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Positioning test prep > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

Alternative name of the ankle joint

A

Mortise

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2
Q

Cushions between tibia and femur

A

Menisci

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3
Q

Between femoral condyles on posterior aspect

A

Intercondylar Fossa

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4
Q

Tarsal located between talus and cuneiforms

A

Navicular

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5
Q

Most superior tarsal bone

A

Talus

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6
Q

Lateral tarsal bone

A

Cuboid

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7
Q

Superior, lateral process of femur

A

Greater trochanter

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8
Q

Articular surfaces on superior tibia

A

Plateaus

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9
Q

Two joints in the lower leg

A

Tibiofibular

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10
Q

Process on distal end of tibia and fibula

A

Malleolus

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11
Q

Processes on proximal tibia

A

Condyles

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12
Q

Sesamoid that protects knee joint

A

Patella

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13
Q

How much angulation on an AP axial projection of toes?

A

15 degrees

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14
Q

What is the central ray orientation if the joint spaces of the toes are of primary interest?

A

15 degrees posteriorly (toward the heel)

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15
Q

How many degrees of rotation are needed to rotate the foot properly for the AP oblique projection of toes?

A

30 to 45 degrees

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16
Q

Which individual toes are best demonstrated using the AP oblique projection with the foot rotated laterally?

A

Fourth and fifth ( sometimes the third)

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17
Q

How much angulation on an AP axial projection of the foot?

A

10 degrees

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18
Q

For the AP oblique projection, the leg should be rotated medially until the plantar surface of the foot forms an angle of…

A

30 degrees

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19
Q

Degrees of Angulation for plantodorsal axial projection of the calcaneus

A

40 degrees cephalic. CR enters base of third metatarsal

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20
Q

How many bones in the foot?

How many parts are they divided into?

A

There are 26 bones divided into three parts

Tarsus or tarsal bones

Metatarsals(bones of the instep)

Phalanges

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21
Q

Name the tarsal bones

A

Calcaneus

Talus

Navicular

Cuboid

Internal cuneiform
Middle cuneiform
External cuneiform

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22
Q

Essential projection of the Calcaneus: Plantodorsal axial

A
  • collimate to 1 inch on three sides of the calcaneous shadow.
  • patient seated or supine with leg extended; posterior surface of foot resting on IR; foot dorsoflexed so plantar surface is vertical and not rotated.
  • malleoli parallel with plane of IR; plantar surface vertical
  • CR angled 40 degrees cephalic; enters base of third metatarsal
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23
Q

Essential projection of calcaneus: lateral

A
  • collimate to 1 inch past posterior and inferior heel shadow; include medial malleolus and 5th metatarsal base
  • Patient seated or supine with knee flexed and lateral surface of calcaneus centered to collimated field; leg rotated laterally to place plantar surface of calcaneus perpendicular to IR.
  • long axis of calcaneus aligned with long axis of IR
  • CR perpendicular; enters 1 inch distal to medial malleolus
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24
Q

ESSENTIAL PROJECTION FOR THE ANKLE: AP

A
  • collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
  • patient seated or supine with knee extended; dorsal surface of ankle centered to IR/collimated field; ankle in anatomic position; foot dorsiflexed to right ankle.
  • malleoli in anatomic position; plantar surface of foot positioned vertical.
  • CR perpendicular; enters ankle joint midway between malleoli
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25
Q

Essential projection for the ankle: Lateral

A
  • collimate to 1 inch on all sides of the ankle and 8 inches long to include heel and 5th metatarsal base
  • patient turned on affected side until ankle is resting on lateral surface; ankle resting on lateral surface and centered to IR/collimated field; foot dorsiflexed and lateral
  • Malleoli superimposed and perpendicular to IR
  • CR perpendicular; enters medial malleolus
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26
Q

Essential projection for the ankle: AP oblique- medial rotation

A
  • collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
  • patient seated or supine with knee extended; lower limb rotated medially 45 degrees; ankle centered to IR; foot dorsiflexed
  • coronal plane of lower limb and malleoli at 45 degree angle with IR
  • CR perpendicular; enters ankle joint midway between the malleoli
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27
Q

Essential projection for the ankle: AP oblique- medial rotation for mortise

A
  • collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
  • patient seated or supine with knee extended; lower limb rotated medially 15-20 degrees; ankle centered to IR; foot dorsiflexed
  • coronal plane of lower limb at 15-20 degree angle with IR; intermalleolar plane parallel with IR
  • CR perpendicular; enters ankle joint midway between the malleoli
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28
Q

Essential projection for the ankle: AP stress

A
  • collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
  • patient seated or supine with knee extended; ankle in anatomic position while foot is forcibly held in inversion and eversion stress for two separate exposures.
  • malleoli in anatomic position; foot inverted and everted
  • CR perpendicular; enters ankle joint midway between the malleoli
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29
Q

The AP projection should demonstrate the joint space between the medial malleolus and the talus without any overlapping of structures

A

True

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30
Q

The AP projection should demonstrate the distal third of the fibula without superimposition with the talus or tibia

A

False

Some overlapping of the distal fibula with the talus and tibia is expected

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31
Q

The AP projection should demonstrate the lateral and medial malleoli

A

True

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32
Q

Why is dorsiflexion of the foot required for the lateral(mediolateral projection of the ankle?

A

To prevent rotation

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33
Q

The lateral (mediolateral) projection of the ankle should demonstrate the fibula over the posterior half of the tibia

A

True

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34
Q

An image of the lateral (mediolateral) projection of the ankle should demonstrate the lateral malleolus free from superimposition by the talus

A

False

The distal fibula will appear superimposed with the talus

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35
Q

The tuberosity and base of the fifth metatarsal should be demonstrated on a lateral projection of the ankle

A

True

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36
Q

How many degrees and in what direction should the leg and foot be rotated for an AP oblique projection (medial) of the ankle

A

45 degrees medially

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37
Q

From the supine position, how many degrees should the lower limb and foot be rotated to position the ankle for the medial AP oblique projection

A

15-20 degrees

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38
Q

With reference to the position of the patient’s leg and foot during the procedure, how is it determined that the leg has been rotated the correct number of degrees for an AP oblique mortise

A

The intermalleolar plane should be parallel with the IR

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39
Q

The talofibular joint space should be demonstrated in profile without any bony superimposition on an Ap oblique mortise

A

True

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40
Q

The foot should be plantar flexed to place the long axis of the foot parallel with the IR for an AP oblique mortise

A

False

The foot should be dorsiflexed to place the long axis of the foot perpendicular to the IR

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41
Q

State the purpose of performing AP stress studies of the ankle

A

To verify the presence of a ligament out tear

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42
Q

How can the patient hold the foot in the stress position during AP stress studies?

A

The patient may be instructed to pull on a strip of bandage looped around the foot

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43
Q

How do images indicate that’s a patient has a torn ligament affecting the ankle?

A

An increase in the joint space on the side of the injury indicates a torn ligament.

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44
Q

Essential projection for the leg: AP

A
  • collimate to 1 inch on all sides and 1.5 inches beyond ankle and knee joints
  • patient supine or seated with knee extended; knee extended; ankle and foot dorsiflexed
  • femoral condyles parallel to IR
  • CR perpendicular to center of leg
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45
Q

Essential projection of the leg: lateral

A
  • collimate to 1 inch on all sides and 1.5 inches beyond ankle and knee joints
  • patient lying on affected side with leg extended; leg resting on lateral surface; knee may be slightly flexed
  • femoral condyles and patella perpendicular to IR
  • CR perpendicular to midpoint of leg
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46
Q

What should the radiographer do if the leg is too long to demonstrate the knee and the ankle joint with the same exposure?

A

Perform two AP projections to ensure that the entire lower limb is demonstrated

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47
Q

The AP projection of the leg should demonstrate the fibula without any overlapping with the tibia.

A

False

Proximal and distal articulations of tibia and fibula should have moderate overlapping

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48
Q

For the lateral projection of the leg, should the patella be positioned perpendicular or parallel with reference to the plane of the IR?

A

Perpendicular

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49
Q

What procedure should the radiographer perform if the patient is unable to turn from the supine position toward the affected side to position a fractured leg on the IR for the lateral projection?

A

Perform a cross-table lateral projection by placing an IR vertically between the patient’s legs and directing a horizontal CR to the leg

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50
Q

The lateral projection should demonstrate some interosseous space between the shafts of the fibula and tibia

A

True

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51
Q

Essential projection of the knee: AP

A

• collimate to 10x12
• patient supine or seated w/ knee extended; 1/2 inch below patellar apex in center of IR
• femoral condyles parallel to IR
• according to ASIS to tabletop measurement
<19 cm- 3-5 degrees caudad
19-24 cm perpendicular
>24 cm 3-5 degrees cephalad

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52
Q

Essential projection for the knee: lateral

A
  • collimate to 10x12
  • patient lying on affected side with opposite limb on table for support: normal knee flexed 20-30 degrees; flexed knee resting on lateral side; ankle supported to lie in same plane if necessary
  • femoral condyles superimposed and perpendicular to IR; patella perpendicular to IR
  • CR angled 5-7 degrees cephalad; enters 1 inch distal to medial epicondyle
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53
Q

Essential projection for knee: AP standing (weight bearing)

A
  • collimate to 14x17
  • patient standing upright facing x-ray tube; posterior surface of knee in contact with IR; standing straight; knee extended with weight equally distributed
  • tibial condyles parallel to IR; 1/2 inch below apex of patella at center of IR
  • CR horizontal and perpendicular to 1/2 inch below patellar apex
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54
Q

Essential projection of the knee: AP oblique in lateral rotation position

A

• collimate to 10x12
• patient supine; knee extended; lower limb externally rotated 45 degrees
• tibial condyle at a 45 degree angle to IR; 1/2 inch below apex of patella at center of IR
• CR according to ASIS to tabletop measurement
<19cm 3-5 degrees caudad
19-24cm perpendicular
>24cm 3-5 degrees cephalad

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55
Q

Essential projection for the knee: AP oblique in medial rotation position

A

• collimate to 10x12
• patient supine; knee extended; lower limb internally rotated 45 degrees
• tibial condyles at a 45 degree angle to IR; 1/2 inch below apex of patella at center of IR
• CR according to ASIS to tabletop measurement
<19cm 3-5 degrees caudad
19-24cm perpendicular
>24cm 3-5 degrees cephalad

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56
Q

Where is the patella located on a correctly positioned Ap projection of the knee

A

Slightly off center to the medial side of the femur

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57
Q

On an image of a correctly positioned AP projection of the knee, the patella should be demonstrated…

A

Completely superimposed one the femur

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58
Q

The AP projection image of a normal knee should demonstrate a femorotibial joint space with equal distances on both sides

A

True

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59
Q

In a lateral projection of the knee how much flexion should you have?

A

20-30 degrees

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60
Q

On a lateral projection when a new or healing fracture is present, the knee should be flexed no more than…

A

10 degrees

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61
Q

On a lateral projection of the knee, how many degrees and in what direction should the CR be directed?

A

5-7 degrees

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62
Q

Why is the CR angled cephalad for the lateral projection?

A

To prevent the joint space from being obscured by the magnified shadow of the femoral condyle

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63
Q

On the lateral projection of the knee the CR should enter the patient 1 inch distal to the…

A

Medial epicondyle

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64
Q

The femoral condyles should appear superimposed on a lateral projection of the knee.

A

True

65
Q

The lateral projection of the knee demonstrates the patella with slight overlapping with the femoral condyles

A

False

66
Q

Essential projection of the patella and patellofemoral joint: PA

A
  • 6 x 6 collimation
  • patient prone: patella parallel to IR; heel rotated laterally 5 to 10 degrees
  • Patella parallel and in center of IR
  • CR perpendicular to midpopliteal area; exits patella lateral
67
Q

Essential projection of the patella and patellofemoral joint: lateral

A
  • collimate to 4x4 inches
  • patient lateral recumbent on affected side: knee flexed 5 to 10 degrees; patella perpendicular to IR
  • femoral condyles superimposed and patella perpendicular
  • CR perpendicular; enters patellofemoral joint space
68
Q

Essential projection of the patella and patellofemoral joint: tangential (Settegast)

A

• single patella- collimate to 4 x 4
Bilateral- collimate to 4 x 10
• Patient supine or prone; knee flexed as much as possible
• tibial condyles parallel to IR
• CR angled 15 to 20 degrees cephalic to enter perpendicular to patellofemoral joint space

69
Q

For a lateral projection of the patella, the knee should be flexed no more than how many degrees?

A

10 degrees

70
Q

What might occur if the patient flexes the knee more than the recommended number of degrees in regard to a lateral patella projection

A

Reduction in the femoropatellar joint space

71
Q

What projection of the patella should be performed before a tangential projection is attempted? Explain why

A

Lateral

Rules out a transverse fracture

72
Q

Describe how the lesser trochanter should appear in the AP projection of the proximal femur

A

The lesser trochanter should not be seen beyond the medial border of the femur, or only a very small portion of the lesser trochanter should be seen

73
Q

How many and what kind of bones comprise the foot and ankle?

A

14 phalanges, 5 metatarsals, and 7 tarsals

74
Q

Which bone classification are tarsals?

A

Short bones

75
Q

What is the most distal part of a metatarsal?

A

Head

76
Q

Where in the foot is the tuberosity that is easily palpable?

A

Proximal portion of the fifth metatarsal

77
Q

Which tarsal bone is the most superior tarsal bone?

A

Talus

78
Q

Which tarsal bone is the largest of the tarsal bones

A

Calcaneus

79
Q

Which tarsal bone is located on the lateral side of the foot between the calcaneus and the fourth and fifth metatarsals

A

Cuboid

80
Q

Which tarsal bone is located on the medial side of the foot between the talus and the three cuneiforms?

A

Navicular

81
Q

Which bone articulates medially with the cuboid?

A

Lateral cuneiform

82
Q

Which bones comprise the midfoot?

A

Navicular, cuboid, and cuneiforms

83
Q

Which bone articulates with the superior surface of the calcaneus?

A

Talus

84
Q

Which bones articulate dismally with the tarsal navicular?

A

Cuneiforms

85
Q

Which bones articulate distally with the three cuneiforms?

A

Metatarsals

86
Q

Which bones articulate with the metatarsals?

A

Cuneiforms and cuboid

87
Q

Which cuneiform is the largest?

A

Medial

88
Q

Where in the foot are the cuneiforms located?

A

Between the navicular and the metatarsals

89
Q

What articulation is an ellipsoid-type joint?

A

Metatarsophalangeal

90
Q

Which articulation of the foot is a gliding-type joint?

A

Intertarsal

91
Q

Which two tarsal bones articulate with each other by way of three facets?

A

Talus and calcaneus

92
Q

Which part of the talus articulates with the distal tibia?

A

Trochlea

93
Q

Which type of joint is the ankle joint?

A

Hinge

94
Q

Where is the medial malleolus located in the leg?

A

Distal tibia

95
Q

Where is the lateral malleolus located in the leg?

A

Distal fibula

96
Q

What structure is located on the proximal end of the fibula?

A

Apex

97
Q

Where is the intercondylar eminence located?

A

Proximal tibia

98
Q

On which border of the tibia is the crest located?

A

Anterior

99
Q

Which term refers to the sharp ridge on the anterior border of the tibia?

A

Crest

100
Q

Which term refers to the prominent process on the anterior surface of the proximal tibia that is just inferior to the condyles?

A

Tuberosity

101
Q

Which joint is formed by the articulation of the head of the fibula with the lateral condyle of the tibia?

A

Proximal tibiofibular

102
Q

Which type of joint is the proximal tibiofibular joint?

A

Gliding

103
Q

Which structure is located on the head of the fibula?

A

Apex

104
Q

With which structure does the head of the fibula articulate?

A

Lateral tibial condyle

105
Q

Which term refers to the inferior tip of the patella?

A

Apex

106
Q

Which part of the patella is the base?

A

Superior border

107
Q

Where on the femur is the greater trochanter located?

A

Lateral and superior

108
Q

Where on the femur is the lesser trochanter located?

A

Medial and posterior

109
Q

Where is the fovea capital located?

A

Distal femur

110
Q

Which femoral structures articulate with the tibia?

A

Condyles

111
Q

With which structure does the head of the femur articulate?

A

Acetabulum

112
Q

How many degrees and in what direction should the CR be directed for the AP axial projection of the toes

A

15 degrees cephalad

113
Q

How many degrees and in what direction should the foot be rotated for the AP oblique projection to demonstrate the second toe?

A

30-45 degrees medially

114
Q

How and toward what centering point should the CR be directed for the AP oblique projection to demonstrate all five toes?

A

Perpendicular to the third MTP joint

115
Q

How many degrees and in what direction should the foot be rotated for the AP oblique projection for the best demonstration of the great toe?

A

30-45 degrees medially

116
Q

What other projection term refers to the AP projection of the foot?

A

Dorsoplantar

117
Q

How many degrees and in what direction should the CR be directed for the AP axial projection of the foot?

A

10 degrees cephalad

118
Q

Which projection of the foot best demonstrates the cuboid and its articulations?

A

AP oblique (medial rotation)

119
Q

How many degrees and in what direction should the foot be rotated for the AP oblique projection of the foot?

A

30 degrees medially

120
Q

What is the appropriate collimated field size for the AP projection of the foot?

A

1 inch on all sides, including 1 inch beyond the calcaneus and distal tips of the toes

121
Q

Where should the central ray be directed for the AP oblique projection of the foot?

A

To the base of the third metatarsal

122
Q

Regardless of the condition of the patient, which positioning maneuver should be performed to position the foot for the lateral projection?

A

Ensure that the plantar surface is perpendicular to the IR

123
Q

How should the CR be directed for the best demonstration of the tarsometatarsal joint spaces of the midfoot for the AP projection of the foot?

A

10 degrees posteriorly (toward heel)

124
Q

Which projection of the foot best demonstrates the sinus tarsal?

A

AP oblique projection(medial rotation)

125
Q

Which projection of the foot best demonstrates most of the tarsals with the least amount of superimposition?

A

AP oblique projection (medial rotation)

126
Q

Which projection of the foot best demonstrates the bases of the fourth and fifth metatarsals free from superimposition?

A

AP oblique projection (medial rotation)

127
Q

Which projection of the foot should demonstrate the metatarsals nearly superimposed on each other?

A

Lateral projection

128
Q

Which two projections comprise the typical series that best demonstrates the calcaneous?

A

Axial(plantodorsal) and lateral projections

129
Q

How many degrees and in what direction should the CR be directed for the axial (plantodorsal) projection of the calcaneus?

A

40 degrees cephalad

130
Q

What procedural compensation is required for the plantodorsal axial projection of the calcaneus when the patient cannot dorsiflex the foot sufficiently to place the plantar surface vertical?

A

Elevate the leg on sandbags to achieve the correct position

131
Q

At which level on the plantar surface should the central ray enter the foot for the axial(plantodorsal) projection of the calcaneus?

A

Base of the third metatarsal

132
Q

Where should the CR be directed for the lateral projection of the calcaneus?

A

Toward the midpoint of the calcaneus

133
Q

Where should the CR enter for the lateral projection of the ankle?

A

At the medial malleolus

134
Q

How many degrees and in which direction should the foot and leg be rotated for the best demonstration of the mortise joint for the AP oblique projection of the ankle?

A

15-20 degrees medially

135
Q

Which projection of the ankle best demonstrates the talofibular joint space free from bony superimposition?

A

AP oblique projection (medial rotation)

136
Q

Which articulation should be seen in profile with the AP oblique projection(medial rotation) of the ankle?

A

Talofibular

137
Q

With reference to the plane of the IR, how should the malleoli be positioned for the AP oblique projection of the ankle for the best demonstration of the mortise joint spaces open?

A

Perpendicular

138
Q

Which projection of the ankl;e should be performed for the best demonstration of a ligamentous tear?

A

AP projection with inversion

139
Q

How long should the collimated field be for the AP and AP oblique projections of the ankle?

A

8 inches

140
Q

Which projection of the knee best demonstrates the femorotibial joint space open if the patient measures more than 10 inches (24cm) between the ASIS and the tabletop?

A

AP projection with the CR angled 3 to 5 degrees cephalad

141
Q

For the lateral projection of the knee, how many degrees should the knee be flexed?

A

20-30 degrees

142
Q

How many degrees of angulation should be formed between the femur and the radiographic table for the PA axial projection (holmblad method) of the knee?

A

70 degrees

143
Q

Which of the following projections of the knee best demonstrates the intercondylar fossa?

A

PA axial projection (holmblad method)

144
Q

How many degrees and in what direction should the CR be directed for the lateral projection of the knee?

A

5-7 degrees cephalad

145
Q

Which structure of the knee is best demonstrated with the tangential projection?

A

Patella

146
Q

Which structure of the knee is best demonstrated with the PA axial projection (the Holmblad Method)?

A

Femoral intercondylar fossa

147
Q

Which projection of the knee best demonstrates the proximal tibiofibular articulation without bony superimposition?

A

Ap oblique projection (medial rotation)

148
Q

Which projection of the knee best demonstrates the femoropatellar space open?

A

Lateral projection

149
Q

Which of the following evaluation criteria indicates that the knee is properly positioned for a lateral projection?

A

The femoral condyles are superimposed

150
Q

What should be done to prevent the knee joint space from being obscured by the magnified shadow of the medial femoral condyle when the lateral projection of the knee is performed?

A

Direct the CR 5-7 degrees cephalad

151
Q

Which of the following evaluation criteria indicates that the knee is properly positioned for the Ap projection?

A

The femorotibial joint space is open

152
Q

Where should the patella be demonstrated on the image of the AP oblique projection of the knee with medial rotation?

A

Over the medial condyle of the femur

153
Q

Where should the patella be demonstrated on the image of the AP oblique projection of the knee with lateral rotation?

A

Over the lateral femoral condyle

154
Q

For the lateral projection of the patella, which positioning maneuver reduces the femoropatellar joint space?

A

Flexing the knee more than 10 degrees

155
Q

Which area of the knee should the CR enter for the PA axial projection (Holmblad method)?

A

Posterior

156
Q

Which of the following projections of the knee best demonstrates the femoral intercondylar fossa?

A

PA axial projection (Camp-Coventry method)

157
Q

Which projection of the knee should be used to demonstrate the patella completely superimposed on the femur?

A

AP projection

158
Q

Which projection of the knee should be used to demonstrate the patella in profile?

A

Lateral projection

Positioning test prep (4 decks)

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