Ch 7 Patellofermoral
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| An acute or direct blow to the PF joint, would cause? | Contusions and fractures
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| An onset of an injury by dynamic overload of musculotendinous unit, would cause? | Strains or ruptures of the patella tendon
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| A chronic injury to the PF joint such as walking or running( low energy trauma) would cause? | exacerbation of patellar maltracking problems- can lend to tendinitis, bursitis, fat pad syndrome or subtle subluxations
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| When the location of pain is radiating medially or laterally from the patella, what does this indicate? | Pathological glide within the trochles or an abnormal tilt.
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| When the location of the pain is posterior to the PF joint, what doest this indicate? | Synovitis ( thought pain can radiate to any area of the knee)
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| When the location of the pain referred pain to anterior knee, this would indicate? | Legg-clave perthes disases or slipped captial fermoral epiphysis
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| When asking the History what questions which may place excressive or unaccustomed forces on the PF joint? | Change in level of activity? change in surfaces, change in footwear or equipment?
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| Prior surgery to the PF joint can result in? | Inflammation, abhesion, or entrapment of the patella restraints- results in painful movement and reduced ROM.
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| Prior injury to the PF joint, can also result in? | May alter the biomechanices of the extensor mechanism.
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| Injuries to area below and above the PF joint can also affect the PF joint such as? | Foot pathology, recurrent ankle sprains, achilles tendon pathology, knee sprains, injury to the hip, or conditions involving the lumber spine.
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| Inspection of the PF joint Patella alta is? | Abnormally long patella tendon
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| Patella alta consequences are? | Increased patella glide, Decreased quad strength, Increased in PF compressivce forces when the knee flexed
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| Inspection of the PF joint Patella Baja is ? | Abnormally short patella tendon, Arthrofibrosis after surgery or injury.
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| Patella Baja consequences are? | Decreased patella glide, Decreased tibiofemoral ROM, dreaced quad stenght, increased PF compressive forces when the is flexed.
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| Inspection of the PF joint Squinting patella causes? | Hip anteversion, internal femoral rotation, internal tibial rotation, Arthrofibrosis after suergery or injury?
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| Squinting patella conseqences are? | increased Q angle, Tight medical retinaculum, maltracking of the patella, Altered PF compressive forces
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| Inspection of the PF joint "frog Eyed" patella casues? | hip retroversion, External femoral rotation, external tibial rotation.
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| Frog Eyes patella consqences are? | increased lateral patellar glide, patellar maltracking, dreaced quad strenght, increased PF compressive forces when knee flaxed.
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| Genu Varum has what kind of affect on the PF joint? | Increased compressive force on the lateral patellar facets
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| Genu valgum has what kind of affect on the PF joint? | excressive lateral force, increasing the pressure on the medical and odd facet
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| Genu recurvatum has what kind of affect on the PF joint? | Additional pressure on the superior articular surfaces
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| Inspection of Q angle what are the degrees for both males and females? | Males 13 degrees, and females 18 degrees
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| When performing tubercle sulcus angle, what is does the degrees indicate? | if the tuberosity is more an 10 degrees lateral to the inferior pole, the patient is predisposed to lateral-patellat tracking.
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| What does antenersion mean? | A forward bending or angulation of a bone or ogran
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| What kind of affects does a q angle have on the patella? | Increaced Q angle force placed on the medial patellar facet, medial patellar retinaculum and lateral border of the femoral trochlea
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| When the PF joint is at 0 degrees of extension and rest, where is the facet? | Patella reating on the suprapatella fat pad on the distal femoral shaft
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| When the PF joint is ar 20 degress of flexion, facet in contact with the femoral trochlear groove? | Inferior portion of the facet is in contact with the femoral trochlear groove.
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| At 45 degrees where is the contact on the femoral trochlear groove/ | Medial and later facet
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| At 90 degrees where is the facet in contact with the femoral trochlear groove? | Largest contact area across the medial and lateral facet
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| At 135 degree of flexion where is the facet in contact with the femoral trochlear groove? | Odd facet
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| Clarke's sign for chondromalacia patella postive test results in/ | patient experiences patellofemoral pain and inability to hold the contraction
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| Clark's sign for chondromalacia patella implication are? | Possibly chondromalacia patella
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| Patella glide test postive results for medial glide? | The patella should glide one -two quadrants (one-half its width)movement of less is hypomobile medial glide, Movement more than two quadrates results in hypermobile medial glide
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| Patella gilde test postive results for lateral glide> | Normal lateral motion 0.5-2.0 quadrate of glide. less than hypomobile, more hypermobile lateral glide
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| Patella tilt test postive results are? | normally results in lateral border raising 0-15 degrees, more than 15 degrees is hypermobile lateral tilt, less than 0 hypomobile
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| Dislocating or subluxation patella MOI is? | During extenion of the knee or an eccentric contraction of the quads within the last 30 degrees of ROM, valgus forces may also be assoicated
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| Morphologic means? | Changes is form or structures with regard to function
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| Apprehension test for a subluxating/ dislocating patella postive results in? | Contraction of the quads by the patient to guad against dislocation of the patella. Demostrate apprehension verbally or thought facial expression
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| Apprehension test implications are? | Laxity of the medial patellar retinaculum, predisposing the patient to patellar subluxation or dislocation
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| what is the MOI of Patellar tendinitis? | Repeated activitu involving resisted knee extension (jumping)or secondary to contusive forces on the patella
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| What is the MOI for Patellar tendon rupture? | Dynmain overload of the entensor mechanism secondary to entending the knee against resistance or forcefull eccentric contraction of the quads
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| what is the MOI for prepatellar bursitis? | Direct trauma to the bursa or overuse
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| what is the MOI for synovial plica syndromes? | Friction casued by the plica rubbing a femoral condyle
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| Stutter test for a medial synovial plica postive results in? | Irregular motion or stuttering between 40-60 degrees as the plica passes over the medical condyle
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| what is the MOI for Sinding-larsen johansson disease? | Repetitive stresses from running and jumping, Superior or inferior patellar pole point tenderness (insidious)
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| What is the MOI for Osgood schlatter diseae? | Stress placed on the tibial tuberositys growth plate by forcful contraction or passive tension of the extensor mechanism, onset often assoicated with the rapid growth spurt or overtraining.
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| What is the MOI patellar fracture? | Blunt trauma to the patella
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| Ballotable patella (tap) test postive results in? | Downward movement of the patella followed by a rebound will give a apperance of a floating
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| Test for medial synovial plica postive results in ? | reproducation of the symptoms is decribed by the patient, clinician may feel the plica crossing the medial femoral condyle espeacilly during 60-45 degrees flexion
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