Unit 3 Clinical Aspects

Question 1

What is chondromalacia?

Answer 1

Dull pain around the knee that gets worse with exercise or when going from a flexed to extended position at the knee joint

(like walking up and down stairs or standing from a sitting position)

Question 2

What is patella emarginata?

Answer 2

A patella where the superior lateral portion of the bone is unossified

Question 3

What is Bipartite/Tripartite Patella?

Answer 3

A patella where the superior lateral portion ossifies by itself. It occurs in about 3% of the population

Question 4

What is iliotibial band syndrome?

Answer 4

Stinging pain on the lateral aspect of the knee where the distal end of the IT band repeatedly rubs on the lateral epicondyle of the femur

Question 5

Weakness of the Psoas Major/iliacus will cause what?

Answer 5

Disability from climbing stairs, walking up hills, or getting up from a reclining position

Question 6

Disease or inflammation of the kidneys, parts of the lower intestine, pancreas, and/or appendix may cause pain referred pain in what muscle?

Answer 6

Psoas Major/Iliacus

Question 7

A patient with difficulty extending their leg against resistance, or if they have abnormal patellar movements, may have what?

Answer 7

Atrophy of the quadriceps

Question 8

What term is used to indicate a cramping or spasm of the quadriceps?

Answer 8

Charley Horse

(it’s also used to indicate trauma to the muscles, which can cause a tearing of a muscle fiber and lead to a painful hematoma and bruising)

Question 9

What term is used to indicate a painful overuse injury of the common tendon of insertion of the quadriceps and/or the patellar ligament?

Answer 9

Jumper’s Knee

Question 10

A patient who complains of pain and soreness in the area of the common tendon of insertion of the quadriceps or the patellar ligament, and who’s pain is intensified with activity, may have what?

Answer 10

Jumper’s Knee

Question 11

What is another term for Jumper’s Knee?

Answer 11

Patellar Tendonitits

Question 12

The patellar reflex tests for the segmental innervation of what spinal nerves?

Answer 12

L2, L3, L4

Question 13

Which bursae separates the superior part of the muscle (gluteus maximus) from the greater trochanter?

Answer 13

Trochanteric Bursae

Question 14

Which bursae separates the inferior part of the muscle (gluteus maximus) from the ischial tuberosity?

Answer 14

Ischial Bursae

Question 15

What do we call a common painful contusion injury of the soft tissue associated with the iliac crest?

Answer 15

Hip Pointers

(very common in contact sports and usually result in painful hematomas)

Question 16

What is a normal angle of inclination at birth? What about an adult?

Answer 16

Birth: 145 degrees
Adult: 125 Degrees

Question 17

An increase in the angle of inclination is what?

Answer 17

Coxa Valga

• Occurs with developmental hip dysplasia and congenital dislocation

Question 18

An decrease in the angle of inclination is what?

Answer 18

Coxa Vara

• Occurs in a fracture to the proximal part of the femur and can cause rickets

Question 19

Degeneration to the femoral head due to a lack of blood supply caused by a fracture is known as what?

Answer 19

Avascular Necrosis

Question 20

What causes an indirect trauma fracture to the patella?

Answer 20

Sudden contraction of the quadriceps muscle, causing a transverse fracture to the patella

Question 21

What are the different types of grades of a pulled groin?

Answer 21

Grade 1 - Micro tear of fibers
Grade 2 - Partial tear
Grade 3 - Complete tear

Question 22

What is the term used to denounce an adductor muscle that stretches past its origin and beyond its tensile strength?

Answer 22

Pulled Groin

Question 23

Weakness of this muscle causes patients to have difficulty getting from a sitting to a standing position, straightening from bending on a hill, and/or walking uphill or up stairs.

Answer 23

Weakness of the Gluteus Maximus

Question 24

During an orthopedic exam on your patient you discover a positive Trendelenburg Sign, which nerve is not functioning properly?

Answer 24

Superior Gluteal Nerve of the gluteus medius and minimus muscles.

Question 25

A patient shows a positive Trendelenburg Sign while lifting their left foot. Which muscles are atrophied, and what side of the body are they on?

Answer 25

Gluteus Medius & Minimus on the right side of the body.

Question 26

Weakness of the right gluteus medius and minimus will give rise to a "C" curve on which side of the body?

Answer 26

Left "C" curve, with the opening of the C opening to the right side of the body where the muscles are weak.

Question 27

An athlete who runs very hard with quick starts are at a greater disposition for developing what?

Answer 27

A pulled hamstring

Question 28

What 4 factors contribute to a pulled hamstring?

Answer 28

1. Running Style 2. Over developed quadriceps 3. Biomechanical factors 4. Inadequate warm ups and stretches

Question 29

Forcible flexion of the hip when the knee is extended may result in what?

Answer 29

Avulsion of the Ischial Tuberosity

Question 30

The body may compensate for weak or tight hamstrings by changing the position of what bone?

Answer 30

The pelvic bone

Question 31

Meralgia Paresthesia is compression neuropathy of what nerve?

Answer 31

The lateral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament

Question 32

A patient comes into your office complaining of a burning and tingling sensation along the lateral aspect of the thigh. What condition might they have?

Answer 32

Meralgia Paresthesia

Question 33

What are some common causes of Meralgia Paresthesia?

Answer 33

- Obesity - Tight fit clothing - Any activity which puts the femur in a flexed position for a long period of time

Question 34

What happens when the motor supply of the femoral nerve is damaged?

Answer 34

- Quadriceps are involved and the leg cannot be extended - Flexion at the hip joint is diminished

Question 35

What areas are affected when the sensory supply of the femoral nerve is damaged?

Answer 35

- Medial and intermediate anterior aspect of the thigh - Medial aspect of the leg and foot

Question 36

What nerve can be damaged during a difficult birth or by an anterior dislocation of the hip joint?

Answer 36

Obturator Nerve

Question 37

Adduction of the femur tests for which nerve?

Answer 37

Obturator Nerve

Question 38

Which nerve can be damaged by fracturing the pelvis, a posterior dislocation of the hip joint, or a penetrating wound like an injection in the wrong spot?

Answer 38

Sciatic Nerve

Question 39

What nerve is injured causing foot drop?

Answer 39

Motor part of the sciatic nerve

Question 40

When the motor supply of the sciatic nerve is damaged, the foot falls into plantar flexion (foot drop) due to what?

Answer 40

Gravity

Question 41

If the motor part of the sciatic nerve is damaged, hamstring muscles will be atrophied, but weak flexion of the leg is still possible due to which muscles?

Answer 41

Gracilis and Sartorius

Question 42

Damage to what nerve can cause loss of sensation below the knee except for an area along the medial aspect of the leg and foot?

Answer 42

Sensory part of the sciatic nerve