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Donny Rad positioning 2 > Ch 6 Lower Limb > Flashcards

Ch 6 Lower Limb Flashcards

1
Q

How many bones in the foot?
What is the breakdown of these bones?

A

26 total
14 Phalanges
5 metatarsals
7 tarsals

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2
Q

How many phalanges in each toe digit?

A

3 in toes 2-5
2 in first toe
distal, middle, and proximal

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3
Q

The 3 parts of the of the metatarsals are?

A

Head (most distal)
body/shaft (middle)
Base (most proximal)

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4
Q

How many total tarsal bones?

A

7 tarsal bones in the foot

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5
Q

MTP stands for?
What is it?

A

Metatarsophalangeal joint
the head of the metatarsal is the MTP joint articulates with proximal phalange

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6
Q

TMT stands for?
is what?

A

Tarsometatarsal joint
joint located at in between the base of metatarsal and the tarsals

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7
Q

Sesamoid bones are?

A

small detached bones

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8
Q

CR for AP and oblique foot?

A

Base of 3rd metatarsal
10 degrees posteriorly (supine)
15 degrees posteriorly (standing)

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9
Q

The sesamoid bones in the foot location?

A

plantar surface first metatarsal (head)

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10
Q

2 sesamoid bones name?
Which is medial, which is lateral?

A

Tibial is medial sesamoid bone
Fibular is lateral sesamoid bone

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11
Q

Mnemonic for Tarsals?

A

Come (calcaneus)
To (talus)
Colorado (cuboid)
Next (Navicular)
3 Christmases (3 Cuneiforms)

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12
Q

What is the Sinus tarsi?

A

The space in between the calcaneus and talus articulation

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13
Q

Calcaneus articulates anteriorly with:
Superiorly:

A

Cuboid
Talus

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14
Q

What is the largest Tarsal bone?

A

Calcaneus

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15
Q

Deep depression between posterior and middle articular facets are:

A

Calcaneal sulcus

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16
Q

What are the Tarsals from proximal to distal?

A

Calcaneus
Talus
Cuboid-Navicular
3 Cuneiforms

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17
Q

What are the three facets of the calcaneus in order?

A
  1. posterior facet (articular process)
  2. middle facet (articular surface)
  3. Anterior facet (articular surface)
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18
Q

What does the Navicular tarsal articulate with? (5)

A

Proximally (Posterior): talus (1)
Laterally: Cuboid (1)
Distally (Anteriorly): 3 Cuneiforms (3)

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19
Q

What does the Talus articulate with? (4)

A

superiorly: Tibia and Fibula (2)
Inferiorly: Calcaneus (1)
Distally (anteriorly): Navicular (1)

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20
Q

The superior calcaneus articulation with the Talus forms:

A

Subtalar joint

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21
Q

What does the Calcaneus articulate with? (2)

A

Anteriorly: Cuboid (1)
Superiorly: Talus (1)

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22
Q

What does the Cuboid articulate with? (5)

A

Proximally: calcaneus (1)
Medially: navicular & lateral cuneiform (2)
Distally: Fourth and fifth metatarsal (2)

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23
Q

What does the medial cuneiform articulate with? (4)

A

Proximally: Navicular (1)
Distally: First and second metatarsals (2)
Laterally: intermediate cuneiform (1)

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24
Q

What does the intermediate cuneiform articulate with? (4)

A

Proximally: Navicular (1)
Distally: Second metatarsal (1)
Laterally: Lateral cuneiform (1)
Medially: Medial cuneiform (1)

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25
Q

What does lateral cuneiform articulate with? (6)

A

Distally: 2nd, 3rd, 4th metatarsals (3)
Proximally: Navicular (1)
Laterally: Cuboid (1)
Medially: intermediate cuneiform (1)

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26
Q

How many arches are there in the foot?
What are they?

A

2 arches
Transverse: from lateral to medial
longitudinal: From Calcaneus to metatarsals

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27
Q

Medial malleolus is more ____ & ____ than the lateral malleolus

A

Anterior
Superior

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28
Q

What kind of joint is the ankle?

A

Sellar or saddle joint

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29
Q

Inversion:
AKA?

A

Inward turning/bending of the ankle
aka Varus

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30
Q

Eversion:
AKA?

A

outward turning/bending of ankle
aka valgus

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31
Q

Dorsiflexion:

A

anterior side of the foot (dorsal side) is flexed upwards
(tippy toes)

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32
Q

Plantar flexion:

A

posterior side of the foot (plantar side) is flexed downwards

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33
Q

What type of joints are the interphalangeal joints?

A

ginglymus or hinge

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34
Q

What kind of joints are the Metatarsophalangeal joints?

A

ellipsoidal or condyloid (modified)

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35
Q

What kind of joints are the Tarsometatarsal joints:

A

plane or gliding

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36
Q

What kind of joints are the Intertarsal joint:
(tarsals)

A

plane or gliding

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37
Q

What kind of joints are the ankle joint:

A

Saddle or sellar

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38
Q

What kind of joints are the knee joints:
AKA Femorotibial

A

Bicondylar

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39
Q

What kind of joints are the Knee joints:
AKA patellofemoral

A

saddle or sellar

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40
Q

What kind of joints are the proximal tibiofibular joint:

A

plane or gliding

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41
Q

Distal tibiofibular
Classification:
Mobility type:

A

Fibrous
Amphiarthrodial (slightly moveable)
syndesmosis Type

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42
Q

AP foot is what kind of projection?

A

Dorsoplantar (DP)

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43
Q

PA foot is what kind of projection?

A

Plantodorsal

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44
Q

Pathology:
Gout

A

form of arthritis
excessive blood in joints
Starts in first MTP

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45
Q

Pathology:
Bone Cysts

A

bone lesions filled with clear fluid
common in pediatric patients in the knee

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46
Q

Pathology:
Osgood-Schlatter disease

A

bone/cartilage inflammation of the anterior proximal tuberosity
common among boys 10-15

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47
Q

Pathology:
Paget Disease

A

disrupts new bone growth
very dense and soft bone

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48
Q

Pathology:
Don Juan

A
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49
Q

Pathology:
Reiter syndrome

A

erosion of the Achilles tendon of the posterosuperior calcaneus

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50
Q

Pathology:

A
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51
Q

Pathology:

A
52
Q

Pathology:

A
53
Q

Pathology:

A
54
Q

Pathology:

A
55
Q

Criteria for AP Toes:

A

Patient supine, knee flexed
10-15 degrees toward calcaneus/ (knee)
CR at MTP joint
40 SID
55 kvp 2-5 mAs

56
Q

Criteria for oblique Toes:

A

Patient supine, knee flexed
30-45 degrees rotation (medially or lateral)
CR at the digits MTP
SID 40”
55 kVp 2-5 mAs

57
Q

Criteria for lateral Toes:
(will be on lab exam)

A

position towards side with least amount of OID (medial or lateral side)
40” SID
CR at the IP joint for first digit
CR at the PIP joint for digits 2-5

58
Q

Criteria for AP foot:
aka Dorsoplantar projection

A

Patient supine, knee flexed
angle 10 degrees toward heel (posteriorly)
(15 degrees for standing)
CR at BASE of third metatarsal
40” SID
55 kVp 2-5 mAs

59
Q

Criteria for Oblique foot:

A

Patient supine
Rotate foot medially 30-40 degrees (2 fingers underneath)
CR base of 3rd metatarsal
SID 40”
55 kVp 2-5 mAs

60
Q

Criteria for lateral foot:

A

Patient Supine
Mediolateral projection
CR is at medial cuneiform (level of base of third metatarsal)
SID 40”
55 kVp 2-5 mAs

61
Q

Criteria for AP Mortise ankle:

A

patient supine
internally rotate about 15-20 degrees until intermalleolar is parallel to IR (Malleoli are even)
CR midway between malleoli
SID 40”
55 kVp 2-5 mAs

62
Q

Criteria for AP ankle:

A

Patient supine
CR midpoint between malleoli
SID 40”
55 kVp 2-5 mAs

63
Q

Criteria for lateral ankle:

A

Patient supine
Mediolateral projection
CR pointed at medial malleolus
SID 40”
55 kvp 2-5 mAs

64
Q

How many degrees difference is there between the lateral and medial distal femur epicondyles?

A

5-7 degree difference
(this is why we angle 5-7 degrees cephalic for superimposition for lateral knee)

65
Q

The fibula is considered to be more _____

A

posterior

66
Q

The extreme proximal aspect of the fibula is pointed and known as the

A

apex

67
Q

The patella is a:

A

sesamoid bone

68
Q

How many degrees is the tibial plateau?
where is this located?

A

10-20 degrees
Proximal tibia (where it connects to the knee joint)

69
Q

Patellar surface is:
aka?

A

smooth shallow triangular depression on anterior distal femur
also known as intercondylar sulcus
(behind the patella)

70
Q

where is the popliteal located?

A

Distal posterior femur

71
Q

What is the joint name for between the patella and femur?

A

patellofemoral joint

72
Q

What is the intercondylar fossa?
Where is it located?

A

very deep notch located on the posterior distal femur

73
Q

Which side of the patella is smooth?
Which side is rough?

A

posterior surface smooth
anterior surface rough

74
Q

Base of the patella is located?
Apex of patella is located?

A

Base located superiorly
Apex located at the inferior portion (due to Apex meaning “point”)

75
Q

4 major ligaments of the knee include:

A

Anterior cruciate ligament (ACL)
Posterior cruciate ligament (PCL)
Fibular (lateral) collateral ligament (LCL)
Tibial (medial) collateral ligament (MCL)

75
Q

Patellofemoral joint is apart of the:

A

knee joint

76
Q

The Fibular collateral ligament (LCL) extends from:

A

femur to lateral proximal fibula

77
Q

PA foot is a ____ projection:

A

Plantodorsal projection

78
Q

AP foot is a _____ projection:

A

Dorsoplantar projection

79
Q

Sustentaculum tali means:
Located?

A

support for the talus
medial proximal aspect of the calcaneus

80
Q

Which bone in the foot is most often fractured?

A

base of fifth metatarsal

81
Q

What is the strongest and largest tarsal bone?

A

Calcaneus

81
Q

Sustentaculum tali is found on the

A

calcaneus

82
Q

The articular facets making up the tibial plateau slopes posteriorly at angles of:

A

10 to 20 degrees

83
Q

CR for AP toe vs CR for lateral Toe

A

AP is MTP
Lateral is PIP

83
Q

Main difference between intercondylar sulcus and fossa?

A

Sulcus is located behind the patella
(anterior distal femur)
fossa is located behind the femur
(posterior distal femur)

83
Q

AP Toe angle:

A

10 to 15 degrees towards the calcaneus

83
Q

What Tarsal is shown free of superimposition in a lateral Foot?

A

Cuboid
(possibly base/tuberosity of 5th metatarsal)

83
Q

Which side of the patella is smooth?

A

Posterior surface of patella

84
Q

Which side of the patella is rough?

A

anterior surface of the patella

84
Q

What cuneiform is shown in a lateral (mediolateral) foot?

A

Medial cuneiform

84
Q

Intercondyloid eminence is located:

A

Proximal anterior tibula

84
Q

Intercondylar fossa is located on:

A

Distal anterior femur

85
Q

Where is the patellar surface located?

A

distal anterior femur

85
Q

Where is the popliteal surface located?

A

distal posterior femur

85
Q

How much angle difference between the medial and lateral condyles of the distal femur?

A

5-7 degrees difference
(medial sits lower than the lateral)
(why we angle in lateral knee)

86
Q

What is the inferior surface of the patella?

A

Apex

86
Q

Patella is what?

A

a sesamoid
(largest in the body)

86
Q

What is the superior part of the patella called?

A

Base

86
Q

The patella lies superior to the _____ ______

A

distal femur

87
Q

What are the 3 parts of the proximal fibula in order from proximal to distal?

A

Apex of fibula
Head of fibula
Neck of fibula

87
Q

Patella surface is also known as the:

A

intercondylar sulcus
or
trochlear groove

87
Q

Where is the patellofemoral joint?

A

located between the patella and femur
(hint the name)

88
Q

What is the anatomy located on the distal anterior tibia?

A

anterior tubercle

88
Q

What is the tuberosity located on the anterior proximal tibia?

A

Tibial tuberosity

89
Q

______ _______ ______ is seen on the ankle only for pediatric patients

A

tibial epiphyseal plate
(epiphyseal fusion plate)

90
Q

Where is the Apex of the fibula located?

A

where the fibula and tibia meet

91
Q

What makes the lateral malleolus?

A

Fibula

92
Q

What is the trauma for AP knee?

A

non weight bearing table top

93
Q

What view do you see the patella free of superimposition?

A

lateral knee

94
Q

What is the CR for AP knee?

A

1/2 inch inferior to Apex of the knee

94
Q

Angle for supine AP foot:
Angle for standing AP foot:

A

10 degrees cephalic (toward heel)
15 degrees cephalic (toward heel)

95
Q

for an AP supine knee with a patient measuring 19-24cm thighs and buttocks?
<19cm?
>24cm?

A

0 angle
3-5 caudad
3-5 cephalic

96
Q

PA flexion angle and CR?

A

angle 10 degrees caudad
CR 1/2-inch inferior to the Apex of patella

97
Q

How many degrees should femur be from IR in a PA flexion knee?

A

45 degrees from IR

98
Q

What method does Mayo use for a PA knee flexion?

A

Rosenberg method

99
Q

What are the 3 variations of the PA flexion knee?

A

camp Coventry
Holmblad method
Beclere Method

100
Q

What is the position, projection and flexion of the camp Coventry method?

A

Prone
PA
40-50 flexion

101
Q

What is the position, projection and flexion of the Holmblad method?

A

prone-ish, kneeling on all fours
PA
60-70 degree flexion

102
Q

What is the position, projection and flexion of the Beclere method?

A

Supine
AP
40-45 degrees flexion of knee

103
Q

for a lateral knee, Bontrager recommends bringing the _____ knee forward while Mayo insists on the _______ knee forward

A

affected
unaffected

104
Q

What is the CR and angle for a lateral knee?

A

CR 1 inch inferior to femoral epicondyles
angle 5-7 degrees cephalic
(due to the condyles of the femur being angled)

105
Q

In a lateral knee, we flex the knee?

A

20-30 degrees flexion

106
Q

What are the two obliques for the knee?

A

External (lateral)
Internal (medial)

107
Q

How many views for Tibia and Fibula?
IR size?

A

2 views
AP and Lateral
14 x 17 inches

108
Q

If limb is too long for the IR how can we correct this?

A

anatomy placed diagonally on IR

109
Q

How much rotation for a AP oblique (medial)?

A

Plantar surface 30-40 degrees medially

Donny Rad positioning 2 (5 decks)

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