lower extremity Flashcards
1
Q
what are the 26 bones of the foot? (distribution)
A
14 phalanges
5 metatarsals
7 tarsal bones
2
Q
what are the divisions of the foot?
A
forefoot, midfoot, and hindfoot
3
Q
what bones are a part of the forefoot?
A
toes and metatarsals
4
Q
what bones are a part of the midfoot?
A
cuneiforms, navicular, and cuboid
5
Q
what bones are a part of the hindfoot?
A
calcaneous and talus
6
Q
what are the 3 cuneiforms
A
medial, middle, lateral
7
Q
what is another word for calcaneous
A
os calcis
8
Q
which side of the foot goes up in a 45 degree
A
the lateral (5th) side
9
Q
what is the hallux
A
the great toe
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
11
Q
why is the tuberosity of the 5th metatarsal significant
A
very common place to fracture
12
Q
what is on the base of the fifth metatarsal
A
the tuberosity of the 5th metatarsal
13
Q
what is a Jones’ fracture
A
twist injury
tendon pulls a small portion of the fifth metatarsal off
regularly causing avascular mecrosis
14
Q
what is the most superior tarsal bone
A
the talus
15
Q
what does the talus articulate with? (4)
A
tibia, fibula, calcaneous, navicular
16
Q
what makes the talus a ball and socket joint
A
the head that articulates with navicular
17
Q
what part of the talus articulates with the tibia and fibula
A
talar domes
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)
19
Q
what is the sinus tarsi
A
the hole inferior to the talus
20
Q
what does the talus have 3 of
A
articular facets (articulate with the ant/mid/pos calcaneous)
21
Q
what are the 3 articular facets of the talus
A
anterior, middle, posteriorw
22
Q
with what do the articular facet articulate with to form subtalar joints
A
the facets of the calcaneous
23
Q
which is the largest tarsal bone
A
the calcaneous
24
Q
what is the posterior tuberosity of the calcaneous for
A
Achilles attachment
25
what are on the superior side of the calcaneous
the 3 facets (anterior, middle, posterior)
26
what forms the floor of the sinus tarsi
the calcaaneal sulcus
27
what is the sustentaculum tali
forms a "shelf" for the middle subtalar joints (middle facet)
28
what is on the lateral side of the calcaneous
the lateral process and the trochlea
29
which joints can be seen easily on the axial view of the calcaneous
the middle and posterior subtalar joints
30
what are the 4 joints of the talus
tibiotalar joint
fibulotalar joint
subtalar joints (3)
talonavicular joint
31
what is special about the talonavicular joint
it is one of only 3 ball and socket joints in the body
32
what is at the proximal end of the femur
the head (fovea capitis
33
what is the slope of the neck of the femur
slopes 15-20 deg posteriorly from the pelvis
34
what is done with the legs when taking an AP of the pelvis
we turn the legs 15-20 deg inwards to compensate
35
how do you palpate the greater trochanter
turn leg inwards and outwards
36
where is the lesser trochanter located on a true AP pelvis
it will be posterior to the femur
37
where are the femoral trochanters on a proper x table lateral
greater: superimposed on the femoral neck
lesser: posterior to the femoral neck
38
where are the femoral trochanters on a x table lateral with not enough internal rotation
greater: posterior to the femoral neck
lesser: medial
to neck
39
what is the angle from the side of the femur to the femoral neck
135 (125 + 10)
40
how many degrees do you angle in a x table hip
45 degrees from the femoral neck
(135 is 45 away from 180)
41
what does it prove when you image the femur without being able to see the lesser trochanters
that you are seeing the femoral neck without any foreshortening
42
what is at the distal end of the femur
medial and lateral femoral condyles
43
what are the parts of the medial femoral condyle
medial epicondyle
adductor tubercle
44
where is the adductor tubercle
its on the medial condyle, and very posterior on it
45
what is part of the lateral femoral condyle
lateral epicondyle
sulcus terminalis
46
how can you tell apart the femoral condyles
if there's a bump out the back, that's the adductor tubercle, so the medial condyle
47
when can you see the sulcus terminalis
in a lateral view of the femur
48
which tibial condyle is curved
the medial tibial plateau
49
which femoral condyle is more distal? by how much?
medial condyle
by 5-7 degrees
50
what angle is used for a mediolateral knee
5-7 cephalad
51
why would we do a x table lateral knee
to show lipohemarthrosis
52
what is on the anterior surface of the distal femur
trochlear groove (patella articulation)
53
what is on the posterior surface of the distal femur
intercondylar notch, fossa, or tunnel
54
what is the white line visible in the middle of a lateral knee
the roof of the tunnel (on the posterior surface)
55
what does the line at the end of the femur on a lateral view correspond to
, (in a skyline view ex)
56
what does the little rounded line inside the middle of a lateral knee correspond to
the trochlear groove
57
which side of the patella is the base (top or bottom)
the top
58
which side of the patella is the apex
the bottom
59
what does the patella articulate with
the trochlear groove
60
what tendon is attached to the patella
the quadriceps ligaments come together to the quadriceps tendon
61
what makes up the bony pelvis
2 hip bones, sacrum, coccycx
62
what is the purpose of the pelvis
connects the lower extremity to the axial skeleton
protects lower reproductive organs, GItract,
strong support for the trunk
63
what are the parts of the hip bone
ilium
ischium
pubis
64
what is the upper part of the ilium called
the Ala
65
how is the Ala curved
posterior is most medial, anterior part is most lateral
66
what is the iliac crest the landmark for
L4
67
what is ASIS
anterior superior iliac spine
68
what is the AIIS
anterior inferior iliac spine
69
which one (ASIS, AIIS) can you palpate
the ASIS
70
PSIS
posterior superior iliac spine
71
PIIS
posterior inferior iliac spine
72
why is the PSIS a landmark
the SI joint is immediately interior to the PSIS
73
where is the greater sciatic notch
the big groove between the ilium and ischium
74
why is the greater sciatic notch important
shows it the body is in a true lateral by looking at superimposition
75
what parts of the hip forms most of the acetabulum
the body of the ilium
76
what forms the sacral iliac joint
the auricular surface of the ilium forms with the auricular surface of the sacrum
77
why is the arcuate fossa significant
it separates Ala from body (of ilium)
but more importantly, forms part of the pelvic brim
78
where does the arcuate line run to and from
from the auricular surface to the pubis
79
where (directionally) is the ischium
inferior and posterior
80
when can the ischial spine be seen
when the pelvis is rotated
81
what do we sit on
the ischial tuberosity (star)
82
what is the ischial ramus
projects anteriorly and medially
connecting to the inferior pubic ramus
83
what are the parts of the pubis
superior pubic ramus
body
inferior pubic ramus
84
what parts of the pubis form the acetabulum
superior pubic ramus
85
what does the inferior pubic ramus ramus connect to
ischial ramus
86
what is the pubic arch
the angle between the two inferior pubis rami
87
what can you tell from the pubic arch
whether the body is male or femal
88
what is the pectineal line
travels along superior pubic ramus, meets the arcuate line of the ilium
89
when looking down at a pelvis, wta is the round 'bowl' seen
the epelvuc brim
90
1
body of ilium
91
3
Ala of ilium
92
4
arcuate line of ilium
93
5
iliac crest
94
10
ASIS
95
what is the ASIS a landmark for
SI
96
11
AIIS
97
14
iliac fossa
98
21
ischial ramus
99
25
body of pubis
100
26
pubic tubercle
101
28
pubic crest
102
29
superior pubic ramus
103
32
inferior pubic ramus
104
33
obturator foramen
105
what happens in an RPO position
as we turn to the right, the right Ala becomes much wider, and the left Ala becomes in profile (star)
106
what happens to the obturator foramen in an RPO
as they turn to the right, the left obturator foramen becomes open
107
if a right obturator foramen is open, and the left Ala appears wider, which way is the pelvis rotated
LPO
108
what are the pubic arch angles for males and females, respecively
<90 males
>90 female
109
what forms the superior part of the acetabulum
the ilium
110
what forms the posterior part of the acetabulum
ischium
111
what forms the anterior part of the acetabulum
pubis
112
what are Judet views for
fractures of the acetabulum
113
what are the two columns of bones in the Judet views
iliopobic column (anterior)
ilioischial column (posterior)
114
what is the pelvic brim
boundary line that separates the true pelvis form the false pelvis
115
what are the five parts that make up the pelvic brim
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
what is the pelvic brim
the entrance to the true pelvis
117
what is in the false pelvis
superior mart of bladder
lower intestines
uterus, ovaries, fallopian tubes
118
what is the false pelvis bound by
lumbar spine, Ala, anterior abdominal wall
119
what is the true pelvis bound by
sacrum/coccyx, body of ilium, ischium, pubic bones
120
what does the true pelvis contain
rectum, bladder, prostate/vagina/cervix
121
what forms the pelvic inlet
the same things that forms the pelvic brim
122
what is the pelvic outlet
the inferior opening of the true pelvis
123
what is the pelvis outlet bounded by laterally
between the ischial tuberosities
124
what is the AP diameter of the pelvic outlet
tip of coccyx to inferior margin of pubic symohysis
125
what do you do for pubic bone fractures
inlet and outlet views
126
what do you do for acetabulum fractures
Judet views
127
what angle is used for a inlet view
40 degrees caudad
128
what angle is used for a pelvic outlet view
30 degrees cephalad
129
what are the differences between female and male pelves
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
what determines the width of the pelvic inlet
the width of the arcuate lines on the ilium
131
what are the 3 calcaneal articulations
subtalar/talocalcaneal joints (3)
calcaneonavicular joint
calcaneocuboid joint
132
where is the calcaneonavicular joint
on the anterior process of the calcaneous
133
what are the navicular articulations (3)
calcaneonavicular joint
talonavicular joint
all 3 cuneiforms
134
what are the cuboid articulations (4)
calcaneocuboid joint
joint between cuboid and lateral cuneiform
TMT joints (w4/5 metatarsals)
navicular
135
what are the 3 cuneiform articulations
medial cuneiform
intermediate cuneiform
lateral cuneiform
136
what is the medial cuneiform joint
TMT joints with great toe
137
what is the intermediate cuneiform joint
TMT joints with 2nd toe
138
what is the elateral cuneiform joint
TMT joints with 3rd toe
139
what lines up in the cuneiform joints?
the medial part of the cuneiforms must line up with the medial aspect of the metatarsals
140
what are 2 properties of longitudinal arches
shock absorber
provides leverage while walking
141
what forms the longitudinal arches
tarsal and metatarsal bones
142
what are the 2 longitudinal arches
medial longitudinal arch and lateral longitudinal arch
143
which longitudinal arch is higher
medial
144
where is the medial longitudinal arch
originates at the calcaneous
rises to the talus
ends at the heads of the first 3 metatarsals
145
where is the lateral longitudinal arch
originates at the calcaneous
rises to cuboid
ends at the head of the lateral 2 metatarsals
146
what forms the transverse arch
3 cuneiforms, cuboid, bases of all 5 metatarsals
147
what are the 2 major bones of the lower leg
tibia and fibula
148
tib/fib which is more medial
tibia
149
tib/fib which is more posterior
fibula
150
where is the tibial plateau
on the proximal part of the tibia
151
what forms the tibial plateau
medial and lateral condyles
152
where is the facet in the tibial plateau
posterolateral surface
153
which tibial condyle is curved form anterior to posterior
medial
154
what direction is the slope of the proximal tibia
posterior slope
155
what separates the tibial condyles
intercondylar eminences
156
what is the tibial tuberosity
the attachment for the patellar ligament
157
what is a part of the distal tibia (4)
medial malleolus
fibular notch
anterior tubercle
tibial plafond
158
where is the fibular notch
the lateral side of the distal tibia
159
what is the ankle mortise
refers to the bony arch formed between the tibial plafond and malleoli
160
what is on the distal tibia
posterior malleolus
161
what does the head of the fibula articulate with
lateral condyle of the tibia
162
what is the anterior/posterior difference between the 2 malleoli?
the lateral malleolus is 15-20 degrees more posterior
163
what is the longest, strongest, heaviest bone?
the femur
164
what is the intertrochanteric line
joints the femoral trochanters anteriorly
165
what is the intertrochanteric crest
a ridge that joints the femoral trochanters posteriorly
166
what is the anterior join of the femoral trochanters
intertrochanteric line
167
what is the posterior join of the femoral trochanters
intertrochanteric crest
168
what is the linea aspera
ridge on the posterior femur, site for muscle attachment
