Lower limb: patellar stability: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Lower limb: patellar stability

Sample item

A 17-year-old girl with a wide pelvis and increased Q angle has recurrent lateral dislocation of the patella. Strengthening of which muscle component is most useful as the dynamic restraint against lateral displacement?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Lower oblique fibres of vastus medialis

The patella tends to be pulled laterally because the quadriceps line of pull is lateral to the line of the patellar tendon (the Q angle). The horizontally directed lowest fibres of vastus medialis (vastus medialis obliquus) counteract this, and the high lateral femoral condyle also helps. Weakness or hypoplasia of this component predisposes to lateral subluxation.

Option by option

  • A. Rectus femoris

    Rectus femoris pulls straight upward and has little medial component.

  • B. Tensor fasciae latae

    Tensor fasciae latae acts through the iliotibial tract and tends to pull laterally.

  • C. Vastus lateralis

    Vastus lateralis pulls the patella laterally and would worsen the tendency.

  • D. Lower oblique fibres of vastus medialis (correct)

    The oblique fibres of vastus medialis pull the patella medially and resist lateral dislocation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Lower oblique fibres of vastus medialis. The patella tends to be pulled laterally because the quadriceps line of pull is lateral to the line of the patellar tendon (the Q angle).

Why is "Rectus femoris" not the answer?

Rectus femoris pulls straight upward and has little medial component.

Why is "Tensor fasciae latae" not the answer?

Tensor fasciae latae acts through the iliotibial tract and tends to pull laterally.

Why is "Vastus lateralis" not the answer?

Vastus lateralis pulls the patella laterally and would worsen the tendency.

What concept does this question test?

It tests Lower limb: patellar stability in Anatomy. The horizontally directed lowest fibres of vastus medialis (vastus medialis obliquus) counteract this, and the high lateral femoral condyle also helps. Weakness or hypoplasia of this component predisposes to lateral subluxation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lower limb: patellar stability?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.