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Knee review Questions. In the middle of a collegiate rugby tournament a player gets tackled just as he is kicking the ball. He has all of his weight planted.

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Presentation on theme: "Knee review Questions. In the middle of a collegiate rugby tournament a player gets tackled just as he is kicking the ball. He has all of his weight planted."— Presentation transcript:

1 Knee review Questions

2 In the middle of a collegiate rugby tournament a player gets tackled just as he is kicking the ball. He has all of his weight planted on his left leg when another player clips him on one side of his knee. He falls to the ground and clutches his knee in pain. When the team physician examines the knee he is able to elicit abnormal side to side movement of the femur on the tibia and abnormal forward motion of the tibia on the femur (anterior drawer sign).

3 The forward motion is caused by damage to which of the following ligaments: A) Oblique popliteal ligament B) Patellar ligament C) Anterior cruciate ligament D) Posterior cruciate ligament

4 When diagnosing damage to the knee joint, it is important to look at the three structures most often damaged. These three structures, otherwise known as the "unhappy triad" include the: A) Medial meniscus, anterior cruciate ligamnet, tibial collateral ligament B) Lateral meniscus, posterior cruciate ligament, fibular collateral ligament C) Lateral meniscus, oblique popliteal ligament, fibular collateral ligament D) Oblique popliteal ligament, patellar ligament, anterior cruciate ligament

5 The knee joint is a hinge-joint involving the articulation of the femur, tibia, and patella. Since the femur and the tibia join at an angle, the joint is mechanically weak. However, many ligaments and tendons help strengthen and stabilize it.

6 The tendons that strengthen and stabilize the knee joint on the lateral side consist of all of the following except: A) Biceps femoris B) Gastrocnemius C) Iliotibial tract D) Soleus

7 The tendons supporting the medial side of the knee joint include the three which form the pes anserinus. Which one of the following four tendons is not part of the pes anserinus: A) Semitendinosus B) Sartorius C) Gracilis D) Semimembranosus

8 A fourth year medical student did an elective working with the camp pediatrician at a rural camp in northern Maine. One day when a young boy came down with a high fever the pediatrican gave the child an intramuscular injection. In his haste the physician plunged the needle into the medial aspect of the boy's right gluteus maximus.

9 A few hours later the medical student observed the boy walking to his cabin. He noticed that in addition to appearing lethargic, the boy was walking in a strange manner. He seemed to be lifting his right foot unusually high and letting it hang down while he walked. After examining the boy the medical student realized that the boy's unusual gait was a result of his inability to dorsiflex and evert his right foot.

10 The medical student remembered that the nerve that innervates the muscles wich are directly responsible for dorsiflexion and eversion of the foot is the: A) Tibial nerve B) Deep peroneal (fibular) nerve C) Sciatic D) Common peroneal

11 The muscles responsible for dorsiflexion of the foot include the: A) Tibialis Posterior B) Tibialis Anterior C)Extensor Digitorum Longus D) Two of the above. Both the Tibialis Anterior and the Extensor Digitorum Longus dorsiflex the foot

12 End of Section one!

13 Remembering the pediatrician's earlier IM injection into the boy and considering the symptoms, the third year student determined that the damage from the injection must have occurred to which nerve in the gluteal region: A) Obturator B) Superior gluteal C) Common peroneal portion of the sciatic D) Inferior gluteal

14 The name for this clinical condition is: A) Obturator syndrome B) Gluteus medius limp C) Positive Trendelenberg sign D) Foot drop

15 On his 50th birthday a sedentary father of three makes a personal resolution to exercise more and to lead a healthier lifestyle. The next day, eager to begin his new training regime he gets up early and begins a three mile jog. Less than one mile into the run, however, his leg muscles cramp and he is forced to stop. Humbly, he walks home wincing with the pain of every step.

16 The next day at his yearly exam the man tells his physician of the pain in his legs upon exercise. The physician commends him for his initiative but warns him to start exercising at a slower pace. He examines the man's legs and notes tenderness along their anterior aspect. He tells the man that the pain he is experiencing is most likely caused by the swelling of his muscles upon experiencing unusual exertion. The swelling causes compression of the blood vessels and subsequent lack of oxygen to the muscles.

17 The muscles most likely to lose oxygen and cause this man's symptoms (Anterior Compartment Syndrome) include all of the following except: A) Tibialis anterior B) Extensor digitorum longus C) Extensor hallicus brevis D) Extensor hallicus longus

18 The blood supply might be compromised in which of the following arteries due to Anterior Compartment Syndrome: A) Anterior tibeal B) Posterior tibeal C) Dorsal pedis artery D) Two of the above. Both the Anterior tibeal and the Dorsalis pedis artery might be compromised

19 In order to check and see if the nerve travelling in the anterior compartment is damaged the physician checks for sensory loss in: A) The area between the first and second toes B) The area along the dorsum of the foot C) The area along the lateral aspect of the fifth toe D) The area between the fourth and fifth toes

20 A propane tank explodes during a medical school 4th of July barbeque and sends metal shrapnel into one of the dinner guests. A large piece of metal embeds itself in the student's left thigh. The student is conscious but appears to be in shock and is bleeding profusely from his femoral artery.

21 The femoral artery travels within the adductor canal (Hunter's Canal) to reach the popliteal fossa. Which of the following muscles forms the anterior lateral boundary of the canal? A) Vastus lateralis B) Sartorius C) Vastus medialis D) Adductor magnus

22 Which of the following travel within the adductor canal? A) Femoral Vein B) Profunda Femoris Artery C) Profunda Femoris Vein D) Two of the above

23 The proximal part of the femoral artery is enclosed within the femoral sheath, along with the femoral vein. The femoral canal contains lymph vessels, connective tissue and fat. In relation to the vein and artery the femoral canal: A) Is lateral to the femoral vein and medial to the femoral artery B) Is medial to the femoral vein and lateral to the femoral artery C) Is lateral to both the femoral vein and the femoral artery D) Is medial to both the femoral artery and the femoral vein

24 The End

25 Knee review Questions Answer Section

26 In the middle of a collegiate rugby tournament a player gets tackled just as he is kicking the ball. He has all of his weight planted on his left leg when another player clips him on one side of his knee. He falls to the ground and clutches his knee in pain. When the team physician examines the knee he is able to elicit abnormal side to side movement of the femur on the tibia and abnormal forward motion of the tibia on the femur (anterior drawer sign).

27 The forward motion is caused by damage to which of the following ligaments: A) Oblique popliteal ligament B) Patellar ligament C) Anterior cruciate ligament D) Posterior cruciate ligament

28 When diagnosing damage to the knee joint, it is important to look at the three structures most often damaged. These three structures, otherwise known as the "unhappy triad" include the: A) Medial meniscus, anterior cruciate ligamnet, tibial collateral ligament B) Lateral meniscus, posterior cruciate ligament, fibular collateral ligament C) Lateral meniscus, oblique popliteal ligament, fibular collateral ligament D) Oblique popliteal ligament, patellar ligament, anterior cruciate ligament

29 The knee joint is a hinge-joint involving the articulation of the femur, tibia, and patella. Since the femur and the tibia join at an angle, the joint is mechanically weak. However, many ligaments and tendons help strengthen and stabilize it.

30 The tendons that strengthen and stabilize the knee joint on the lateral side consist of all of the following except: A) Biceps femoris B) Gastrocnemius C) Iliotibial tract D) Soleus

31 The tendons supporting the medial side of the knee joint include the three which form the pes anserinus. Which one of the following four tendons is not part of the pes anserinus: A) Semitendinosus B) Sartorius C) Gracilis D) Semimembranosus

32 A fourth year medical student did an elective working with the camp pediatrician at a rural camp in northern Maine. One day when a young boy came down with a high fever the pediatrican gave the child an intramuscular injection. In his haste the physician plunged the needle into the medial aspect of the boy's right gluteus maximus.

33 A few hours later the medical student observed the boy walking to his cabin. He noticed that in addition to appearing lethargic, the boy was walking in a strange manner. He seemed to be lifting his right foot unusually high and letting it hang down while he walked. After examining the boy the medical student realized that the boy's unusual gait was a result of his inability to dorsiflex and evert his right foot.

34 The medical student remembered that the nerve that innervates the muscles wich are directly responsible for dorsiflexion and eversion of the foot is the: A) Tibial nerve B) Deep peroneal (fibular) nerve C) Sciatic D) Common peroneal

35 The muscles responsible for dorsiflexion of the foot include the: A) Tibialis Posterior B) Tibialis Anterior C)Extensor Digitorum Longus D) Two of the above. Both the Tibialis Anterior and the Extensor Digitorum Longus dorsiflex the foot

36 Remembering the pediatrician's earlier IM injection into the boy and considering the symptoms, the third year student determined that the damage from the injection must have occurred to which nerve in the gluteal region: A) Obturator B) Superior gluteal C) Common peroneal portion o fthe sciatic D) Inferior gluteal

37 The name for this clinical condition is: A) Obturator syndrome B) Gluteus medius limp C) Positive Trendelenberg sign D) Foot drop

38 On his 50th birthday a sedentary father of three makes a personal resolution to exercise more and to lead a healthier lifestyle. The next day, eager to begin his new training regime he gets up early and begins a three mile jog. Less than one mile into the run, however, his leg muscles cramp and he is forced to stop. Humbly, he walks home wincing with the pain of every step.

39 The next day at his yearly exam the man tells his physician of the pain in his legs upon exercise. The physician commends him for his initiative but warns him to start exercising at a slower pace. He examines the man's legs and notes tenderness along their anterior aspect. He tells the man that the pain he is experiencing is most likely caused by the swelling of his muscles upon experiencing unusual exertion. The swelling causes compression of the blood vessels and subsequent lack of oxygen to the muscles.

40 The muscles most likely to lose oxygen and cause this man's symptoms (Anterior Compartment Syndrome) include all of the following except: A) Tibialis anterior B) Extensor digitorum longus C) Extensor hallicus brevis D) Extensor hallicus longus

41 The blood supply might be compromised in which of the following arteries due to Anterior Compartment Syndrome: A) Anterior tibeal B) Posterior tibeal C) Dorsal pedis artery D) Two of the above. Both the Anterior tibeal and the Dorsalis pedis artery might be compromised

42 In order to check and see if the nerve travelling in the anterior compartment is damaged the physician checks for sensory loss in: A) The area between the first and second toes B) The area along the dorsum of the foot C) The area along the lateral aspect of the fifth toe D) The area between the fourth and fifth toes

43 A propane tank explodes during a medical school 4th of July barbeque and sends metal shrapnel into one of the dinner guests. A large piece of metal embeds itself in the student's left thigh. The student is conscious but appears to be in shock and is bleeding profusely from his femoral artery.

44 The femoral artery travels within the adductor canal (Hunter's Canal) to reach the popliteal fossa. Which of the following muscles forms the anterior lateral boundary of the canal? A) Vastus lateralis B) Sartorius C) Vastus medialis D) Adductor magnus

45 Which of the following travel within the adductor canal? A) Femoral Vein B) Profunda Femoris Artery C) Profunda Femoris Vein D) Two of the above

46 The proximal part of the femoral artery is enclosed within the femoral sheath, along with the femoral vein. The femoral canal contains lymph vessels, connective tissue and fat. In relation to the vein and artery the femoral canal: A) Is lateral to the femoral vein and medial to the femoral artery B) Is medial to the femoral vein and lateral to the femoral artery C) Is lateral to both the femoral vein and the femoral artery D) Is medial to both the femoral artery and the femoral vein

47 The End


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