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w.RADT 132: Procedures II > knee, patella, femur > Flashcards

knee, patella, femur Flashcards

1
Q

kVp range for AP, oblique, and lateral knee

A

65-80 kVp

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2
Q

to position the knee for an AP knee, do the following:
______________________________________

A

rotate leg internally 3-5 degrees for a true AP or until inter-epicondylar line is parallel to plane of IR

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3
Q

to position the knee for an oblique (medial/internal) knee, do the following:
______________________________________

A

internally rotate entire leg 45 degrees

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4
Q

to position the knee for an oblique (lateral/external) knee, do the following:
______________________________________

A

externally rotate entire leg 45 degrees

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5
Q

for an AP knee, rotate leg _________________ for a true AP or until inter-epicondylar line is (parallel/not parallel) to plane of IR

A

internally 3-5 degrees, parallel

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6
Q

for an AP knee, align CR ________________________________; direct CR to a point ______ distal to the ____ of the patella

A

parallel to articular facets (tibial plateau); 1/2 inch; apex

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7
Q

CR angulation for an AP and oblique(s) knee exam…
thinner patient =
average patient =
thicker patient =

A

thinner patient = 5 caudad
average patient = 0
thicker patient = 5 cephalad

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8
Q

What is a “thinner”/”average”/”thicker” patient measurements when measuring for AP and oblique knee exams?

A

less than 19 cm = thinner
19-24 cm = average
greater than 24 = thicker

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9
Q

in an AP knee, the ______________ joint space should be (open/closed)

A

femorotibial; open

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10
Q

in an AP knee, the femorotibial joint space should be open with the articular facets of the tibia seen on end with only _____________________________

A

minimal surface area visualized

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11
Q

in an AP knee, the medial half of the fibular (head/base) (should/should not) be superimposed by the tibia

A

head; should

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12
Q

for an oblique (medial/internal) knee, direct the CR ___________

A

1/2 inch distal to apex of patella

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13
Q

for an oblique (lateral/external) knee, direct the CR ___________

A

1/2 inch distal to apex of patella

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14
Q

in an oblique (medial) knee, the patella superimposes __________

A

the medial femoral condyle

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15
Q

in an oblique (medial) knee, the __________________ are well demonstrated and the _________________ appear unequal

A

lateral condyles of the femur and tibia; medial and lateral knee joint spaces

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16
Q

in an oblique (medial) knee, the fibula is shown (with/without) superimposition. Approximately ____ of the patella should be seen free of superimposition by the femur

A

without; half

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17
Q

in an oblique (medial) knee, the tibiofibular articular is (open/closed)

A

open

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18
Q

in an oblique (lateral) knee, direct the CR ________

A

1/2 inch distal to apex of patella

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19
Q

in an oblique (lateral) knee, the patella superimposes the _____________

A

lateral femoral condyle

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20
Q

in an oblique (lateral) knee, the _____________ and ____ are seen in profile

A

medial condyles of femur, tibia

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21
Q

in an oblique (lateral) knee, the proximal fibula (is /is not) superimposed by the proximal tibia

A

is

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22
Q

in an oblique (lateral) knee, approximately ____ of the patella should be seen free of superimposition by the femur

A

half

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23
Q

a lateral knee utilizes the _________ projection

A

mediolateral

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24
Q

for a lateral knee in the lateral recumbent position, the knee is to be flexed ____ degrees with the affected side ____

A

20-30 degrees; down

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25
Q

what is an alternative for a lateral knee if patient is unable to flex the knee?

A

horizontal beam

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26
Q

a true lateral knee has the femoral epicondyles ____________ and plane of patella is ________

A

directly superimposed; perpendicular to the plane of the IR

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27
Q

the CR angulation on a lateral recumbent knee should be __________

A

5-7 degrees cephalad

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28
Q

Direct CR to ________________ for lateral knee (both lateral recumbent and horizontal beam)

A

1 inch distal to medial epicondyle

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29
Q

in a lateral knee, the _____________ should be open

A

patellofemoral and knee joints

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30
Q

over rotation in a lateral knee will show ________________

A

less superimposition of fibular head

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31
Q

under rotation in a lateral knee will show ________________

A

more superimposition of fibular head

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32
Q

a true lateral knee without rotation shows ____________________ of the femoral condyles ___________

A

posterior borders, directly superimposed

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33
Q

in a lateral knee, the 5-7 degree angulation of the CR causes:

A

direct superimposition of distal borders of the condyles

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34
Q

for an AP femur (proximal and distal), CR is directed _________

A

midpoint of femur/IR

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35
Q

for an AP femur, the lower IR margin should be approximately _________ below knee joint

A

2 inches

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36
Q

in an AP femur, the knee joint (will/will not) appear open. The patella will be ____________

A

will not; slightly medial

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37
Q

kVp range for AP and lateral femur

A

75-85 kVp

38
Q

a lateral recumbent femur (should/should not) be attempted in a trauma

A

should not

39
Q

knee flexion for lateral recumbent femur

A

45 degrees

40
Q

for a lateral femur, CR is directed _________

A

perpendicular to femur and directed to midpoint of IR

41
Q

a true lateral femur will have ___________ and _______________

A

anterior and posterior margins of medial and lateral femoral condyles superimposed; open patellofemoral joint space

42
Q

a lateral recumbent femur will have a ________ projection

A

mediolateral

43
Q

the upper IR margin on a lateral femur should be at the _____

A

ASIS

44
Q

AP weight-bearing knees will have the CR at this angle

A

perpendicular to the IR

45
Q

where is the CR directed with an AP weight bearing knee?

A

between the knees, 1/2 inch distal to patella apex

46
Q

in an AP knee, the patella is just __________ to the femoral patellar surface and _____________ to midline of the knee

A

proximal, slightly lateral

47
Q

what is the SID for Merchant Board sunrise patella?

A

48 or 72 inch SID

48
Q

kVp range for Camp Conventry method

A

70-80 kVp

49
Q

Camp Conventry: patient is _____. Flex knee _________.
CR: caudad angle ________________

A

prone, 40-50 degrees, to match the flexion of the knee

50
Q

for Camp Coventry, the CR is directed at __________

A

popliteal crease

51
Q

CR angle for PA patella

A

perpendicular to IR

52
Q

CR angle for lateral patella

A

perpendicular to IR

53
Q

where is the CR directed entered at for a lateral patella?

A

mid-patellofemoral joint

54
Q

where is the CR directed entered at for a PA patella?

A

mid-popliteal/midpatella area

55
Q

for a true PA patella, the inter-epicondylar line is __________ to the IR; how is this achieved?

A

parallel; rotating knee 5 degrees internally (similar to an AP knee)

56
Q

how many inches of overlap is necessary for femur exams?

A

at least 2 inches

57
Q

AP proximal femur positioning
-Make sure pelvis (is/is not) rotated (_____________)
-Rotate leg __________ to place the femoral neck _______to IR for a true AP of the proximal femur
-Place top of cassette to the level of _________

A

-is not (ASISs equidistant from table)
-15-20° internally, parallel
-Place top of cassette to the level of the ASIS

58
Q

in an AP proximal femur, the obturator foramen should be ____

A

open

59
Q

AP distal/mid femur positioning
-Rotate affected leg _____________ so that the ___________________

A

medially 5º; epicondyles are parallel with the IR

60
Q

the AP femur will show the _________
the lateral femur will show the ___________

A

AP = greater trochanter
lateral = lesser trochanter

61
Q

kVp range for Beclere method

A

65-80 kVp

62
Q

Positioning for Beclere method: Flex knee __________ (place support under IR as needed to place it firmly against the posterior thigh and lower leg)

A

45-50º

63
Q

CR angle for Beclere method

A

approx. 40-45 cephalad, directed perpendicular to lower leg

64
Q

CR centering for Beclere method

A

1/2 inch distal to apex of patella

65
Q

Positioning for a lateral patella
___________ projection
femoral epicondyles _________________; plane of patella _____________to plane of IR
flexed knee at ____________

A

mediolateral
directly superimposed; perpendicular
flexed knee at 5-10 degrees

66
Q

What are the 2 intercondylar fossa views we covered in lecture?

A

Camp Coventry, Beclere

67
Q

PA weight-bearing knees will have the CR at this angle

A

10 degrees caudad (PA only; AP is perpendicular)

68
Q

Hughston is method for what type of exam?

A

patella tangential/sunrise

69
Q

Camp Conventry is method for what type of exam?

A

intercondylar fossa

70
Q

Merchant board is method for what type of exam?

A

patella tangential/sunrise

71
Q

Settegast is method for what type of exam?

A

patella tangential/sunrise

72
Q

Positioning for Hughston exam

A

patient prone, knee flexed 50-60 degrees from full extension

73
Q

CR angle for Hughston method

A

45 degrees cephalad

74
Q

CR entrance for Hughston method

A

tangential to patellofemoral joint

75
Q

Positioning for Settegast exam

A

patient either prone or sitting

-knee at least 90 degree flexion for prone
-knee “90 degree flexion” for seated (less in real life)

76
Q

CR angle for Settegast method (specifically for the prone position)

A

15-20 degrees tangential to patellofemoral joint space

77
Q

CR angle for Settegast method (as learned at clinical for seated position)

A

15-20 degrees tangential to patellofemoral joint space

**not in textbook, but from clinical & for memory’s sake = crosshairs of light beam at patellofemoral joint space (107 degrees cephalic)

78
Q

Positioning for merchant board exam

A

Place patient in supine position on the table with legs hanging off of the end and knees flexed 40º resting on the Merchant Board

distal femurs resting on tabletop; knees and feet together

79
Q

CR entrance for Merchant board exam

A

midway between patellae (bilateral)

80
Q

CR angle for Merchant board exam

A

caudad, 30 degrees from horizontal plane (CR 30 deg. from femur)

81
Q

What muscle must be relaxed for a Merchant Board exam? Why?

A

Quadriceps femora muscles, to prevent subluxation of the patellae.

Can be pulled into the intercondylar sulcus/groove —> false reading

82
Q

Camp Coventry positioning

A

Patient prone, knee flexed 40-50 degrees

83
Q

CR angle for Camp Coventry

A

40-50 degrees caudad (perpendicular to lower leg)

84
Q

CR entrance for Camp Conventry

A

Center to knee joint emerging at distal margin of patella

85
Q

Positioning for Holmbald method

A

Patient on all fours or partially standing; kneeling on board, weight on opposite leg

Lean patient forward 20-30 degrees

86
Q

CR angle for Holmbald method

A

Perpendicular

87
Q

CR entrance for Holmbald method

A

Midpopliteal crease

88
Q

Positioning for Hobbs method

A

Patient sitting on chair/table with board under knees; feet slightly underneath chair/table

89
Q

CR angle for Hobbs method

A

Perpendicular to IR

90
Q

CR entrance for Hobbs method

A

Mid patellofemoral joint

91
Q

SID considerations for Hobbs and Merchant exam

A

Increase to reduce magnification

w.RADT 132: Procedures II (9 decks)

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