Ch 6 - Lower Limb Flashcards

1
Q

Conical projection at the head of the fibula

A

Apex

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2
Q

Known as the anterior border of the tibia

A

Crest

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3
Q

Larger of the two bones of the leg

Medial lower leg bone

A

Tibia

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4
Q

Lateral bone of the leg

Smaller of the bones of the leg

A

Fibula

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5
Q

Two prominent processes on the proximal end of the tibia

Two large eminences on the distal end

A

Condyles

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6
Q

Two peaklike processes arising from the intercondylar eminence

A

Tubercles

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7
Q

Prominent process on the anterior surface of the tibia, just below the condyles

A

Tuberosity

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8
Q

Large, rounded eminence on the superior end of the fibula

A

Head

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9
Q

Constricted portion just inferior from the head of the fibula

A

Neck

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10
Q

Enlarged distal end of the fibula

A

Lateral malleolus

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11
Q

Large process that extends both medially and inferiorly from the distal end of the tibia

A

Medial malleolus

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12
Q

Deep depression between the condyles

TIbial spine

A

Intercondylar eminence

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13
Q

3 types of movement in the knee

A

Flexion
Extension
Slight rotation

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14
Q

2 types of movement in the ankle

A

Flexion

Extension

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15
Q

Type of movement in the intertarsal joints

A

Gliding

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16
Q

2 types of movement in the interphalangeal joints

A

Flexion

Extension

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17
Q

4 types of movement in the tarsometatarsal joints

A

Flexion
Extension
Abduction
Adduction

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18
Q

Type of movement in the distal tibiofibular joint

A

Syndesmosis (slight movement)

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19
Q

Type of movement in the proximal tibiofibular joint

A

Gliding

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20
Q

4 types of movement in the metatarsophalangeal joint

A

Flexion
Extension
Abduction
Adduction

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21
Q

Incomplete separation or avulsion of the tibial tuberosity

A

Osgood-Schlatter disease

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22
Q

3 groups of bones found in the foot and ankle and quantity (26)

A

7 tarsals
5 metatarsals
14 phalanges

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23
Q

How many interphalangeal articulations does one foot have?

A

9

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24
Q

What type of joint is an interphalangeal joint?

A

Hinge

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25
Q

With what do the heads of the metatarsals articulate?

A

Phalanges

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26
Q

How are metatarsals identified within the foot?

A

1-5 medial to lateral

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27
Q

With what do the heads of the metatarsals articulate?

A

Phalanges

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28
Q

How are metatarsals identified within the foot?

A

Numbered 1 through 5 medial to lateral

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29
Q

Which metatarsal has a tuberosity that is prominent at its base?

A

5th

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30
Q

7 tarsal bones

A
Calcaneus
Talus
Navicular
Cuboid
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
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31
Q

Comprises the heel of the foot

Largest tarsal bone

A

Calcaneus

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32
Q

Tarsal bone that articulates superiorly on the calcaneus
Forms part of the ankle joint
Articulates with the undersurface of the tibia
Most superior tarsal bone

A

Talus

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33
Q

Tarsal bone that is located between the calcaneus and the fourth and fifth metatarsals
Lateral tarsal bone

A

Cuboid

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34
Q

Tarsal bone that is located between the talus and the cuneiforms

A

Navicular

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35
Q

4 tarsal bones that articulate with metatarsals

A

Medial, intermediate and lateral cuneiforms

Cuboid

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36
Q

2 bones of the leg

A

Tibia

Fibula

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37
Q

Tibial condyle that has a facet for articulation with the head of the fibula

A

Lateral

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38
Q

Where specifically is the tibial tuberosity located?

A

Anterior surface below the condyles

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39
Q

Bones of the forefoot
5 numbered 1-5 beginning at medial aspect/great toe side
Consist of body (shaft) and two articular extremities

A

Metatarsals

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40
Q

Articular surfaces on superior tibia

A

Plateaus

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41
Q

Toe bones
14, 2 in great toe and 3 in each of the lesser toes
Named by location

A

Phalanges

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42
Q

Sesamoid that protects knee joint

“Kneecap”

A

Patella

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43
Q

DIP

A

Distal interphalangeal joint

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44
Q

TMT

A

Tarsometatarsal joint

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45
Q

MTP

A

Metatarsophalangeal joint

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46
Q

IP

A

Interphalangeal joint

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47
Q

What is the central ray orientation of the joint spaces if the toes are of primary interest?

A

15 degrees posteriorly (toward heel)

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48
Q

How should the central ray be directed to demonstrate toes when the plantar surface of the affected foot is in contact with a foam wedge, which should be inclined 15 degrees so that the toes are elevated above a horizontally placed IR?

A

Perpendicular

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49
Q

What projection for the toes normally does NOT demonstrate open interphalangeal joints?

A

AP projection of the toes with the central ray directed perpendicular

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50
Q

For the AP oblique projection demonstrating all of the toes, which way (medially or laterally) should the foot and lower leg be rotated?

A

Medially

51
Q

How many degrees of rotation are needed to rotate the foot properly for the AP oblique projection with the foot rotated laterally?

A

4th and 5th

52
Q

Where should the central ray enter the foot for AP oblique projection of the toes?

A

3rd MTP

53
Q

True or false: the bases of the metatarsals should be included within the image for AP oblique projections of the toes

A

False, heads

54
Q

True or false: all phalanges should be seen in the image in an AP oblique of the toes

A

True

55
Q

For lateral projections of the toes, what can be down to prevent the superimposition of toes?

A

Tape

56
Q

Where should the central ray enter the foot for the lateral projection of the great toe?

A

Metatarsophalangeal joint

57
Q

Where should the central ray enter the foot for the lateral projection of the lesser toes?

A

Proximal phalangeal joint

58
Q

True or false: for the lateral projection of the 5th toe, the patient should lie in the lateral recumbent position on the unaffected side

A

False, affected

59
Q

True or false: for the lateral projection of the great toe, the patient should lie in the lateral recumbent position on the unaffected side

A

False, affected

60
Q

True or false: interphalangeal and metatarsophalangeal joint spaces should appear open on the lateral projection of the toes

A

True

61
Q

What other projection refers to the AP projection of the foot?

A

Dorsoplantar

62
Q

How should the central ray be directed for best demonstration of tarsometatarsal joints with a dorsoplantar projection of the foot?

A

CR angled 10 degrees posteriorly

63
Q

Toward what point of the foot should the central ray be directed for AP and AP axial projections of the foot?

A

Base of the third metatarsal

64
Q

In which direction (medially or laterally) should the foot be rotated for the AP oblique projection of the foot to best demonstrate the cuboid and its related articulations?

A

Medially

65
Q

What projection of the foot best demonstrates the lateral tarsals with the least superimposition of structures?

A

AP oblique projection with medial rotation

66
Q

For the ap oblique projection of the foot, the leg should be rotated medially until the plantar surface of the foot forms an angle of what with the IR?

A

30 degrees

67
Q

What two metatarsal bases appear overlapped in the image of the AP oblique projection, medial rotation of the foot?

A

1st and 2nd

68
Q

For patient comfort, which side of the foot (medial or lateral) should be placed in contact with the IR for the lateral projection of the foot?

A

Lateral

69
Q

With reference to the lower leg, how should the foot be positioned for the lateral projection of the foot?

A

Dorsiflex the foot to form a 90 degree angle with the lower leg

70
Q

Where should the distal fibula be seen in images of the lateral projection of the foot?

A

Fibula overlapping the posterior portion of the tibia

71
Q

True or false: the tibiotalar joint must be seen in the lateral projection of the foot

A

True

72
Q

With reference to the IR, how should the plantar surface of the foot be for the axial projection of the calcaneus?

A

Perpendicular

73
Q

How many degrees and in what direction is the CR angled for an AP axial projection of the heel?

A

40 degrees cephalad

74
Q

True or false: the plantar surface of the foot should be in contact with the IR in the axial projection of the calcaneus

A

False

75
Q

True or false: the central ray should enter the dorsal surface of the foot for axial projection of the calcaneus

A

False

76
Q

Where on the medial surface of the foot should the central ray enter the calcaneus for the lateral projection of the calcaneus?

A

1 inch distal to the medial malleolus at the subtalar joint

77
Q

Which projection of the calcaneus best demonstrates the sinus tarsi?

A

Lateral

78
Q

True or false: the AP projection of the ankle should demonstrate the joint space between the medial malleolus and the talus without any overlapping of structures

A

True

79
Q

True or false: the AP projection of the ankle should demonstrate the distal third of the fibula without superimposition with the talus or tibia

A

False

80
Q

True or false: the AP projection should demonstrate the lateral and medial malleoli

A

True

81
Q

Why is dorsiflexion of the foot required for the lateral (mediolateral) projection of the ankle?

A

Prevents lateral rotation of the ankle

82
Q

True or false: the lateral (mediolateral) projection of the ankle should demonstrate the fibula over the posterior half of the tibia

A

True

83
Q

True or false: the tuberosity and base of the fifth metatarsal should be demonstrated as a lateral projection image of the ankle

A

True

84
Q

How many degrees and in what direction should the leg and foot be rotated?

A

45 degrees medially

85
Q

3 structures demonstrated in the image of the AP oblique ankle

A

Talus
Distal tibia
Distal fibula

86
Q

What articulation is demonstrated in the image of the AP oblique ankle?

A

Tibiofibular

87
Q

From the supine position, how many degrees should the lower limb and foot be rotated to position the ankle for this projection?

A

15-20 degrees medially

88
Q

With reference to the position of the patient’s leg and foot during the procedure, how is it determined that the leg has been rotated the correct number of degrees?

A

Intermalleolar plane parallel with IR

89
Q

True or false: the talofibular joint space should be demonstrated in profile in the AP oblique projection (medial rotation) of the ankle without any bony superimposition

A

True

90
Q

True or false: the foot should be plantar flexed to place the long axis of the foot parallel with the IR in the AP oblique projection (medial rotation) of the ankle

A

True

91
Q

The placement of the top border of the IR should extend at least how many inches above the knee joint to avoid being projected off by beam divergence for the AP projection of the leg?

A

1 to 1.5

92
Q

What should the radiographer do if the leg is too long to demonstrate the knee and the ankle joint with the same exposure for the AP projection of the leg?

A

Perform two AP projections to ensure that the entire lower limb is demonstrated

93
Q

True or false: the AP projection of the leg should demonstrate the fibula without any overlapping with the tibia

A

False

94
Q

What procedure should the radiographer perform if the patient is unable to turn from the supine position toward the affected side to position a fractured leg on the IR for the lateral projection?

A

Perform a cross table lateral projection by placing an IR vertically between the patients legs and directing a horizontal central ray to the leg

95
Q

If a radiographer positions the lower limb very carefully to ensure that femoral condyles are physically superimposed, but they do not appear to be well superimposed on the radiograph, what could have caused the image to appear that way?

A

The natural divergence of the beam may prevent the femoral condyles from appearing superimposed

96
Q

True or false: the lateral projection should demonstrate some interosseous space between the shafts of the fibula and tibia

A

True

97
Q

2 factors that should be considered when deciding whether or not to use a grid for AP projections of the knee

A

Size

Preference

98
Q

With reference to the knee, where is the centering point used for positioning the IR or centering the collimated field to the knee on the AP projection of the knee?

A

1/2 inch below the apex of the patella

99
Q

Where is the patella be located on a correctly positioned AP projection of the knee?

A

Slightly off center to the medial side of the femur

100
Q

On an image of a correctly positioned AP projection of the knee, the patella should be demonstrated?

A

Completely superimposed on the femur

101
Q

True or false: the AP projection image of a normal knee should demonstrate a femorotibial joint space with equal distance on both sides

A

True

102
Q

For the lateral projection of the knee, should the patella be parallel or perpendicular to the IR?

A

Perpendicular

103
Q

For the lateral projection of the knee, how many degrees should the knee be flexed?

A

20-30

104
Q

For the lateral projection of the knee, the knee should be flexed no more than how many degrees when a new or healing fracture is present?

A

10

105
Q

What could occur if a patient with healing fracture flexes the knee more than the recommended number of degrees?

A

Fragment separation

106
Q

How many degrees and in what direction should the central ray be directed for the lateral projection of the knee?

A

5-7 degrees cephalad

107
Q

Why is the central ray angled cephalad for the lateral projection of the knee?

A

Prevents the joint space from being obscured by the magnified image of the medial femoral condyle

108
Q

Where should the central ray enter the patient 1 inch distal to for the lateral projection of the knee?

A

Medial epicondyle

109
Q

Which positioning maneuver relaxes the muscles and shows the maximum volume of the joint cavity for the lateral projection of the knee?

A

Flexing the knee 20 to 30 degrees

110
Q

True or false: the femoral condyles should appear superimposed on the lateral projection of the knee

A

True

111
Q

True or false: the lateral projection of the knee demonstrates the patella with slight overlapping with the femoral cavities

A

False

112
Q

For a patella tangential projection, settegast method, why is it preferable to place the patient in the prone position for the tangential projection?

A

The knee can usually be flexed to a greater degree, and immobilization is easier

113
Q

What projection of the patella should be performed before a tangential projection is attempted? Why?

A

Lateral because of the danger of fragment displacement by the acute knee flexion; rule out transverse fracture of the patella

114
Q

When the patient is placed in the prone position for a patella tangential projection, settegast method, and is unable to maintain a steady lower leg after flexing the knee, what can be done to help the patient hold the position?

A

Instruct the patient to hold over his or her shoulder a long strip of bandage that is looped around the ankle or foot

115
Q

For a patella tangential projection, settegast method, how and where the central ray should be directed?

A

Perpendicular to the patellofemoral joint space, central ray angulation will be 15 to 20 degrees

116
Q

For a patella tangential projection, settegast method, what determines the number of degrees the central ray is angled?

A

The degree of flexion of the knee

117
Q

True or false: the patellofemoral articulation is seen in slight overlap with the anterior surfaces of the femoral condyles on the patella tangential projection, settegast method

A

False

118
Q

True or false: the patella should be seen in profile on the patella tangential projection, settegast method

A

True

119
Q

True or false: the bony detail of the femoral condyles should be demonstrated on the patella tangential projection, settegast method

A

True

120
Q

Joints named by location in the distal foot; synovial, diarthrodial hinge type

A

Interphalangeal (IP) joints

121
Q

Proximal end of the metatarsals

A

Base

122
Q

Distal end of the metatarsals

A

Head

123
Q

3 articulations the ankle joint is formed by between the talus tarsal

A

Lateral malleolus of fibula
Inferior surface of tibia
Medial malleolus of tibia