Lower limb: plantar digital nerves: 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.

Try it

Anatomy · Lower limb: plantar digital nerves

Sample item

A 45-year-old woman has burning pain in the forefoot on wearing high-heeled shoes. Squeezing the forefoot reproduces a painful click and the pain is relieved by removing the shoe. What is the most likely site of the lesion?

ABetween the first and second metatarsal heads, on the deep fibular nerveBBehind the medial malleolus, on the tibial nerveCBeneath the calcaneal tuberosity, on the nerve to abductor digiti minimiDBetween the third and fourth metatarsal heads, on the third common plantar digital nerve

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

The answer and the reasoning

D. Between the third and fourth metatarsal heads, on the third common plantar digital nerve

Morton neuroma is a perineural fibrosis of the third common plantar digital nerve, which is thickest here because it receives a communicating branch from the lateral plantar nerve to the medial plantar contribution. It is compressed by the deep transverse metatarsal ligament in the third web space and produces burning pain and a palpable click (Mulder sign).

Option by option

A. Between the first and second metatarsal heads, on the deep fibular nerve
The deep fibular nerve supplies only the first web space skin and does not form interdigital neuromas.
B. Behind the medial malleolus, on the tibial nerve
The tibial nerve compressed behind the medial malleolus produces tarsal tunnel syndrome, with sole numbness.
C. Beneath the calcaneal tuberosity, on the nerve to abductor digiti minimi
Entrapment of the nerve to abductor digiti minimi produces chronic heel pain and not forefoot pain.
D. Between the third and fourth metatarsal heads, on the third common plantar digital nerve (correct)
Morton neuroma affects the third common plantar digital nerve in the third web space.

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 D, Between the third and fourth metatarsal heads, on the third common plantar digital nerve. Morton neuroma is a perineural fibrosis of the third common plantar digital nerve, which is thickest here because it receives a communicating branch from the lateral plantar nerve to the medial plantar contribution.

Why is "Between the first and second metatarsal heads, on the deep fibular ne…" not the answer?

The deep fibular nerve supplies only the first web space skin and does not form interdigital neuromas.

Why is "Behind the medial malleolus, on the tibial nerve" not the answer?

The tibial nerve compressed behind the medial malleolus produces tarsal tunnel syndrome, with sole numbness.

Why is "Beneath the calcaneal tuberosity, on the nerve to abductor digiti min…" not the answer?

Entrapment of the nerve to abductor digiti minimi produces chronic heel pain and not forefoot pain.

What concept does this question test?

It tests Lower limb: plantar digital nerves in Anatomy. It is compressed by the deep transverse metatarsal ligament in the third web space and produces burning pain and a palpable click (Mulder sign).

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: plantar digital nerves?

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.