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Anatomy > Lower extremity imaging > Flashcards

Lower extremity imaging Flashcards

1
Q

What should you always look at when looking at bone x-rays?

A

A - adequacy, alignment
B - bones
C - cartilage
S - soft tissues
EVERYTIME

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2
Q

What makes your viewing adequate?

A

minimum of 2 views - AP & lateral, 3 views are even better with an oblique view!

Is the exposure sufficient?

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3
Q

What are you looking for in regards to alignment?

A

anatomic relation of bone axes – fractures/dislocations can alter normal axes

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4
Q

What’s a lisfranc injury?

A

dislocation of the second metatarsal

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5
Q

What can soft tissue help recognize?

A

swelling can speak for an occult fracture that may not be visible

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6
Q

What are examples of occult fractures?

A
  • distal radius fracture (pronator quadratus fat pad sign +)
  • neck of femur fracture
  • radial head fracture (sail sign may be +)
  • scaphoid fracture
  • supracondylar fracture (loss of alignment)
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7
Q

What are the 4 anatomical classes of bones?

A

long, short, flat, and irregular

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8
Q

What are the benefits of splintage?

A

reducing pain and blood loss, pressure on skin, pressure on adjacent neurovascular structures, and reducing risk of fat embolism and further damage

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9
Q

What is: the assessment and reassessment of neurovascular status before and after any manipulation or handling of the fracture?

A

principles of immobilization

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10
Q

Always immobilize joints ____ and ____ the fracture

A

above and below

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11
Q

What type of fracture is simple, noncomplicated, with no skin wounds at or near fracture site?

A

closed fracture

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12
Q

What type of fracture is complicated, with a skin wound, and may be comminuted and dislocated?

A

open fracture

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13
Q

How are long bone fractures described?

A

reference to direction of fracture

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14
Q

What’s a transverse fracture?

A

fracture passes at right angles to shaft of bone

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15
Q

What’s a displaced fracture?

A

loss of alignment along the long axis

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16
Q

What can medial angulation of a displaced fracture also be called?

A

varus

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17
Q

What can lateral angulation of a displaced fracture also be called?

A

valgus

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18
Q

What can a proximal migration of the distal fracture result in?

A

shortening

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19
Q

what type of fracture is when the bone is crushed?

A

compression

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20
Q

What type of fracture is when one end of the extremity is fixed but the rest of the extremity remains in motion?

A

spiral fracture

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21
Q

In who are accidental spiral fractures of the tibia common?

A

preschool children who fall short distances onto an extended leg “toddler’s fractures”

22
Q

What type of fracture should you suspect abuse?

A

spiral fractures

23
Q

What type of fracture is urgent in children?

A

epiphyseal fractures because they are growth plate fractures – it could result in a limb that is crooked or unequal in length

24
Q

Where are growth plates found?

A

long bones of the body – femur, radius, ulna, metacarpal
most have at least 2 growth plates on ends of the bone

25
Q

What are salter-harris fractures?

A

fractures around the end of the bone

26
Q

What is a fracture that breaks through the bone at the growth plate separating the end of the bone and disrupting the growth plate?

A

Type 1 Salter-Harris fracture

27
Q

What is a fracture that break through part of the bone at the growth plate and crack through the bone shaft but not entirely?

A

Type 2 Salter-Harris fracture – MC growth plate fracture

28
Q

What is a fracture that crosses through a portion of the growth plate and breaks off a piece of the bone at the end? (90 degree angle)?

A

Type 3 Salter-Harris fracture - MC in older children

29
Q

What is a fracture that breaks through the bone shaft, the growth plate, AND the end of the bone (diagonal)?

A

Type IV Salter Harris fracture

30
Q

What is a fracture that occurs due to a crushing injury to the growth plate from a compression force?

A

Type V Salter Harris fracture

31
Q

What is a fracture that results in more than 2 separate bone components like “butterfly” or “segmental”?

A

comminuted fractures

32
Q

What type of fracture results from 2 oblique fractures forming a “butterfly” fragment?

A

butterfly fracture (comminuted)

33
Q

What type of fracture is when segments of bone are separated from both proximal and distal portions of tibial and fibular shafts?

A

segmental fracture (comminuted)

34
Q

What type of fracture occurs when force results in bending such that the bone doesn’t break completely “incomplete break” but still results in a fracture?

A

greenstick fracture!

35
Q

What type of fracture is common in young children, especially less than 10 years, commonly mid-diaphyseal, affecting forearm and lower leg?

A

greenstick fracture

36
Q

What type of fracture is at the lower end of the fibula and medial mallelous of tibia and is associated w/ a rolled ankle and eversion of the ankle and tear of the deltoid ligament?

A

Pott fracture

37
Q

What type of fracture is caused by the radius overriding the rest of the bone causing a dinner fork deformity?

A

Colle’s fracture

38
Q

What type of fracture is a distal radial fragment is tilted into a posterior angulation and may be displaced ventrally (REVERSE COLLE’s)?

A

Smith’s Fracture

39
Q

How many views does the elbow usually require?

A

3 - AP, oblique w/ elbow extended, and lateral with the elbow flexed

40
Q

What fat pads should you be analyzing in the elbow?

A

anterior and posterior
seeing a posterior fat pad is NEVER normal

41
Q

What is important to remember about ossification in the elbow?

A

develops during childhood and can be mistaken for fractures

42
Q

What order does the elbow ossification occur?

A

CRITOE
capitellum - radial head - internal/medial epicondyle - trochlea - olecranon - external/lateral epicondyle

43
Q

When the imaginary line drawn from front of humerus does NOT intersect the middle-anterior 1/3 of the capitellum, what should you suspect?

A

supracondylar fracture

44
Q

When the imaginary line down the middle of the radius does NOT pass through the middle of the capitellum, what should you suspect?

A

radial head dislocation

45
Q

What is the sail sign?

A

elevated anterior fat pad

46
Q

What is the most common metatarsal fractured?

A

5th metatarsal

47
Q

What is the most important weight-bearing structure in the forefoot?

A

metatarsals

48
Q

What are the attachments of the 5th metatarsal?

A

peroneus brevis, tertius, lateral band of plantar fascia

49
Q

How is the fifth metatarsal supplied by arterial branches?

A

dorsalis pedis, posterior tibial, peroneal arteries
nutrient artery from 4th plantar metatarsal artery and inserts into plantar medial diaphysis – vulnerable to increased nonunion rates due to anatomic location of the bloody supply which results in watershed

50
Q

What is the fifth metatarsal?

A

pinky toe but below the toe part and in the foot part

51
Q

What type of fracture is at the distal portion of the fibula above the lateral mallelolus w/ associated tear of tibiofibular ligaments and the deltoid ligament and therefore affects BIMALLEOLAR ligaments?

A

dupuytren fracture

52
Q

This is a reminder

A

to review xray anatomy!

Anatomy (19 decks)

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