lower extremity Flashcards

1
Q

what are the 26 bones of the foot? (distribution)

A

14 phalanges
5 metatarsals
7 tarsal bones

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2
Q

what are the divisions of the foot?

A

forefoot, midfoot, and hindfoot

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3
Q

what bones are a part of the forefoot?

A

toes and metatarsals

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4
Q

what bones are a part of the midfoot?

A

cuneiforms, navicular, and cuboid

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5
Q

what bones are a part of the hindfoot?

A

calcaneous and talus

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6
Q

what are the 3 cuneiforms

A

medial, middle, lateral

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7
Q

what is another word for calcaneous

A

os calcis

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8
Q

which side of the foot goes up in a 45 degree

A

the lateral (5th) side

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9
Q

what is the hallux

A

the great toe

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10
Q

what is different about the hallux

A

it has 2 sesamoids posterior to the head of the metatarsal, separated by a ridge of bone

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11
Q

why is the tuberosity of the 5th metatarsal significant

A

very common place to fracture

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12
Q

what is on the base of the fifth metatarsal

A

the tuberosity of the 5th metatarsal

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13
Q

what is a Jones’ fracture

A

twist injury
tendon pulls a small portion of the fifth metatarsal off
regularly causing avascular mecrosis

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14
Q

what is the most superior tarsal bone

A

the talus

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15
Q

what does the talus articulate with? (4)

A

tibia, fibula, calcaneous, navicular

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16
Q

what makes the talus a ball and socket joint

A

the head that articulates with navicular

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17
Q

what part of the talus articulates with the tibia and fibula

A

talar domes

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18
Q

what is the sulcus tali and where is it

A

the groove that forms the roof of the sinus tarsi
(inferior neck of the talis)

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19
Q

what is the sinus tarsi

A

the hole inferior to the talus

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20
Q

what does the talus have 3 of

A

articular facets (articulate with the ant/mid/pos calcaneous)

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21
Q

what are the 3 articular facets of the talus

A

anterior, middle, posteriorw

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22
Q

with what do the articular facet articulate with to form subtalar joints

A

the facets of the calcaneous

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23
Q

which is the largest tarsal bone

A

the calcaneous

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24
Q

what is the posterior tuberosity of the calcaneous for

A

Achilles attachment

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25
Q

what are on the superior side of the calcaneous

A

the 3 facets (anterior, middle, posterior)

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26
Q

what forms the floor of the sinus tarsi

A

the calcaaneal sulcus

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27
Q

what is the sustentaculum tali

A

forms a “shelf” for the middle subtalar joints (middle facet)

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28
Q

what is on the lateral side of the calcaneous

A

the lateral process and the trochlea

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29
Q

which joints can be seen easily on the axial view of the calcaneous

A

the middle and posterior subtalar joints

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30
Q

what are the 4 joints of the talus

A

tibiotalar joint
fibulotalar joint
subtalar joints (3)
talonavicular joint

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31
Q

what is special about the talonavicular joint

A

it is one of only 3 ball and socket joints in the body

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32
Q

what is at the proximal end of the femur

A

the head (fovea capitis

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33
Q

what is the slope of the neck of the femur

A

slopes 15-20 deg posteriorly from the pelvis

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34
Q

what is done with the legs when taking an AP of the pelvis

A

we turn the legs 15-20 deg inwards to compensate

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35
Q

how do you palpate the greater trochanter

A

turn leg inwards and outwards

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36
Q

where is the lesser trochanter located on a true AP pelvis

A

it will be posterior to the femur

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37
Q

where are the femoral trochanters on a proper x table lateral

A

greater: superimposed on the femoral neck
lesser: posterior to the femoral neck

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38
Q

where are the femoral trochanters on a x table lateral with not enough internal rotation

A

greater: posterior to the femoral neck
lesser: medial
to neck

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39
Q

what is the angle from the side of the femur to the femoral neck

A

135 (125 + 10)

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40
Q

how many degrees do you angle in a x table hip

A

45 degrees from the femoral neck
(135 is 45 away from 180)

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41
Q

what does it prove when you image the femur without being able to see the lesser trochanters

A

that you are seeing the femoral neck without any foreshortening

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42
Q

what is at the distal end of the femur

A

medial and lateral femoral condyles

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43
Q

what are the parts of the medial femoral condyle

A

medial epicondyle
adductor tubercle

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44
Q

where is the adductor tubercle

A

its on the medial condyle, and very posterior on it

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45
Q

what is part of the lateral femoral condyle

A

lateral epicondyle
sulcus terminalis

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46
Q

how can you tell apart the femoral condyles

A

if there’s a bump out the back, that’s the adductor tubercle, so the medial condyle

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47
Q

when can you see the sulcus terminalis

A

in a lateral view of the femur

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48
Q

which tibial condyle is curved

A

the medial tibial plateau

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49
Q

which femoral condyle is more distal? by how much?

A

medial condyle
by 5-7 degrees

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50
Q

what angle is used for a mediolateral knee

A

5-7 cephalad

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51
Q

why would we do a x table lateral knee

A

to show lipohemarthrosis

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52
Q

what is on the anterior surface of the distal femur

A

trochlear groove (patella articulation)

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53
Q

what is on the posterior surface of the distal femur

A

intercondylar notch, fossa, or tunnel

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54
Q

what is the white line visible in the middle of a lateral knee

A

the roof of the tunnel (on the posterior surface)

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55
Q

what does the line at the end of the femur on a lateral view correspond to

A

, (in a skyline view ex)

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56
Q

what does the little rounded line inside the middle of a lateral knee correspond to

A

the trochlear groove

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57
Q

which side of the patella is the base (top or bottom)

A

the top

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58
Q

which side of the patella is the apex

A

the bottom

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59
Q

what does the patella articulate with

A

the trochlear groove

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60
Q

what tendon is attached to the patella

A

the quadriceps ligaments come together to the quadriceps tendon

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61
Q

what makes up the bony pelvis

A

2 hip bones, sacrum, coccycx

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62
Q

what is the purpose of the pelvis

A

connects the lower extremity to the axial skeleton
protects lower reproductive organs, GItract,
strong support for the trunk

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63
Q

what are the parts of the hip bone

A

ilium
ischium
pubis

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64
Q

what is the upper part of the ilium called

A

the Ala

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65
Q

how is the Ala curved

A

posterior is most medial, anterior part is most lateral

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66
Q

what is the iliac crest the landmark for

A

L4

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67
Q

what is ASIS

A

anterior superior iliac spine

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68
Q

what is the AIIS

A

anterior inferior iliac spine

69
Q

which one (ASIS, AIIS) can you palpate

A

the ASIS

70
Q

PSIS

A

posterior superior iliac spine

71
Q

PIIS

A

posterior inferior iliac spine

72
Q

why is the PSIS a landmark

A

the SI joint is immediately interior to the PSIS

73
Q

where is the greater sciatic notch

A

the big groove between the ilium and ischium

74
Q

why is the greater sciatic notch important

A

shows it the body is in a true lateral by looking at superimposition

75
Q

what parts of the hip forms most of the acetabulum

A

the body of the ilium

76
Q

what forms the sacral iliac joint

A

the auricular surface of the ilium forms with the auricular surface of the sacrum

77
Q

why is the arcuate fossa significant

A

it separates Ala from body (of ilium)
but more importantly, forms part of the pelvic brim

78
Q

where does the arcuate line run to and from

A

from the auricular surface to the pubis

79
Q

where (directionally) is the ischium

A

inferior and posterior

80
Q

when can the ischial spine be seen

A

when the pelvis is rotated

81
Q

what do we sit on

A

the ischial tuberosity (star)

82
Q

what is the ischial ramus

A

projects anteriorly and medially
connecting to the inferior pubic ramus

83
Q

what are the parts of the pubis

A

superior pubic ramus
body
inferior pubic ramus

84
Q

what parts of the pubis form the acetabulum

A

superior pubic ramus

85
Q

what does the inferior pubic ramus ramus connect to

A

ischial ramus

86
Q

what is the pubic arch

A

the angle between the two inferior pubis rami

87
Q

what can you tell from the pubic arch

A

whether the body is male or femal

88
Q

what is the pectineal line

A

travels along superior pubic ramus, meets the arcuate line of the ilium

89
Q

when looking down at a pelvis, wta is the round ‘bowl’ seen

A

the epelvuc brim

90
Q

1

A

body of ilium

91
Q

3

A

Ala of ilium

92
Q

4

A

arcuate line of ilium

93
Q

5

A

iliac crest

94
Q

10

A

ASIS

95
Q

what is the ASIS a landmark for

A

SI

96
Q

11

A

AIIS

97
Q

14

A

iliac fossa

98
Q

21

A

ischial ramus

99
Q

25

A

body of pubis

100
Q

26

A

pubic tubercle

101
Q

28

A

pubic crest

102
Q

29

A

superior pubic ramus

103
Q

32

A

inferior pubic ramus

104
Q

33

A

obturator foramen

105
Q

what happens in an RPO position

A

as we turn to the right, the right Ala becomes much wider, and the left Ala becomes in profile (star)

106
Q

what happens to the obturator foramen in an RPO

A

as they turn to the right, the left obturator foramen becomes open

107
Q

if a right obturator foramen is open, and the left Ala appears wider, which way is the pelvis rotated

A

LPO

108
Q

what are the pubic arch angles for males and females, respecively

A

<90 males
>90 female

109
Q

what forms the superior part of the acetabulum

A

the ilium

110
Q

what forms the posterior part of the acetabulum

A

ischium

111
Q

what forms the anterior part of the acetabulum

A

pubis

112
Q

what are Judet views for

A

fractures of the acetabulum

113
Q

what are the two columns of bones in the Judet views

A

iliopobic column (anterior)
ilioischial column (posterior)

114
Q

what is the pelvic brim

A

boundary line that separates the true pelvis form the false pelvis

115
Q

what are the five parts that make up the pelvic brim

A

sacral promontory
aurate lines of ilium
pectineal lines of pubis
pubic crest (or superior part of superior pubic ramus)
superior part of pubic symphysis (NOT a bony part)

116
Q

what is the pelvic brim

A

the entrance to the true pelvis

117
Q

what is in the false pelvis

A

superior mart of bladder
lower intestines
uterus, ovaries, fallopian tubes

118
Q

what is the false pelvis bound by

A

lumbar spine, Ala, anterior abdominal wall

119
Q

what is the true pelvis bound by

A

sacrum/coccyx, body of ilium, ischium, pubic bones

120
Q

what does the true pelvis contain

A

rectum, bladder, prostate/vagina/cervix

121
Q

what forms the pelvic inlet

A

the same things that forms the pelvic brim

122
Q

what is the pelvic outlet

A

the inferior opening of the true pelvis

123
Q

what is the pelvis outlet bounded by laterally

A

between the ischial tuberosities

124
Q

what is the AP diameter of the pelvic outlet

A

tip of coccyx to inferior margin of pubic symohysis

125
Q

what do you do for pubic bone fractures

A

inlet and outlet views

126
Q

what do you do for acetabulum fractures

A

Judet views

127
Q

what angle is used for a inlet view

A

40 degrees caudad

128
Q

what angle is used for a pelvic outlet view

A

30 degrees cephalad

129
Q

what are the differences between female and male pelves

A

females have a larger true pelvis (inlet and outlet)
females have a shallow false pelvis, males have a deep false pelvis
female have a pubic arch greater than 90 degrees

130
Q

what determines the width of the pelvic inlet

A

the width of the arcuate lines on the ilium

131
Q

what are the 3 calcaneal articulations

A

subtalar/talocalcaneal joints (3)
calcaneonavicular joint
calcaneocuboid joint

132
Q

where is the calcaneonavicular joint

A

on the anterior process of the calcaneous

133
Q

what are the navicular articulations (3)

A

calcaneonavicular joint
talonavicular joint
all 3 cuneiforms

134
Q

what are the cuboid articulations (4)

A

calcaneocuboid joint
joint between cuboid and lateral cuneiform
TMT joints (w4/5 metatarsals)
navicular

135
Q

what are the 3 cuneiform articulations

A

medial cuneiform
intermediate cuneiform
lateral cuneiform

136
Q

what is the medial cuneiform joint

A

TMT joints with great toe

137
Q

what is the intermediate cuneiform joint

A

TMT joints with 2nd toe

138
Q

what is the elateral cuneiform joint

A

TMT joints with 3rd toe

139
Q

what lines up in the cuneiform joints?

A

the medial part of the cuneiforms must line up with the medial aspect of the metatarsals

140
Q

what are 2 properties of longitudinal arches

A

shock absorber
provides leverage while walking

141
Q

what forms the longitudinal arches

A

tarsal and metatarsal bones

142
Q

what are the 2 longitudinal arches

A

medial longitudinal arch and lateral longitudinal arch

143
Q

which longitudinal arch is higher

A

medial

144
Q

where is the medial longitudinal arch

A

originates at the calcaneous
rises to the talus
ends at the heads of the first 3 metatarsals

145
Q

where is the lateral longitudinal arch

A

originates at the calcaneous
rises to cuboid
ends at the head of the lateral 2 metatarsals

146
Q

what forms the transverse arch

A

3 cuneiforms, cuboid, bases of all 5 metatarsals

147
Q

what are the 2 major bones of the lower leg

A

tibia and fibula

148
Q

tib/fib which is more medial

A

tibia

149
Q

tib/fib which is more posterior

A

fibula

150
Q

where is the tibial plateau

A

on the proximal part of the tibia

151
Q

what forms the tibial plateau

A

medial and lateral condyles

152
Q

where is the facet in the tibial plateau

A

posterolateral surface

153
Q

which tibial condyle is curved form anterior to posterior

A

medial

154
Q

what direction is the slope of the proximal tibia

A

posterior slope

155
Q

what separates the tibial condyles

A

intercondylar eminences

156
Q

what is the tibial tuberosity

A

the attachment for the patellar ligament

157
Q

what is a part of the distal tibia (4)

A

medial malleolus
fibular notch
anterior tubercle
tibial plafond

158
Q

where is the fibular notch

A

the lateral side of the distal tibia

159
Q

what is the ankle mortise

A

refers to the bony arch formed between the tibial plafond and malleoli

160
Q

what is on the distal tibia

A

posterior malleolus

161
Q

what does the head of the fibula articulate with

A

lateral condyle of the tibia

162
Q

what is the anterior/posterior difference between the 2 malleoli?

A

the lateral malleolus is 15-20 degrees more posterior

163
Q

what is the longest, strongest, heaviest bone?

A

the femur

164
Q

what is the intertrochanteric line

A

joints the femoral trochanters anteriorly

165
Q

what is the intertrochanteric crest

A

a ridge that joints the femoral trochanters posteriorly

166
Q

what is the anterior join of the femoral trochanters

A

intertrochanteric line

167
Q

what is the posterior join of the femoral trochanters

A

intertrochanteric crest

168
Q

what is the linea aspera

A

ridge on the posterior femur, site for muscle attachment