CHAPTER 18 knee conditions
True or False? If the quadriceps tendon is ruptured from the superior pole of the patella and the extensor retinaculum is still intact, knee extension is still possible. A) True B) False
A) True
True or False? Ligaments provide the main source of stability in the knee. A) True B) False
A) True
The pes anserine is the common attachment of the sartorius, gracilis, and A) semitendinosus B) semimembranosus C) biceps femoris D) popliteus
A) semitendinosus
Posterior swelling may indicate each of the following conditions except A) Baker's cyst NOT A B) gastrocnemius strain C) pes anserine strain C) biceps femoris strain NOT D) venous thrombosis
B,C,D
The "unhappy triad" involves the I)posterior cruciate II) anterior cruciate III) fibular collateral ligament IV) medial menisci V) tibial collateral ligament Question 6 options: A) I, II, and IV NOT A B) I, IV, and V C) II, III, and IV D) II, IV, and V
B,C,D
True or False? A kick or blow to the posterolateral aspect of the knee can contuse the peroneal nerve, leading to weak dorsiflexion and eversion. A) True B) False
A) True
A kick or blow to the posterolateral aspect of the knee can contuse which nerve? A) common peroneal B) obturator C) saphenous D) tibial
A) common peroneal
True or False? A soft tumorous mass that can be palpated in the medial popliteal space that may or may not be painful indicates a Baker's cyst involving the semimembranosus bursa. A) True B) False
A) True
True or False? An apophyseal fracture at the tibial tuberosity commonly results from a violent quadriceps contraction against a fixed foot. A) True B) False
A) True
True or False? For flexion to be initiated from a position of full extension, the popliteus must first act to laterally rotate the femur with respect to the tibia, thereby unlocking, or freeing, the joint for motion. Question 10 options: A) True B) False
A) True
True or False? If an anterior cruciate ligament injury is suspected, Lachman's test should be performed before any other stress test. A) True B) False
A) True
True or False? If the anterior cruciate ligament is injured, joint effusion may not appear until 1 to 2 hours after the injury, even though an acute care protocol was followed. A) True B) False
A) True
True or False? In the sagittal plane, the patella serves to increase the angle of pull of the patellar tendon on the tibia, thereby improving the mechanical advantage of the quadriceps muscles for producing knee extension. Question 9 options: A) True B) False
A) True
True or False? Normal passive glide of the patellofemoral joint should be restored before full flexion exercises, resisted exercises, or bicycling is initiated. A) True B) False
A) True
True or False? Point tenderness over the lateral facet of the patella and intense pain and crepitus when the patella is manually compressed into the patellofemoral groove are signs of patellofemoral stress syndrome. A) True B) False
A) True
True or False? The knee is directly affected by motions and forces coming from the foot, ankle, and lower leg. Question 10 options: A) True B) False
A) True
True or False? The vastus medialis oblique (VMO) is the dynamic stabilizer that resists lateral displacement of the patella. A) True B) False
A) True
What ligament is often injured during a cutting maneuver, sudden deceleration, or landing in an off-balance position after a jump? A) anterior cruciate B) fibular collateral C) posterior cruciate D) tibial collateral
A) anterior cruciate
The most frequently seen rotary instability at the knee is ________ instability. A) anterolateral B) anteromedial C) posterolateral D) posteromedial Save
A) anterolateral
The patellar tap test is used to indicate A) intraarticular or extraarticular swelling B) lateral patellar excursion C) patellar fracture D) patellar subluxation/dislocation
A) intraarticular or extraarticular swelling
Larsen-Johansson disease involves all but which of the following? A) occurs at the tibial tubercle B) occurs in the prepubescent athlete C) occurs at the inferior pole of the patella D) occurs from excessive strain on the patellar tendon
A) occurs at the tibial tubercle
A meniscal tear in which an entire longitudinal segment is displaced medially toward the center of the tibia is termed a Question 7 options: A) parrot-beak tear B) horizontal tear C) bucket-handle tear D) medial meniscus tear
A) parrot-beak tear
A high riding patella caused by a long patella tendon is termed A) patella alta B) patella baja C) squinting patella D) "frog-eyed" patella
A) patella alta
Which of the following is not characteristic of "jumper's knee"? A) point tenderness at the superior pole of the patella B) pain with resisted knee extension C) pain with passive knee flexion beyond 120 degrees D) pain after prolonged sitting
A) point tenderness at the superior pole of the patella
Meniscal injuries are difficult to assess because A) they lack innervation by nociceptors B) of the position of the meniscus within the knee C) of the lack of valid tests to assess meniscal injuries D) of the thickness of the meniscus
A) they lack innervation by nociceptors
Rotational capability of the tibia with respect to the femur is maximal at approximately ______ of knee ______. A) 90 degrees, extension NOT A B) 90 degrees, flexion C) 45 degrees, flexion D) 30 degrees, flexion
B) 90 degrees, flexion
True or False? A patellar fracture will produce diffuse intra-articular swelling. A) True B) False
B) False
True or False? A positive valgus test result in 30 degrees of flexion indicates at least a grade 3 injury to the middle and posterior third of the capsular ligaments and medial collateral ligament. Question 10 options: A) True B) False
B) False
True or False? Because the cruciate ligaments are intrasynovial and extracapsular, they have a special protective covering to protect them from the synovial fluid. A) True B) False
B) False
True or False? Damage to the posterior cruciate ligament commonly occurs during a cutting or turning maneuver, landing in an off-balance position after a jump, or during sudden deceleration. Question 8 options: A) True B) False
B) False
True or False? Each of the bursa in the knee is contained within the joint capsule. A) True B) False
B) False
True or False? Failure of the medial structures to restrain the patella in a balanced position can result in medial tilting or medial excursion of the patella, which leads to patellofemoral arthralgia. A) True B) False
B) False
True or False? Longitudinal tears of the meniscus are due largely to degeneration. A) True B) False
B) False
True or False? Palpable pain and crepitus, particularly along the edge of the medial femoral condyle, with the knee flexed at 45 degrees indicates of patellar tendinitis. A) True B) False
B) False
True or False? Peak incidence of meniscal injuries occurs in men and women between the ages of 21 and 40. Question 4 options: A) True B) False
B) False
True or False? The iliotibial band is a medial stabilizer of the knee. A) True B) False
B) False
True or False? The medial collateral ligament resists medially directed rotational forces at the knee and is separated from the joint capsule by a small fat pad. A) True B) False
B) False
True or False? The tibial nerve innervates all of the hamstrings and continues down the leg to innervate all of the muscles in the posterior lower leg. A) True B) False
B) False
Which of the following tests should be performed to confirm a suspected patellar dislocation? A) anterior drawer test NOT A B) apprehension test C) ballotable patella test D) patella compression test
B) apprehension test
The _______ nerve innervates all of the muscles in the hamstring group except the short head of the biceps. A) common peroneal NOT A B) tibial C) femoral D) deep peroneal
B) tibial
Anteromedial instability indicates damage to all of the following structures except the A) anterior cruciate ligament NOT A B) vastus medialis oblique C) medial capsular ligament ? D) tibial collateral ligament
B) vastus medialis oblique
A Q-angle greater than ______ can predispose the individual to patellar injuries. Question 5 options: A) 8 NOT A B) 11 C) 15 D) 18
B,C,D
A condition in which the lateral retinaculum is tight or the vastus medialis is weak, leading to lateral excursion and pressure on the lateral facet of the patella, is called A) chondromalacia patellae NOT A B) iliotibial band friction syndrome C) patellofemoral stress syndrome D) subluxed patella
B,C,D
A positive valgus instability test result at 30 degrees of flexion indicates damage to what ligament? A) anterior cruciate NOT A B) fibular collateral C) posterior cruciate D) tibial collateral
B,C,D
A runner reports with lateral leg pain that is point tender over the femoral condyle about 2 to 3 cm above the lateral joint line. Evaluation indicates a positive Ober's test. What structure could be involved with this injury? A) pes anserine tendon NOT A B) iliotibial band C) rectus femoris D) fibular collateral ligament
B,C,D
A traction-type injury to the tibial apophysis where the patellar tendon attaches onto the tibial tuberosity is called A) Larsen-Johansson disease NOT A B) Osgood-Schlatter disease C) patellar tendinitis D) tibial periostitis
B,C,D
An A-angle of _______ has been linked to increased patellofemoral pain. A) less than 20 degrees NOT A B) 20-35 degrees C) greater than 35 degrees D) greater than 50 degrees
B,C,D
An athlete has developed a synovial herniation in the popliteal space. This condition is termed A) a neoplasm NOT A B) Baker's cyst C) arthralgia D) osteochondritis Save
B,C,D
Because the medial and lateral condyles of the femur differ somewhat in size, shape, and orientation, the tibia rotates laterally on the femur during the last few degrees of extension. This action is known as A) loose packed position NOT A B) gliding C) screwing home mechanism D) tibial shift
B,C,D
Closed-chain exercises for the knee include A) terminal knee extensions NOT A B) mini-squats C) leg curls D) straight leg raises
B,C,D
Deceleration and internal rotation of the tibia are primary mechanisms of injury for A) straight anterior cruciate injuries NOT A B) straight posterior cruciate injuries C) anteromedial rotary instability D) posteromedial rotary instability
B,C,D
Immediate swelling of the knee after acute injury usually indicates A) fibular collateral ligament injury NOT A B) intraarticular injury C) tibial collateral ligament injury D) extraarticular injury
B,C,D
Inflammation or partial avulsion of the apex of the patella due to traction forces is termed A) Osgood-Schlatter disease NOT A B) jumper's knee C) chondromalacia D) Sinding-Larsen-Johansson's disease
B,C,D
The Q-angle is the A) angle between a vertical line dividing the patella into half and a second line drawn from the tibial tubercle to the apex of the inferior pole of the patella. NOT A B) angle formed by the meeting of a line drawn through the shaft of the femur with one passing through the long axis of the femoral neck C) angle between the line of quadriceps force and the patellar tendon D) alteration of the angle made by the axis of the femoral neck to the axis of the femoral shafts
B,C,D
The bursa most commonly injured by compressive forces at the knee is the A) deep infrapatellar NOT A B) prepatellar C) superficial infrapatellar D) suprapatellar
B,C,D
The dynamic medial stabilizer of the knee is the A) medial meniscus NOT A B) medial patellar retinacula C) tibial collateral ligament D) vastus medialis oblique
B,C,D
The largest bursa of the body is the A) deep infrapatellar NOT A B) prepatellar C) superficial infrapatellar D) suprapatellar
B,C,D
The medial meniscus can often be injured in combination with a hamstring injury because A) the medial meniscus is firmly attached to the tibia NOT A B) the medial meniscus is mobile C) the medial meniscus is attached to fibers of the semimembranosus D) the medial meniscus is attached to fibers of the semitendinosus
B,C,D
The medial meniscus is attached to the medial collateral ligament and to fibers from the A) anterior cruciate ligament NOT A B) popliteus C) semimembranosus D) semitendinosus
B,C,D
The menisci are attached to the superior plateaus of the tibia by what structure? A) arcuate ligaments NOT A B) collateral ligaments C) coronary ligaments D) cruciate ligaments
B,C,D
The muscle that unlocks the knee from its close-packed position is the A) gastrocnemius NOT A B) popliteus C) quadriceps D) semimembranosus
B,C,D
The screw-home mechanism occurs when the A) tibia rotates medially on the femur during the last degrees of knee extension NOT A B) tibia rotates laterally on the femur during the last degrees of knee extension ??????????????? C) patellofemoral joint rotates laterally during the last degrees of knee extension D) fibula rotates medially on the femur during full knee extension
B,C,D
The strongest ligament at the knee is the A) anterior cruciate NOT A B) fibular collateral C) posterior cruciate D) tibial collateral
B,C,D
When a force displaces the medial tibia condyle in an anterior externally rotated position, what is the primary ligamentous restraint to this motion? A) anterior cruciate NOT A B) fibular collateral C) posterior cruciate D) tibial collateral
B,C,D
When observing the knee during injury evaluation, the knee should be in _______ to relieve any strain on the joint structure. A) full extension NOT A B) 90 degrees of flexion C) 60 degrees of flexion D) 30 degrees of flexion Save
B,C,D
Which nerve innervates the quadriceps? A) common peroneal NOT A B) femoral C) obturator D) sciatic
B,C,D
Which of the following is not a function of the meniscus? A) absorption and dissipation of force NOT A B) improve congruency of the joint surfaces C) serve as soft tissue restraints that resist anterior tibial displacement D) assist the ligaments and capsule in preventing hyperflexion
B,C,D
Which of the following is not characteristic of patella plica syndrome? A) pseudolocking NOT A B) significant joint effusion C) positive stutter test D) anterior knee pain aggravated by quadriceps exercises
B,C,D
Which of the following tests should be used to confirm chondromalacia? A) McMurray's NOT A B) Apley's C) Clarke's D) Lachman's
B,C,D
______ bursitis is often associated with running and cycling and is routinely aggravated by knee flexion. A) Infrapatella NOT A B) Deep infrapatella C) Suprapatellar D) Pes anserine
B,C,D
After placing ice on an acutely injured knee, an athlete develops paresthesia down the lateral aspect of the injured knee. This could be attributed to A) femoral artery paresthesia NOT A B) tibial nerve paresthesia C) common peroneal nerve paresthesia D) stiffness of the iliotibial band
BC,D
Which of the following tests is not used to assess straight posterior laxity? A) posterior sag test NOT A B) reverse Lachman's test C) Slocum drawer test D) posterior drawer sign
C) Slocum drawer test
Bursitis is most likely to result from A) tensile force B) resilient force C) compressive force D) axial loading force
C) compressive force