Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

The muscle primarily involved in extending the great toe against resistance is the extensor hallucis longus. This muscle originates from the fibula and inserts into the distal phalanx of the great toe, enabling it to extend that digit. When testing for the ability to extend the great toe, the force that one applies against resistance primarily engages this muscle, as it is specifically responsible for the extension of the hallux.

In the context of the question, the tibialis anterior is more involved in dorsiflexion of the foot and does not play a significant role in extending the great toe. The gluteus maximus is primarily responsible for hip extension and does not contribute to toe movement. The gastrocnemius, located in the calf, mainly functions to plantarflex the foot and bend the knee, also not playing a role in the extension of the great toe. Therefore, the extensor hallucis longus is the most appropriate choice when considering the specific action of extending the great toe against resistance.