FOOT/ANKLE PROC. Flashcards
Metatarsals consist of:
Proximal = __________, Distal = ___________
Which metatarsal is the thickest? Longest?
Which metatarsal contains a tuberosity?
Most common fractures occur where? Name?
Body (shaft) & two articular ends.
-Prox = base, Distal = Head
-Thickest = first
Longest = second
-Base of Fifth Metatarsal
- 5th metatarsal tuberosity = Jone Fx
Joints of the metatarsals =
How many bones of Foot?
Mnemonic?
Metatarsophalanges (MTP) and Tarsometatarsal (TMT)
Calcaneus, Talus, Cuboid, Navicular & Cuneiform
-COME TO COLORADO NEXT CHRISTMAS
-LARGEST TARSAL?
-WHERE DOES ACHILLIES TENDON ATTACH?
-WHAT ARTICULATES WITH TALUS?
-LATERAL TARSAL BONE =
-MEDIAL TARSAL BONE =
-TARSAL CONNECTING TO DIGITS 1-3 =
-CALCANEUS = LARGEST
-TUBEROSITY OF CALCANEUS
-TIB, FIBM CALCANEUS & NAVICULAR ART.
-LATERALLY = CUBOID
-MEDIALLY = NAVICULAR
-CUNEIFORMS CONNECT DIGITS 1-3
WHERE IS THE WEIGHT OF THE BODY TRANSMITTED IN ERECT POSITION?
- AKA?
WHAT IS THE SINUS TARSI?
WHAT IS A SESAMOID BONE? WHERE LOCATED?
THREE ARTICULAR FACETS AT SUBTALAR JOINT
- TALOCALCANEAL JOINT = SUBTALAR
SINUS TARSI = OPENING IN MIDDLE OF SUBTALAR JOINT
-SMALL DETACHED BONES IN FEET & HANDS, EMBEDDED IN TENDONS / NEAR JOINTS
LARGEST SESAMOID BONE LOCATED WHERE?
NAME & LOCATION OF SESAMOID BONES IN FEET: ____________ & _______________
WHY ARE THEY IMPORTANT?
HOW ARE BONES IN FOOR ARRANGED? WHY?
PATELLA = LARGEST
TIBIAL (MEDIAL) & FIBULAR (LATERAL) - LOCATED BETWEEN 1ST MT & MTP JOINT
COMMON FRACTURE / PAINFUL DUE TO LOCATION
LONGITUDINAL & TRANSVERSE ARCHES = STRONG SHOCK ABSORBERS FOR WEIGHT
PROJECTIONS OF FOOT:
ROUTINE:
ADVANCED:
TECHNIQUE:
R: AP AXIAL, AP OBLIQUE & LATERAL (MEDIOLATERAL OR LATEROMEDIAL)
A: WEIGHT-BEARING, SESAMOID
TECH: 55-58 @ 2-3
AP AXIAL FOOT
AKA:
CR:
ANATOMY:
AKA: DORSOPLANTAR
CR: 10* POSTERIORLY (TO HEEL) @ BASE OF 3RD MTP
ANATOMY: TMT & MTP JOINTS OPEN,
- OVERLAP OF 2ND-5TH MT BASES
AP OBLIQUE FOOT
CR:
POSITION:
ANATOMY:
CR: BASE OF 3RD MTP
POSITION: 30* MEDIAL OBLIQUE
ANATOMY: 3-5TH MT BASES FREE OF SUPERIMP.
- TUBEROSITY OF 5TH IN PROFILE
- SINUS TARSI & JOINT AROUND CUBOID
LATERAL FOOT
CR:
POSITION:
ANATOMY:
CR: MEDIAL CUNEIFORM (LEVEL OF BASE OF 3RD MT)
POSITION: MEDIOLATERAL (COMMON) LATEROMEDIAL (ALTERNATIVE)
ANATOMY: TIBIOTALAR JOINT OPEN
- DOSTAL TIB/FIB SUPERIMP.
-MT SUPERIMP. W/ TUBEROSITY OF 5TH IN PROFILE
SESAMOID
CR:
POSITION:
ANATOMY:
COLLIMATION:
CR: TANGITIALLY TO POSTERIOR ASPECT OF 1ST MTP
POSITION: PRONE, FOOT DORSIFLEXED - TOES TO IR (can do supine w tape holding back toes)
- PLANTAR SURFACE 15-20* ANGLE FROM VERTICAL
ANATOMY: SESAMOIDS IN PROFILE FREE OF SUPERIMP.
- METATARSAL HEADS
COLLIMATION: 1-3RD DISTAL MT FOR POSSIBLE SESAMOID
WEIGHT BEARING AP FOOT
WHY?
CR:
POSITION:
ANATOMY:
-DEMO LONGITUDINAL ARCHES UNDER WEIGHT
CR: 15* POSTEIRORLY (TO HEEL) MIDPOINT BTQN FEET
POSITION: WEIGHT EVEN DISTRIBUTED
ANATOMY: Weight bearing projection of the feet
- soft tissue, phalanges, metatarsals, and distal tarsals
- Weight bearing marker should be present
WEIGHT BEARING LATERAL FOOT
CR:
POSITION:
ANATOMY:
CR: Directed horizontally to leve base of 3rd MT
POSITION: LATEROMEDIAL OR MEDIOLATERAL
ANATOMY: The longitudinal arch of the foot
- Heads of metatarsals superimp.
- Distal fibula superimposed BY TIB
LABEL THE IMAGE
A. Interphalangeal joint of first digit
B. Proximal phalanx of first digit
C. Metatarsophalangeal joint of first digit
D. Head of first metatarsal
E. Body of first metatarsal
F. Base of first metatarsal
G. Second or intermediate cuneiform
H. Navicular
I. Talus
J. Tuberosity of calcaneus
K. Third or lateral cuneiform
L. Cuboid
M. Tuberosity of the base of the fifth metatarsal
N. Fifth metatarsophalangeal joint
O. Proximal phalanx of fifth digit
LABEL THE IMAGE
A. Tibia
B. Calcaneus
C. Tuberosity of calcaneus
D. Cuboid
E. 5th MT tuberosity
F. Superimposed cuneiforms
G. Navicular
H. Subtalar joint
I. Talus
ANKLE JOINT IS FORMED BY:
LATERAL MALLEOLUS LOCATED:
- POSITION?
MEDIAL MALLEOLUS LOCATED:
-POSITION?
-TIBIA, FIBULA & TALUS OF FOOT
LAT. MAL = FIBULA
- 15-20* MORE POSTERIOR THAN MEDIAL MAL.
MED. MALL = TIBIA
- 1CM MORE POSTERIOR & 1CM MORE DISTAL THAN TIBIA
NAME OF INFERIOR TIB/FIB WHERE TALUS FITS:
IS THIS SEEN ON AP ANKLE? WHY/WHY NOT?
DEGREE OF MORTISE?
DISTAL TIBIAL JOINT (ROOF OF MORTISE) IS CALLED:
-MORTISE
-NOT SEEN IN AP B/C OVERLAPPING OF DISTAL FIBULA BY TALUS
-15-20* INTERNALLY TO OPEN MORTISE JOINT
TIBIAL PLAFOND (CEILING)
ANKLE PROJECTIONS
ROUTINE:
ADVANCED:
TECHNIQUE:
R: AP, AP MORTISE, AP OBLUQE & LATERAL
A: AP STRESS VIEW, AP WEIGHT BEARING
TECH: 58-60 @ 3-5
AP ANKLE
CR:
POSITION:
ANATOMY:
-CR: MIDWAY BTWN MALLEOLI
-POSITION: DORSIFLEX FOOT
-ANATOMY: TIBIOTALAR JOINT OPEN
- MEDIAL MORTISE OPEN, LATERAL MORTISE CLOSED
-SLIGHT SUPERIMP. TIB/FIB
AP MORTISE ANKLE
CR:
POSITION:
ANATOMY:
CR: MIDWAY BTW MALLEOLI
POSITION: 15-20* INTERNAL/MEDIAL ROTATION
- INTERMALLEOLAR LINE PARALLEL TO IR
ANATOMY: Entire mortise joint OPEN
- Distal fibula without talar superimposition- open lateral mortise
- Slight superimp. of distal TIB/FIB
AP OBLQUE ANKLE
CR:
POSITION:
ANATOMY:
CR: MIDWAY BTW MALLEOLI
POSITION: 45* MEDIAL ROTATION
ANATOMY: Distal tibiofibular joint is open
- Lateral malleolus & talus joint should show
min. Superimp
-Medial malleolus & talus SLIGHT superimposed
LATERAL ANKLE
CR:
POSITION:
ANATOMY:
CR: MEDIAL MALLEOLUS
POSITION: DORSIFLEX FOOT
ANAT: Distal fibula superimposed over
posterior half of tibia on a true lateral
- TIBIOTALAR JOINT OPEN
- Tuberosity of 5th MT, navicular & cuboid seen
LABEL THE IMAGE
A. Fibula
B. Lateral malleolus
C. Lateral mortise
D. Calcaneus
E. Talus
F. Medial mortise
G. Medial malleolus
H. Tibiotalar joint
I. Tibia
LABEL THE IMAGE
A. Fibula
B. Tibiotalar joint
C. Talar domes
D. Calcaneus
E. Talocalcaneal joint
F. Cuboid
G. Fifth metatarsal tuberosity
H. Navicular bone
I. Talus
J. Tibia
TYPE OF ANKLE JOINT:
WHAT EXTENDS FROM MALLEOLI TO TALUS/CALCANEUS?
EXPLAIN LATERAL STRESS OF ANKLE? AKA?
WHY PREFORM AP STRESS VIEWS OF ANKLE?
- SYNOVIAL, DIATHROTIC & SADDLE TYPE
-COLLATERAL LIGAMENTS
-“SPRAIN” - STRETCHED/TORN LIGAMENT (INCREASED IN PARTS OF THE MORTISE JOINT SPACE)
-EVALUATE STABILITY OF MORTISE JOINT SPACE
AP STRESS - ANKLE
WHY PREFORMED?
POSITION:
CR:
ANATOMY:
- ANKLE JOINT SEPRATION / LIGAMENTS
-POSITION: DORSIFLEX FOOT, ANFLE/LEG IN AP- MEDIAL = INVERSION & LATERAL = EVERSION STRESS
-CR: PERP. TO IR / MIDWAY BTW MALLEOLI
ANATOMY: Inversion = open up the joint space on the lateral side
- Eversion = open ankle joint space on medial side
WHICH STRESS VIEW IS WHICH:
WHO PREFORMS THE STRESS?
WHAT IS REQUIRED?
-AP ANKLE
- EVERSION STRESS (NO DAMAGE)
- INVERSION (RUPTURE OF LATERAL LIGAMENT)
DOCTOR PREFORMS / NEED TO HAVE LEAD SHIELD & GLOVES
AP WEIGHT BEARING ANKLE:
WHY PREFORMED?
POSITION:
CR:
ANATOMY:
-ANKLE JOINT SPACE NARROWING
POSITION: EQUAL WEIGHT DISTRIPUTED
CR: PERP. TO CASETTE, BTWN ANKLE JOINTS
ANATOMY: Medial mortise open
- Lateral mortise closed
- Distal tibia and talus partially superimp. BY FIB
