Chapter 8 Study Guide

What is/are the purpose(s) of the patella? a. increase the angle between the tendon and tibia b. increase the mechanical advantage of the quadriceps c. to protect the anterior aspect of the knee d. all of the above

d. all of the above

Which of the following is part of the pelvic girdle? a. the ilium b. the ischium c. the pubis d. all of the above

d. all of the above

The pelvic girdle is comprised of three bones, ___________________, _________________, and ___________________.

ilium; ishium; pubis

A condition of inward deviation in alignment from the proximal to the distal end of a segment is called ___________________.

varus

Discuss anterior cruciate ligament injuries, including probable causes, most commonly affected persons, symptoms and treatment options.

ACL injuries are common in sports which involve pivoting and cutting (ie. basketball; also common within skiers when they catch a ski tip in the snow resulting in simultaneous twisting and falling). Approximately 70% of ACL injuries are noncontact. ACL injuries are occur when activities involving sudden changes in direction combined with acceleration or deceleration of the body produce large rotational moments and varus/valgus forces at the knee. Women are 3.5 times more likely to sustain a noncontact ACL injury than men. No relationship has been found between measures of lower extremity strength and the likeilhood of ACL rupture.

*List the four major ligaments of the knee, describe the location of each and explain the role each one plays in providing stability to the joint.

The four major ligaments of the knee are the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament. The medial and lateral collateral ligaments prevent lateral motion at the knee. The fibers of the MCL merge with the joint capsule and the medial meniscus to connect to the medial epicondyle of the femur to the medial tibia. The LCL runs a few centimeters posterior to the ridge of the lateral epicondyle of the femur to the head of the fibula, contributing to the lateral stability of the knee. The anterior and posterior cruciate ligaments limit forward and backward sliding of the femur on the tibial plateaus during knee flexion and extension, and also limit knee hyperextension. These ligaments cross each other and attach to their respective tibial attachments.

List and describe the four quadriceps muscles, including location, actions, and possible injury implications in the case of imbalance.

The four muscles of the quadriceps include the rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius. These muscles have various attachment sites from the pelvis and femur to the patella. These muscles are primarily responsible for extension of the knee. Possible injury implications may result in imbalance when the other muscles of the same leg or other leg begin to overcompensate for the injured area, leading to more potential damage.

Describe iliotibial band friction syndrome, including affected area, symptoms and probable causes.

The tensor fascia lata develops tension to assist with stabilization of the pelvis when the is in flexion during weight bearing. This can produce friction of the posterior edge of the iliotibial band (ITB) against the lateral condyle of the femur around the footstrike, primarily during foot contact with the ground. The result is inflammation of the distal portion of the ITB, as well as the knee joint capsule under the ITB, with accompanying symptoms of pain and tenderness over the lateral aspect of the knee. Iliotibial band friction syndrome is and overuse condition typically affecting runners and cyclists. Both training errors and anatomical malalignments of the lower extremities increase the risk of ITB syndrome.

List and describe at three common overuse injuries of the lower extremity, including symptoms, probably causes and treatment options.

Three common overuse injuries of the lower extremity include: torn meniscus, iliotibial band friction syndrome, and shin splints. Torn meniscus is the most common knee injury, with the medial meniscus injured 10 time more frequently than the lateral meniscus. A torn meniscus is problematic in that the attached cartilage often slips from its normal position, interfering with normal joint mechanics. Symptoms include pain, which is accompanied by intermittent bouts of locking or buckling of the joint. ITB syndrome is an overuse condition that typically affect runners and cyclists. The tensor fascia lata develops tension to assist with stabilization of the pelvis when the knee is in flexion during weight bearing. this can produce friction of the posterior edge of the ITB against the lateral condyle of the femur around the time of footstrike, primarily during foot contact with the ground. The result is inflammation of the distal portion of the ITB, as well as the knee joint capsule under the ITB, with accompanying symptoms of pains and tenderness over the lateral aspect of the knee. Shin splints involve generalized pain along the anterolateral or posteromedial aspect of the lower leg. This condition is a loosely defined overuse injury, often associated with running or dancing on a hard surface, that may involve microdamage to muscle attachments on the tibia and/or inflammation of the periosteum. Treatment of overuse injuries typically includes rest, ice, pain medication if necessary, and exercises or stretches.

The hip joint is the articulation between the ________ and the _______. a. femur; acetabulum b. femur; spine c. femur; tibia d. none of the above

a. femur; acetabulum

Which of the following is the most typical cause of ankle sprain? a. forced inversion of the ankle during landing while the foot is plantar flexed b. forced eversion of the ankle during landing while the foot is dorsiflexed c. both A and B d. none of the above

a. forced inversion of the ankle during landing while the foot is plantar flexed

Which knee ligament is most likely to be damaged from a lateral blow? a. medial collateral b. lateral collateral c. anterior cruciate (ACL) d. posterior cruciate

a. medial collateral

Which of the following statements is true regarding ACL injuries? a. occur more frequently in women than in men b. occur more frequently in men than in women c. occurrence is approximately equal between men and women d. frequency between men and women is sport specific

a. occur more frequently in women than in men

The strong layer of fibrous tissue which covers the plantar muscles of the foot is called what? a. plantar fascia b. plantar flexion c. longitudinal ligament d. plantar interossei

a. plantar fascia

Which of the following does not attach to the calcaneus? a. sartorius b. gastrocnemius c. plantaris d. soleus

a. sartorius

Fractures in the ankle region occur most often to which of the following structures? a. the lateral malleolus b. the medial malleolus c. the talus d. none of the above

a. the lateral malleolus

Patellofemoral pain syndrome is likely associated with what? a. weakness of vastus medialis relative to vastus lateralis b. weakness of vastus lateralis relative to vastus medialis c. weakness of biceps femoris relative to semitendinosus d. weakness of semitendinosus relative to biceps femoris

a. weakness of vastus medialis relative to vastus lateralis

Lateral pelvic tilt positions the acetabulum in a more favorable position for hip ______. a. flexion b. abduction c. extension d. adduction

b. abduction

Which of the following characterizes a "bow-legged" condition? a. femoral varus and tibial valgus b. femoral valgus and tibial varus c. both A and B d. none of the above

b. femoral valgus and tibial varus

What is the anatomical name for the big toe? a. pollicis b. hallux c. digiti maximi d. digiti minimi

b. hallux

Anterior pelvic tilt positions the acetabulum in a more favorable position for hip ______. a. flexion b. hyperextension c. abduction d. adduction

b. hyperextension

Where is the weakest point of the femur? a. head b. neck c. shaft d. greater trochanter

b. neck

Which of the following statements is true regarding ACL injuries? a. occur more frequently in during player contact b. occur more frequently during non-contact c. occurrence is approximately equal between contact and non-contact d. it is unknown whether contact or non-contact ACL injuries are more frequent

b. occur more frequently during non-contact

Which of the following inserts on the patella? a. hamstrings b. quadriceps c. both A and B d. none of the above

b. quadriceps

Which muscle does not affect both the hip and the knee? a. rectus femoris b. vastus intermedius c. biceps femoris d. semimembranosus

b. vastus intermedius

The lower extremity is well structured for its functions of weight ______________ and __________________.

bearing; locomotion

The three hamstring muscles are __________ _________, ___________________, and ___________________.

biceps femoris; semimembranosus; semitendinosus

When the legs are not free to move (i.e. they are supporting your body weight), what action will result from contraction of the hip flexors? a. hip flexion b. hip extension c. anterior pelvic tilt d. posterior pelvic tilt

c. anterior pelvic tilt

Knee extensors cross the joint ___ to the ___ axis. a. anterior; anteroposterior b. posterior; anteroposterior c. anterior; mediolateral d. posterior; mediolateral

c. anterior; mediolateral

Which of the following statements is/are true? a. The iliopsoas complex is the major flexor of the hip. b. Two-joint muscles function more effectively at one joint when the position of the other joint stretches the muscle slightly. c. both A and B d. none of the above

c. both A and B

Which of the following statements is/are true? a. When the knee undergoes a significant amount of flexion, it is necessary for the femur to slide forward on the tibia in order to prevent its rolling off of the tibial plateau. b. During extension, the femur must slide backwards on the tibia. c. both A and B d. none of the above

c. both A and B

Which of the following does not bear weight? a. femur b. tibia c. fibula d. talus

c. fibula

Runner's knee is associated with which of the following structures? a. lateral meniscus b. ACL c. iliotibial band d. medial meniscus

c. iliotibial band

What is the largest and most complex joint in the body? a. hip b. shoulder c. knee d. ankle

c. knee

The medial and lateral collateral ligaments limit which type of knee motion? a. knee hyperextension b. forward and backward sliding of the femur on the tibia during knee flexion and extension c. lateral knee motion d. both A and B e. all of the above

c. lateral knee motion

Which of the following muscles serves to "unlock" the knee from full extension? a. plantaris b. gracilis c. popliteus d. sartorius

c. popliteus

Which of the following is not true about pelvic girdle movements? a. position the acetabulum favorably for femoral movement b. occurs in all 3 planes c. occurs around the lumbosacral joint d. all of the above are true

d. all of the above are true

Which of the following is not true about the hip joint? a. triaxial b. more stable than shoulder c. several bursae present d. all of the above are true

d. all of the above are true

Which of the following is not true about the menisci in the knee joint? a. made of cartilage b. larger surface area to distribute load c. absorb shock d. all of the above are true

d. all of the above are true

Symptoms of plantar fasciitis include which of the following? a. pain in the arch b. pain in the heel c. pain on top of the foot d. both A and B e. all of the above

d. both A and B

The anterior and posterior cruciate ligaments limit which type of knee motion? a. knee hyperextension .b forward and backward sliding of the femur on the tibia during knee flexion and extension c. lateral knee motion d. both A and B e. all of the above

d. both A and B

Which of the following causes hip abduction? a. gluteus medius b. gluteus minimus c. gluteus maximus d. both A and B e. all of the above

d. both A and B

Which of the following conditions must be met for rotation of the tibia relative to the femur? a. the knee is not bearing weight b. the knee is in flexion c. the knee is in extension d. both A and B e. all of the above

d. both A and B

Which of the following is/are nonaxial joint(s)? a. tarsometatarsal joint b. intermetatarsal joint c. subtalar joint d. both A and B e. all of the above

d. both A and B

Which of the following is/are two-joint muscle(s)? a. rectus femoris b. sartorius c. pectineus d. both A and B e. all of the above

d. both A and B

Which of the following is not a hamstring muscle? a. semimembranosus b. semitendinosus c. biceps femoris d. gluteus maximus

d. gluteus maximus

During walking, which of the following actions is combined to cause supination? a. dorsiflexion; eversion; and abduction b. dorsiflexion; inversion; and abduction c. plantar flexion; inversion; and abduction d. plantar flexion; inversion; and adduction

d. plantar flexion; inversion; and adduction

Which of the following is the most common of all knee injuries? a. rupture of the anterior cruciate ligament b. rupture of the medial collateral ligament c. tear of the lateral meniscus d. tear of the medial meniscus

d. tear of the medial meniscus

Which of the following causes hip adduction? a. adductor magnus b. adductor longus c. gracilis d. both A and B e. all of the above

e. all of the above

Supination of the foot combines the motions of ___________________, ___________________, and _______________ _______________.

inversion; adduction; plantar flexion