Lower limb: childhood avascular necrosis: 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: childhood avascular necrosis

Sample item

A 6-year-old boy has a painless limp, and X-ray shows a flattened, sclerotic femoral capital epiphysis. At this age the femoral head depends mainly on which vessels?

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

The answer and the reasoning

B. Lateral epiphyseal branches of the medial circumflex femoral artery

This is Perthes disease, avascular necrosis of the capital femoral epiphysis. In childhood the lateral epiphyseal retinacular vessels from the medial circumflex femoral artery supply the head, and the ligamentum teres artery contributes little, so it is vulnerable.

Option by option

  • A. Superior gluteal artery

    This artery supplies the gluteal muscles and not the femoral head.

  • B. Lateral epiphyseal branches of the medial circumflex femoral artery (correct)

    Correct. These retinacular vessels are the main supply at this age and are the vulnerable ones.

  • C. Metaphyseal branches of the lateral circumflex femoral artery

    Metaphyseal vessels cannot cross the physis after infancy to supply the epiphysis.

  • D. Artery of the ligamentum teres

    This vessel is small and contributes little to the head at this age.

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 B, Lateral epiphyseal branches of the medial circumflex femoral artery. This is Perthes disease, avascular necrosis of the capital femoral epiphysis.

Why is "Superior gluteal artery" not the answer?

This artery supplies the gluteal muscles and not the femoral head.

Why is "Metaphyseal branches of the lateral circumflex femoral artery" not the answer?

Metaphyseal vessels cannot cross the physis after infancy to supply the epiphysis.

Why is "Artery of the ligamentum teres" not the answer?

This vessel is small and contributes little to the head at this age.

What concept does this question test?

It tests Lower limb: childhood avascular necrosis in Anatomy. In childhood the lateral epiphyseal retinacular vessels from the medial circumflex femoral artery supply the head, and the ligamentum teres artery contributes little, so it is vulnerable.

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: childhood avascular necrosis?

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.