Deck 20: The Knee and Related Structures

Question 1

Please check all of the factors that may contribute to patellofemoral stress syndrome.

A) Tightness in the gastrocnemius
B) Decreased Q angle
C) Supination of the foot
D) Tightness of the iliotibial band
E) Patella baja
F) Weak hip adductors
G) Vastus medialis oblique insufficiency

Answer 1

Tightness in the gastrocnemius
Tightness of the iliotibial band
Weak hip adductors
Vastus medialis oblique insufficiency

Question 2

Please check all of the therapeutic exercises that would be appropriate for a person who is in the acute injury phase of surgical repair of an anterior cruciate ligament.

A) Insert quad sets video with no audio (strengthening hip and thigh folder)
B) Insert hamstring curls on NK video with no audio (strengthening hip and thigh folder)
C) Insert video hip flexor strengthening with no audio (strengthening hip and thigh folder)
D) Insert straight leg lift adduction video with no audio from strengthening hip and thigh folder
E) Insert machine squat video with no audio from strengthening hip and thigh folder
F) Insert posterior tibial glides distal with no audio from joint mobilizations folder
G) Insert patellar glides video with no audio from joint mobilizations folder

Answer 2

Insert quad sets video with no audio (strengthening hip and thigh folder)
Insert straight leg lift adduction video with no audio from strengthening hip and thigh folder
Insert patellar glides video with no audio from joint mobilizations folder

Question 3

Which of the following statements about the knee and related structures is INCORRECT?

A) The patella is the largest sesamoid bone in the human body.
B) The knee joint consists of four articulations between the femur and the tibia, the femur and the patella, the femur and the fibula, and the tibia and the fibula.
C) The articular surface of the medial condyle is shorter from front to back than is the surface of the lateral condyle.
D) The medial meniscus is C-shaped, where the lateral meniscus is more O-shaped.
E) The anterior cruciate ligament comprises three twisted bands: the anteromedial, intermediate, and posterolateral bands.

Answer 3

The articular surface of the medial condyle is shorter from front to back than is the surface of the lateral condyle.

Question 4

From the following descriptive statements of the patella, select the INCORRECT statement.

A) The patella is the largest sesamoid bone in the human body.
B) The lateral aspect of the patella is wider than the medial aspect.
C) Tracking within this groove depends on the pull of the quadriceps muscle and patellar tendon.
D) The patella articulates between the concavity provided by the tibial plateaus.
E) The patella is located in the tendon of the quadriceps femoris muscle and divided into three medial facets and a lateral facet.

Question 5

Which of the following is a characteristic of the medial meniscus?

A) It is a round, fibrous cord that is about the size of a pencil.
B) It is a horseshoe-shaped fat pad.
C) It is attached to the lateral articular facet on the superior aspect of the tibia.
D) It is attached to fibers of the semimembranous muscle posteriorly.
E) It is an O-shaped fibrocartilage.

Question 6

The major purpose of the medial collateral ligament is:

A) to prevent hyperextension of the knee.
B) to limit anterior translation of the tibia in non-weight bearing.
C) to prevent the knee from valgus and external rotating forces.
D) to work in conjunction with the thigh muscles to stabilize the knee joint.
E) to attach the medial meniscus to the femur and to allow the tibia to move on the meniscus inferiorly.

Question 7

Identify a function of a bursa.

A) To supply blood to the knee
B) To maintain spacing between the femoral condyles and tibial plateau
C) To act as a separator between the patellar tendon and the joint capsule
D) To reduce the friction between anatomical structures
E) To produce external tibial rotation as the knee moves into extension

Question 8

In the context of bony palpation, which of the following structures is palpated on the lateral aspect by an athletic trainer?

A) Inferior patellar border
B) Intercondylar fossa
C) Tibial tuberosity
D) Head of the fibula
E) Adductor tubercle

Question 9

At what degree of knee flexion are the mensci the most helpful in stabilizing the knee?

A) 15°
B) 35°
C) 90°
D) 125°
E) 180°

Question 10

What structure within the knee attaches to the superior fibers of the semimembranosus muscle?

A) The posterior cruciate ligament
B) The lateral meniscus
C) The anterior cruciate ligament
D) The medial meniscus
E) Pes anserine

Question 11

The anterior cruciate ligament prevents the femur from moving posteriorly during weight bearing. What is its role in non-weight bearing?

A) Limits anterior translation of the tibia
B) Limits posterior translation of the tibia
C) Limits anterior translation of the femur
D) Limits the tibia against excessive external rotation
E) Limits the tibia against excessive internal rotation

Question 12

Why are the cruciate ligaments "extrasynovial"?

A) The synovial membrane lines the inner surface of the joint capsule.
B) The cruciate ligaments consist of two or more multidirectional fibrous bands.
C) The synovial membrane passes in front of the cruciate ligaments.
D) The collateral ligaments are intrasynovial.
E) The synovium attaches to only the collateral ligaments.

Question 13

Why does the tibia externally rotate with extension of the knee during the "screw-home" mechanism?

A) It occurs because the lateral femoral condyle is larger than the medial condyle.
B) It occurs because the medial femoral condyle is larger than the lateral condyle.
C) It occurs to unlock the knee.
D) It occurs to lock the knee.
E) It occurs to allow the anterior cruciate ligament to loosen.

Question 14

Where does the patella lie on the femur when the knee is in full extension?

A) The patella lies slightly medial and proximal to the trochlea.
B) The patella lies slightly distal to the intercondylar eminence and proximal to the tibial tuberosity.
C) The patella lies slightly lateral and distal to the trochlea.
D) The patella lies slightly medial and superior to the femoral groove.
E) The patella lies slightly lateral and proximal to the trochlea.

Question 15

In the history section of a knee assessment, what would be considered an inappropriate question to ask the patient?

A) What were you doing when the knee was hurt?
B) Did your ankle also give out?
C) What is your major complaint?
D) Was the pain in your knee from side-to-side?
E) What position was your body when it was injured?

Question 16

In the observation section of a knee assessment, what would be considered an inappropriate action to perform?

A) Assessing leg alignment
B) Assessing the gait pattern
C) Assessing if the patient can do a half-squat to extension
D) Assessing a sacral shift
E) Assessing the way the patellar sit

Question 17

Which of the following would be unable to be discovered during the palpation section of a knee assessment?

A) Bursitis
B) Tendinosis
C) Joint effusion
D) Muscle soreness
E) Ligament sprain

Question 18

What does a ballotable patella indicate?

A) Intracapsular swelling
B) Displaced fracture
C) Bursitis
D) Tendinitis
E) Extracapsular swelling

Question 19

According to the different knee stability tests, a positive Apley's grinding test indicates a torn

A) medial meniscus.
B) posterior cruciate ligament.
C) lateral meniscus.
D) anterior cruciate ligament.
E) lateral collateral ligament.

Question 20

Which of the following tests is similar to the flexion-rotation drawer test but is done in a side-lying position?

A) The posterior drawer test
B) The jerk test
C) The Thessaly test
D) Godfrey's Test
E) Losee's test

Question 21

Which of the following is an advantage of the Lachman drawer test?

A) It tests the knee at a comfortable 90-degree position.
B) It reduces the restriction created by the hamstring muscles.
C) It can be performed easily on very large patients.
D) It is performed when a patient is in a comfortable, side-lying position.
E) It helps in determining a torn meniscus easily.

Question 22

Which of the following is true of the external rotation recurvatum test?

A) An athletic trainer uses one hand to press against the head of the fibula and the other to grasp a patient's ankle.
B) An athletic trainer places one hand on the foot and one hand over the top of the knee, fingers touching the medial joint line.
C) An athletic trainer grasps the great toe of a patient and lifts his or her leg off a table.
D) A clinician stands in front of and supports a patient by holding his or her outstretched hands.
E) An athletic trainer stands facing the anterior aspect of a patient's leg, with both hands encircling the upper portion of the leg immediately below the knee joint.

Question 23

In the context of special tests for assessment of knee joint instability, the patient stands flatfooted on the floor in

A) the Thessaly test.
B) mcMurray's meniscal test.
C) the Apley compression test.
D) the pivot-shift test.
E) the Lachman drawer test.

Question 24

Why are there several alternate methods to perform the Lachman drawer test?

A) Because many different physicians have found more valid methods
B) Because the alternate methods involve testing for rotator instabilities
C) Because many different athletic trainers have found more valid methods
D) Because the female population within the profession created alternate methods
E) Because larger patients are difficult to assess using the original Lachman drawer test

Question 25

A patient presents with an increased Q angle, pain on the lateral facet of the patella, tightness in their hamstrings, patella alta, and a tight iliotibial band. What is the patient's assessment?

A) Patellar subluxation
B) Chondromalacia patella
C) Patellofemoral stress syndrome
D) Patellofemoral arthralgia
E) Hemarthrosis

Question 26

What is the normal Q angle for both male and female patients?

A) 15 degrees male, 15 degrees female
B) 15 degrees male, 10 degrees female
C) 10 degrees male, 10 degrees female
D) 10 degrees male, 15 degrees female
E) 20 degrees male, 15 degrees female

Question 27

If the verbal cue "soft knees" were used, what should that mean to the patient?

A) Hip flexion to aid in impact absorption
B) Try not to make a sound when landing
C) Landing on forefoot
D) Landing with knee in flexion
E) Rolling into heel contact

Question 28

What type of brace is used to protect grade 1 or 2 sprains of the ACL?

A) Prophylactic
B) Hinge brace
C) Functional brace
D) Post-operative brace
E) Rehabilitation brace

Question 29

When the anterior cruciate ligament is torn, what signs and symptoms could the patient experience?

A) A snapping sound, immediate pain and rapid swelling at the joint line
B) A pop followed by immediate disability, and rapid swelling at the joint line
C) A snapping sound, delayed pain and rapid swelling at the joint line
D) A popping sound, delayed pain and no swelling at the joint line
E) A snapping sound, delayed pain and no swelling at the joint line

Question 30

In the context of a knee plica, the characteristics of locking and snapping could be misinterpreted as a

A) meniscal tear.
B) patella subluxation.
C) patella femoral stress syndrome.
D) patellar tendonitis.
E) joint contusion.

Question 31

Why should this rehabilitative exercise be performed following an anterior cruciate ligament repair?

A) To mobilize the patella
B) To mobilize the fibula
C) To mobilize the femur
D) To mobilize the lateral meniscus
E) To mobilize the medial meniscus

Question 32

Which brace would be the most appropriate to wear for an athlete recovering from a grade 3 medial collateral ligament tear?

A)
B)
C)
D)

Question 33

If a patient is found to have loose bodies within the knee, what would be the appropriate management?

A) Surgical removal
B) Immobilization
C) Rest and anti-inflammatory agents
D) RICE
E) Rest and the application of heat

Question 34

A patient complains of diffuse pain along the joint line after a direct force to the knee. The pain is localized and with immediate joint effusion and pain with weight bearing when standing or walking. What is most likely the problem?

A) Joint contusion
B) Osteochondritis dissecans
C) Osteochondral knee fracture
D) Knee plica
E) Patellar fracture

Question 35

Which of the following conditions may cause an increase in a patient's Q angle?

A) Genu valgum
B) Genu varum
C) Genu recurvatum
D) Shallow femoral grooves
E) Externally rotated fibulas

Question 36

An injury to the intrapatella fat pad can occur when the pad becomes wedged between which of the following?

A) Tibia and fibula
B) Femur and tibia
C) Patella and femur
D) Tibia and patella
E) Patella and fibula

Question 37

Which of the following involves correction of foot and leg alignment problems as part of its management process?

A) Runner's knee
B) Larsen-Johansson disease
C) Osgood-Schlatter disease
D) Osteochondritis dissecans
E) Jumper's knee

Question 38

In the context of jumper's knee, when chronic inflammation develops in the patellar tendon at the superior patellar pole, it is usually referred to as

A) patellar tendinitis.
B) quadriceps tendinitis.
C) pes anserinus tendinitis.
D) an apophysitis.
E) an eccentric contraction.

Question 39

In the context of jumper's knee, the shock-absorbing function that the quadriceps provides upon landing from a jump is known as

A) an isometric contraction.
B) straight instability.
C) rotatory instability.
D) translation.
E) an eccentric contraction.

Question 40

Please identify the correct location of a baker's cyst.

A)
B)
C)
D)
E)

Question 41

In the context of knee joint rehabilitation, which of the following is an example of a closed kinetic chain activity?

A) Walking
B) Rock climbing
C) Exercise tubing
D) Running
E) Jumping

Question 42

In the context of knee joint rehabilitation, when regaining neuromuscular control of joint motion after injury, which of the following can be used to improve proprioception and balance?

A) The Genucom
B) DynaDisc
C) An orthotic device
D) Cryotherapy
E) A soft posterior splint

Question 43

If a doctor were to perform a pivot-shift test, a jerk test, and an Apley's compression test, what are the involved structures?

A) ACL and LCL
B) PCL and MM
C) ACL, PCL, MM
D) MCL, LCL, MM
E) ACL, PCL, MCL

Question 44

What does this apparatus measure?

A) Quad strength
B) Displacement of the knee
C) Joint effusion
D) Proprioception ability of the knee
E) Nerve conduction

Question 45

What is being measured in this illustration?

A) The girth of the femur.
B) The length of the femur.
C) The diameter of the patella.
D) The A angle.
E) The Q angle.

Question 46

When bracing a Grade 3 medial collateral ligament sprain, conservative initial treatment would involve setting a hinge brace to allow what degrees of motion?

A) 30 to 90 degrees
B) 0 to 90 degrees
C) 90 to 120 degrees
D) 0 to 30 degrees
E) 0 to 45 degrees

Question 47

A sustained noncontact anterolateral rotary instability injury is caused by which of the following motions?

A) Deceleration with a valgus stress and rotation
B) Acceleration with a valgus stress and rotation
C) Deceleration with a varus stress and rotation
D) Acceleration with a varus stress and rotation
E) Acceleration with a valgus stress and no rotation

Question 48

What surgical repair of this structure requires no postoperative bracing?

A) Anterior cruciate repair
B) Posterior cruciate repair
C) Partial menisectomy
D) Meniscal repair
E) Osteochondral fracture repair

Question 49

Based on this picture, what is the patient's condition?

A) Osgood Schlatter's disease
B) Larsen-Johansson disease
C) Jumper's knee
D) Cyclist's knee
E) Patellofemoral stress syndrome