Patellofemoral Joint Flashcards
As the patello-femoral joint articulates with the trochlea (1/2 / 2/3) of it is covered in hyaline cartilage. The inferior pole (is/is not) covered in hyaline cartilage. This tells you that the (anterior/posterior) part of the patella takes on most of the load.
2/3; not covered; anterior
The cartilage at the patellofemoral joint is the (thickest/thinnest) cartilage we have in the entire body. All the complex movements that we perform, that cartilage has to have absorption quality.
thickest
The patella has a (loose/tight) fit in the trochlea groove. Problems occur if the patella does not fit (loosely/tightly) in the groove. If the femur is malaligned, then the groove is not well aligned which could cause issues in the body.
tight; tightly
The patella tendon and the patella have a relationship and this relationship is the ratio of the patella tendon length to the patellar length. So between the two, the formula for the ratio is ____ divided by ____. This ratio is measured at _ degrees of knee flexion.
patella tendon length / patella length; 30
Any ratio between the patellar tendon length and patella that is .8-1.2 would be considered what?
Normal
Any ratio between the patellar tendon length and patella that is above 1.2 would be considered patella (alta/baja).
alta
Any ratio between the patellar tendon length and patella that is less than .8 would be considered patella (alta/baja).
baja
The position of the patella in the (sagittal/frontal) plane is constant and normal.
sagittal
If the knee is in (flexion/extension), the patella is not within the groove.
extension
If the relationship between the patellar tendon length and the patella are off, you can get an (increased/decreased) risk of patellofemoral dysfunction, meaning it does not operate the way it is supposed to .
increased
If the patella tendon length is too big compared to the patella length, it would be patella (alta/baja) and the patella would be sitting (higher/lower) and (closer to/ further away from) the groove. And as you flex your knee it will take longer for the patella to slide in the groove.
alta; higher; further away from
“The Q angle (Quadriceps angle) which is also known as quadriceps angle, is defined as the angle formed between the quadriceps muscles and the patella tendon. Q angle is the angle formed by a line drawn from the ___ to the ___ patella and a second line drawn from the ___ patella to tibial ___.”
ASIS; mid; mid; tubercle
A normal Q angle between males and females is roughly - degrees.
13-18
There is a lot of variability due to palpation when measuring the Q angle, so the (intrarater/interrater) reliability is not as good.
interrater
Generally speaking, you are trying to figure out whether the Q angle has effects on the mechanics. Postural deviations could lead to a higher Q angle which could be genu (varum/valgum).
valgum
A more varus knee equates to a (smaller/larger) q angle. A more valgus knee equates to a (smaller/larger) q angle.
smaller; larger
A wider pelvis may lead to more genu (varum/valgum).
valgum
If I had a q angle that was way (medial/lateral) to the actual angle, the patellar mechanics would be worse because it would not fit perfectly in the groove, it would be further lateral. The patella would be out of the groove which would effect the mechanics and could lead to (increased/decreased) risks of patellofemoral pain.
lateral; increased
If a patient has (lateral/medial) patella pain, you could check the q angle to see if that could play a factor in this pain.
lateral
If I am really (relaxed/tense), I can slide the patella left and right. The patella is able to move and have accessory motions.
relaxed
For the patellofemoral joint, flexion of the knee is an (inferior/superior) glide. Extension of the knee is a (inferior/superior) glide.
inferior; superior
Medial and lateral glides are (active/passive). Now the patella is able to move left and right as I am moving it and that little bit of accessory motion is thought to be very important after having a surgery if that person’s patella feels stuck because they don’t really have that accessory glide. Osteokinematic motion would be affected because their arthrokinematics motion would be affected.
passive
If there is limited medial/lateral glide of the PF joint, there is typically limited (anterior/posterior / superior/inferior) glides. You could tell if someone’s medial/lateral glide is off by checking the other limb.
superior/inferior
Angles and tilts are similar.
Got it
A lateral tilt of the PF joint rocks the patella (laterally/medially).
laterally
A medial tilt of the PF joint rocks the patella (medially/laterally).
medially
Someone might have lateral patellar tilts as normal and have pain on the (lateral/medial) side of the patella.
lateral
If I have a lateral tilt of my patella, I would expect there to be tension on the (lateral/medial) side, compression on the (medial/lateral) side.
medial; lateral
If I have a medial tilt of my patella, I would expect there to be tension on the (lateral/medial) side, compression on the (medial/lateral) side.
lateral; medial
In a medial tilt, i would expect there to be pain on the (medial/lateral) side.
medial
(Medial/Lateral) tilts are more common to see based on Kodali’s experience.
Lateral
Doing a superior/inferior mobilization, the therapist will be trying to improve knee flexion and extension. The patella has to glide superior during knee (flexion/extension) and glide inferior during knee (flexion/extension). If they have decreased flexion ROM, maybe the mobilizations can help. Baseline measurements can detect if there is improvement.
extension; flexion
The patella as it slides in and out of the trochlea in different levels of knee (flexion/extension) has different contact points.
flexion
The patella has the most contact area with the groove of the trochlea in (45/90) degree of knee flexion.
90
At 90 degree of flexion, the (superior/middle) part of the patella is the most engaged with the groove of the trochlea.
superior
At 45 degrees of flexion, the (superior/middle) area of the patella is in contact with the groove of the trochlea.
middle
At 20 degrees of flexion, the (middle/inferior) part of the patella (which doesn’t have the hyaline cartilage) is in most contact with the groove of the trochlea.
inferior
The (superior/inferior) part of the patella does not have any hyaline cartilage.
inferior
As you flex the knee more, you will be (deeper/shallower) in the trochlea.
deeper
At _ degrees of extension the patella is out of the trochlea.
0
In 135 degrees of knee flexion, most of the contact is on the (medial/superior) and (lateral/inferior) borders of the patella.
medial and lateral
Most people have around _ degrees of knee fleixon.
140
The larger the internal force the (smaller/larger) the JRF.
larger
The JRF is (same/opposite) to the line of pull.
opposite
The knee internal moment responds to the external moment. So as one goes up, the other goes (up/down).
up
The leg press is a (closed/open) kinetic chain exercise and the leg extension is a(n) (closed/open) kinetic chain exercise.
closed; open
At 0 degrees of knee extension with the leg press, there is very (little/large) moment being experienced by the knee. Think at the end range of the leg press. As you start to bend or come down, the moment starts to increase until we get to 90. There is (more/less) moment experienced by the knee at 90 degrees of knee flexion.
little; more
The graph would tell me that someone with PF knee pain in a leg press should not have them go into a full squat. Can’t have them getting 90 degrees of flexion and that would put more pressure on the PF joint. You can do the leg press, but work in the little ranges (before/after) 90 degrees.
before
In the leg extension, the moment at 0 degrees of knee extension is really (low/high) because at that point you are lifting the weight fully so the external moment arm is the (greatest/least) at that point. The PF joint stress is high because the moment is high.
high; greatest
For the person with PF pain, maybe you can do knee extension exercises, just know the ranges of where it won’t hurt them or where you won’t have (maximum/minimum) stress on the joints.
maximum
Leg extension at _ degrees is where the highest joint stress occurs.
0
Osteochondral defect (something wrong with the cartilage) on the (superior/inferior) to (mid/lateral) patella. So maybe deep squats or leg presses might not be the move early on for them. I have to have that knowledge as a therapist.
superior to mid
High load on PF joint with leg press at _ degrees of flexion.
90
The force of the muscle is the (external/internal) force.
internal
If you make the quad work really hard, it is going to (increase/decrease) the force of the PF joint.
increase
If I am in open chain, the force of my quad does not create a lot of PF joint stress because the external moment arm is (smaller/larger). It is almost like the vector is pulling on the patella and it is getting driven into the trochlea. In the 90 degree position, now the quad is pulling heavily in that position and it is compressing the joint together.
smaller
