Deck 10: Knee Pathologies

Question 1

During the screw-home mechanism,the tibia externally rotates on the femur.What muscle is responsible for "unscrewing" the tibia?

A) Plantaris
B) Vastus medialis
C) Popliteus
D) Biceps femoris long head

Answer 1

C

Question 2

What injury is assessed using the noble compression test?

A) IT band friction syndrome
B) Meniscal injury
C) Osteochondral defect
D) Plica

Answer 2

A

Question 3

Which of the following is the origin and insertion of the sartorius?

A) Anterior superior iliac spine and pes anserine tendon
B) Anterior superior iliac spine and fibula
C) Anterior superior iliac spine and adductor tubercle
D) Anterior inferior iliac spine and the pes anserine tendon

Answer 3

A

Question 4

What muscles are included in the pes anserine group?

A) Sartorius, vastus medialis, and gracilis
B) Gracilis, sartorius, and semitendinosus
C) Gracilis, sartorius, and semimembranosus
D) Sartorius, gracilis, and adductor longus

Question 5

Which of the following can occur following ACL surgery?

A) Gain in hamstring strength
B) Loss of patellar function
C) Loss of knee extension
D) Gain in sartorius strength

Question 6

Injury to which of the following would cause edema instead of effusion?

A) PCL
B) LCL
C) ACL
D) Deep fibers of the MCL

Question 7

In what position should the knee be placed when performing the anterior drawer test?

A) Full extension
B) 30° of knee flexion
C) 60° of knee flexion
D) 90° of knee flexion

Question 8

What is indicated by an enlargement of the tibial tuberosity?

A) Patellar tendinitis
B) Osgood-Schlatter disease
C) Sever disease
D) Quadriceps tendinitis

Question 9

Which force is the most disruptive to the collateral knee ligaments?

A) Tension
B) Compression
C) Shearing
D) Rotation

Question 10

An athlete with a dislocated patella will present with the knee in what position?

A) Extension
B) Flexion
C) Internal rotation
D) External rotation

Question 11

A posterior sag typically indicates injury to what ligament?

A) ACL
B) MCL
C) LCL
D) PCL

Question 12

During open-chained kinetic exercise,at what range of motion (ROM)is the strain on the ACL the greatest?

A) 0° to 30° of extension
B) 0° to 30° of flexion
C) Full extension
D) 120° of flexion

Question 13

The roles of the menisci do not include which of the following?

A) Deepen the articulation and fill the gaps that normally occur during the knee's articulation
B) Improve lubrication for the articulating surfaces
C) Provide shock absorption
D) Allow for extremes of flexion and extension

Question 14

At which position should the knee be placed in order to palpate the menisci?

A) 15° of flexion
B) 30° of flexion
C) 45° of flexion
D) 0° of flexion

Question 15

Which of the following is indicated by a ballottable patella?

A) Knee edema
B) Inflamed infrapatellar bursa
C) Inflamed suprapatellar bursa
D) Knee effusion

Question 16

On what bony structure does the iliotibial (IT)band insert?

A) Gerdy's tubercle
B) Lateral femoral condyle
C) Fibular head
D) Tibial tubercle

Question 17

What nerve roots lead to innervation of the knee?

A) L1-S2
B) T12-S1
C) L3-S2
D) L2-S2

Question 18

Which of the following is the strongest ligament of the knee and the primary stabilizer?

A) Anterior cruciate ligament (ACL)
B) Posterior cruciate ligament (PCL)
C) Medial collateral ligament (MCL)
D) Lateral collateral ligament (LCL)

Question 19

The anterior cruciate ligament (ACL)serves as a static stabilizer against all of the following movements except

A) anterior translation of the tibia on the femur.
B) internal rotation of the tibia on the femur.
C) posterior translation of the tibia on the femur.
D) hyperextension of the tibiofemoral joint.

Question 20

Which of the following activities would be the most difficult if the PCL was torn?

A) Forward running
B) Backward running
C) Side shuffle
D) Knee extension

Question 21

What position should the knee and lower leg be placed in when performing the Slocum drawer test for anterolateral capsular instability?

A) 90° knee flexion; 25° internal tibial rotation
B) 30° knee flexion; 25° internal tibial rotation
C) 90° knee flexion; 15° external tibial rotation
D) 30° knee flexion; 15° external tibial rotation

Question 22

Based on the evidence,which is the best clinical test when assessing for a meniscal tear?

A) Thessaly test
B) McMurray test
C) Apley compression test
D) Apley distraction test

Question 23

What bony landmark does the patella glide through as the knee flexes and extends?

A) Femoral trochlea
B) Adductor tubercle
C) Intercondylar notch
D) Linea aspera

Question 24

In approximately how many degrees of flexion should the knee be placed to isolate the MCL for the valgus stress test?

A) 5°
B) 15°
C) 25°
D) 35°

Question 25

Which of the following is not a long-term consequence of an ACL-deficient knee?

A) Instability
B) Meniscal degeneration
C) Chondral surface damage
D) Patellofemoral pain

Question 26

What test can be used as a clinical evaluation tool for the presence of osteochondral defects on the knee's articular surface?

A) Thessaly test
B) Wilson's test
C) Ober test
D) Jerk test

Question 27

Which part of the joint capsule is supported by the arcuate ligament?

A) Posterolateral
B) Posteromedial
C) Anterolateral
D) Anteromedial

Question 28

Damage to which of the following structures is not an implication of a positive pivot shift test?

A) ACL
B) LCL
C) Anterolateral capsule
D) Semimembranosus

Question 29

One positive sign for the dynamic posterior shift test is a "clunk" or "jerk" as the knee approaches what position?

A) Full extension
B) 90° of flexion
C) 60° of flexion
D) 30° of flexion

Question 30

When compared to the gold standard of arthroscopy,which test combines sensitivity and specificity,making it the best examination technique for detecting whether or not an ACL sprain is present?

A) Lachman test
B) Anterior drawer test
C) Slocum drawer test
D) Quadriceps active test

Question 31

Which of the following is the end-feel for knee extension?

A) Hard
B) Firm
C) Soft
D) Bony

Question 32

What ligament can be palpated easily by placing the knee in 90° of flexion and externally rotating and abducting the hip?

A) MCL
B) Arcuate ligament
C) Anterior collateral ligament
D) LCL

Question 33

Which of the following is not a true statement about the MCL?

A) The MCL has two layers (deep and superficial).
B) The MCL attaches to a meniscus.
C) The MCL thickens the joint capsule.
D) The MCL is a cordlike structure.

Question 34

Which of the following muscles is not one of the four muscles that make up the quadriceps femoris muscle group?

A) Vastus lateralis
B) Vastus medialis
C) Biceps femoris
D) Vastus intermedius

Question 35

The tibiofemoral joint has a double condyloid articulation that allows for how many degrees of freedom of movement?

A) 1°
B) 2°
C) 3°
D) 4°

Question 36

Which is an implication of a positive quadriceps active test?

A) Grade I PCL sprain
B) Grade I ACL sprain
C) Grade III PCL sprain
D) Grade III ACL sprain

Question 37

Which of the following is not a documented special test to identify trauma to the posterolateral corner of the knee and/or posterolateral rotary instability?

A) Dynamic posterior shift test
B) External rotation (Dial) test
C) Reverse-pivot shift test
D) Internal rotation recurvatum test

Question 38

The menisci are attached to the tibia at their peripheries by which of the following ligaments?

A) Transverse
B) Patellomeniscal
C) Meniscofemoral
D) Coronary

Question 39

At what degree of knee flexion does the IT band shift behind the lateral femoral epicondyle,giving it a knee flexor angle of pull?

A) 20°
B) 30°
C) 40°
D) 50°

Question 40

What position should the tibia be placed in for the first pass of the McMurray test for meniscal lesions?

A) Neutral position
B) Internally rotated
C) Externally rotated
D) Position of the tibia is not specified for the first pass.

Question 41

Based on the evidence,which statement best describes the clinical usefulness of the Lachman test?

A) The Lachman test is useful for ruling in an ACL sprain.
B) The Lachman test is useful for ruling out an ACL sprain.
C) The Lachman test is useful for ruling in or ruling out an ACL sprain.
D) The Lachman test is not useful for ruling in or ruling out an ACL sprain.

Question 42

Which muscle of the quadriceps muscle group is not directly palpable?

A) Vastus intermedius
B) Vastus medialis
C) Vastus lateralis
D) Rectus femoris

Question 43

Where does the sweep test assess for swelling?

A) Inside the joint capsule
B) Outside the joint capsule
C) Inside or outside the joint capsule
D) Neither inside nor outside the joint capsule

Question 44

Which test would be appropriate to perform in an on-field evaluation situation?

A) Valgus stress test
B) McMurray test
C) Pivot shift test
D) Slocum drawer test