Lowers (Foot, Ankle, Tib/Fib, Knee, Femur)

Question 1

AP Foot Criteria

Answer 1

• is there a real lead marker not in the anatomy of interest?
• Anatomy from toes to tarsals may include portions of the talus and calcaneus
• No rotation of foot; equal amount of space between the second through 4th metatarsals
• Overlap of the second through fifth metatarsal bases

Question 2

Lateral Foot

Question 3

AP Ankle Criteria

Answer 3

• Ankle joint center to exposure area
• Medial and lateral malleoli
• talus
• no rotation of ankle
• Normal overlapping of the tibiofibular articulation with the anterior tubercle slightly superimposed over the fibula
• Talus slightly overlapping the distal fibula
• Tibiotalar Joint space open (ankle joint?)

Question 4

What projection of the foot shows the cuboid in profile? What else is well shown?

Answer 4

Medial Oblique Foot, Sinus Tarsi

Question 5

What joint space(s) are shown on a AP axial-foot?

Answer 5

Open joint space between medial and intermediate cuneiforms

Question 6

What projection of the foot shows the navicular, lateral cuneiform, and cuboid with less superimposition than in the AP projection?

Answer 6

Medial projection

Question 7

What projection of the foot shows the lateral tarsometatarsal and intertarsal joints?

Answer 7

AP medial oblique

Question 8

What projection shows the medial and lateral malleoli?

Answer 8

AP Ankle

Question 9

What projection shows an open Tibiofibular joint space?

Answer 9

AP Ankle

Question 10

What joint is well visualized on a lateral ankle?

Answer 10

Tibiotalar joint, with medial and lateral talar domes superimposed

Question 11

The axial foot projection demonstrates improved visibility of what anatomical structures?

Answer 11

Improve visibility of the interphalangeal, metatarsal phalangeal, and tarsometatarsal joint spaces

Question 12

What should be visualized on a PA chest?

Answer 12

apices to costophrenic ranges, sternal ends should be equidistant

Question 13

What should be visualized on a KUB?

Answer 13

The area from pubic symphysis to kidneys

Question 14

What is the centering point for a PA hand?

Answer 14

Perpendicular to 3rd MTP joint

Question 15

What should be visualized on a PA hand?

Answer 15

Open MCP and IP joints, indicating that the hand is placed flat on the IR

Question 16

The lateral wrist should have superimposed what?

Answer 16

Radius and ulna

Question 17

What should be open on an AP forearm?

Answer 17

Radioulnar space

Question 18

A properly positioned lateral foot will show what?

Answer 18

An open sinus tarsi and talar dome, fibula over posterior half of tibia

Question 19

The AP leg should show what joints?

Answer 19

Knee and ankle joint

Question 20

A lateral oblique does what to the Tib/Fib?

Answer 20

Superimposes it

Question 21

On a lateral knee, the femoral condyles should be superimposed.
If they aren’t, then what caused that?

Answer 21

A 5-7 degree cephalad tit wasn’t put on

Question 21

A medial oblique does what to the knee?

Answer 21

Clears the tib/fib of superimposition

Question 22

What does a lateral oblique of the knee do?

Answer 22

Superimposes the Tib/Fib

Question 23

AP Femur

Question 24

What is the central ray for an AP Knee Projection?

Answer 24

• 1/2 inch inferior to the patellar apex
• Variable, depending on the measurement between the anterior superior iliac spine (ASIS) and the tabletop:

<19 cm 3-5 degree caudad (thin pelvis)
19-24 cm 0 degrees
>24 3-5 degree cephalad (large pelvis)

Question 25

For an AP Knee, adjust the patients leg by placing the _____ parallel with the IR for a true AP projection.

Answer 25

femoral epicondyles

Question 26

Evaluation Criteria for AP Knee Projection:

(Pg. 347)

Answer 26

• 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

Question 27

Central Ray for Lateral Knee Projection:

Answer 27

• Directed to the knee joint 1 inch distal to the medial epicondyle at an angle of 5 to 7 degrees cephalad.

Question 28

Lateral Knee Projection;
Flexion of the knee ____ is usually preferred.
Grasp the epicondyles and adjust them so that they are ____ to the IR (condyles superimposed).
The patella is ___ to the plane of the IR

Answer 28

-20-30 degrees
-perpendicular
-perpendicular

Question 29

If condyles are NOT superimposed on a lateral knee projection, why might this be?

Answer 29

• if condyles are not superimposed Side to Side it’s a rotation error
• if condyles are not superimposed Up and Down it’s a tube angle error
  (have to have a 5-7 degree cephalad angle for a lateral knee!!!!)

Question 30

Structures Shown on an Lateral Knee:

Answer 30

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)

Question 31

Evaluation Criteria for a Lateral Knee:

Pg. 350

Answer 31

• ## knee flexed 20 to 30 degrees in true lateral position as demonstrated by femoral condyles superimposed

Question 32

How do you tell if a Scap-Y is over or under rotated?

Answer 32

If you see the “cup” of the scapula it is under rotated
If the scapula is going into the ribs, it is over rotated