Ch. 6 Lower Limb Flashcards
To turn the foot inward
inversion (varus)
To turn the foot outward
eversion (valgus)
kVp adjustment for a small to medium plaster cast
increase 5-7 kVp
kVp adjustment for a large plaster cast
increase 8-10 kVp
kVp adjustment for a fiberglass cast
increase 3-4 kVp
What is CR for AP toes
angled 10-15 degrees toward calcaneus, to MTP joint
What is part positioning for a tangential projection of the toes - sesamoid bones
dorsiflex the foot until forms 15-20 degree angle from vertical position, pt can be either prone or supine
what is CR for an AP foot
tube angle 10 degrees posteriorly (toward calcaneus), perp to metatarsals, to base of 3rd metatarsal
What is part positioning for an AP oblique foot
medially rotate foot until plantar surface is 30-40 degrees to IR, dorsum plane of foot should be parallel to IR
What should you see on a good oblique foot
open sinus tarsi
What is part positioning for a lateral foot
plantar surface needs to be perp to IR, need to lift knee slightly to prevent over rotation, dorsiflex the foot in a good L
What is CR for lateral foot
medial cuneiform (base of 3rd metatarsal)
Recommended collimation for foot
collimate to outer skin margins and include 1” proximal ankle joint
What is CR for weight-bearing feet projection
angle 15 degrees posteriorly toward calcaneus and toward midpoint between feet at base of metatarsal level
Best way to see longitudinal arch
Weight bearing lateral projection
What do we use weight-bearing feet projections for
condition of longitudinal arches and injury to ligaments such as Lisfranc joint injury
what is the CR for the plantodorsal (axial) projection of the calcaneus
angled 40 degrees cephalad from long axis of foot (40 from vertical if foot is perp to IR), direct to base of 3rd metatarsal and exit just distal to lateral malleolus
What is part positioning for plantodorsal (axial) projection of the calcaneus
dorsiflex foot so plantar surface is perp to IR
What do we want to see on the axial calcaneal projection
talocalcaneal joint, 5th metatarsal’s tuberosity and sustentaculum tali
What side is the sustentaculum tali on
medial side
If a patient cant dorsiflex their foot on the axial calcaneus projection how is your tube angle going to look
more degree of angulation from the 40 degrees
CR for lateral calcaneus
directed 1” below medial malleolus
part positioning for lateral calcaneus
put ankle in a true lateral, dorsiflex foot into an L,
What is CR for AP ankle
direct midway between malleoli
What is part positioning for an ankle mortise
internally rotate leg and foot medial 15-20 degrees
What is part positioning for an AP oblique of ankle
rotate leg and foot medial 45 degrees, foot can not be plantar flexed more than 10-15 degrees from vertical
Who is allowed to do stress views
only the doctor/physician, not us
CR for AP knee
1/2” distal to apex of patella, parallel to tibial plateau
If the patient has thick thighs and butt, what is your CR for an AP knee
angled 5 degrees cephalad
if the patient has very thin thighs and butt what is your CR for an AP knee
angled 5 degrees caudad
What is CR for a lateral knee
angled 5-7 degrees cephalad, directed 1” distal to medial epicondyle
What is part positioning for a lateral knee
flex knee 20-30 degrees, patella should be perp to IR
On a lateral knee what does superior to inferior misalignment of the condyles of the femur indicate
no tube angle
On a lateral knee what does right to left misalignment of the condyles of the femur indicate
rotation of the knee
if you see the adductor tubercle on the posterior side of the knee on a lateral knee what does that tell you
knee is underrotated
What are we looking at on a weight-bearing knee projection
femorotibial joint spaces
What position do you need in order to get a good intercondylar fossa tunnel view
CR perp to tibia and fibula angle
a true AP of knee or patella requires what kind of positioning
internal rotation 3-5 degrees
What is part positioning for a lateral patella
flex knee 5-10 degrees, patella perp to IR, knee in true lateral
how many phalanges in the foot
14
how many metatarsals (instep) of the foot
5
how many tarsals in the foot
7
how many bones are in the foot total
26
when counting digits of the foot which side do we start on
medial to lateral
how many phalanges in the first digit of the foot
2
what are the two big differences between phalanges of the foot and phalanges of the hand
phalanges of foot are smaller adn their movement is more limited
bones of the instep of the foot
metatarsals
base of 5th metatarsal expands laterally into this to provide for attachment of a tendon
tuberosity
common trauma site of the foot
proximal portion of 5th metatarsal - tuberosity
small detached bones, often found in the feet or hands
sesamoid bones
extra bones embedded in tendons and often present near joints
sesamoid bones
where are sesamoid bones most commonly found in the hand
palmar surface near MCP joint or IP joint
where are sesamoid bones most commonly found in the lower limb
almost always present on the plantar surface at the head of the 1st metatarsal near 1st MTP joint
what is the sesamoid bone on the plantar, medial side of the head of the 1st metatarsal
tibial sesamoid bone
what is the sesamoid bone on the plantar, lateral side of the head of the 1st metatarsal
fibular sesamoid bone
large bones of the proximal foot
tarsals
what is another name for the calcaneus
os calcis
what is another name for talus
astragalus
what is another name for the navicular
scaphoid
largest and strongest bone of the foot
calcaneus
posterior portion of the calcaneus
heel bone
most posterior-inferior part of the calcaneus contains a process called
tuberosity
common site for bone spurs in the foot
tuberosity of the calcaneus
sharp outgrowths of bone that can be painful on weight bearing
bone spurs