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(1) MS: Orthopedic and Rheumatic Conditions 🩺 > S2_L2: Knee Conditions > Flashcards

S2_L2: Knee Conditions Flashcards

1
Q

TRUE OR FALSE: The anterior cruciate ligament is slack when knee is flexed and taut when extended. It prevents anterior displacement of femur

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

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2
Q

The following statements are true about the Iliotibial band friction syndrome, EXCEPT:

A. repetitive stress injury
B. most common overuse syndrome of the knee
C. results from friction of the ITB as it slides over the lateral femoral condyle at approximately 30 degrees of knee flexion
D. palpable tenderness over Gerdy’s tubercle
E. None of the above

A

E. None of the above

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3
Q

Match the following conditions to its corresponding descriptions.

  1. Apophysitis of the tibial tubercle/tuberosity
  2. Apophysitis of the inferior pole of the patella
  3. Can be hereditary or because of avulsion
  4. Occurs in skeletally immature individuals
  5. (+) fragmentation of the tibial tubercle

A. Osgood–Schlatter disease
B. Sinding–Larsen–Johanssen syndrome

A
  1. A
  2. B
  3. A
  4. B
  5. B
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4
Q

Match the following conditions to its corresponding descriptions.

  1. pseudo locking of the knee
  2. may mimic acute internal derangement of the knee
  3. associated with eccentric overloading during deceleration activities

A. Plica Syndrome
B. Patellar tendinitis

A
  1. A
  2. A
  3. B
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5
Q

TRUE OR FALSE: A bursa is a sac that is not too thin that it can burst, but not too thick that it can be palpated. Once palpated, it is inflamed.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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6
Q

An ACL Tear is often caused by a sudden (1)_______, an abrupt change of (2)_______, and a fixed (3)______.

A
  1. deceleration
  2. direction
  3. foot
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7
Q

What type of joint is the Tibiofemoral joint classified as?

A

hinge joint

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8
Q

The proximal Tibia-Fibula joint, also known as the (1)________, is a (2)_____ joint

A
  1. forgotten joint
  2. plane
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9
Q

What nerve supplies that Proximal Tibia-Fibula joint?

A

common peroneal nerve

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10
Q

TRUE OR FALSE: The knee joint is the largest and most complex joint in the body. In the forgotten joint, small amount of gliding movement takes place during movements at the ankle joint.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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11
Q

Determine the action of the muscles around the knee.

  1. hamstring
  2. popliteus
  3. quadriceps
  4. biceps femoris
  5. semitendinosus

A. Knee flexor
B. Knee extensor
C. Lateral rotator of flexed knee
D. Medial rotator of flexed knee

A
  1. A
  2. D
  3. B
  4. C
  5. D
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12
Q

Stability of the knee joint depends on? (1-2)

A
  1. Strength and actions of the surrounding muscles
  2. Ligaments that connect the femur and tibia
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13
Q

The Patellar ligament is part of the distal (1)_______ and inserts to the (2)_____.

A
  1. quadriceps tendon
  2. tibial tuberosity
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14
Q

Determine the following ligament.

  1. prevents excessive abduction of the knee
  2. prevents excessive adduction of the tibia
    3 rounded, cordlike, ropelike strong ligament
  3. prevent valgus
  4. prevent varus

A. fibular collateral ligament
B. tibial collateral ligament

A
  1. B
  2. A
    3 A
  3. B
  4. A
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15
Q

Determine the following ligament.

  1. Wider
  2. AKA Lateral collateral ligament
  3. strong flat band that extends from medial condyle to the medial of tibia
  4. deep part is attached to the medial meniscus
  5. when injured, shows a (+) valgus stress test

A. fibular collateral ligament
B. tibial collateral ligament

A
  1. B
  2. A
  3. B
  4. B
  5. B
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16
Q

The Oblique popliteal ligament is an expansion of what muscle?

A

semimembranosus

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17
Q

The following is true about Cruciate Ligaments, EXCEPT:

A. located at the center of the joint
B. named according to tibial attachment
C. main bond between the tibia and femur throughout the knee’s joint motion
D. wearing of braces prevents injuries to it
E. None

A

D. wearing of braces prevents injuries to it

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18
Q

Determine which Cruciate Ligament is being described.

  1. more commonly injured
  2. poor blood supply
  3. provides rotational (torsional) stability
  4. drawer’s test
  5. main stabilizing factor for femur during WB on flexed knee

A. anterior cruciate
B. posterior cruciate
C. both
D. neither

A
  1. A
  2. A
  3. A
  4. C
  5. B
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19
Q

Determine which Cruciate Ligament is being described.

  1. weaker
  2. tight when knee is flexed
  3. helps prevent hyperflexion
  4. prevents anterior displacement of femur on the tibia
  5. prevents posterior displacement of the tibia on the femur

A. anterior cruciate
B. posterior cruciate
C. both
D. neither

A
  1. A
  2. B
  3. B
  4. B
  5. B
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20
Q

Determine which menisci is being described.

  1. circular and smaller and more freely movable
  2. anterior to attachment of ACL
  3. part of the Unhappy triad of O’Donoghue
  4. Is firmly attached to the deep surface of tibial collateral ligament
  5. only attach to intercondylar eminence

A. medial meniscus
B. lateral meniscus

A
  1. B
  2. A
  3. A
  4. A
  5. B
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21
Q

Enumerate the structures part of the Unhappy triad of O’Donoghue.

A

Medial collateral ligament, anterior cruciate ligament and medial meniscus

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22
Q

Both menisci are found on top of what bone?

A

tibia

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23
Q

What is the function of a menisci?

A

Cushion between tibia and femur (shock absorber)

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24
Q

TRUE OR FALSE: The medial condyle extends more distally and is more convex than the lateral femoral condyle. This results to the physiologic varus of the femur.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

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25
Q

Distal Femur Fractures includes what regions?

A

supracondylar and condylar

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26
Q

In Distal Femur Fractures, the gastrocnemius, quadriceps, an hamstrings bring deforming forces.

The gastrocnemius causes (1)_____ or (2)_____. The Quadriceps and hamstrings exert proximal (3)______, resulting in (4)______ of the lower extremity

A
  1. posterior displacement
  2. angulation
  3. traction
  4. shortening
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27
Q

In Distal Femur Fractures, what is the MOI for young adults?

A

high-energy trauma

examples: motor vehicle collision & fall from a height

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28
Q

In Distal Femur Fractures, what is the MOI for the elderly?

A

minor slip or fall onto a flexed knee

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29
Q

In Distal Femur Fractures, what is the most common MOI?

A

severe axial load with a varus, valgus, or rotational force

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30
Q

The following is true about Distal Femur Fractures, EXCEPT:

A. Orthogonal views of the distal femur should be obtained
B. Only a skeletal traction is used for non-displaced fx
C. Skeletal traction + bracing is use for a displaced fx
D. Early knee ROM is recommended
E. None

A

B. Only a skeletal traction is used for non-displaced fx

NOTE: for non-displaced fx, mobilization of the extremity in a hinged knee brace, with partial weight bearing is the typical tx given.

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31
Q

In Distal Femur Fractures, this is indicated for extra-articular fractures and simple intra-articular fractures

A

Retrograde IM nail

32
Q

In Distal Femur Fractures, this is indicated when associated with pre-existing joint arthropathy and select cases when stable internal fixation not achievable

A

Arthroplasty

33
Q

True or False: Knee Dislocations is considered an uncommon injury. However, it is is considered an orthopaedic emergency.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

34
Q

In Knee Dislocations, what nerve is most commonly affected?

A

Fibular/peroneal nerve

35
Q

In Knee Dislocations, what is the most common direction of dislocation?

A

Posterolateral

36
Q

TRUE OR FALSE: In Knee Dislocations, immediate reduction is recommended before radiographic evaluation.

A

True

37
Q

The following are consistent findings in a Knee Dislocation, EXCEPT:

A. Patellar sunrise
B. Medial capsular sign
C. Segond Sign
D. Osteochondral defects
E. None

A

B. Medial capsular sign

38
Q

This is a quick, simple way to check for peripheral artery disease (PAD

A

ankle-brachial index test

39
Q

What is the normal value for the ankle-brachial index?

A

1-1.4

40
Q

An ankle-brachial index test of less than _____ means that there is diminished or absent pedal pulse.

A

0.9

41
Q

TRUE OR FALSE: An MRI is indicated for all knee dislocations.

A

True

42
Q

In Knee Dislocations, how long is the golden period to return vascularization?

A

6 hours

43
Q

What is the most common complication after knee dislocations?

A

Stiffness/ Arthrofibrosis/ Contracture

44
Q

The following is true about the patella, EXCEPT:

A. largest sesamoid bone in the body
B. has an odd facet
C. increases lever arm of the extensor mechanism of knee
D. acts as an anatomic pulley for quadriceps muscle
E. None

A

E. None

45
Q

The anterior surface of the patella is covered by expansion from the tendon of the ___________.

A

Quadriceps

46
Q

The patella increases quadriceps strength by how much?

A

33 – 50%

47
Q

Which articular facet of the patella is the largest?

A

lateral facet

48
Q

TRUE OR FALSE: The patella increase the chemical advantage and leverage of the quadriceps tendon. It protects the femoral condyles from indirect trauma.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

B. Both statements are false

NOTE: it increases mechanical advantage. it protects from direct trauma

49
Q

What is the normal Q-angle?

A

13.5+/- 4.5 degrees

Range: 9-18 degrees

50
Q

The following is true about the Q-angle, EXCEPT:

A. Q angle in women is 4.6 degrees greater than men
B. Ensures that the resultant vector of pull with quadriceps action is laterally directed
C. Can increase in wider hips, anteverted patients, weak lateral aspect of quadriceps
D. An increased Q angle predisposes to patella dislocation
E. None

A

C. Can increase in wider hips, anteverted patients, weak lateral aspect of quadriceps

NOTE: It increases in weak medial aspect of the quads

51
Q

The following is true about Patellar Fractures, EXCEPT:

A. Female > Male
B. Most common age group 20 to 50 years old
C. Unilateral > Bilateral
D. Indirect MOI > Direct MOI
E. None

A

A. Female > Male

52
Q

The following is true about Patellar Dislocation, EXCEPT:

A. Lateral dislocation is most common
B. More common in women
C. Associated with patella alta
D. (+) apprehension test
E. None

A

E. None

53
Q

TRUE OR FALSE: The medial and lateral extensor retinacula are strong longitudinal expansions of the quadriceps and insert directly onto the tibia. If these remain intact in patellar fx, then active extension will be preserved.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

54
Q

(1)______ over the area or (2)_____ injuries are common in patellar fx.

A
  1. abrasions
  2. open
55
Q

How does patellar fx result from an indirect MOI?

A

d/t to forcible quadriceps contraction while the knee is in a semiflexed position

56
Q

The following is true about Tibial Plateau Fracture, EXCEPT:

A. lateral plateau fractures > medial plateau fractures
B. may use CT scan, MRI, or arteriography
C. MOI: rotational forces coupled with axial loading
D. WB is allowed at 8 to 12 weeks
E. None

A

C. MOI: rotational forces coupled with axial loading

NOTE: MOI is d/t varus or valgus forces

57
Q

This is the major weight-bearing bone of the leg.

A

Tibia

58
Q

Which tibial plateau is larger and concave?

A. medial plateau
B. lateral plateau

A

A. medial plateau

59
Q

Which tibial plateau extends higher?

A. medial plateau
B. lateral plateau

A

B. lateral plateau

60
Q

The tibial plateau has a (1)_____ degree posteroinferior slope and is
separated by the (2)______

A
  1. 10
  2. intercondylar eminence
61
Q

This condition occurs d/t calcification along the insertion of the medial collateral ligament.

A

Pellegrini-Stieda lesion

62
Q

This condition is the most common cause of mechanical symptoms in the knee. It occurs when the patient attempts to turn, twist, or change direction when weight-bearing.

What is this condition?

A

Meniscal tears

63
Q

TRUE OR FALSE: Women being 2-8x more likely to sustain an ACL injury than men participating in the same sports. Acute hemarthrosis is a classic sign in ACL tears

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

64
Q

TRUE OR FALSE: Females typically have a smaller ACL than males.

A

True

65
Q

Determine the following condition.

  1. Initially non -inflammatory but develops swelling later on
  2. Softening of the cartilage on the posterior aspect of the patella
  3. Most common in the 12–35-year-old group
  4. Predominance in females
  5. knee popping or giving out as the tibia subluxed anteriorly

A. Tibiofemoral Osteoarthritis
B. Chondromalacia Patella
C. Both
D. Neither

A
  1. A
  2. B
  3. B
  4. B
  5. D
66
Q

Determine the following condition.

  1. Surface degeneration of the patella that is age dependent and most often asymptomatic
  2. Basal degeneration results from trauma and abnormal tracking of the patella and is symptomatic
  3. Causes: Age, weight, type of work, previous history of trauma, muscle weakness
  4. Pain with weight-bearing activities and, at times, pain at rest
  5. Pain is felt on standing after sitting for a long time

A. Tibiofemoral Osteoarthritis
B. Chondromalacia Patella

A
  1. B
  2. B
  3. A
  4. A
  5. B
67
Q

In Chondromalacia Patella, a blister or raised portion of the articular surface is seen

In what grade is this classified as?

A

Grade 1. Closed disease

68
Q

In Chondromalacia Patella, there is a severe exuberant fibrillation or crabmeat appearance

In what grade is this classified as?

A

Grade 3

69
Q

Most common joint to have Osteoarthritis?

A

Knee

70
Q

These result from an overconstrained patella whose motion is severely restricted by surrounding soft tissues

A

Patellar compression syndromes

71
Q

This is performed to reduce the inflammation and mechanical irritation within a given joint

A

arthroscopic lavage and debridement

72
Q

Determine the condition.

  1. Decreased medial patellar glide
  2. Related to direct trauma and subsequent pathologic fibrous hyperplasia in the peripatellar tissues
  3. Weak vastus medialis, strong vastus lateralis
  4. May be d/t prolonged immobilization after surgery
  5. Characterized by a restriction of patellar movement because both the medial and lateral retinaculum are excessively tight

A. Lateral patellar compression syndrome
B. Infrapatellar contracture syndrome (IPCS)

A
  1. A
  2. B
  3. A
  4. B
  5. B
73
Q

Determine which stage is being described in Infrapatellar contracture syndrome (IPCS).

  1. 2-8 wks after trauma to the knee
  2. restriction of passive and active knee ROM
  3. dx may be made by a 10-degree or greater loss of extension, a 25-degree or greater loss of flexion, and significantly reduced patellar mobility as demonstrated by decreased patellar glide
  4. findings include atrophy of the quadriceps femoris, palpable patellofemoral crepitus, diffuse synovitis, and an antalgic or flexed knee gait.
  5. (+) shelf sign

A. Active stage
B. Prodromal stage
C. Residual stage

A
  1. B
  2. A
  3. C
  4. C
  5. A
74
Q

This condition is characterized by pain in the vicinity of the patella that is worsened by sitting and climbing stairs, inclined walking and squatting

A

Patellofemoral pain

75
Q

The following is true about Patellofemoral pain, EXCEPT:

A. more prone to athletes
B. more prone to women who are not athletic
C. male athletes > female athletes
D. tight lateral retinaculum
E. None

A

D. tight lateral retinaculum

76
Q

This is the single most important factor implied in the genesis of patellar instability

A

Femoral trochlear dysplasia

77
Q

Enumerate the 4 classic factors implied in the genesis of patellar instability

A
  1. trochlear dysplasia
  2. patella alta
  3. Increase in Q angle
  4. patellar tilt (excessive patellar tilt with medial ligamentous disruption)

(1) MS: Orthopedic and Rheumatic Conditions 🩺 (13 decks)

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