Knee - Exam Questions Flashcards

Question

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 ## Footnote *Knee - Clinical Anatomy and Biomechanics*

Answer 1

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 ## Footnote * 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.

Answer 2

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) ## Footnote * 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.

Answer 3

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) ## Footnote * 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.

Answer 4

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 ## Footnote * 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.

Answer 5

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) ## Footnote * 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.

Answer 6

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 ## Footnote * 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.

Answer 7

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 ## Footnote * 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.

Answer 8

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 ## Footnote * 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.

Answer 9

What is the function of the [Pes Anserinus](https://www.dptsport.com/Injuries-Conditions/Knee/Knee-Issues/Pes-Anserine-Bursitis-of-the-Knee/a~346/article.html)? * 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 ## Footnote * 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.

Answer 10

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** ## Footnote * 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.

Answer 11

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 ## Footnote * 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.

Answer 12

Which structure is located distal to the Patella? * A - Medial Femoral Condyle * B - Adductor Tubercle * **C - Tibial Tuberosity** * D - Medial and Lateral Meniscus ## Footnote * 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.

Answer 13

Which structure serves as the distal attachment of the Patellar Ligament? * A - Medial Collateral Ligament * B - Fibular Head * **C - Tibial Tuberosity** * D - Pes Anserinus ## Footnote * 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.

Answer 14

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 ## Footnote * 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.

Answer 15

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 ## Footnote * 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.

Answer 16

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 ## Footnote * 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.

Answer 17

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 ## Footnote * 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.

Answer 18

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 ## Footnote * 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.

Answer 19

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 ## Footnote * 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.

Answer 20

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 ## Footnote * 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.

Answer 21

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. ## Footnote **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.

Answer 22

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. ## Footnote * 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.

Answer 23

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 ## Footnote * 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.

Answer 24

What are the [Ottawa Knee Rules](https://www.mdcalc.com/calc/368/ottawa-knee-rule) 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 ## Footnote * 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.

Answer 25

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 ## Footnote * 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.

Answer 26

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 ## Footnote * 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.

Answer 27

What is the normal range of knee flexion during the knee examination? * A - 0 degrees * B - 45 degrees * C - 90 degrees * **D - 135 degrees** ## Footnote * 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.

Answer 28

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 ## Footnote * 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.

Answer 29

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) ## Footnote * 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.

Answer 30

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** ## Footnote * 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.

Answer 31

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 ## Footnote **Rationale**: * The [Ottawa Knee Rules](https://www.mdcalc.com/calc/368/ottawa-knee-rule) 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.

Answer 32

* A) < 18 and > 60 * **B) < 12 and > 50** * C) < 20 and > 55 * D) < 15 and > 45 ## Footnote * 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.

Answer 33

Which of the following criteria is assessed by both the [Ottawa Knee Rules](https://www.physio-pedia.com/Ottawa_Knee_Rules) and the [Pittsburgh Knee Rules](https://www.physio-pedia.com/Pittsburgh_Knee_Rules)? * A - Tenderness at patella * **B - Inability to ambulate 4 steps** * C - Genu varus/valgus alignment * D - Skin appearance ## Footnote * 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.

Answer 34

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** ## Footnote * 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.

Answer 35

During Tibiofemoral Joint Posterior Glide testing, what direction does the clinician apply force to the tibia? * A - Anterior * **B - Posterior** * C - Medial * D - Lateral ## Footnote * 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.

Answer 36

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 ## Footnote * 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.

Answer 37

During Tibiofemoral Joint Anterior Glide testing, what does reproduction of concordant pain suggest? * A - Normal joint mobility * **B - Impaired joint mobility** * C - Adequate muscle strength * D - Neurological involvement ## Footnote * Reproduction of concordant pain during Tibiofemoral Joint Anterior Glide testing suggests impaired joint mobility, potentially indicating dysfunction or abnormalities. * The other options do not accurately describe the significance of concordant pain during this test.

Answer 38

What is the primary purpose of the Valgus Stress Test at 30° Knee Flexion? * **A - To assess ligamentous injuries** * B - To evaluate quadriceps strength * C - To promote medial joint stability * D - To assess joint mobility and end-feel ## Footnote * The primary purpose of the Valgus Stress Test at 30° Knee Flexion is to assess ligamentous injuries, particularly the integrity of the medial collateral ligament (MCL). * The other options represent different purposes or assessments.

Answer 39

During Tibiofemoral Joint Posterior Glide testing, what does impaired joint mobility or end-feel suggest if concordant pain is also reproduced? * A - Normal joint function * **B - Ligamentous laxity** * C - Muscle weakness * D - Neurological involvement ## Footnote * Impaired joint mobility or end-feel, along with reproduction of concordant pain during Tibiofemoral Joint Posterior Glide testing, may suggest ligamentous laxity. * The other options represent different implications of the assessment findings.

Answer 40

What does reproduction of concordant pain during joint play testing suggest? * A - Normal joint mobility * **B - Potential joint dysfunction** * C - Adequate muscle strength * D - Neurological involvement ## Footnote * Reproduction of concordant pain during joint play testing suggests potential joint dysfunction, indicating an abnormality in joint mobility or function. * The other options do not accurately describe the significance of concordant pain during joint play testing.

Answer 41

What does the Varus Stress Test at knee primarily assess? * **A - Lateral joint stability** * B - Medial joint stability * C - Flexion range of motion * D - Muscle strength ## Footnote * The Varus Stress Test at knee primarily assesses lateral joint stability, particularly the integrity of the lateral collateral ligament (LCL). * The other options represent different assessments or structures.

Answer 42

What does a positive McMurray's test indicate? * A) Medial collateral ligament (MCL) disruption * B) Lateral collateral ligament (LCL) disruption * C) **Meniscal tear (Posterior Horn)** * D) Meniscal tear (Anterior Horn) ## Footnote * A positive McMurray's test indicates a meniscal tear, particularly involving the posterior horn. This test involves forced rotation and flexion/extension of the knee, which may cause clicking or popping sensations if a meniscal tear is present. * Options A, B, and D are incorrect because McMurray's test specifically assesses for meniscal tears, not ligamentous disruptions.

Answer 43

What assessment finding suggests a positive Ege's test? * **A) Joint-line pain** * B) Audible thud or click * C) Increased posterior tibial translation * D) Mechanical block at full extension ## Footnote * A positive Ege's test is indicated by pain or a click along the corresponding joint line during the maneuver. * This suggests a meniscal tear, particularly involving the posterior horn. * Options B, C, and D are incorrect because they do not align with the assessment findings characteristic of Ege's test.

Answer 44

Which test is indicative of patellofemoral joint instability? * A) Anterior Drawer Test * B) McMurray's Test * **C) Clarke's Sign** * D) Lachman’s Test ## Footnote * Clarke's Sign is indicative of patellofemoral joint instability. * It involves manually tilting the patella to assess for patellar subluxation or dislocation, which suggests instability of the patellofemoral joint. * Options A, B, and D are incorrect because they are tests for ligamentous integrity or meniscal pathology, not patellofemoral joint instability.

Answer 45

What does a positive Apley's test indicate? * A) Soft-tissue sprain * **B) Meniscal tear (Midsubstance)** * C) Patellofemoral compression * D) Patellar instability ## Footnote * A positive Apley's test indicates a meniscal tear, particularly involving the midsubstance. * This test involves axial loading and rotation of the tibia to provoke pain or clicking, indicating meniscal pathology. * Options A, C, and D are incorrect because they do not align with the assessment findings characteristic of Apley's test.

Answer 46

What assessment finding suggests a positive Steinmann Sign II? * A) Increased anterior tibial excursion * **B) Joint-line pain moving in a posterior direction** * C) Mechanical block at full knee extension * D) Posterior sagging of the tibia ## Footnote * A positive Steinmann Sign II is indicated by joint-line pain that moves in a posterior direction during knee flexion. * This suggests a meniscal tear, particularly involving the anterior horn. * Options A, C, and D are incorrect because they do not align with the assessment findings characteristic of Steinmann Sign II.

Answer 47

What does a positive Reverse Pivot-Shift Test indicate? * A) Meniscal tear (Anterior Horn) * B) Antero-Lateral Rotatory Instability * **C) Postero-Lateral Rotatory Instability** * D) Patellofemoral Instability ## Footnote * A positive Reverse Pivot-Shift Test indicates postero-lateral rotatory instability of the knee. * It is characterized by a jerk-like movement of the lateral tibial plateau during flexion, indicating instability of the posterolateral corner of the knee. * Options A, B, and D are incorrect because they do not align with the assessment findings characteristic of the Reverse Pivot-Shift Test.

Answer 48

Which test is used to assess sciatic nerve involvement? * A) McMurray’s Test * **B) Straight Leg Raise (SLR) Test** * C) Anterior Drawer Test * D) Posterior Drawer Test ## Footnote * The [Straight Leg Raise (SLR) Test](https://app.clinicalpattern.com/ortho/p1264/) is used to assess sciatic nerve involvement. * Positive test results include reproduction of concordant pain, different symptoms on the involved versus non-involved side, and symptoms affected by distant movements such as head movement. * Options A, C, and D are incorrect because they do not assess sciatic nerve involvement.

Answer 49

What assessment finding suggests a positive [Pivot Shift Test](https://app.clinicalpattern.com/ortho/p1094/)? * A) Audible thud or click * B) Mechanical block at full knee extension * **C) Anterior subluxation of the lateral tibial plateau** * D) Posterior sagging of the tibia ## Footnote * A positive Pivot Shift Test is indicated by anterior subluxation of the lateral tibial plateau during flexion, followed by reduction with knee extension. * This indicates anterior instability

Answer 50

Which test is indicative of patellar instability? * A) Anterior Drawer Test * B) McMurray's Test * **C) Clarke's Sign** * D) Lachman’s Test ## Footnote * Clarke's Sign, also known as the Patellar Grind Test, is indicative of patellar instability. * It involves manually tilting the patella to assess for patellar subluxation or dislocation, which suggests instability of the patellofemoral joint. * A positive test is indicated by reproduction of the client’s pain during the maneuver, indicating potential patellar instability. * Options A, B, and D are incorrect because they are tests for ligamentous integrity or meniscal pathology, not specifically for patellar instability.

Answer 51

What assessment finding suggests a positive Posterior Sag Sign (Godfrey’s Test)? * **A) Posterior sagging of the tibia** * B) Increased anterior tibial excursion * C) Joint-line pain moving in a posterior direction during knee flexion * D) Reproduction of client’s concordant pain ## Footnote * A positive Posterior Sag Sign, also known as Godfrey’s Test, is indicated by posterior sagging of the tibia when the client's hip and knee are flexed to 90°. * This sagging is observed due to the lack of PCL restraint, indicating a PCL tear. * Options B, C, and D are incorrect because they do not align with the characteristic assessment finding of Godfrey’s Test, which specifically assesses for PCL integrity.

Answer 52

Which test is primarily used to assess the integrity of the lateral collateral ligament (LCL)? * A) Apley’s Test * B) Pivot Shift Test * C) Lateral Pull Test * **D) Varus Stress Test at knee** ## Footnote * The Varus Stress Test at knee is specifically designed to assess the integrity of the lateral collateral ligament (LCL). * In this test, the clinician applies a varus force by adducting the ankle while stabilizing the thigh. Pain at the lateral joint line or increased excursion between the femur and tibia indicates LCL disruption. * Options A, B, and C are incorrect because they assess different structures or pathologies.

Answer 53

Which test is utilized to assess for a meniscal tear involving the posterior horn? * A) Bounce-home test * B) Ege’s test * **C) Steinmann Sign II** * D) Thessaly Test ## Footnote * Steinmann Sign II is utilized to assess for a meniscal tear involving the anterior horn. * In this test, the clinician flexes the knee and hip while palpating the joint line. Joint-line pain that moves in a posterior direction during knee flexion is considered a positive sign for a meniscal tear, particularly involving the anterior horn. * Options A, B, and D are incorrect because they assess different meniscal pathologies or structures.

Answer 54

Which nerve root is primarily associated with the patellar reflex? * A) L2-L3 * **B) L3-L4** * C) L4-L5 * D) L5-S1 ## Footnote * The patellar reflex is primarily associated with the nerve roots of L3-L4. Stimulating this reflex helps assess the integrity of the spinal cord segments and nerve roots associated with the knee reflex arc. **Incorrect Answers**: * A) L2-L3: This nerve root is not primarily associated with the patellar reflex. * C) L4-L5: While these nerve roots are adjacent to L3-L4, they are not primarily involved in the patellar reflex. * D) L5-S1: These nerve roots are primarily associated with different lower limb reflexes, not the patellar reflex.

Answer 55

During a neurological assessment of the knee, which nerve root is commonly tested for sensation along the medial aspect of the lower leg? * A) L2-L3 * **B) L3-L4** * C) L4-L5 * D) L5-S1 **Rationale**: * Sensation along the medial aspect of the lower leg is primarily innervated by the femoral nerve, which receives contributions from the L3-L4 nerve roots. * [Kenhub Derm/Myotomes](https://www.kenhub.com/en/study/anatomy-pns-dermatomes) ## Footnote **Incorrect Answers**: * A) L2-L3: These nerve roots primarily innervate different regions of the lower limb, not the medial aspect of the lower leg. * C) L4-L5: While adjacent to the L3-L4 nerve roots, they are not primarily involved in sensation along the medial aspect of the lower leg. * D) L5-S1: These nerve roots primarily innervate different areas of the lower limb, not the medial aspect of the lower leg.

Answer 56

Which functional test primarily assesses dynamic stability and control of the knee joint during weight-bearing activities? * **A) Single-leg stance test** * B) Timed Up and Go test * C) Four Square Step Test * D) Six-Minute Walk test ## Footnote * The single-leg stance test evaluates the ability of an individual to maintain balance and stability on one leg, providing insight into the dynamic stability of the knee joint during weight-bearing activities. **Incorrect Answers**: * B) Timed Up and Go test: While it assesses mobility and balance, it does not specifically target knee joint stability during weight-bearing. * C) Four Square Step Test: Primarily assesses dynamic balance and agility but does not specifically target knee joint stability. * D) Six-Minute Walk test: Assesses aerobic capacity and endurance, not knee joint stability.

Answer 57

Which functional test is most appropriate for evaluating the ability to ascend and descend stairs, which places significant demand on the knee joint? * A) Berg Balance Scale * **B) Stair Climb Test** * C) Functional Reach Test * D) 30-Second Chair Stand Test ## Footnote * This test specifically assesses the individual's ability to ascend and descend stairs, which requires significant knee joint function and strength. **Incorrect Answers**: * A) Berg Balance Scale: Assesses balance across various tasks but does not specifically focus on stair climbing. * C) Functional Reach Test: Measures balance during reaching tasks but does not address stair climbing. * D) 30-Second Chair Stand Test: Assesses lower limb strength and endurance but does not specifically evaluate stair climbing ability.

Answer 58

* A) Patellar Tendinopathy * B) Osgood-Schlatter Disease * C) Meniscus Injury * D) **Anterior Cruciate Ligament (ACL) Injury** ## Footnote **Rationale**: * Michael's symptoms of sharp pain, swelling, difficulty bearing weight, and feeling of instability, along with positive Lachman and pivot shift tests, suggest an ACL injury. * These tests indicate ligamentous instability, which is characteristic of an ACL tear. **Incorrect Answers**: * A) Patellar Tendinopathy - Patellar tendinopathy typically presents with localized pain in the patellar tendon, especially with activities involving jumping or squatting. Michael's symptoms and physical examination findings are not consistent with this diagnosis. * B) Osgood-Schlatter Disease - Osgood-Schlatter Disease is characterized by tenderness at the tibial tubercle in adolescents and is typically not associated with acute trauma or instability episodes like those experienced by Michael. * C) Meniscus Injury - While meniscus injuries can cause pain, swelling, and difficulty with weight-bearing, Michael's symptoms and physical examination findings, particularly the feeling of instability, suggest ligamentous rather than meniscal involvement.

Answer 59

* A) Osgood-Schlatter Disease * B) Meniscus Injury * C) Collateral Ligament Injury * **D) Osteoarthritis** ## Footnote Correct Answer: D) Osteoarthritis **Rationale**: * Emma's symptoms of stiffness, crepitus, tenderness along the joint line, and limited range of motion, along with her age, are indicative of osteoarthritis. * Osteoarthritis commonly affects middle-aged individuals and presents with these characteristic symptoms. **Incorrect Answers**: * A) Osgood-Schlatter Disease - Osgood-Schlatter Disease typically affects adolescents during growth spurts and presents with pain at the tibial tubercle. Emma's age and symptoms are not consistent with this diagnosis. * B) Meniscus Injury - While meniscus injuries can cause knee pain and crepitus, Emma's symptoms of stiffness, tenderness along the joint line, and limited range of motion suggest osteoarthritis rather than a meniscus injury. * C) Collateral Ligament Injury - Emma's symptoms and physical examination findings are not indicative of a collateral ligament injury. There are no signs of instability or positive stress tests for ligamentous laxity.

Answer 60

* A) Meniscus Injury * B) Patellar Tendinopathy * **C) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease)** * D) Osteoarthritis ## Footnote **Rationale**: * Sarah's symptoms of sharp pain, difficulty fully extending her leg, tenderness around the tibial tubercle, and discomfort with resisted knee extension are indicative of Osgood-Schlatter Disease. * This condition commonly affects adolescents, especially those engaged in sports requiring repetitive knee extension. **Incorrect Answers**: * A) Meniscus Injury - Sarah's symptoms and physical examination findings are not consistent with a meniscus injury. There are no signs of joint effusion, clicking, or positive meniscal tests. * B) Patellar Tendinopathy - While patellar tendinopathy can cause pain around the patellar tendon, it typically presents with localized pain during activities involving jumping or squatting. Sarah's symptoms are more suggestive of Osgood-Schlatter Disease. * D) Osteoarthritis - Osteoarthritis typically affects older individuals and presents with symptoms such as stiffness, crepitus, and limited range of motion. Sarah's age and presentation are not consistent with osteoarthritis.

Answer 61

* A) Meniscus Tear * B) Osteoarthritis * **C) Posterior Cruciate Ligament (PCL) Injury** * D) Collateral Ligament Injury ## Footnote **Rationale**: * David's symptoms of a sudden twisting motion followed by intense pain, swelling, and increased laxity in his left knee, along with tenderness along the joint line and positive anterior drawer test, are indicative of a PCL injury. * The PCL helps stabilize the knee against posterior translation, and injury to this ligament can result in increased laxity and posterior sag of the tibia. **Incorrect Answers**: * A) Meniscus Tear - While meniscus tears can cause pain, swelling, and difficulty with bending and weight-bearing, David's symptoms and physical examination findings, particularly the increased laxity and positive anterior drawer test, suggest ligamentous rather than meniscal involvement. * B) Osteoarthritis - David's age and presentation are not consistent with osteoarthritis. Osteoarthritis typically affects older individuals and presents with symptoms such as stiffness, crepitus, and limited range of motion. * D) Collateral Ligament Injury - David's symptoms and physical examination findings are not indicative of a collateral ligament injury. There are no signs of instability or positive stress tests for ligamentous laxity.

Answer 62

* A) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease) * B) Patellar Tendinopathy * C) Meniscus Injury * **D) Osteoarthritis** ## Footnote **Rationale**: * Emma's symptoms of stiffness, crepitus, tenderness along the joint line, and limited range of motion, along with her age, are indicative of osteoarthritis. * Osteoarthritis commonly affects middle-aged individuals and presents with these characteristic symptoms.

Answer 63

* A) Meniscus Injury * B) Patellar Tendinopathy * C) Collateral Ligament Injury * **D) Anterior Cruciate Ligament (ACL) Injury** ## Footnote **Rationale**: * Jessica's mechanism of injury, immediate swelling, tenderness along the joint line, and significant instability during the [Lachman test](https://app.clinicalpattern.com/ortho/p1057/) are indicative of an ACL injury. * The lack of pain during the McMurray's test further supports this diagnosis.

Answer 64

* A) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease) * B) Meniscus Injury * C) Posterior Cruciate Ligament (PCL) Injury * **D) Anterior Cruciate Ligament (ACL) Injury** ## Footnote **Rationale**: Ryan's mechanism of injury, popping sensation, swelling, tenderness along the joint line, and significant laxity during the anterior drawer test are indicative of an ACL injury. The absence of pain during the Thessaly's test supports this diagnosis.

Answer 65

* A) Patellar Tendinopathy * B) Meniscus Injury * C) Collateral Ligament Injury * **D) Anterior Cruciate Ligament (ACL) Injury** ## Footnote **Rationale**: Emily's mechanism of injury, immediate swelling, tenderness along the joint line, and significant anterior translation during the Lachman test suggest an ACL injury. The absence of pain during the Apley's compression test further supports this diagnosis.

Answer 66

* A) Tibial Tubercle Apophysitis (Osgood-Schlatter Disease) * B) Meniscus Injury * **C) Anterior Cruciate Ligament (ACL) Injury** * D) Posterior Cruciate Ligament (PCL) Injury ## Footnote **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.

Answer 67

* A) Collateral Ligament Injury * **B) Anterior Cruciate Ligament (ACL) Injury** * C) Meniscus Injury * D) Patellar Tendinopathy ## Footnote **Rationale**: Olivia'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 Thessaly's test supports this diagnosis

Answer 68

* a) Meniscus tear (anterior) * **b) Meniscus tear (mid-substance)** * c) Meniscus tear (posterior) * d) IT band syndrome ## Footnote **Rationale**: The patient's history of a popping sensation, pain, swelling, and positive McMurray test are suggestive of a meniscus tear. * Additional assessments such as MRI or diagnostic ultrasound may be considered to confirm the diagnosis.

Answer 69

* a) Patellofemoral pain syndrome * b) Ligamentous injury * c) Osteoarthritis * **d) Meniscus injury** ## Footnote **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.

Answer 70

* a) Focus solely on strengthening exercises * b) Incorporate flexibility exercises only * **c) Consider biomechanical factors and movement patterns** * d) Ignore somatosensory training ## Footnote **Rationale**: * Rehabilitation for a meniscus injury should consider biomechanical factors and movement patterns to address underlying issues contributing to the injury. * Incorporating neuromuscular control and somatosensory training helps improve proprioception and balance, reducing the risk of re-injury.

Answer 71

* a) Lateral meniscus tear; Thessaly test * b) Medial meniscus tear; Lachman test * c) Lateral meniscus tear; Lachman test * **d) Medial meniscus tear; Thessaly test** ## Footnote **Rationale**: * The patient's symptoms of pain exacerbated by weight-bearing activities and occasional locking or catching sensations suggest a medial meniscus tear. * The Thessaly test, involving internal and external rotation while weight-bearing, is used to assess for this condition.

Answer 72

* a) Immobilization of the knee joint; Avoidance of exercises * b) Gradual increase in weight-bearing activities; Strengthening exercises for quadriceps * **c) Early mobilization and range of motion exercises; Progressive strengthening and neuromuscular training** * d) Aggressive high-impact exercises; Immediate return to sports activities ## Footnote **Rationale**: Post-surgical rehabilitation for a meniscus tear involves early mobilization and range of motion exercises to prevent stiffness. Progressive strengthening and neuromuscular training help restore function and stability to the knee joint over time.

Answer 73

* a) ACL tear; MRI * b) Medial collateral ligament (MCL) sprain; X-ray * c) Lateral meniscus tear; Ultrasound * **d) LCL injury; MRI** ## Footnote **Rationale**: The patient's history of twisting the knee, immediate pain on the outer aspect of the knee, tenderness over the lateral joint line, and increased laxity on varus stress testing suggest an injury to the Lateral Collateral Ligament (LCL). MRI is the preferred imaging modality to confirm the diagnosis and assess the extent of the injury.

Answer 74

* a) Lachman test * b) McMurray test * c) Valgus stress test * **d) Dial test** ## Footnote **Rationale**: The [dial test](https://youtu.be/3UGffd71KyI?si=MX_8rAyWIqS6f7bY) assesses the integrity of the posterolateral corner (PLC) of the knee, which includes the LCL. Since the patient presents with symptoms indicative of an LCL injury, performing a dial test can help evaluate the extent of the injury and assess for associated posterolateral instability.

Answer 75

* a) Grade I * b) Grade II * **c) Grade III** * d) Grade IV ## Footnote **Rationale**: The patient's history of a motor vehicle accident with a forceful impact to the knee, along with ongoing knee instability and increased laxity on examination, suggests a complete tear of the LCL, indicating a Grade III injury. Grade III injuries involve complete ligament tears and significant laxity.

Answer 76

* A) Hip weakness * B) ACL deficiency * **C) Previous ankle sprains** * D) Patellar tendinopathy ## Footnote **Rationale**: The patient's history of multiple ankle sprains can lead to altered biomechanics and increased stress on the knee joint, potentially predisposing him to LCL injury. This aligns with the information provided about how lower extremity instability from ankle sprains can affect knee joint biomechanics and increase the risk of knee ligament injuries.

Answer 77

* A) Rapid deceleration in low flexion angle * **B) Varus force applied to the knee joint** * C) Forced hyperextension of the knee * D) Tibial anterior shear during pivoting ## Footnote **Rationale**: The history of a blow to the outside of the knee suggests a varus force, which is a common mechanism of injury for MCL tears. This force applies stress to the medial side of the knee, leading to MCL injury.

Answer 78

* A) Positive Lachman's test * B) Positive anterior drawer test * **C) Positive valgus stress test** * D) Positive McMurray's test ## Footnote **Rationale**: The valgus stress test is commonly used to assess the integrity of the MCL. A positive test result, indicating increased laxity on the medial side of the knee, is a common clinical finding in patients with MCL injuries.

Answer 79

* A) 5-10 years old * **B) 20-40 years old** * C) 45-60 years old * D) 65-80 years old ## Footnote **Rationale**: MCL injuries often occur in young to middle-aged adults, particularly those engaged in activities involving sudden changes in direction or contact sports.

Answer 80

* A) Immediate surgical repair * **B) Immobilization in full extension** * C) Early return to high-impact activities * D) Application of cold therapy only ## Footnote **Rationale**: Immobilization in full extension helps protect the MCL and promote healing. This conservative approach is commonly recommended for managing MCL injuries.

Answer 81

* A) Quadriceps tendon rupture * B) Patellar dislocation * C) Tibial plateau fracture * **D) Medial meniscus tear** ## Footnote **Rationale**: Untreated or severe MCL injuries can lead to increased stress on other structures in the knee joint, such as the medial meniscus, potentially resulting in a tear.

Answer 82

Which of the following factors is most commonly associated with MCL injuries? * A) Excessive external rotation of the tibia * B) Direct blow to the anterior aspect of the knee * C) Sudden deceleration with the knee in flexion * **D) Varus force applied to the lateral aspect of the knee** **Rationale**: MCL injuries often result from a varus force applied to the lateral aspect of the knee, leading to stress on the medial collateral ligament and potential injury.

Answer 83

During a physical examination of a patient with a suspected MCL injury, which test is specifically used to assess the integrity of the MCL? * A) Anterior drawer test * B) Lachman's test * **C) Valgus stress test** * D) Pivot shift test **Rationale**: The valgus stress test is specifically used to assess the integrity of the MCL by applying a valgus force to the knee joint and observing for medial joint line gapping, indicating MCL laxity.

Answer 84

Which age group is most commonly affected by MCL injuries? * A) Adolescents * **B) Young adults** * C) Middle-aged adults * D) Elderly population **Rationale**: MCL injuries commonly occur in young adults, particularly in individuals engaged in activities involving sudden changes in direction or contact sports.

Answer 85

What is the initial management approach for a patient with an isolated grade I MCL injury? * A) Immediate surgical repair * **B) Immobilization in full extension for 4-6 weeks** * C) Early return to high-impact activities * D) Application of heat therapy only **Rationale**: Immobilization in full extension helps protect the MCL and promote healing for grade I MCL injuries. * Conservative management is typically recommended initially.

Answer 86

Which structure is at risk for injury if an MCL injury is left untreated or inadequately managed? * A) Patellar tendon * B) Anterior cruciate ligament (ACL) * C) Posterior cruciate ligament (PCL) * **D) Medial meniscus** **Rationale**: Untreated or inadequately managed MCL injuries can lead to increased stress on other structures within the knee joint, such as the medial meniscus, potentially resulting in a tear.

Answer 87

A 55-year-old female presents with progressive knee pain, stiffness, and bony enlargement around the joint. She reports pain with closed-chain motions and decreased range of motion with crepitus. Morning stiffness resolves within 30 minutes of activity. Which condition is most likely present? * A) Patellofemoral Pain Syndrome (PFPS) * **B) Rheumatoid Arthritis (RA)** * C) Total Knee Arthroplasty (TKA) * D) Hip Osteoarthritis (OA) **Rationale**: The clinical presentation described aligns with the characteristics of rheumatoid arthritis, including morning stiffness lasting less than 30 minutes, bony enlargement, pain with motion, and decreased range of motion with crepitus.

Answer 88

Which of the following is a risk factor for developing Patellofemoral Pain Syndrome (PFPS)? * A) ACL deficiency or laxity * **B) Hip weakness** * C) Medial compartment osteoarthritis * D) Lateral collateral ligament (LCL) injury **Rationale**: Hip weakness is a predisposing factor for PFPS, contributing to altered biomechanics and increased stress on the patellofemoral joint, leading to pain and dysfunction.

Answer 89

What is the most common cause of disability in individuals with knee osteoarthritis (OA)? * **A) Medial compartment collapse** * B) Hip weakness * C) Knee instability * D) Cartilage disruption **Rationale**: Medial compartment collapse, resulting from excessive load on the medial side of the knee, is a common consequence of knee OA and a significant contributor to disability in affected individuals.

Answer 90

Which intervention has decent evidence for improving quality of life and delaying surgery in patients with knee osteoarthritis? * A) Corticosteroid injections * B) Hyaluronic acid injections * C) Manual therapy for pain modulation * **D) Strengthening programs** **Rationale**: Strengthening programs have substantial support in the literature for improving outcomes and quality of life in patients with knee OA, making them an essential component of management.

Answer 91

What is a characteristic clinical finding in individuals with ankle instability predisposing them to LCL injury? * A) Bony enlargement around the knee * B) Antalgic gait * **C) Excessive internal rotation of the tibia** * D) Varus deformity **Rationale**: Ankle instability can lead to altered lower extremity alignment and function, including excessive internal rotation of the tibia, which predisposes individuals to lateral collateral ligament (LCL) injury in the knee.

Answer 92

Which joint deformity is commonly observed in individuals with knee osteoarthritis? * A) Valgus deformity * **B) Varus deformity** * C) Genu recurvatum * D) Genu varum **Rationale**: Varus deformity, characterized by inward angulation of the distal segment of the knee joint, is commonly observed in individuals with knee osteoarthritis.

Answer 93

What is the initial step in the pathogenesis of osteoarthritis (OA) in the knee? * **A) Alteration of load** * B) Progression of cartilage disruption * C) Upregulation of catabolic factors * D) Medial compartment collapse **Rationale**: The pathogenesis of knee OA begins with alterations in load, leading to cartilage disruption and subsequent joint degeneration.

Answer 94

Which factor is speculated to contribute significantly to the initiation of osteoarthritis (OA) in the knee? * **A) ACL deficiency** * B) Hip weakness * C) Cartilage disruption * D) Excessive weight-bearing **Rationale**: ACL deficiency can lead to altered lower extremity mechanics, including increased tibiofemoral rotation, predisposing individuals to knee OA.

Answer 95

What percentage of individuals over 60 years old have symptomatic knee osteoarthritis? * A) 5-7% * **B) 10-13%** * C) 15-18% * D) 20-23% **Rationale**: Approximately 10-13% of individuals over the age of 60 experience symptomatic knee osteoarthritis.

Answer 96

Which of the following medications is most appropriate for a patient with neuropathic pain? * A) Ibuprofen * B) Flexeril * ***C) Neurontin*** * D) Morphine **Rationale**: * [Neurontin](https://www.webmd.com/drugs/2/drug-9845-8217/neurontin-oral/gabapentin-oral/details), also known as ***gabapentin***, is an anticonvulsant medication commonly used for neuropathic pain conditions. * It is effective in managing nerve-based pain, hyperalgesia, and allodynia, making it the most appropriate choice for patients with neuropathic conditions.

Answer 97

Which minimally invasive intervention is commonly recommended for patients with osteoarthritis but has poor research support? * A) Corticosteroid Injection * **B) Hyaluronic Acid Injection** * C) Prolotherapy * D) Platelet Rich Plasma (PRP) **Rationale**: Hyaluronic Acid Injection, although commonly used for osteoarthritis, has poor research support according to the provided information. Despite anecdotal success, many orthopedic groups have withdrawn it from their list of recommended treatments due to the lack of strong evidence supporting its efficacy.

Answer 98

What is the primary benefit of Platelet Rich Plasma (PRP) injections for knee injuries? * A) Reduction of inflammation * **B) Stimulation of tissue healing** * C) Lubrication of joint surfaces * D) Pain reduction **Rationale**: Platelet Rich Plasma (PRP) injections contain high concentrations of autologous platelets, which stimulate tissue healing. They are most beneficial for individuals with mild to moderate connective tissue injuries, as they promote angiogenesis, cellular proliferation, and tissue regeneration.

Answer 99

Which surgical intervention involves the removal and debridement of the injured area of the meniscus? * A) Meniscus Repair * **B) Meniscectomy** * C) Microfracture * D) ACL Reconstruction **Rationale**: Meniscectomy is the surgical procedure involving the removal and debridement of the injured area of the meniscus. * It is indicated for patients with meniscus lesions that have not responded to conservative care and are in areas with inadequate vascularity.

Answer 100

In which situation is Total Knee Replacement typically recommended? * A) Patellar Tendinopathy * B) Partial ACL Tear * **C) Moderate to severe osteoarthritis** * D) Focal chondral defects **Rationale**: Total Knee Replacement is indicated for patients with moderate to severe osteoarthritis who have not responded to conservative treatments. * It involves the surgical removal of the distal femur and proximal tibia, providing pain relief and improved function in affected individuals.

Answer 101

Which medication is commonly used to manage pain and inflammation in patients with knee osteoarthritis? * A) Baclofen * B) Hydrocodone * **C) Celebrex** * D) Cymbalta **Rationale**: Celebrex, a selective Cox-2 inhibitor, is commonly used for pain and inflammation management in patients with knee osteoarthritis. * Unlike traditional NSAIDs, Cox-2 inhibitors like Celebrex are associated with fewer digestive issues, making them preferable for long-term use.

Answer 102

What is the primary mechanism of action of stem cell injections for knee injuries? * A) Reduction of inflammation * **B) Promotion of tissue healing** * C) Lubrication of joint surfaces * D) Modulation of pain perception **Rationale**: Stem cell injections promote tissue healing by reducing apoptosis, modulating inflammation, and increasing angiogenesis and cellular proliferation. * They are beneficial for individuals with moderate to severe connective tissue injuries, aiding in the regeneration of damaged tissues.

Answer 103

Which minimally invasive intervention involves injecting hypertonic dextrose into poorly healing areas of the body? * A) Corticosteroid Injection * B) Hyaluronic Acid Injection * **C) Prolotherapy** * D) Platelet Rich Plasma (PRP) Injection **Rationale**: Prolotherapy involves injecting hypertonic dextrose into poorly healing areas of the body to reactivate the inflammatory response and promote tissue healing. * It is beneficial for individuals with recurrent dysfunction and conditions like osteoarthritis.

Answer 104

What is the primary benefit of corticosteroid injections for knee injuries? * A) Stimulation of tissue healing * **B) Reduction of inflammation** * C) Pain reduction * D) Lubrication of joint surfaces **Rationale**: Corticosteroid injections reduce inflammation by delivering corticosteroids directly to areas of suspected inflammation, providing pain relief and improving function. * They are indicated for individuals with inflammatory conditions like patellar tendinopathy and osteoarthritis.

Answer 105

Which surgical intervention is indicated for patients with a tear of their ACL? * A) Meniscus Repair * B) Meniscectomy * C) Microfracture * **D) ACL Reconstruction** **Rationale**: ACL Reconstruction involves the surgical removal of the injured ACL and replacement with a graft harvested from various sources. * It is indicated for patients who have experienced a tear of their ACL, restoring stability and function to the knee joint.

Answer 106

Which minimally invasive intervention is typically accompanied by Platelet Rich Plasma (PRP) injections? * A) Corticosteroid Injection * B) Hyaluronic Acid Injection * C) Prolotherapy * D) Stem Cell Injection **Rationale**: Stem Cell Injection is often accompanied by Platelet Rich Plasma (PRP) injections. * This combination therapy aims to enhance tissue healing and regeneration in patients with moderate to severe connective tissue injuries.

Answer 107

Which joint is most commonly affected by osteoarthritis (OA)? * A) Hip * B) Elbow * **C) Knee** * D) Shoulder **Rationale**: Knee osteoarthritis is the most commonly affected joint, with around 10-13% of people over 60 years old experiencing symptomatic knee OA.

Answer 108

What is the primary risk factor associated with patellofemoral pain syndrome (PFPS)? * **A) Hip weakness** * B) Medial compartment collapse * C) ACL deficiency * D) Varus deformity **Rationale**: Hip weakness can lead to altered biomechanics and increased stress on the patellofemoral joint, contributing to the development of PFPS.

Answer 109

Which of the following interventions is supported by literature as effective for managing ankle instability predisposing to lateral collateral ligament (LCL) injury? * A) Corticosteroid injections * **B) Ankle bracing** * C) Hip strengthening exercises * D) Topical pain relievers **Rationale**: Ankle bracing can provide stability to the ankle joint, reducing the risk of excessive lower extremity rotation and subsequent LCL injury.

Answer 110

Which activity is most commonly associated with the development of patellar tendinopathy? * A) Cycling * B) Swimming * **C) Running** * D) Yoga **Rationale**: According to the information provided, patellar tendinopathy is often seen in activities involving repetitive jumping and landing, such as running.

Answer 111

What physical examination finding is typically present in individuals with patellar tendinopathy? * A) Medial joint line tenderness * B) Pain with passive knee flexion * **C) Tenderness at the inferior pole of the patella** * D) Positive McMurray's test **Rationale**: The PowerPoint mentioned tenderness at the inferior pole of the patella as a typical physical examination finding in individuals with patellar tendinopathy.

Answer 112

What intervention has shown supportive evidence for the treatment of patellar tendinopathy? * A) Corticosteroid injection * B) Topical pain relievers * **C) Strengthening programs** * D) Soft tissue mobilization **Rationale**: The PowerPoint highlighted strengthening programs as having strong support in the literature for the treatment of patellar tendinopathy.

Answer 113

What is the most common symptom reported by individuals with patellofemoral pain syndrome? * A) Anterior knee pain * B) Medial knee pain * C) Posterior knee pain * D) Lateral knee pain **Rationale**: The PowerPoint mentioned that individuals with patellofemoral pain syndrome typically present with anterior knee pain.

Answer 114

Which of the following factors is NOT commonly associated with the development of patellofemoral pain syndrome? * A) Quadriceps weakness * **B) Tight hamstrings** * C) Excessive pronation * D) Tight iliotibial band (ITB) ## Footnote **Rationale**: * While quadriceps weakness, excessive pronation, and tight ITB are mentioned as contributing factors in the PowerPoint, tight hamstrings are not specifically mentioned in the context of patellofemoral pain syndrome.

Answer 115

Which intervention has shown to be beneficial in managing patellofemoral pain syndrome? * A) Passive knee flexion * B) Rest and immobilization * **C) Strengthening exercises for hip abductors and external rotators** * D) Prolonged sitting **Rationale**: According to the PowerPoint, strengthening exercises for hip abductors and external rotators are recommended interventions for managing patellofemoral pain syndrome.

Answer 116

Which population is most commonly affected by quadriceps tendon rupture? * A) Adolescents * B) Middle-aged adults * **C) Elderly individuals** * D) Professional athletes **Rationale**: Quadriceps tendon rupture is most commonly seen in elderly individuals, often associated with degenerative changes and weakening of the tendon.

Answer 117

What is a common mechanism of injury for quadriceps tendon rupture? * A) Direct blow to the knee * **B) Forced knee flexion with foot planted** * C) Hyperextension of the knee * D) Eccentric contraction of the quadriceps **Rationale**: The PowerPoint may indicate that forced knee flexion with the foot planted is a common mechanism of injury for quadriceps tendon rupture.

Answer 118

Which sign may be observed during physical examination in a patient with quadriceps tendon rupture? * A) Lachman test positivity * B) Anterior drawer sign * C) Patellar tap test * **D) Palpable defect above the patella** **Rationale**: A palpable defect above the patella is a characteristic finding during physical examination in individuals with quadriceps tendon rupture.

Answer 119

What is a characteristic symptom reported by individuals with [plica syndrome](https://www.physio-pedia.com/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.

Answer 120

Which structure becomes irritated and inflamed in plica syndrome? * A) Quadriceps tendon * B) Medial collateral ligament (MCL) * **C) Synovial plica** * D) Popliteus tendon **Rationale**: Plica syndrome involves irritation and inflammation of the synovial plica within the knee joint.

Answer 121

What intervention is typically recommended for managing plica syndrome? * A) Corticosteroid injections * **B) Surgical resection of the plica** * C) Rest and immobilization * D) Strengthening exercises for the quadriceps **Rationale**: Surgical resection of the symptomatic [plica](https://www.knee-pain-explained.com/plica-syndrome.html) is often recommended for managing plica syndrome when conservative measures fail.

Answer 122

Which of the following treatment modalities is most appropriate for managing acute prepatellar bursitis? * A) Corticosteroid injection into the bursa * B) Surgical excision of the bursa * **C) Activity modification and rest** * D) Eccentric strengthening exercises for the quadriceps ## Footnote **Rationale**: Acute prepatellar bursitis typically responds well to conservative management, including activity modification, rest, and the application of ice packs to reduce inflammation. Corticosteroid injections may be considered for refractory cases, while surgical excision is reserved for chronic or recurrent bursitis unresponsive to conservative measures.

Answer 123

Which of the following physical examination findings is most characteristic of PFPS? * A) Positive McMurray test * B) Apprehension during the patellar apprehension test * C) Pain with resisted knee extension * **D) Pain with prolonged sitting and knee flexion** ## Footnote **Rationale**: Patients with PFPS often report anterior knee pain exacerbated by activities that load the patellofemoral joint, such as prolonged sitting with the knee flexed or activities involving repetitive knee bending and straightening. Positive McMurray and patellar apprehension tests are more indicative of meniscal and patellar instability, respectively, while pain with resisted knee extension suggests quadriceps tendon or patellar tendon pathology.

Answer 124

Which of the following radiographic features is consistent with advanced knee osteoarthritis? * A) Presence of joint effusion * B) Osteophyte formation at the patellofemoral joint * **C) Joint space narrowing with subchondral sclerosis** * D) Focal cartilage defects at the medial femoral condyle ## Footnote **Rationale**: * Advanced knee osteoarthritis is characterized by joint space narrowing due to cartilage loss, accompanied by subchondral sclerosis and osteophyte formation. * Joint effusion may be present in both early and advanced stages of OA but is not specific to advanced disease. * Focal cartilage defects are more commonly observed in early OA or traumatic injuries.

Answer 125

A runner presents with lateral knee pain aggravated by running downhill and prolonged sitting. Physical examination reveals tenderness over the lateral femoral condyle and positive Ober's test. Which of the following interventions is most appropriate for managing ITBS in this patient? * A) Eccentric strengthening of the quadriceps * B) Iontophoresis with dexamethasone * **C) Stretching of the ITB and iliotibial tract** * D) Patellar taping ## Footnote **Rationale**: ITBS is characterized by lateral knee pain due to friction between the ITB and the lateral femoral condyle during repetitive knee flexion and extension. Stretching of the ITB and iliotibial tract can help reduce tension and alleviate symptoms. * Eccentric strengthening exercises may be beneficial for addressing biomechanical factors contributing to ITBS, but stretching is the primary intervention. * Iontophoresis with dexamethasone and patellar taping are not commonly used for ITBS management.

Answer 126

Which of the following factors is most strongly associated with the development of ITBS? * **A) Weakness of the hip abductor muscles** * B) Excessive ankle dorsiflexion * C) Tightness of the quadriceps muscles * D) Tibial torsion ## Footnote **Rationale**: Weakness of the hip abductor muscles, particularly the gluteus medius, is a primary risk factor for ITBS. * Impaired control of hip abduction → increased pelvic drop and excessive adduction of the femur during weight-bearing activities, predisposing individuals to ITB friction syndrome. * While excessive ankle dorsiflexion, quadriceps tightness, and tibial torsion may contribute to lower extremity biomechanical abnormalities, they are not as strongly associated with ITBS as hip muscle weakness.

Knee - Exam Questions Flashcards

(150 cards)