Knee - Exam Questions Flashcards
Which of the following structures primarily guides the flexion and extension of the knee joint?
- a) Patellofemoral joint
- b) Tibiofibular joint
- c) Medial meniscus
- d) Tibiofemoral joint
Knee - Clinical Anatomy and Biomechanics
Which of the following structures primarily guides the flexion and extension of the knee joint?
- a) Patellofemoral joint
- b) Tibiofibular joint
- c) Medial meniscus
- d) Tibiofemoral joint
- The tibiofemoral joint is primarily responsible for guiding the flexion and extension of the knee joint, as well as rotation into internal and external rotation.
- The patellofemoral joint contributes to knee extension mechanics but is not primarily responsible for guiding these movements. The tibiofibular joint is involved in stability rather than movement of the knee.
What is the main function of the proximal tibiofibular joint?
- a) Facilitation of knee flexion and extension
- b) Anchoring the fibula for muscle attachment
- c) Stabilization of the patella during movement
- d) Articulation between the femur and the patella
Knee - Clinical Anatomy and Biomechanics
What is the main function of the proximal tibiofibular joint?
- a) Facilitation of knee flexion and extension
- b) Anchoring the fibula for muscle attachment
- c) Stabilization of the patella during movement
- d) Articulation between the femur and the patella
- The proximal tibiofibular joint primarily serves to anchor the fibula for muscle attachment and contribute to the stability of the knee joint.
- It is not directly involved in knee flexion and extension or patellar stabilization.
Which plane of movement primarily allows the screw-home mechanism to occur at the knee joint?
- a) Frontal plane
- b) Sagittal plane
- c) Transverse plane
- d) Oblique plane
Knee - Clinical Anatomy and Biomechanics
Which plane of movement primarily allows the screw-home mechanism to occur at the knee joint?
- a) Frontal plane
- b) Sagittal plane
- c) Transverse plane
- d) Oblique plane
- The screw-home mechanism primarily occurs in the sagittal plane of movement at the knee joint.
- As the knee extends, the extra articulation in the medial condyle allows for external rotation of the tibia, facilitating the screw-home mechanism.
What is the purpose of the screw-home mechanism in the knee joint?
- a) Facilitation of knee flexion
- b) Stabilization of the patella
- c) Promotion of internal tibial rotation
- d) Enhancement of knee extension
Knee - Clinical Anatomy and Biomechanics
What is the purpose of the screw-home mechanism in the knee joint?
- a) Facilitation of knee flexion
- b) Stabilization of the patella
- c) Promotion of internal tibial rotation
- d) Enhancement of knee extension
- The screw-home mechanism enhances knee extension by coupling tibiofemoral extension with tibial external rotation, allowing for maximal stability and efficiency during weight-bearing activities.
Which structure contributes to the improvement of the mechanical advantage of the quadriceps during knee extension?
- a) Lateral meniscus
- b) Tibiofibular joint
- c) Patellofemoral joint
- d) Medial collateral ligament
Knee - Clinical Anatomy and Biomechanics
Which structure contributes to the improvement of the mechanical advantage of the quadriceps during knee extension?
- a) Lateral meniscus
- b) Tibiofibular joint
- c) Patellofemoral joint
- d) Medial collateral ligament
- The patellofemoral joint contributes to the improvement of the mechanical advantage of the quadriceps during knee extension by bringing the quadriceps tendon anterior to the axis of rotation, enhancing the lever arm of the muscle.
What role does the patella play during knee flexion?
- a) Sliding inferiorly along the femoral condyles
- b) Compression against the femur
- c) Stabilization of the tibiofibular joint
- d) Enhancement of knee extension
Knee - Clinical Anatomy and Biomechanics
What role does the patella play during knee flexion?
- a) Sliding inferiorly along the femoral condyles
- b) Compression against the femur
- c) Stabilization of the tibiofibular joint
- d) Enhancement of knee extension
- During knee flexion, the patella slides inferiorly along the femoral condyles in a ‘C’ shaped motion, facilitating smooth articulation between the patella and the femur.
What forces are exerted on the knee joint during activities such as jogging and deep squatting?
- a) Minimal forces due to the weight-bearing nature of the knee
- b) Compressive forces equal to body weight
- c) Compressive forces up to 7 times body weight
- d) Compressive forces up to 20 times body weight
Knee - Clinical Anatomy and Biomechanics
What forces are exerted on the knee joint during activities such as jogging and deep squatting?
- a) Minimal forces due to the weight-bearing nature of the knee
- b) Compressive forces equal to body weight
- c) Compressive forces up to 7 times body weight
- d) Compressive forces up to 20 times body weight
- During activities such as jogging and deep squatting, the knee joint experiences compressive forces that can be as high as 20 times body weight, highlighting the significant load-bearing capacity of the knee.
What factors influence the dynamics of patellofemoral interactions?
- a) Depth of the intercondylar sulcus and quadriceps activation only
- b) Extensibility of the IT band and patellar facets only
- c) Extensibility of the quads and IT band only
- d) Depth of the intercondylar sulcus, patellar facets, and quadriceps activation
Knee - Clinical Anatomy and Biomechanics
What factors influence the dynamics of patellofemoral interactions?
- a) Depth of the intercondylar sulcus and quadriceps activation only
- b) Extensibility of the IT band and patellar facets only
- c) Extensibility of the quads and IT band only
- d) Depth of the intercondylar sulcus, patellar facets, and quadriceps activation
- The dynamics of patellofemoral interactions are influenced by various factors, including the depth of the intercondylar sulcus, the shape of the patellar facets, and the activation level of the quadriceps muscles.
What type of motion occurs at the knee joint during the screw-home mechanism?
- a) Flexion with tibial external rotation
- b) Flexion with tibial internal rotation
- c) Extension with tibial external rotation
- d) Extension with tibial internal rotation
Knee - Clinical Anatomy and Biomechanics
What type of motion occurs at the knee joint during the screw-home mechanism?
- a) Flexion with tibial external rotation
- b) Flexion with tibial internal rotation
- c) Extension with tibial external rotation
- d) Extension with tibial internal rotation
- During the screw-home mechanism at the knee joint, there is extension coupled with tibial external rotation. This mechanism primarily occurs in the sagittal plane of movement.
- As the knee extends, the extra articulation in the medial condyle allows for external rotation of the tibia, creating a screw-home mechanism.
- This coupling of extension with tibial external rotation enhances knee stability and contributes to the efficiency of weight-bearing activities.
- About 80% of this coupling happens within the terminal 30 degrees of knee extension, making it primarily a “leg-straight” event
Which plane of movement primarily allows for lateral patellar tracking during knee flexion?
- a) Sagittal plane
- b) Frontal plane
- c) Transverse plane
- d) Oblique plane
Knee - Clinical Anatomy and Biomechanics
Which plane of movement primarily allows for lateral patellar tracking during knee flexion?
- a) Sagittal plane
- b) Frontal plane
- c) Transverse plane
- d) Oblique plane
- Lateral patellar tracking during knee flexion primarily occurs in the frontal plane.
- This movement pattern is influenced by factors such as muscle imbalances and structural abnormalities.
What structures guide the patella to achieve full contact with the femoral condyles at approximately 30 degrees of knee flexion?
- a) Quadriceps tendon
- b) Extensor retinaculum
- c) Medial and lateral patellar retinacula
- d) Patellar ligament
Knee - Clinical Anatomy and Biomechanics
What structures guide the patella to achieve full contact with the femoral condyles at approximately 30 degrees of knee flexion?
- a) Quadriceps tendon
- b) Extensor retinaculum
- c) Medial and lateral patellar retinacula
- d) Patellar ligament
- The medial and lateral patellar retinacula guide the patella to achieve full contact with the femoral condyles at approximately 30 degrees of knee flexion.
- These structures help maintain proper patellar alignment during movement.
Which forces exerted on the knee joint are significantly increased during deep squatting compared to walking?
- a) Tensile forces
- b) Compressive forces
- c) Shear forces
- d) Torsional forces
Knee - Clinical Anatomy and Biomechanics
Which forces exerted on the knee joint are significantly increased during deep squatting compared to walking?
- a) Tensile forces
- b) Compressive forces
- c) Shear forces
- d) Torsional forces
- During deep squatting, compressive forces exerted on the knee joint are significantly increased compared to walking.
- This increased load-bearing capacity of the knee joint is essential for supporting the body’s weight in a squatting position.
What role does the proximal tibiofibular joint play in knee function?
- a) Providing stability during weight-bearing activities
- b) Guiding knee flexion and extension
- c) Anchoring the patella for muscle attachment
- d) Facilitating lateral patellar tracking
Knee - Clinical Anatomy and Biomechanics
What role does the proximal tibiofibular joint play in knee function?
- a) Providing stability during weight-bearing activities
- b) Guiding knee flexion and extension
- c) Anchoring the patella for muscle attachment
- d) Facilitating lateral patellar tracking
- The proximal tibiofibular joint primarily provides stability during weight-bearing activities by anchoring the fibula for muscle attachment.
- While it contributes to knee function, its main role is stability rather than guiding specific movements.
During knee flexion, what motion does the patella undergo as it moves along the femoral condyles?
- a) Medial rotation
- b) Lateral translation
- c) Inferior sliding
- d) Superior gliding
Knee - Clinical Anatomy and Biomechanics
During knee flexion, what motion does the patella undergo as it moves along the femoral condyles?
- a) Medial rotation
- b) Lateral translation
- c) Inferior sliding
- d) Superior gliding
- During knee flexion, the patella undergoes inferior sliding along the femoral condyles.
- This movement pattern helps maintain proper patellar tracking and alignment during dynamic knee movements.
What anatomical feature allows the tibial plateau to facilitate the screw-home mechanism during knee extension?
- a) Declination angle
- b) Biconcave shape
- c) Lateral meniscus
- d) Extensor retinaculum
Knee - Clinical Anatomy and Biomechanics
What anatomical feature allows the tibial plateau to facilitate the screw-home mechanism during knee extension?
- a) Declination angle
- b) Biconcave shape
- c) Lateral meniscus
- d) Extensor retinaculum
- The declination angle of the tibial plateau allows it to facilitate the screw-home mechanism during knee extension.
- This angle helps wind up the cruciate ligaments by creating a posterior slope, promoting tibial external rotation during knee extension.
Which of the following factors primarily influences patellofemoral interactions?
- a) Quadriceps activation
- b) IT band extensibility
- c) Patellar facet depth
- d) Tibiofemoral alignment
Knee - Clinical Anatomy and Biomechanics
Which of the following factors primarily influences patellofemoral interactions?
- a) Quadriceps activation
- b) IT band extensibility
- c) Patellar facet depth
- d) Tibiofemoral alignment
- Patellar facet depth primarily influences patellofemoral interactions.
- The depth of the intercondylar sulcus and the shape of the patellar facets affect the patellar tracking and stability during knee movements.
In what direction does the tibia rotate during the screw-home mechanism?
- a) Internal rotation
- b) External rotation
- c) Medial rotation
- d) Lateral rotation
Knee - Clinical Anatomy and Biomechanics
In what direction does the tibia rotate during the screw-home mechanism?
- a) Internal rotation
- b) External rotation
- c) Medial rotation
- d) Lateral rotation
- During the screw-home mechanism, the tibia rotates externally as the knee extends. This external rotation of the tibia helps stabilize the knee joint and promotes optimal alignment of the lower limb segments during weight-bearing activities.
What contributes to the increased likelihood of ACL tear with steeper declination angles of the tibial plateau?
- a) Decreased tension in the cruciate ligaments
- b) Greater tibial external rotation
- c) Reduced medial-lateral translation
- d) Increased anterior tibial translation
Knee - Clinical Anatomy and Biomechanics
What contributes to the increased likelihood of ACL tear with steeper declination angles of the tibial plateau?
- a) Decreased tension in the cruciate ligaments
- b) Greater tibial external rotation
- c) Reduced medial-lateral translation
- d) Increased anterior tibial translation
- Steeper declination angles of the tibial plateau increase the likelihood of ACL tear by promoting greater anterior tibial translation. This places excessive strain on the ACL, leading to potential ligamentous injury.
Which ligament dynamically stabilizes the knee and has its greatest load during knee extension?
- a) Medial collateral ligament (MCL)
- b) Posterior cruciate ligament (PCL)
- c) Anterior cruciate ligament (ACL)
- d) Lateral collateral ligament (LCL)
Knee - Clinical Anatomy and Biomechanics
Which ligament dynamically stabilizes the knee and has its greatest load during knee extension?
- a) Medial collateral ligament (MCL)
- b) Posterior cruciate ligament (PCL)
- c) Anterior cruciate ligament (ACL)
- d) Lateral collateral ligament (LCL)
- The ACL dynamically stabilizes the knee joint and experiences its greatest load during knee extension.
- It plays a crucial role in preventing anterior tibial translation and controlling rotational movements of the knee.
What is the function of the helical structure of the ACL fibers?
- a) Enhance proprioception
- b) Store energy during loading
- c) Increase vascularization
- d) Reduce friction between joint surfaces
Knee - Clinical Anatomy and Biomechanics
What is the function of the helical structure of the ACL fibers?
- a) Enhance proprioception
- b) Store energy during loading
- c) Increase vascularization
- d) Reduce friction between joint surfaces
- The helical structure of the ACL fibers allows them to store energy during loading, which is released during knee extension.
- This mechanism contributes to the dynamic stability and function of the knee joint.
What is the primary source of innervation for the ACL?
- a) Femoral nerve
- b) Tibial nerve
- c) Peroneal nerve
- d) Genicular nerve
Knee - Clinical Anatomy and Biomechanics
What is the primary source of innervation for the ACL?
- a) Femoral nerve
- b) Tibial nerve
- c) Peroneal nerve
- d) Genicular nerve
- The primary source of innervation for the ACL is the tibial nerve. While other nerves may contribute to sensation around the knee joint, the tibial nerve provides proprioceptive feedback to the ACL, aiding in joint stability and coordination.
In the patellofemoral joint, which motion is typically observed during the first 10 degrees of knee flexion?
- a) Superior glide
- b) Medial tilt
- c) Inferior glide
- d) Lateral rotation
Knee - Clinical Anatomy and Biomechanics
In the patellofemoral joint, which motion is typically observed during the first 10 degrees of knee flexion?
- a) Superior glide
- b) Medial tilt
- c) Inferior glide
- d) Lateral rotation
- During the initial phase of knee flexion, the patella typically undergoes inferior glide, moving downward along the femoral condyles to facilitate smooth articulation between the patella and femur.
During which phase of knee extension is the anterior cruciate ligament (ACL) most susceptible to injury due to its slackness?
- a) Initial 10 degrees
- b) Middle 30 degrees
- c) Terminal 50 degrees
- d) Final 20 degrees
Knee - Clinical Anatomy and Biomechanics
During which phase of knee extension is the anterior cruciate ligament (ACL) most susceptible to injury due to its slackness?
- a) Initial 10 degrees
- b) Middle 30 degrees
- c) Terminal 50 degrees
- d) Final 20 degrees
- The ACL and posterior cruciate ligament (PCL) are most slack between approximately 20 and 50 degrees of knee flexion, making the ACL particularly vulnerable to injury during the final 20 degrees of knee extension where it may not effectively control anterior tibial translation and rotational instability.
How does the twisted nature of the anterior cruciate ligament (ACL) fibers contribute to its biomechanical function?
- a) By providing a broad attachment at the origin and insertion
- b) By allowing for greater extensibility during knee flexion
- c) By storing energy in flexion that is released into extension moments
- d) By minimizing the risk of tibial external rotation
Knee - Clinical Anatomy and Biomechanics
How does the twisted nature of the anterior cruciate ligament (ACL) fibers contribute to its biomechanical function?
- a) By providing a broad attachment at the origin and insertion
- b) By allowing for greater extensibility during knee flexion
- c) By storing energy in flexion that is released into extension moments
- d) By minimizing the risk of tibial external rotation
Rationale:
- The twisted fibers of the ACL enable it to store energy during knee flexion, which is then released into extension moments.
- This mechanism contributes to the dynamic stability of the knee joint during activities such as walking, running, and jumping.
Which nerve innervates the anterior cruciate ligament (ACL), primarily providing proprioceptive feedback and coordinating firing patterns of surrounding muscles?
- a) Sciatic nerve
- b) Femoral nerve
- c) Tibial nerve
- d) Common fibular nerve
Knee - Clinical Anatomy and Biomechanics
Which nerve innervates the anterior cruciate ligament (ACL), primarily providing proprioceptive feedback and coordinating firing patterns of surrounding muscles?
- a) Sciatic nerve
- b) Femoral nerve
- c) Tibial nerve
- d) Common fibular nerve
- The ACL is innervated by the tibial nerve, which primarily provides proprioceptive feedback to the brain, informing it about the knee’s position in space.
- Additionally, the tibial nerve helps coordinate firing patterns of the hamstrings and quadriceps muscles to stabilize the knee joint.
Which ligament resists posterior tibial translation primarily between 70-90 degrees of knee flexion?
- a) Medial collateral ligament (MCL)
- b) Lateral collateral ligament (LCL)
- c) Anterior cruciate ligament (ACL)
- d) Posterior cruciate ligament (PCL)
Knee - Clinical Anatomy and Biomechanics
Which ligament resists posterior tibial translation primarily between 70-90 degrees of knee flexion?
- a) Medial collateral ligament (MCL)
- b) Lateral collateral ligament (LCL)
- c) Anterior cruciate ligament (ACL)
- d) Posterior cruciate ligament (PCL)
- The primary function of the PCL is to resist posterior tibial translation, especially between 70-90 degrees of knee flexion.
- This ligament provides essential stability to the knee joint during weight-bearing activities and helps prevent posterior displacement of the tibia relative to the femur.
Which ligament primarily resists varus forces acting on the knee joint?
- a) Medial collateral ligament (MCL)
- b) Lateral collateral ligament (LCL)
- c) Anterior cruciate ligament (ACL)
- d) Posterior cruciate ligament (PCL)
Correct Answer: b) Lateral collateral ligament (LCL)
Knee - Clinical Anatomy and Biomechanics
Which ligament primarily resists varus forces acting on the knee joint?
- a) Medial collateral ligament (MCL)
- b) Lateral collateral ligament (LCL)
- c) Anterior cruciate ligament (ACL)
- d) Posterior cruciate ligament (PCL)
Correct Answer: b) Lateral collateral ligament (LCL)
- The LCL, also known as the fibular collateral ligament, primarily resists varus forces (forces directed inward) acting on the knee joint.
- It provides lateral stability to the knee and works in conjunction with other structures such as the iliotibial band (ITB) to prevent excessive varus angulation.
What is the primary function of the popliteus muscle in relation to the knee joint?
- a) To resist varus forces
- b) To stabilize the patella
- c) To assist in knee flexion and medial rotation of the tibia
- d) To provide proprioceptive feedback to the ACL
Knee - Clinical Anatomy and Biomechanics
What is the primary function of the popliteus muscle in relation to the knee joint?
- a) To resist varus forces
- b) To stabilize the patella
- c) To assist in knee flexion and medial rotation of the tibia
- d) To provide proprioceptive feedback to the ACL
- The popliteus muscle plays a crucial role in knee function by assisting in knee flexion and medially rotating the tibia, particularly during the initial stages of knee flexion.
- This action helps unlock the knee joint from its fully extended position.
Which ligament provides primary stabilization against valgus stress at the knee, especially at end-ranges of motion?
- a) Posterior cruciate ligament (PCL)
- b) Lateral collateral ligament (LCL)
- c) Medial collateral ligament (MCL)
- d) Anterolateral ligament (ALL)
Knee - Clinical Anatomy and Biomechanics
Which ligament provides primary stabilization against valgus stress at the knee, especially at end-ranges of motion?
- a) Posterior cruciate ligament (PCL)
- b) Lateral collateral ligament (LCL)
- c) Medial collateral ligament (MCL)
- d) Anterolateral ligament (ALL)
- The MCL, particularly its superficial portion, is the primary stabilizer against valgus stress (forces directed outward) at the knee joint, especially at end-ranges of motion.
- It helps prevent excessive widening of the knee joint and provides crucial medial stability.
Which nerve primarily innervates the muscles responsible for dorsiflexion of the foot and extension of the toes?
- a) Sciatic nerve
- b) Deep fibular nerve
- c) Tibial nerve
- d) Common fibular nerve
Knee - Clinical Anatomy and Biomechanics
Which nerve primarily innervates the muscles responsible for dorsiflexion of the foot and extension of the toes?
- a) Sciatic nerve
- b) Deep fibular nerve
- c) Tibial nerve
- d) Common fibular nerve
- The deep fibular nerve innervates the muscles responsible for dorsiflexion of the foot (e.g., tibialis anterior) and extension of the toes (e.g., extensor digitorum longus).
- Dysfunction of this nerve can lead to foot drop and difficulty lifting the toes during walking.
What is the function of the Patellar Ligament?
- A - Provides stability to the medial joint space
- B - Acts as a cushion between the femur and tibia
- C - Attaches the patella to the tibial tuberosity
- D - Secures the lateral meniscus in place
Knee – Examination
What is the function of the Patellar Ligament?
- A - Provides stability to the medial joint space
- B - Acts as a cushion between the femur and tibia
- C - Attaches the patella to the tibial tuberosity
- D - Secures the lateral meniscus in place
- The patellar ligament is a wide band-like structure that extends inferiorly from the patella and attaches to the tibial tuberosity.
- This attachment helps in transmitting forces from the quadriceps muscles to the tibia during knee extension .
- The other options are incorrect because they do not accurately describe the function of the patellar ligament.
Which structure is located distal and posterior to the Lateral Femoral Condyle?
- A - Fibular Head
- B - Gerdy’s Tubercle
- C - Lateral Collateral Ligament
- D - Adductor Tubercle
Knee – Examination
Which structure is located distal and posterior to the Lateral Femoral Condyle?
- A - Fibular Head
- B - Gerdy’s Tubercle
- C - Lateral Collateral Ligament
- D - Adductor Tubercle
- The fibular head is located distal and posterior to the lateral femoral condyle.
- It serves as an attachment point for ligaments and muscles involved in stabilizing the knee joint.
- The other options are incorrect because they do not accurately describe the structure located distal and posterior to the lateral femoral condyle.
What is the function of the Pes Anserinus?
- A - Stabilizes the lateral joint space
- B - Acts as an attachment site for the patellar ligament
- C - Provides medial support to the knee joint
- D - Facilitates extension of the knee joint
Knee – Examination
What is the function of the Pes Anserinus?
- A - Stabilizes the lateral joint space
- B - Acts as an attachment site for the patellar ligament
- C - Provides medial support to the knee joint
- D - Facilitates extension of the knee joint
- The Pes Anserinus is located at the proximal, medial slope of the tibia and consists of the tendinous insertions of the sartorius, gracilis, and semitendinosus muscles.
- It provides medial support to the knee joint.
- The other options are incorrect because they do not accurately describe the function of the Pes Anserinus.
Which structure is a diagonal cord in the anterior joint space?
- A - Patellar Ligament
- B - Adductor Tubercle
- C - Medial Collateral Ligament
- D - Medial and Lateral Patello-Tibial/Meniscal Ligamen
Knee – Examination
Which structure is a diagonal cord in the anterior joint space?
- A - Patellar Ligament
- B - Adductor Tubercle
- C - Medial Collateral Ligament
- D - Medial and Lateral Patello-Tibial/Meniscal Ligament
- The Medial and Lateral Patello-Tibial/Meniscal Ligaments are diagonal cords in the anterior joint space of the knee.
- They contribute to the stability of the patella within the patellofemoral joint.
- The other options are incorrect because they do not accurately describe the structure mentioned.
What structure is located halfway between the Tibial Tuberosity and the Fibular Head?
- A - Medial Collateral Ligament
- B - Gerdy’s Tubercle
- C - Adductor Tubercle
- D - Lateral Collateral Ligament
Knee – Examination
What structure is located halfway between the Tibial Tuberosity and the Fibular Head?
- A - Medial Collateral Ligament
- B - Gerdy’s Tubercle
- C - Adductor Tubercle
- D - Lateral Collateral Ligament
- Gerdy’s Tubercle is a prominent bump located halfway between the Tibial Tuberosity and the Fibular Head.
- It serves as an attachment site for the iliotibial band (ITB).
- The other options are incorrect because they do not accurately describe the structure mentioned.
Which structure is located distal to the Patella?
- A - Medial Femoral Condyle
- B - Adductor Tubercle
- C - Tibial Tuberosity
- D - Medial and Lateral Meniscus
Knee – Examination
Which structure is located distal to the Patella?
- A - Medial Femoral Condyle
- B - Adductor Tubercle
- C - Tibial Tuberosity
- D - Medial and Lateral Meniscus
- The Tibial Tuberosity is the distal attachment site of the patellar ligament.
- It is located inferiorly from the Patella.
- The other options are incorrect because they are not located distal to the Patella.
Which structure serves as the distal attachment of the Patellar Ligament?
- A - Medial Collateral Ligament
- B - Fibular Head
- C - Tibial Tuberosity
- D - Pes Anserinus
Knee – Examination
Which structure serves as the distal attachment of the Patellar Ligament?
- A - Medial Collateral Ligament
- B - Fibular Head
- C - Tibial Tuberosity
- D - Pes Anserinus
- The Tibial Tuberosity serves as the distal attachment of the Patellar Ligament, which extends from the patella to the tibia.
- The other options are incorrect because they do not serve as the distal attachment of the Patellar Ligament.
What is the function of the Medial Collateral Ligament?
- A - Provides lateral support to the knee joint
- B - Facilitates flexion of the knee joint
- C - Provides medial support to the knee joint
- D - Stabilizes the patella within the patellofemoral joint
Knee – Examination
What is the function of the Medial Collateral Ligament?
- A - Provides lateral support to the knee joint
- B - Facilitates flexion of the knee joint
- C - Provides medial support to the knee joint
- D - Stabilizes the patella within the patellofemoral joint
- The Medial Collateral Ligament is a firm structure that helps stabilize the medial aspect of the knee joint, preventing excessive medial movement or valgus stress.
- The other options are incorrect because they do not accurately describe the function of the Medial Collateral Ligament.
What is the primary purpose of conducting a review of systems during the knee examination?
- A - To identify potential red flags and systemic issues that may affect knee health
- B - To assess the range of motion and strength of the knee joint
- C - To evaluate the patient’s response to specific aggravating and easing factors
- D - To determine the severity and irritability of knee symptoms
Knee – Examination
What is the primary purpose of conducting a review of systems during the knee examination?
- A - To identify potential red flags and systemic issues that may affect knee health
- B - To assess the range of motion and strength of the knee joint
- C - To evaluate the patient’s response to specific aggravating and easing factors
- D - To determine the severity and irritability of knee symptoms
- The review of systems helps clinicians identify general health issues, cardiopulmonary concerns, integumentary changes, metabolic conditions, lifestyle factors, and medications that may impact knee function or treatment.
- The other options are incorrect because they do not accurately describe the purpose of conducting a review of systems.
Which of the following is considered a red flag during the knee examination?
- A - Malaise
- B - Night Pain
- C - Prior History of Cancer
- D - Unexplained Weight Gain
Knee – Examination
Which of the following is considered a red flag during the knee examination?
- A - Malaise
- B - Night Pain
- C - Prior History of Cancer
- D - Unexplained Weight Gain
- Red flags are warning signs that may indicate serious underlying pathology.
- A prior history of cancer is one such red flag that should be considered during the knee examination.
- The other options may be relevant symptoms or concerns but are not specifically categorized as red flags.
Which of the following outcome measures assesses knee-related physical performance?
- A - International Knee Documentation Committee (IKDC)
- B - Knee-Injury and Osteoarthritis Outcome Score (KOOS)
- C - Lower Extremity Function Scale
- D - Osteoarthritis Outcome Score
Knee – Examination
Which of the following outcome measures assesses knee-related physical performance?
- A - International Knee Documentation Committee (IKDC)
- B - Knee-Injury and Osteoarthritis Outcome Score (KOOS)
- C - Lower Extremity Function Scale
- D - Osteoarthritis Outcome Score
- The Lower Extremity Function Scale is an outcome measure specifically designed to assess physical performance related to lower extremity function, including the knee.
- The other options assess various aspects of knee function and symptoms but do not specifically focus on physical performance.
Which age group is more likely to present with degenerative knee conditions such as osteoarthritis?
- A. < 40 Years
- B. > 40 Years
- C. 20-30 Years
- D. 50-60 Years
Knee – Examination
Which age group is more likely to present with degenerative knee conditions such as osteoarthritis?
- A. < 40 Years
- B. > 40 Years
- C. 20-30 Years
- D. 50-60 Years
- Older populations, typically aged over 40 years, are more prone to degenerative knee conditions such as osteoarthritis due to natural wear and tear on the joints over time.
- The other options represent younger age groups, which are less likely to present with degenerative knee conditions.
What does the term “SINSS” stand for in the context of knee examination?
- A - Severity, Irritability, Nature, Stability, Stage
- B - Sensation, Intensity, Neuropathy, Stability, Stage
- C - Severity, Intensity, Nature, Stage, Stability
- D - Sensation, Irritability, Neuropathy, Stage, Stability
Knee – Examination
What does the term “SINSS” stand for in the context of knee examination?
- A - Severity, Irritability, Nature, Stability, Stage
- B - Sensation, Intensity, Neuropathy, Stability, Stage
- C - Severity, Intensity, Nature, Stage, Stability
- D - Sensation, Irritability, Neuropathy, Stage, Stability
- SINSS is an acronym used to assess and describe various aspects of pain, including severity, irritability, nature, stage, and stability, during the knee examination.
- The other options either include incorrect terms or do not accurately represent the components of SINSS.
What is the Kennedy Stage associated with pain occurring after 0-25% of activity?
- A - Stage 1
- B - Stage 2
- C - Stage 3
- D - Stage 4
Knee – Examination
What is the Kennedy Stage associated with pain occurring after 0-25% of activity?
- A - Stage 1
- B - Stage 2
- C - Stage 3
- D - Stage 4
- Kennedy Stages categorize pain based on the percentage of activity during which pain occurs. Stage 1 corresponds to pain occurring after 0-25% of activity.
- The other options represent different stages of the Kennedy classification.
What is the primary takeaway regarding pain patterns in the knee examination?
- A - Pain patterns alone can provide a definitive diagnosis of knee conditions.
- B - Pain patterns are not useful in diagnosing knee conditions.
- C - Pain patterns can be a helpful tool, but they cannot diagnose knee conditions independently.
- D - Pain patterns are more reliable than objective measures in diagnosing knee conditions.
Knee – Examination
What is the primary takeaway regarding pain patterns in the knee examination?
- A - Pain patterns alone can provide a definitive diagnosis of knee conditions.
- B - Pain patterns are not useful in diagnosing knee conditions.
- C - Pain patterns can be a helpful tool, but they cannot diagnose knee conditions independently.
- D - Pain patterns are more reliable than objective measures in diagnosing knee conditions.
Rationale:
- While pain patterns can provide valuable information, they are typically used in conjunction with other assessment findings to form a diagnosis.
- Pain patterns alone are not sufficient for a definitive diagnosis.
- The other options either overstate the usefulness of pain patterns or suggest they are not helpful at all.
What is the significance of assessing aggravating and easing factors during the knee examination?
- A - Aggravating factors determine the severity of knee symptoms.
- B - Easing factors provide insight into the patient’s pain tolerance.
- C - Aggravating and easing factors help identify potential causes of knee symptoms.
- D - Easing factors indicate the need for immediate medical intervention.
Knee – Examination
What is the significance of assessing aggravating and easing factors during the knee examination?
- A - Aggravating factors determine the severity of knee symptoms.
- B - Easing factors provide insight into the patient’s pain tolerance.
- C - Aggravating and easing factors help identify potential causes of knee symptoms.
- D - Easing factors indicate the need for immediate medical intervention.
- Assessing aggravating and easing factors helps clinicians understand what activities or conditions worsen or alleviate knee symptoms, providing valuable clues to the underlying pathology.
- The other options either do not accurately describe the significance of assessing aggravating and easing factors or misrepresent their role in diagnosis.
Which observation should be made from a frontal view during the knee examination?
- A - Genu Recurvatum
- B - Knee Flexion Contracture
- C - Quadriceps Atrophy
- D - Posterior Swelling/Baker’s Cyst
Knee – Examination
Which observation should be made from a frontal view during the knee examination?
- A - Genu Recurvatum
- B - Knee Flexion Contracture
- C - Quadriceps Atrophy
- D - Posterior Swelling/Baker’s Cyst
- Quadriceps atrophy can be observed from a frontal view during the knee examination.
- It is an important sign that may indicate muscle weakness or disuse.
- The other options are observed from a side view or indicate different observations.
What are the Ottawa Knee Rules used for during the knee examination?
- A - To assess genu varus and genu valgus alignment
- B - To screen for potential knee fractures
- C - To evaluate range of motion of the knee joint
- D - To assess for ligamentous instability
Knee – Examination
What are the Ottawa Knee Rules used for during the knee examination?
- A - To assess genu varus and genu valgus alignment
- B - To screen for potential knee fractures
- C - To evaluate range of motion of the knee joint
- D - To assess for ligamentous instability
- The Ottawa Knee Rules are a set of criteria used to determine whether a knee X-ray is warranted to rule out a fracture following a knee injury.
- The other options are not the primary purpose of the Ottawa Knee Rules.
According to the Pittsburgh Knee Rules, which age groups are considered at higher risk for knee fractures?
- A - < 12 and > 50
- B - < 18 and > 60
- C - < 20 and > 55
- D - < 15 and > 45
Knee – Examination
According to the Pittsburgh Knee Rules, which age groups are considered at higher risk for knee fractures?
- A - < 12 and > 50
- B - < 18 and > 60
- C - < 20 and > 55
- D - < 15 and > 45
- According to the Pittsburgh Knee Rules, age groups < 12 and > 50 are considered at higher risk for knee fractures.
- The other options include age groups not specified by the Pittsburgh Knee Rules.
What is the primary goal of conducting foundational tests and measures during the knee examination?
- A - To confirm the patient’s subjective hypothesis
- B - To diagnose specific knee conditions
- C - To determine the patient’s willingness to undergo treatment
- D - To assess the patient’s range of motion and strength
Knee – Examination
What is the primary goal of conducting foundational tests and measures during the knee examination?
- A - To confirm the patient’s subjective hypothesis
- B - To diagnose specific knee conditions
- C - To determine the patient’s willingness to undergo treatment
- D - To assess the patient’s range of motion and strength
- The primary goal of conducting foundational tests and measures is to confirm or refute the subjective hypothesis formed based on the patient’s history and presentation.
- The other options may be secondary goals but do not reflect the primary purpose of foundational tests and measures.
What is the normal range of knee flexion during the knee examination?
- A - 0 degrees
- B - 45 degrees
- C - 90 degrees
- D - 135 degrees
Knee – Examination
What is the normal range of knee flexion during the knee examination?
- A - 0 degrees
- B - 45 degrees
- C - 90 degrees
- D - 135 degrees
- The normal range of knee flexion is typically considered to be up to 135 degrees during the knee examination.
- The other options represent different angles or extension rather than flexion.
What should clinicians watch for when performing foundational tests and measures during the knee examination?
- A - Aggravating positions
- B - Redness and swelling
- C - Patient’s willingness to participate
- D - Quadriceps atrophy
Knee – Examination
What should clinicians watch for when performing foundational tests and measures during the knee examination?
- A - Aggravating positions
- B - Redness and swelling
- C - Patient’s willingness to participate
- D - Quadriceps atrophy
- Clinicians should be cautious not to push into aggravating positions too early during foundational tests and measures to avoid exacerbating the patient’s symptoms.
- The other options may also be important considerations but do not specifically relate to foundational tests and measures.
Which observation should be made from a side view during the knee examination?
- A - Quadriceps Atrophy
- B - Genu Recurvatum
- C - Genu Varus/Valgus (Q-Angle)
- D - Skin Appearance (Sheen | Ecchymosis)
Knee – Examination
Which observation should be made from a side view during the knee examination?
- A - Quadriceps Atrophy
- B - Genu Recurvatum
- C - Genu Varus/Valgus (Q-Angle)
- D - Skin Appearance (Sheen | Ecchymosis)
- Genu recurvatum, or hyperextension of the knee joint, can be observed from a side view during the knee examination.
- The other options are observed from a frontal view or represent different observations.
What is the significance of assessing knee range of motion during the knee examination?
- A - To diagnose specific knee conditions
- B - To determine the patient’s age
- C - To evaluate muscle strength
- D - To assess joint function and mobility
Knee – Examination
What is the significance of assessing knee range of motion during the knee examination?
- A - To diagnose specific knee conditions
- B - To determine the patient’s age
- C - To evaluate muscle strength
- D - To assess joint function and mobility
- Assessing knee range of motion helps clinicians evaluate the flexibility, mobility, and function of the knee joint.
- The other options may be secondary considerations but do not reflect the primary purpose of assessing knee range of motion.
What criteria are assessed by the Ottawa Knee Rules?
- A - Genu varus and genu valgus alignment
- B - Age, tenderness at fibular head, and inability to flex to 90°
- C - Range of motion and muscle strength
- D - Joint stability and ligamentous laxity
Knee – Examination
What criteria are assessed by the Ottawa Knee Rules?
- A - Genu varus and genu valgus alignment
- B - Age, tenderness at fibular head, and inability to flex to 90°
- C - Range of motion and muscle strength
- D - Joint stability and ligamentous laxity
Rationale:
- The Ottawa Knee Rules assess specific criteria including age, tenderness at the head of the fibula, and inability to flex the knee to 90° to determine the need for knee X-ray in suspected knee fractures.
- The other options do not accurately describe the criteria assessed by the Ottawa Knee Rules.
According to the Pittsburgh Knee Rules, what age groups are considered at higher risk for knee fractures?
- A) < 18 and > 60
- B) < 12 and > 50
- C) < 20 and > 55
- D) < 15 and > 45
Knee – Examination
- A) < 18 and > 60
- B) < 12 and > 50
- C) < 20 and > 55
- D) < 15 and > 45
- The Pittsburgh Knee Rules consider age groups < 12 and > 50 as at higher risk for knee fractures.
- The other options include age groups not specified by the Pittsburgh Knee Rules.
Which of the following criteria is assessed by both the Ottawa Knee Rules and the Pittsburgh Knee Rules?
- A - Tenderness at patella
- B - Inability to ambulate 4 steps
- C - Genu varus/valgus alignment
- D - Skin appearance
Knee – Examination
Which of the following criteria is assessed by both the Ottawa Knee Rules and the Pittsburgh Knee Rules?
- A - Tenderness at patella
- B - Inability to ambulate 4 steps
- C - Genu varus/valgus alignment
- D - Skin appearance
- Both the Ottawa Knee Rules and the Pittsburgh Knee Rules assess the inability to ambulate 4 steps as a criterion for determining the need for further investigation in suspected knee fractures.
- The other options are not criteria assessed by both sets of rules.
What is the purpose of the Pittsburgh Knee Rules?
- A - To screen for ligamentous injuries in the knee
- B - To assess knee range of motion
- C - To evaluate joint stability
- D - To determine the need for X-ray in suspected knee fractures
Knee – Examination
What is the purpose of the Pittsburgh Knee Rules?
- A - To screen for ligamentous injuries in the knee
- B - To assess knee range of motion
- C - To evaluate joint stability
- D - To determine the need for X-ray in suspected knee fractures
- The Pittsburgh Knee Rules are used to determine the need for X-ray in suspected knee fractures based on specific criteria including age and the ability to ambulate 4 steps.
- The other options do not accurately describe the purpose of the Pittsburgh Knee Rules.
During Tibiofemoral Joint Posterior Glide testing, what direction does the clinician apply force to the tibia?
- A - Anterior
- B - Posterior
- C - Medial
- D - Lateral
Knee – Examination
During Tibiofemoral Joint Posterior Glide testing, what direction does the clinician apply force to the tibia?
- A - Anterior
- B - Posterior
- C - Medial
- D - Lateral
- During Tibiofemoral Joint Posterior Glide testing, the clinician applies a posterior force to the tibia to assess joint play and passive accessory motion.
- The other options represent different directions of force application.
What movement does the Varus Stress Test at knee primarily promote?
- A - Medial rotation of the tibia
- B - Lateral rotation of the tibia
- C - Abduction of the ankle
- D - Adduction of the ankle
Knee – Examination
What movement does the Varus Stress Test at knee primarily promote?
- A - Medial rotation of the tibia
- B - Lateral rotation of the tibia
- C - Abduction of the ankle
- D - Adduction of the ankle
- The Varus Stress Test at knee primarily promotes lateral rotation of the tibia to assess the integrity of the lateral collateral ligament (LCL).
- The other options represent different movements or structures.
Daniel Smith, a 35-year-old recreational basketball player, landed awkwardly after attempting a layup, causing his right knee to twist. He immediately felt a popping sensation and sharp pain in his knee, accompanied by swelling. Daniel’s physical examination revealed joint effusion and tenderness along the joint line. He experienced significant anterior translation during the Lachman test but no pain with the pivot shift test.
- What is the most likely diagnosis for Daniel’s right knee injury?
- A) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease)
- B) Meniscus Injury
- C) Anterior Cruciate Ligament (ACL) Injury
- D) Posterior Cruciate Ligament (PCL) Injury
Knee-Evaluation
- A) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease)
- B) Meniscus Injury
- C) Anterior Cruciate Ligament (ACL) Injury
- D) Posterior Cruciate Ligament (PCL) Injury
Rationale:
- Daniel’s mechanism of injury, popping sensation, swelling, tenderness along the joint line, and significant anterior translation during the Lachman test are indicative of an ACL injury. The absence of pain during the pivot shift test supports this diagnosis.
A 45-year-old female presents with chronic knee pain and stiffness, particularly during activities that require bending or twisting of the knee. She reports no history of trauma but mentions that her symptoms have gradually worsened over the past few months.
- What are the differential diagnoses to consider in this case, and what specific clinical signs would support your thoughts?
- a) Patellofemoral pain syndrome
- b) Ligamentous injury
- c) Osteoarthritis
- d) Meniscus injury
Knee-Evaluation
- a) Patellofemoral pain syndrome
- b) Ligamentous injury
- c) Osteoarthritis
- d) Meniscus injury
Rationale:
- The patient’s symptoms of chronic knee pain exacerbated by bending or twisting activities are suggestive of a meniscus injury.
- Specific clinical signs supporting this diagnosis include joint line tenderness and positive McMurray or Apley’s test.
What is a characteristic symptom reported by individuals with plica syndrome?
- A) Anterior knee pain exacerbated by climbing stairs
- B) Lateral knee pain exacerbated by running
- C) Medial knee pain exacerbated by squatting
- D) Posterior knee pain exacerbated by prolonged sitting
Knee-Evaluation
What is a characteristic symptom reported by individuals with plica syndrome?
- A) Anterior knee pain exacerbated by climbing stairs
- B) Lateral knee pain exacerbated by running
- C) Medial knee pain exacerbated by squatting
- D) Posterior knee pain exacerbated by prolonged sitting
Rationale: Anterior knee pain exacerbated by activities such as climbing stairs is a common symptom reported by individuals with plica syndrome.
