Final review : Leg, knee, femur , foot, ankle Flashcards

1
Q

Two bones of the leg

A

tibia and fibula

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2
Q

largest second bone in the body

A

tibia

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3
Q

what side is the tibia located on

A

medial

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4
Q

what side is the fibula located on

A

lateral side and slightly posterior

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5
Q

two prominent and palpable processes on the proximal end of the tibia

A

medial and lateral condyles

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6
Q

sharp projection between articular facets

A

intercondylar eminence

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7
Q

what forms articular facets (plateus) for femur as part as the knee joint

A

superior surfaces of condyles

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8
Q

has facet on posterior surface for articulation with the fibula

A

lateral condyle

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9
Q

-anterior surface of tibia, inferior to condyles
-serves as point of attachment for muscles

A

tibial tuberosity

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10
Q

-located at distal end of tibia
-palpable landmark
-forms part of ankle mortise

A

medial malleolus

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11
Q

-triangular depression for articulation with distal fibula
-distal tibiofibular joint is amphiarthotic (slightly moveable)

A

fibular notch

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12
Q

both classified as long bone

A

tibia and fibula

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13
Q

does not bear weight

A

fibula

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14
Q

proximal end of fibula and articulates with lateral condyle of tibia

A

head of fibula

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15
Q

conical projection on lateral, posterior head

A

apex of fibula

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16
Q

-distal end of fibula
-forms part of ankle mortise
-projects lower than medial malleolus

A

lateral malleolus

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17
Q

-formed by femoral condyles and tibial plateaus
- synovial diarthrodial, hinge type joint
-protected by patella
-supported by ligaments
stabilized and cushioned by menisci

A

knee

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18
Q

lie on tibial plateuas

A

lateral and medial maniscus

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19
Q

largest, most constant sesamoid bone in the body

A

patella

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20
Q

-situated on the distal, anterior femur
-develops in quadriceps femoris tendon between 3 and 5 years of age
-triangular shaped
-apex points toward knee
-base is superior aspect

A

patella

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21
Q

largest bone in the body

A

femur

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22
Q

-proximal, rounded end
-articulates with acetabulum of pelvis to form hip joint

A

head of femur

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23
Q

slender region just below head

A

neck of femur

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24
Q

large prominent, palpable process at proximal end of lateral side

A

greater trochanter

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25
Q

located medial and posterior surface of femur

A

lesser trochanter

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26
Q

distal end, just above condyles
-designated as medial and lateral

A

epicondyles of femur

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27
Q

-expanded, palpable distal ends
-medial and lateral articulate with tibia to form knee joint

A

condyles of femur

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28
Q

depression between condyles on posterior surface of femur

A

intercondylar fossa

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29
Q

CR for AP and lateral lower leg

A
  • perp to center of leg
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30
Q

distance for AP and lateral lower leg

A

SID maybe rasied to 48 inches to decrease magnification to fit image on IR

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31
Q

where is the lateral malleolus

A

on the fibula

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32
Q

where is the medial malleolus

A

on the tibia

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33
Q

If the leg does not fit for tib fib what can you do

A

-turn cassette catty corner
- increase sid to 48

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34
Q

what two joints do you need for the tib fib

A

ankle and knee joints

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35
Q

do you need to dorsiflex for ap and lateral tib fib

A

yes

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36
Q

how are the femoral condyles in the lateral tib fib

A

superimposed and perpendicular to IR

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37
Q

what is perpendicular to the IR in lateral leg

A

-patella
-femoral condyles

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38
Q

what views of the knee must be standing

A

weight bearing knees

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39
Q

distance for weight bearing knees

A

40 inches

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40
Q

how much do you angle for AP knee

A

5-7 degrees

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41
Q

where do you center for AP knee

A

1/2 inch below the patellar apex

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42
Q

how are the femoral epicondyles in the AP knee

A

parallel with IR

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43
Q

for a lateral knee, how much should you bend the knee?

A

20 to 30 degrees

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44
Q

how much do you angle the tube for a lateral knee?

A

5 to 7 degrees cephalic angle to move the medial condyles superior to superimpose it

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45
Q

which condyle has the adductor tubercle

A

medial condyle

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46
Q

what is the main purpose to put an angle on the lateral knee

A

because the medial condyles sit lower and we want to superimpose them

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47
Q

what is perpendicular in the lateral knee

A

epicondyles and patella are perpendicular to IR

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48
Q

what is superimposed in the lateral knee

A

condyles

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49
Q

where are we centering for a lateral knee

A

enters knee joint 1 inch distal to medial epicondyle

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50
Q

what is in profile in a lateral knee

A

patella

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51
Q

is the medial condyle anterior or posterior

A

anterior

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52
Q

is the lateral condyle anterior or posterior

A

posterior

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53
Q

how much do you rotated knee for medial oblique?

A

45 degrees medially

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54
Q

where do you center for medial oblique knee

A

1/2 inch below patellar apex

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55
Q

how do you know its a medial oblique knee

A

separate head of fibula and tibia, lateral condyle more magnified and the separation

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56
Q

rotation of knee for lateral oblique knee

A

45 degrees

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57
Q

what is being best demonstrated for lateral oblique knee

A

medial condyle

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58
Q

CR for ap oblique lateral knee

A

enters 1/2 inch below patellar apex

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59
Q

how is the fibula in the lateral oblique knee

A

fibula is rolling behind the tibia, laying on anterior surface of it

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60
Q

central ray for ap knee weight bearing

A

-horizontal and pependicular to center of IR
-enters 1/2 inch below patellar apex

61
Q

for the knee, where do we measure at to determine the degree of angulation

A

the ASIS

62
Q

In the AP knee, is the fibula superimposed over the tibia?

A

slightly- 1/4 of an inch

63
Q

in the lateral oblique knee how is the fibula

A

fibula is superimposed on the anterior portion of the tibia

64
Q

How do we know its a medial oblique knee?

A

Separates the fibula and tibia (joint space open between space of fibula head and tibia)

65
Q

What are the views for the intercondylar fossa

A

holmblad (PA)
Camp coventry (PA)
Beclere (AP)

66
Q

How much do you flex the knee for the Holmblad method

A

70 degrees

67
Q

what is the CR for all three views for the intercondylar fossa

A

Perp to the tib fib

68
Q

what is the patient position for camp coventry

A

prone

69
Q

how is the knee flexed in the camp coventry and how much is the tube angled

A

knee flexed 40-50 degrees and tube angled 40-50 degrees

70
Q

How is the knee flexed in the beclere

A

60 degrees

71
Q

Settegast view is also called

A

sunrise view

72
Q

tube angle for settegast (sunrise views)

A

Varies depending on the patients abilities to bending

73
Q

what is in profile in the settegast view

A

patella

74
Q

What kind of view is settegast

A

tangential

75
Q

What is the CR for PA patella

A

perp to midpopliteal area

76
Q

How much do you rotate the heel for the PA patella

A

5-10 degrees

77
Q

Why is it preferred to do patella PA

A

because it is closer to the IR, better detail

78
Q

Most common fracture of the patella

A

Transverse fractures

79
Q

how much is the knee flexed in a lateral patella

A

5 to 10 degrees

80
Q

how is the patella in a lateral patella

A

perp and in profile

81
Q

CR for lateral patella

A

perp to ir, center over joint space between patella and femur

82
Q

Rule out transveres fracture of patella before attempting this projection

A

Tangential patella (settegast)

83
Q

CR for settegast

A

angle varies, perp to ir, perp to joint space

84
Q

how is the patient positioned for hughston method

A

prone

85
Q

How much do we rotate foot for the ap femur

A

10 to 15 degrees inward

86
Q

what does rotating the foot do in the AP femur

A

Greater trochanter in profile and puts the femoral neck parallel to IR

87
Q

What is being best demonstrated in the AP femur

A

greater trochanter

88
Q

In the lateral femur what is being best demonstrated

A

The lesser trochanter

89
Q

CR for the AP femur

A

perp to the IR

90
Q

in the AP femur where should the top of the IR be?

A

at the ASIS

91
Q

CR for the lateral femur?

A

perp to midpoint of IR

92
Q

how is the patella in the lateral femur

A

in profile

93
Q

how much do you rotate the pelvis for a lateral femur

A

10-15 degrees

94
Q

eversion and inversion of the ankle or foot

A

stress view

95
Q

distance for all of the lower limbs

A

40 inches

96
Q

How many bones are in the foot

A

26

97
Q

how many phalanges, metatarsals, and tarsal bones are there

A

14 phalanges
5 metatarsals
7 tarsals

98
Q

what are the 7 tarsal bones

A

-calcaneus
-talus
-navicular
-cuboid
-three cuniforms

99
Q

largest tarsal bone

A

calcaneus

100
Q

second largest tarsal bone

A

talus

101
Q

what joint does the talus articulate with the calcaneus at

A

“subtalar” joint

102
Q

on the lateral side between calcaneus and the fourth and fifth metatarsals

A

Cuboid

103
Q

On medial side between calcaneus and the cuneiforms

A

Navicular

104
Q

what cuneiform is the smallest and largest

A

medial-largest
intermediate-smallest

105
Q

The ankle joint is formed by articulation between the talus and the:

A

-lateral malleolus of fibula
-inferior surface of tibia
-medial malleolus of tibia

106
Q

-small detached bones found in the foot
-usually form in points of stress near a joint
-usually found on the posterior surface of first MTP joint
-is possible to fracture and is very painful when fractured

A

Sesamoid

107
Q

why is AP axial toes recommended rather with no angle

A

To open the joint spaces and reduce foreshortening

108
Q

what is the holly and lewis views for?

A

tangential views for the sesamoid bones

109
Q

Where do you center for the AP foot

A

perp to base of the 3rd metatarsal

110
Q

What is the CR for the AP axial foot

A

5-7 degrees toward heel to the base of the third metatarsal

111
Q

what does the AP axial foot demonstrate better than the AP foot

A

the axial projection demonstrates the tarsometatarsal joint spaces better and reduces foreshortening

112
Q

term for top of the foot

A

dorsum

113
Q

term for bottom of the foot

A

plantar

114
Q

how much do you rotate the foot for the AP oblique medial rotation foot

A

30 degrees so the cuboid is parallel with the IR and best seen

115
Q

what is important to include for ap medial oblique foot

A

cuboid, base of fifth, and heel

116
Q

CR for AP medial oblique foot

A

perp to base of the 3rd metatarsal

117
Q

what is the view that best demonstrates the cuboid

A

AP oblique medial rotation

118
Q

CR for lateral foot

A

perp to base of metatarsals

119
Q

do you dorsiflex for lateral foot

A

yes

120
Q

when do you dorsiflex

A

when the ankle is involved

121
Q

why is weightbearing feet done

A

to show the structure of the longitudinal arch

122
Q

what is the CR for the axial (plantodorsal) Calcaneus

A

40 degrees cephalic
enters plantar surface at base of the third metatarsal

123
Q

how much do you angle the tube for the plantodorsal calcaneus

A

40 degrees

124
Q

How do we know what the medial aspect of the heel is?

A

the curvature, its concaved on the medial aspect

125
Q

what is the other view besides plantardorsal for the heel

A

lateral

126
Q

what joints do we need to see in the heel

A

subtalar joints

127
Q

what do you need to be sure to include in the heel

A

dorsiflex, make sure to have ankle joints and base of the fifth

128
Q

what fracture occurs at the base of the fifth

A

Jones Fracture (avulsion fracture)

129
Q

CR for lateral calcaneus

A

perp to calcaneus

130
Q

What bones make up the ankle joint

A

fibula, talus, tibia

131
Q

CR for AP ankle

A

perp through ankle to midway between the malleoli

132
Q

CR for lateral ankle

A

perp to ankle joint
enter medial mallelous

133
Q

what do you need to include on lateral ankle

A

Be sure to dorsiflex and include heel and the fifth metatarsal base

134
Q

How much do you rotate the foot for medial oblique ankle

A

45 degrees

135
Q

CR for oblique ankle

A

perp to ankle joint, midway between the malleoli

136
Q

why do we obliqe 45 degrees for oblique ankle

A

open joint spaces on lateral aspect to take fibula off of talus

137
Q

how much do we rotate foot for ap oblique mortise

A

15 to 20 to open up joint spaces all around the ankle mortise

138
Q

why is stress views done

A

to verify ligamentous tears

139
Q

CR for PA ribs

A

perp to IR

140
Q

Breathing technique for PA upper ribs

A

Full respiration

141
Q

CR for AP ribs

A

Perp to center to IR

142
Q

Breathing technique for AP ribs

A

upper- inspiration
lower-expiration

143
Q

Rotation for AP oblique ribs

A

45 degree RPO or LPO

144
Q

Where should the IR be for upper ribs oblique

A

place top of IR 1 1/2 inches above shoulder

145
Q

Where should the IR be for lower ribs oblique

A

Place lower edge of IR at level of iliac crests

146
Q

CR for AP oblique ribs

A

perp to center of IR

147
Q

Rotation for PA oblique ribs

A

45 degree RAo or LAO

148
Q

CR for PA oblique Ribs

A

perp to center of IR

149
Q
A