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the largest sesamoid bone in the body is:
the patella
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list 3 benefits of the anatomical design of the patella:
- increased mechanical efficiency of the quadriceps muscle group
- protection of the anterior portion of the knee joint
- the absorption and transmission of the joint rxn forces
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forces that are transmitted throught a joint's artiuclar surfaces is called:
joint rxn force
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list and describe the 3 facets of the patella:
- medialsuperior, middle and inferior articular surfaces
- lateralsuperior, middle, and inferior articular surfaces
- odd
- lies medial to the medial facet
- no articular subdivisions
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describe the lateral and medial retinaculums:
- lateral retinaculumoriginates as an expansion off the vastus lateralis tendon and the iliotibial band to insert on the patella's lateral border
- medial retinaculumoriginates from the distal portion of the vastus medialis and adductor magnus and inserts on the medial boarder of the patella
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a primary restraint against lateral patellar displacement, especially in the lateral inferior direction is the:
medial patellofemoral ligament (MPFL)
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the patella's position through an arc of motion is maintained by:
- patellar retinaculum
- patellofemoral ligaments
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a high-riding patella is called:
patella alta
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where is the position of the patella during the following:
flexion:
extension:
- flexion: the patella is pulled inferiorly by the patellar tendon's attachment to the tibial tuberosity
- extension: the quadriceps femoris and its tendon pull the patella superiorly
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the primary muscle for pulling the patella laterally is the:
vastus lateralis
supported by the slips of the IT band
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which muscle guides the patella medially and proximally, preventing lateral patellar subluxation:
oblique fibers of the vastus medialis (VMO)
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lying deep at the distal end of the quadriceps femoris muscle group and allowing free movement over the distal femur is the:
suprapatellar bursa
an extension of the knee joint's capusle
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overlying the anterior portion of the patella and allows the patella to move freely beneat the skin is the:
prepatellar bursa
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the distal portion of the patellar tendon and tibial tuberosity receives protection againse friction and blows by the:
subcutaneous infrapatellar bursa
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located between the tendon and the tibia is the:
deep infrapatellar bursa
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one of the 3 fat pads located in the anterior knee compartment, is intracapuslar, but extrasynovial is the:
infrapatellar fat pad
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during a fxnal assessment ask the patient to replicate the fxnal tasks that exacerbate the symptoms and observe for compensations in:
- lack of hip control
- strategies to minimize pain
most often complain of pain in the midrange of motion with eccentric loading
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with the knee fully extended and the patient weight bearing, observe the patella for alignment.... describe the proper position:
- patella approximately at the center of the femur
- inferior pole located at the upper margin of the femoral trochlea
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a high riding patellae is called:
the potential causes are:
consequences:
patella alta ( the camel sign positioned may be present)
- potential causescongenitally long patellar tendon
- consequencesincreased patellar mobility
- decreased quad strength
- increased patellofemoral compressive forces when knee is flexed
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a low riding patella is called:
the potential causes are:
consequences:
patella baja
- potential causescongenitally short patellar tendon
- arthrofibrosis after surgery or injury
- consequencesdecreased patellar glide
- decreased tibofemoral ROM
- decreased quad strength
- increased compressive patellofemoral forces when knee is flexed
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a patella positioned medially is called:
potential causes:
consequences:
- squinting patella (when standing it looks like they are pointing in)
- potential causesinternal tibial rotation
- arthofibrosis after surgery or injury
- consequencesincreased Q angle
- tight medial retinaculum
- maltracking of the patella
- altered patellofemoral compressive forces
- compensations include external tibial torsion (egg beater running)
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a patella that is positioned high and as positioned laterally is called:
the potential causes:
consequences:
- "frog eyed" patella looks like it is pointing out
- potential causesfemoral retroversion
- external tibial rotation
- consequencesincreased lateral patellar glide
- tight lateral retinaculum
- pateallar maltracking
- decreased quad strength
- increased patellofemoral compressive forces
- when knee is flexed
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the high riding patella exposes the fat pad, forming a "double hump" called:
camel sign
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the relationship between the anterior superior iliac spine, midpoint of the patella, and the tibia tuberosity is called:
Q angle
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the relationship between the long axis of the patella and the tibial tuberosity is called the:
A angle
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with the patient short sitting, the relationship between the tibial tuberosity and the inferior patellar pole is called:
tubercle sulcus angle
if the tuberosity is more than 10 degrees lateral to the inferior pole, pt is predisoposed to lateral patellar tracking
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as the knee moves from flexion into extension in AROM, the patella normally glides superiorly and tracks somewhat laterally creating the:
J sign
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during flexion, the patella glides inferiorly and medially as it situates itself in the femoral trochlea creating the:
reverse J sign
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which muscles frequently implicate patellofemoral pathologies during a MMT:
- hip abductors
- hip external rotators ( glute med)
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which of the following patella malalignments results in decreased patellar glide and decreased tibiofemoral ROM?
A. patella baja
B. "frog eyed" patella
C. patella alta
D. squinting patella
A. patella baja (this multiple choice question has been scrambled)
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this chapter organized patellofemoral injuries based on their onset and stability of the patella within the femoral groove... which injuries fall into the followin categories:
traumatic injuries:
patellofemoral pain with malalignment:
patellofemoral instability:
patellofemoral pain without malalignment:
- traumatic injuiresfxs
- tendon ruptures
- patellofemoral pain with malalignmentpatellar maltracking
- patellofemoral instabilitypatellar dislocations
- subluxations
- patellofemoral pain without malalignmenttendinopathy
- bursitis
- plica syndrome
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how should patellar alignment be inspected:
once with the quadriceps relaxed and again wiht the quadriceps contracted
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is patellar maltracking observed during closed chain activities or open chain motions?
open chain motions
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following knee surgery, such as ACL reconstruction, which 2 things should be emphasized in recovery to keep from changing the normal patellofemoral kinematics:
- preventing scar tissue
- muscle imbalances
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what position should the knee be in to palpate the medial joint line:
what is the big indentation on the joint line called:
- knee flexed to at least 45 degrees
- what is the big indentation on the joint line called: meniscal window
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how much medial and lateral glide constitue excessive motion of the patella?
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the softening and subsequent erosion the the patella's hyaline cartilage is called:
chondromalacia patella
presents as grinding beneath the patella and may cause swelling and pain
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in the patellas resting position within the femoral trochlea, does the medial or lateral border of the trochlea extend further anteriorly?
what is the anatomical signifiance of this orientation?
lateral boarder
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which of the retinaculums would most likely be damaged with a dislocated patella?
medial patellar retinaculum
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