Deck 11: Patellofemoral Pathologies

Question 1

Internal rotation of the tibia has what effect on Q angle?

A) It increases it.
B) It decreases it.
C) It doesn't have an effect on Q angle.
D) It depends on whether the person is weight-bearing versus non-weight-bearing.

Answer 1

B

Question 2

Which of the following is not true about the patella and its articulations?

A) The lateral border of the femoral trochlea forms a strong barrier against lateral patellar movement.
B) The patella moves on the femur when weight-bearing.
C) During flexion, the patella increases its angle of lateral tilt.
D) When the knee is fully extended, the patella is vulnerable to dislocating forces.

Answer 2

B

Question 3

Which of the following pieces of information may make you suspect patellofemoral pain syndrome?

A) "I run 15 miles per week."
B) "I run on asphalt."
C) "I have lost 15 pounds."
D) "I changed shoes about 3 weeks ago."

Answer 3

D

Question 4

With the patient short sitting,observe the relationship between the tibial tuberosity and the inferior patellar pole.If the angle is more than _____,the person is susceptible to lateral tracking.

A) 1°
B) 2°
C) 5°
D) 10°

Question 5

Which of the following would increase the patellofemoral joint force?

A) Weak hip adductors
B) Tight hamstrings
C) Tight soleus
D) Weak hip abductors

Question 6

Which of the following comments may lead you to think the patient is suffering from chondromalacia?

A) "My knee hurts all the time."
B) "When I walk up and down stairs, my kneecap feels like it is grinding."
C) "My knee hurts when I sleep."
D) "My knee hurts when I straighten out my leg."

Question 7

The patella's anatomical design allows for all of the following except

A) increased mechanical efficiency of the quadriceps muscle group.
B) protection of the anterior portion of the knee joint.
C) absorption and transmission of the joint reaction forces.
D) increased strength of the quadriceps muscle group.

Question 8

In a weight-bearing situation,excessive foot pronation will increase internal rotation of both the hip and the femur,resulting in what effect on the patella?

A) It increases lateral force.
B) It increases medial force.
C) It has no effect on patellar tracking.
D) The femur and hip can't both move in the same direction.

Question 9

By what degree of knee flexion is the patella firmly seated in the trochlear groove?

A) 5°
B) 10°
C) 15°
D) 30°

Question 10

What injury is indicated by a positive apprehension test?

A) Patellar malalignment
B) Patellar subluxation or dislocation
C) Patella alta
D) Patella baja

Question 11

An athlete goes down on the field and you run out to evaluate her.She states that her knee is hurting.You know the athlete has received three cortisone injections in the last 6 months.Which injury may you initially suspect given this information?

A) Meniscal injury
B) Medial collateral ligament sprain
C) Patellar tendon rupture
D) Anterior cruciate ligament sprain

Question 12

If a knee effusion is present,what effect does it have on patellar tracking?

A) It has no effect.
B) It causes the patella to be ballottable and therefore nonfunctioning.
C) It neurologically inhibits the vastus medialis oblique.
D) It neurologically inhibits the rectus biceps femoris.

Question 13

Which of the following muscles is responsible for preventing lateral patellar subluxation?

A) Vastus medialis
B) Vastus lateralis
C) Vastus intermedius
D) Gracilis

Question 14

Which patellar alignment problem would an athlete have with a congenitally short patellar tendon?

A) Patella alta
B) Patella baja
C) Squinting patella
D) "Frog-eyed" patella

Question 15

When performing a patellar tilt assessment,a patella that tilts more than ______ is considered hypermobile.

A) 2°
B) 5°
C) 10°
D) 15°

Question 16

Which of the following malalignments causes a hypermobile patella?

A) Genu recurvatum
B) Genu varum
C) Genu valgum
D) Extension lag

Question 17

An athlete presents to the athletic training room complaining of knee pain.Upon evaluation you notice the athlete's patella is high riding and sitting laterally.What patellar alignment problem does the athlete have?

A) Patella alta
B) Patella baja
C) Squinting patella
D) "Frog-eyed" patella

Question 18

What is the name for a high-riding patella indicated by what appears to be a "camel's hump" on the knee?

A) Patella baja
B) Patella alta
C) Squinting patella
D) Bipartite patella

Question 19

Which of the following is most reliable in determining who will have patellofemoral pain?

A) Levels of anterior superior iliac spine (ASIS)
B) Femur length
C) Tibia length
D) Measuring anatomical leg length

Question 20

Which of the following techniques measures the Q angle?

A) Proximal arm: anterior inferior iliac spine; axis: tibial tuberosity; distal arm: lateral malleolus
B) Proximal arm: ASIS; axis: midpoint of patella; distal arm: tibial tuberosity
C) Proximal arm: ASIS; axis: midpoint of patella; distal arm: medial malleolus
D) Proximal arm: greater trochanter; axis: midpoint of patella; distal arm: tibial tuberosity

Question 21

Which of the following occurs at the insertion of the patellar tendon into the inferior pole and is caused by a stress fracture or avulsion due to repetitive forces?

A) Osgood-Schlatter disease
B) Sinding-Larsen-Johansson disease
C) Patellofemoral bursitis
D) Synovial plica

Question 22

When performing the test for medial synovial plica,over what range will the examiner be more likely to feel the plica?

A) 90° to 60°
B) 60° to 45°
C) 45° to 30°
D) 30° to 0°

Question 23

Which test can be completed to assess tension of the iliotibial band?

A) Ober test
B) Navicular drop test
C) Stutter test
D) Clarke's sign

Question 24

With the knee extended,which direction should a patella be moved in order to palpate the odd facet?

A) Lateral
B) Medial
C) Lateral or medial
D) The patella does not need to be moved.

Question 25

When does the patella become seated within the groove as the knee moves from flexion into extension in an open chain?

A) 20° to 30°
B) 10° to 20°
C) 45° to 60°
D) 60° to 75°

Question 26

Which of the following patellar malalignments results in increased patellar mobility,decreased quadriceps strength,and increased patellofemoral compressive forces?

A) Patella alta
B) Patella baja
C) "Frog-eyed" patella
D) Squinting patella

Question 27

In which of the following patellar orientations is the patella positioned in the frontal plane,which is considered a deviation from the patella being centered between the medial and lateral condyles?

A) Anterior/posterior patellar tilt
B) Medial/lateral patellar glide
C) Patellar rotation
D) Medial/lateral patellar tilt

Question 28

Patellofemoral pain syndrome typically presents with pain in what area of the knee?

A) Anterior
B) Posterior
C) Medial
D) Lateral

Question 29

When differentiating between meniscal and patellar pain,which characteristic is more indicative of patellar pain?

A) Pain localized over joint line
B) Inability to "duck walk"
C) Pain when kneeling
D) Pain associated with going upstairs

Question 30

Which of the following is not true when considering Q angle?

A) The Q angle typically decreases as the knee is flexed.
B) Taller people tend to have lower Q angles than shorter people.
C) The Q angle helps quantify the line of pull of the quadriceps and the patellar tendon.
D) The Q angle is the relationship between the long axis of the patella and the tibial tuberosity.

Question 31

When discussing patellar movement,which of the following best describes the J sign?

A) As the knee moves from flexion into extension, the patella glides superiorly and tracks slightly medially.
B) As the knee moves from flexion into extension, the patella glides superiorly and tracks slightly laterally.
C) As the knee moves from flexion into extension, the patella glides inferiorly and tracks slightly laterally.
D) As the knee moves from flexion into extension, the patella glides inferiorly and tracks slightly medially.

Question 32

During open-chain knee movement,at what degree does the patella begin to track laterally when moving from flexion into extension?

A) 5°
B) 18°
C) 23°
D) 45°

Question 33

Which of the following lower-extremity postures places an increased compressive force on the lateral patellar facets?

A) Genu varum
B) Genu valgum
C) Genu recurvatum
D) Forefoot pronation

Question 34

Which bursa lies deep at the distal end of the quadriceps femoris muscle group and is an extension of the knee's joint capsule?

A) Prepatellar bursa
B) Suprapatellar bursa
C) Subcutaneous infrapatellar bursa
D) Deep infrapatellar bursa

Question 35

Which of the following patellar malalignments results in increased patellar glide,a tight lateral retinaculum,and patellar maltracking?

A) Patella alta
B) Patella baja
C) "Frog-eyed" patella
D) Squinting patella

Question 36

Which of the following helps to maintain the patella's position and originates off the vastus lateralis tendon and the iliotibial (IT)band?

A) Lateral retinaculum
B) Medial retinaculum
C) Medial patellofemoral ligament
D) Lateral patellofemoral ligament

Question 37

At what degree of knee flexion is the patella most likely to dislocate?

A) 0° to 10°
B) 20° to 30°
C) 40° to 50°
D) 60° to 70°

Question 38

Patellar tendinopathies most often have an insidious onset and are common in all of the following activities except

A) jumping activities.
B) running sports.
C) weight lifting.
D) swimming.