery
The cause is venous valve failure and not arterial obstruction.
D. Lymphatic blockage raises the pressure in the great saphenous vein
Lymphatic obstruction causes non-pitting oedema, not varicosities from perforator reflux.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, High pressure from the deep veins is transmitted into the superficial veins. Perforating veins normally carry blood from superficial to deep veins, guarded by valves, particularly during calf muscle contraction.

Why is "Deep vein valves block all venous return from the leg" not the answer?

Competent valves enforce one-way flow and do not stop venous return; the duplex finding here is reflux, not obstruction.

Why is "Superficial vein blood flows normally but is obstructed in the femora…" not the answer?

The cause is venous valve failure and not arterial obstruction.

Why is "Lymphatic blockage raises the pressure in the great saphenous vein" not the answer?

Lymphatic obstruction causes non-pitting oedema, not varicosities from perforator reflux.

What concept does this question test?

It tests Lower limb: venous drainage in Anatomy. When the valves fail, the high pressure generated by the calf pump is transmitted to the superficial veins and skin, causing varicosities, pigmentation and ulceration around the medial malleolus.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lower limb: venous drainage?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.