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
forces that are transmitted throught a joint's artiuclar surfaces is called:
joint rxn force
list and describe the 3 facets of the patella:
medial
superior, middle and inferior articular surfaces
lateral
superior, middle, and inferior articular surfaces
odd
lies medial to the medial facet
no articular subdivisions
describe the lateral and medial retinaculums:
lateral retinaculum
originates as an expansion off the vastus lateralis tendon and the iliotibial band to insert on the patella's lateral border
medial retinaculum
originates from the distal portion of the vastus medialis and adductor magnus and inserts on the medial boarder of the patella
a primary restraint against lateral patellar displacement, especially in the lateral inferior direction is the:
medial patellofemoral ligament (MPFL)
the patella's position through an arc of motion is maintained by:
patellar retinaculum
patellofemoral ligaments
a high-riding patella is called:
patella alta
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
the primary muscle for pulling the patella laterally is the:
vastus lateralis
supported by the slips of the IT band
which muscle guides the patella medially and proximally, preventing lateral patellar subluxation:
oblique fibers of the vastus medialis (VMO)
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
overlying the anterior portion of the patella and allows the patella to move freely beneat the skin is the:
prepatellar bursa
the distal portion of the patellar tendon and tibial tuberosity receives protection againse friction and blows by the:
subcutaneous infrapatellar bursa
located between the tendon and the tibia is the:
deep infrapatellar bursa
one of the 3 fat pads located in the anterior knee compartment, is intracapuslar, but extrasynovial is the:
infrapatellar fat pad
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
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
a high riding patellae is called:
the potential causes are:
consequences:
patella alta ( the camel sign positioned may be present)
potential causes
congenitally long patellar tendon
consequences
increased patellar mobility
decreased quad strength
increased patellofemoral compressive forces when knee is flexed
a low riding patella is called:
the potential causes are:
consequences:
patella baja
potential causes
congenitally short patellar tendon
arthrofibrosis after surgery or injury
consequences
decreased patellar glide
decreased tibofemoral ROM
decreased quad strength
increased compressive patellofemoral forces when knee is flexed
a patella positioned medially is called:
potential causes:
consequences:
squinting patella (when standing it looks like they are pointing in)
potential causes
internal tibial rotation
arthofibrosis after surgery or injury
consequences
increased Q angle
tight medial retinaculum
maltracking of the patella
altered patellofemoral compressive forces
compensations include external tibial torsion (egg beater running)
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 causes
femoral retroversion
external tibial rotation
consequences
increased lateral patellar glide
tight lateral retinaculum
pateallar maltracking
decreased quad strength
increased patellofemoral compressive forces
when knee is flexed
the high riding patella exposes the fat pad, forming a "double hump" called:
camel sign
the relationship between the anterior superior iliac spine, midpoint of the patella, and the tibia tuberosity is called:
Q angle
the relationship between the long axis of the patella and the tibial tuberosity is called the:
A angle
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
as the knee moves from flexion into extension in AROM, the patella normally glides superiorly and tracks somewhat laterally creating the:
J sign
during flexion, the patella glides inferiorly and medially as it situates itself in the femoral trochlea creating the:
reverse J sign
which muscles frequently implicate patellofemoral pathologies during a MMT:
hip abductors
hip external rotators ( glute med)
which of the following patella malalignments results in decreased patellar glide and decreased tibiofemoral ROM?
C. patella baja
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 injuires
fxs
tendon ruptures
patellofemoral pain with malalignment
patellar maltracking
patellofemoral instability
patellar dislocations
subluxations
patellofemoral pain without malalignment
tendinopathy
bursitis
plica syndrome
how should patellar alignment be inspected:
once with the quadriceps relaxed and again wiht the quadriceps contracted
is patellar maltracking observed during closed chain activities or open chain motions?
open chain motions
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
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
how much medial and lateral glide constitue excessive motion of the patella?
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
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
which of the retinaculums would most likely be damaged with a dislocated patella?
