Leg, Knee, Femur Ch. 7 Flashcards

1
Q

The __ is the larger of the two bones in the leg

A

Tibia

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2
Q

The proximal end of the tibia has two prominent processes called the ___ and ____.

A

Medial and Lateral Condyles

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3
Q

The two flat-like superior surfaces on the tibia are called the ___ and they slope posteriorly ____ degrees.

A
  • Tibial Plateaus
  • 10 to 20 degrees
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4
Q

Between the two articular of the tibia, the surfaces are a sharp projection called the ___, which terminates in two beaklike processes the ____ & _____ .

A

-Intercondylar eminence
-Medial and lateral intercondylar tubercles

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5
Q

The lateral condyle has a facet at its distal posterior surface for articulation with the ___

A

Head of Fibula

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6
Q

On the anterior surface of the tibia, just below the condyles, is a prominent process called the ___

A

Tibial Tuberosity

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7
Q

The ___ is slender and consists of one ___ and two articular extremities

A
  • Fibula
  • Body
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8
Q

The proximal end of the fibula is expanded into a __, which articulates with the lateral condyle of the tibia.

A

Head

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9
Q

The ________ is the longest and strongest bone in the body.

A

Femur

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10
Q

The __ is cylindrical and slightly convex anteriorly, and slants __

A
  • Femur body
  • 5-15 degrees medially
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11
Q

When the femur is vertical, the ___ condyle is lower than the ___ condyle. The difference is about ___

A
  • Medial
  • Lateral
  • 5 to 7 degrees
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12
Q

Because of this difference, on lateral radiographs of the knee, the central ray is angled ___ to open the joint space of the knee.

A

5 - 7 degrees cephalad

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13
Q

The distal end of the femur is broadened and has two large eminences; the larger ___ and the smaller ___

A
  • Medial Condyle
  • Lateral Condyle
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14
Q

The condyles on the femur are separated anteriorly by the ___; a shallow, triangular depression

A

Patellar surface

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15
Q

Posteriorly, the condyles on the femur are separated by a deep depression called the ___

A

Intercondylar fossa

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16
Q

A slight prominence above and within the curve of each condyle on the femur forms the __ and __

A
  • Medial Epicondyle
  • Lateral Epicondyle
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17
Q

The medial condyle on the femur contains the _ which is located on the posterolateral aspect

A

Adductor tubercle

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18
Q

The largest and most constant sesamoid bone in the body is the ___.
It is a flat, triangular bone situated at the ___ surface of the femur

A
  • Patella
  • Distal Anterior
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19
Q

The __or tip is directed inferiorly and lies half an inch above the joint space of the knee

A

Apex of the knee

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20
Q

The superior border of the patella is called the ___

A

Base

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21
Q

The ___ is one of the most complex joints in the human body.
Which bones make up this joint?

A
  • Knee Joint
  • Tibia, Fibula, Patella, Femur
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22
Q

The __ is held together by a complex group of ligaments that work together to provide ___

A
  • Knee Joint
  • Stability
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23
Q

Many patients with knee injuries do not have __, but they may have one or more __, which can cause great pain and may alter the position of the bones

A
  • Fractures
  • Torn ligaments
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24
Q

Name the four ligaments that hold the knee joint together:

A

Posterior cruciate ligament
Anterior cruciate ligament
Tibial collateral ligament
Fibular collateral ligament

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25
Q

The knee joint contains two fibrocartilage disks called the __ and __

A

Lateral meniscus and medial meniscus

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26
Q

The Mensici provide stability and act as a __. They are commonly torn during injury

A

Shock Absorber

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26
Q

A ___ or ___ must be performed to visualize a meniscus tear

A

Knee arthrogram or MRI

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27
Q

The head of the fibula articulates with the posteroinferior surface of the lateral condyle of the tibia, which forms the ___ joint: a ____ joint

A
  • Proximal tibiofibular joint
  • Synovial Gliding
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28
Q

The patella articulates with the patellar surface of the femur to form the __ joint

A

Patellofemoral joint

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29
Q

When the knee is extended and relaxed, the patella is _ over the patellar surface of the femur

A

Freely Moveable

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30
Q

When the knee is flexed as a ___ joint, the patella is locked in position in front of the patellar surface

A

Synovial Gliding

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31
Q

Unless the leg is unusually long, the IR should extend beyond the knee and ankle joints to __. When the leg is too long, ___ should be taken to include one joint and a separate projection of the other joint. __use of a 14x17 IR is also an option

A
  • 1- 1/2 Inches
  • Two Radiographs
  • Diagonal
32
Q

The knee joint or __ is the largest joint in the body.
It is called a ___

A
  • Synovial Gliding Joint
  • Modified Hinge Joint
33
Q

To reduce the divergence of the x-ray beam and include more of the body part use a __ SID.

A

48 inches

34
Q

For an AP projection of the leg place the patient in the __ position. Ensure the __ is without rotation, the __ are parallel with the IR, and the __ is flexed to place __ vertical

A
  • Supine
  • Pelvis
  • Femoral Condyles
  • Ankle
  • Foot
35
Q

For an AP Leg, The CR is ___

A

Perpendicular to the center of the leg

36
Q

What structures are shown on an AP Leg projection?

A
  • Tibia
  • Fibula
  • Adjacent Joints ( Medial and Lateral Malleolus)
37
Q

Evaluation Criteria for AP Leg Projection

A
  • Ankle and knee joints on one or more images

Entire leg without rotation
- Proximal and distal articulations of the tibia and fibula moderately overlapped
- Fibular midshaft free of tibial superimposition

38
Q

For a lateral projection of the leg place the patient in the ___ position. Turn the patient towards the ___ side with the leg on the IR. Adjust rotation of the body to place the ___ perpendicular to the IR and ensure the ___are superimposed and perpendicular to IR. The __ may be flexed if needed to obtain ___ position.
Include _ on IR, or perform ___

A
  • Supine
  • Affected Side
  • Patella
  • Femoral Condyles
  • Knee
  • True Lateral
  • Ankle and Knee Joints
  • Two radiographs
39
Q

For a Lateral Projection of the leg; If the patient cannot be turned from the supine position. Perform cross-table using __ CR. IR is placed ___ and CR is directed from the _ side

A

-Horizontal
- Between the legs
- Lateral

40
Q

For a lateral projection of the leg; CR is ___

A

Perpendicular to the midpoint of the leg

41
Q

Structures shown on a Lateral Projection of the leg:

A
  • Tibia, Fibula, and Adjacent Joints
    (medial malleolus, femoral condyles, patella)

(pg. 343)

42
Q

Evaluation Criteria for a Lateral Projection of the Leg:

A
  • Ankle and Knee joints on one or more images

The entire leg in a true lateral position
- Distal fibula superimposed by the proximal half of the tibia
- Slight overlap of the tibia on the proximal fibular head

(pg. 343)

43
Q

Radiographs of the knee may be taken with or without a ___, although it is most often used.

A

Grid

44
Q

When performing a knee radiograph; Factors to consider include the ___ and the __ of the radiographer and physician.

A
  • Size of the patient’s knee
  • Preference
45
Q

For all projections of the knee __ IR size is used

A

10 x 12

46
Q

For an AP projection of the knee, place the patient in the __ and ensure no rotation of the __. Center the IR half an inch below the __. The knee should be __

A
  • Supine Position
  • Pelvis
  • Apex
  • Fully extended
47
Q

Structures shown on an AP Knee Projection:

A
  • Distal end of Femur
  • Patella
  • Lateral Epicondyle
  • Lateral Tibial Plateau
  • Intercondylar Eminence
  • Head of Fibula
  • Tibia proximal
  • Fibula proximal

(pg.347)

47
Q

For an AP Knee Projection; The CR enters __ to the patellar apex. It is __ depending on anterior superior iliac spine measurements.

<19 cm= ___
19 - 24 cm= ____
>24 cm= ____

A
  • 1/2 inch
  • Variable
  • 3-5 degrees caudad (thin pelvis)
  • 0 degrees
  • 3-5 degrees cephalad (large pelvis)

(pg. 346)

48
Q

Evaluation Criteria for AP Knee Projection:
(pg. 347)

A
  • Knee fully extended if patient is able to

Entire knee without rotation:
- slight superimposition of the fibular head if the tibia is normal
- Patel completely superimposed on the femur
- Open femorotibial joint space, with interspaces of equal width on both sides of the knee is normal

49
Q

For a lateral projection of the knee, ask the patient to turn onto the __. The unaffected extremity is extended __ it or may also be placed in ___.

A
  • Affected Side
  • Behind
  • Front of the affected knee for support
50
Q

For a Lateral Knee Projection; Flex the knee __ to show the maximum volume of the joint cavity. If a patella fracture is present, use no more than __ of flexion to prevent fragment separation.

A
  • 20-30 degrees
  • 10 degrees
51
Q

For a Lateral Knee Projection; Place a support __ and adjust the knee until the femoral epicondyles are __ to the IR, the condyles are __and the __ is perpendicular to the IR

A
  • Under the Ankle
  • Perpendicular
  • Superimposed
  • Patella
52
Q

For a lateral knee, the central ray enters knee joint ___ to the medial epicondyle at an angle of __

A
  • 1 inch distal
  • 5 to 7 degrees cephalad
53
Q

For a Lateral Knee Projection; The slight angulation of the CR prevents the joint space from being obscured by the ___.

A
  • Magnified medial femoral condyle
54
Q

Structures shown for a Lateral Knee:

A

A lateral image of the distal end of the femur, patella, knee joint, proximal ends of the tibia and fibula, and adjacent soft tissue

(pg.351)

55
Q

Evaluation Criteria for a Lateral Knee:

(pg.351)

A
56
Q

For the AP oblique knee medial rotation, place the patient on the radiographic table in the ___ position and ___ the ankles. Medially rotate the extremity and elevate the hip of the ___ enough to rotate the extremity __ degrees.

A
  • Supine
  • Support
  • Affected Side
  • 45 degrees
57
Q

Structures shown on a AP Oblique Knee Medial Rotation:

A

An AP oblique projection of the medial rotated femoral condyles, patella, tibial condyles, proximal tibiofibular joint, and head of the fibula.

(pg. 355)

58
Q

Eval Criteria for an AP Oblique Knee Medial Rotation:

A
  • tibia and fibula separated at their proximal articulations
  • posterior tibia
  • Lateral condyles of the femur and tibia
  • both tibial plateaus
  • open knee joint
  • margin of the patella projecting slightly beyond the medial side of the femoral condyle

(pg. 355)

59
Q

For an AP Oblique Knee Lateral Projection place the patient on the radiographic table in the ____ position and support the ___.
Center the IR ____ . Externally rotation the extremity 45 degrees.

A
  • Supine
  • Ankles
  • 1/2 inch inferior to the patellar apex
60
Q

The central ray for an AP Oblique Knee Lateral Projection is ____

A

1/2 inch inferior to the patellar apex , the angle depends on the measurement between the ASIS and the tabletop just as it does for a AP
Knee Projection.

61
Q

Eval Criteria and Structures Shown for an AP Oblique Knee Lateral Rotation:

(pg. 354)

A

An AP oblique projection of the laterally rotated femoral condyles, patella, tibial condyles, and head of the fibula

62
Q

For an AP projection of the femur, place the patient in the ___ position, and ensure there is no rotation of the ____

A

-Supine
- Pelvis

63
Q

Center the __ to the IR. If the femur is too long to fit on one IR, include the ___ to the area of interest

A
  • Affected Thigh
  • Joint Closest
64
Q

For an AP projection of the ___ femur with the knee included, the leg is ___, the affected thigh is __ to the midline of IR, the extremity is __ to place femoral epicondyles ___ with the IR, and the bottom of IR extends __ the knee joint.

A
  • Distal femur
  • Extended
  • centered
  • Internally rotated
  • Parallel
  • 2 inches below
65
Q

For an AP projection of the __ femur with the hip included, the leg is __ , the affected thigh is __ to the midline of the IR, the top of the IR is at the __, and the extremity is __ to place femoral necks in profile

A
  • proximal
  • fully extended
  • centered
  • level of ASIS
  • rotated 10-15 degrees internally
66
Q

The CR is ___ to mid-femur and the center of IR.

A

Perpendicular

67
Q

AP Femur Structures Showen and Evaluation Criteria

(pg. 369)

A

An AP projection of the femur, including the knee joint or hip or both

68
Q

For a lateral projection of the femur ask the patient to turn toward the _, and center the _ to the midline to the IR.

A

Affected side, affected thigh

69
Q

For a lateral projection of the _, femur to include knee, place the _ in front of the _ for support, adjust the _ into the true lateral position, _ the affected knee _, and place the _ perpendicular to the tabletop.

A

Distal, unaffected extremity, affected extremity, pelvis, flex, 45 degrees, epicondyles

70
Q

For a lateral projection _ femur to include hip, place the IR at the level of the _, draw the _ posteriorly and support, adjust the pelvis so that it is _ from the lateral position _ just enough to prevent _

A
  • Proximal
  • ASIS
  • unaffected extremity
  • rolled 10-15 degrees
  • posteriorly
  • superimposition
71
Q

Structures Shown and Evaluation Creita for a Lateral Femur:

(pg. 370)

A
72
Q

(Lateral Femur) Evaluation Criteria with Knee Included:

(pg. 371)

A
73
Q

(Lateral Femur) Evaluation Criteria with Hip Included:

(pg.371)

A
74
Q

What is visible on the medial aspect of the proximal femur?

A
  • Lesser Trochanter
75
Q

On a proximal femur, what is something you have to remember to do, that you don’t have to do on a distal femur and why?!

A

Toes are turned inward, pigeon toed to place the femoral neck in profile!!

76
Q

What will you see on a lateral femur with the hip included?

A

Lesser Trochanter