Lower limb: compartment syndrome: 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: compartment syndrome

Sample item

A 20-year-old man has severe leg pain 6 hours after a closed tibial shaft fracture. The leg is tense, passive flexion of the toes is very painful, and sensation is lost in the cleft between the first and second toes. Which compartment is involved and which nerve explains the sensory loss?

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

The answer and the reasoning

C. Anterior compartment; deep fibular nerve

The anterior compartment is the most commonly affected after tibial fracture. Passive toe flexion stretches the ischaemic extensors, and the deep fibular nerve supplies the skin of the first web space. Treatment is urgent fasciotomy of all four compartments, as delay causes irreversible muscle necrosis and nerve damage.

Option by option

  • A. Deep posterior compartment; tibial nerve

    The deep posterior compartment causes pain on passive toe extension, and the tibial nerve supplies the sole.

  • B. Lateral compartment; superficial fibular nerve

    The lateral compartment affects eversion, and the superficial fibular nerve supplies the dorsum of the foot, sparing the first web.

  • C. Anterior compartment; deep fibular nerve (correct)

    Correct. Pain on passive stretch of extensors and first web space loss indicate the anterior compartment and deep fibular nerve.

  • D. Superficial posterior compartment; sural nerve

    The superficial posterior compartment holds gastrocnemius and soleus, and the sural nerve supplies the lateral foot.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Anterior compartment; deep fibular nerve. The anterior compartment is the most commonly affected after tibial fracture.

Why is "Deep posterior compartment; tibial nerve" not the answer?

The deep posterior compartment causes pain on passive toe extension, and the tibial nerve supplies the sole.

Why is "Lateral compartment; superficial fibular nerve" not the answer?

The lateral compartment affects eversion, and the superficial fibular nerve supplies the dorsum of the foot, sparing the first web.

Why is "Superficial posterior compartment; sural nerve" not the answer?

The superficial posterior compartment holds gastrocnemius and soleus, and the sural nerve supplies the lateral foot.

What concept does this question test?

It tests Lower limb: compartment syndrome in Anatomy. Passive toe flexion stretches the ischaemic extensors, and the deep fibular nerve supplies the skin of the first web space. Treatment is urgent fasciotomy of all four compartments, as delay causes irreversible muscle necrosis and nerve damage.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: compartment syndrome?

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.