Positioning 1- Chapter 3 General anatomy and radiographic positioning terminology Flashcards
What is Osteology?
Osteology is the detailed study of the body of knowledge related to the bones of the body.
What are the four fundamental body planes?
Sagittal
Coronal
Horizontal
Oblique
Describe the Sagittal plane
A sagittal plane divides the entire body or a body part into right and left segments. The plane passes vertically through the body from front to back. The midsagittal plane is a specific sagittal plane that passes through the midline of the body and divides it into equal right and left halves
Describe the coronal plane
A coronal plane divides the entire body or a body part into anterior and posterior segments. The plane passes through the body vertically from one side to the other. The midcoronal plane is a specific coronal plane that passes through the midline of the body, dividing it into equal anterior and posterior halves . This plane is sometimes referred to as the midaxillary plane.
Describe the horizontal plane
A horizontal plane passes crosswise through the body or a body part at right angles to the longitudinal axis. It is positioned at a right angle to the sagittal and coronal planes. This plane divides the body into superior and inferior portions. Often it is referred to as a transverse, axial, or cross-sectional plane.
Describe the oblique plane
An oblique plane can pass through a body part at any angle among the three previously described planes. Planes are used in radiographic positioning to center a body part to the image receptor (IR) or central ray and to ensure that the body part is properly oriented and aligned with the IR. The midsagittal plane may be centered and perpendicular to the IR, with the long axis of the IR parallel to the same plane. Planes can also be used to guide projections of the central ray. The central ray for an anteroposterior (AP) projection passes through the body part parallel to the sagittal plane and perpendicular to the coronal plane. Quality imaging requires attention to all relationships among body planes, the IR, and the central ray.
Body planes are used in computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) to identify the orientation of anatomic cuts or slices shown in the procedure. Imaging in several planes is often used to show large sections of anatomy.
Two special planes are used in radiographic positioning. These planes are localized to a specific area of the body only. What are these special planes?
Interilliac
Occlusal
Describe the Interiliac plane
The interiliac plane transects the pelvis at the top of the iliac crests at the level of the fourth lumbar spinous process. It is used in positioning the lumbar spine, sacrum, and coccyx.
Describe the Occlusal Plane
The occlusal plane is formed by the biting surfaces of the upper and lower teeth with the jaws closed. It is used in positioning of the odontoid process and in some head projections.
What are the two great cavities of the torso?
The thoracic and the abdominal
The thoracic cavity is subdivided into…
A pericardial segment and two pleural portions
Although the abdominal cavity has no intervening partition, the lower portion is called the…
Pelvic cavity
Abdominal and pelvic cavities together are referred to as the abdominopelvic cavity
What are the principle structures located in the thoracic cavity?
- pleural Membranes
- Lungs
- trachea
- esophagus
- Pericardium
- heart and great vessels
What are the principle structures in the Abdominal cavity?
- Peritoneum
- liver
- gallbladder
- Pancreas
- Spleen
- Stomach
- intestines
- Kidneys
- Ureters
- Major Blood Vessels
- Pelvic Portion: rectum, urinary bladder, and parts of the reproductive system
What are the four clinical divisions(quadrants) of the abdomen?
- Right upper quadrant (RUQ)
- Right lower Quadrant (RLQ)
- Left lower Quadrant (LUQ)
- Left lower quadrant (LLQ)
What are the nine regions of the abdomen?
Superior
• Right hypochondrium
• Epigastrium
• Left Hypochaondrium
Middle
• Right lateral
• Umbilical
• Left Lateral
Inferior
• Right inguinal
• Hypogastrium
• Left Inguinal
What is anatomy?
The term applied to the science of the structure of the body
What is physiology?
The study of the function of the body organs
The Saginaw plane divides the body into…
Right and left segments, passing vertically from front to back
Midsagital plane(MSP) is a specific sagittal plane that…
Passes through midline and divides the body into equal right and left halves
Coronal planes pass through the body..
Vertically from side to side, dividing the body into anterior and posterior parts
Mid coronal plane(MCP), also called midaxillary plane, is the specific plane that…
Passes through midline and divides the body into equal anterior and posterior halves
Horizontal planes pass…
Crosswise through the body or body part at right angles to the longitudinal axis
- positioned at right angle to sagittal and coronal planes
- divides the body into superior and inferior portions
- also called transverse, axial, or cross-sectional planes
Oblique planes pass through a body part…
At any angle between the sagittal, coronal, or horizontal planes
Interiliac plane transects the body at…
The top of the iliac crests (level of L4)
Occlusal plane formed by the…
Biting surfaces of the upper and lower teeth with jaws closed
What are the divisions of the abdomen?
• Bordered superiorly by diaphragm • bordered inferiority by superior pelvic aperture(pelvic inlet) • abdomen divided in two methods -quadrants -regions
Which body plane passes through the body from anterior to posterior and divides the body into equal rights and left halves?
A. Midsagittal
B. Midcoronal
C. Midaxillary
D. Midtransverse
A. Midsagittal
In which quadrant of the abdomen is the largest portion of the liver located?
A. Right upper
B. Left upper
C. Right lower
D. Left lower
A. Right upper
The detailed study of the body of knowledge relating to the bones of the body defines?
A. Anatomy
B. Arthrology
C. Osteology
D. Pathology
C. Osteology
What is body habitus?
Defined as the common variations in the shape of the human body
Important in radiography because habitus determines size, shape, and position of organs of the thoracic and abdominal cavities
What organs are affected by body habitus?
- heart
- lungs
- diaphragm
- stomach
- colon
- gallbladder
What are the four types of body habitus?
- sthenic =50%
- hyposthenic = 35%
- asthenic = 10%
- hypersthenic = 5%
Sthenic and hyposthenic are considered average
Hypersthenic and asthenic are the extremes
Osteology covers…
- skeletal divisions
- general bone features
- bone development
- classification of bones
Bone functions
- attachment for muscles
- mechanical basis for movement
- protection of internal organs
- support frame for body
- storage for calcium, phosphorus, and other salts
- production of red and white blood cells
Skeletal divisions
• total of 206 bones in the body
• divided into two main groups
- axial skeleton (80 bones)
- appendicular skeleton (126 bones)
• axial skeleton supports and protects the head and trunk
• appendicular skeleton provides means for movement
What is the function of the axial skeleton?
Supports and protects the head and trunk
What is the function of the appendicular skeleton?
Provides means for movement
General bone features
• Compact bone
- strong dense outer layer
• Spongy bone
- inner, less dense layer
- contains a speculated network called trabeculae
• Trabeculae filled with red and yellow marrow
• Red marrow produces red and white blood cells
• yellow marrow stores fat cells
• Medullary cavity
- central cavity of long bones
- contains trabeculae filled with yellow marrow
- red marrow found in ends of long bones
• periosteum
- tough, fibrous connective tissue that covers bone, except at articulate ends
• endosteum
- lines marrow cavity
Describe compact bone
Strong, dense outer layer
Describe spongy bone
Inner less dense layer that contains a spiculated network called trabeculae
Trabeculae is filled with…
Red and yellow marrow
Red marrow produces…
Red and white blood cells
Yellow marrow stores
Fat cells
Describe the medullary cavity
The central cavity of long bones that contains trabeculae filled with yellow marrow.
Red marrow is found in the ends of long bones
Red marrow is found…
In the ends of long bones
What is the periosteum?
Tough fibrous connective tissue that covers bone, except at articulate ends
What is the endosteum?
Lines marrow cavity
What are the bone classifications?
- long
- short
- flat
- irregular
- sesamoid
Describe long bones
Found only in limbs
Consist of body and two enlarged articulate ends
Example: femur and humerus
Describe short bones
Consist mainly of cancellous bone with a thin outer layer of compact bone
Example: carpal bones
Describe flat bones
Consist of two plates of compact bones
Middle layer of cancellous bone called diploe
Examples: sternum and cranium
Describe irregular bones
Are peculiarly shaped
Examples: vertebrae and facial bones
Describe sesamoid bones
Very small and oval
Develop inside and beside tendons
Protect the tendon from excessive wear
Largest is patella
Which of the following is an example of a flat bone?
A. Femur
B. Radius
C. Clavicle
D. Scapula
D. Scapula
All of the following are functions of the skeleton, except:
A. Attachment for muscles
B. Storage for calcium, phosphorus, and other salts
C. Production of minerals
D. Production of red and white blood cells
C. Production of minerals
Which of the following can be palpated to locate T7?
A. Jugular notch
B. Sternal angle
C. Inferior angle of the scapula
D. Xiphoid process
C. Inferior angle of the scapula
What is arthrology?
Defined as the study of joints, or articulation so between bones
Classified in two ways
• functional
• structural
What are the three subdivisions of the functional classification in arthrology?
- synarthroses = immoveable
- amphiarthroses = slightly moveable
- diarthroses = freely moveable
What are the three distinct groups in the structural classification of Arthrology based on connective tissues?
- fibrous
- cartilaginous
- synovial
Describe synovial joints
• permit wide range of motion; freely moveable • complex joints • enclosed by articulate capsule • many have accessory soft tissues - meniscus - bursae
What are the six types of synovial joints?
- gliding
- hinge
- pivot
- ellipsoid
- saddle
- ball and socket
Describe the gliding joint
- simplest synovial joint
* examples: intercarpal and intertarsal joints
Describe the hinge joint
- permits flex ion and extension only
* examples: elbow and knee
Describe the pivot joint
- allows rotation around single axis
* example: atlantoaxial joint (C1-C2 joint)
Describe the ellipsoid joint
- allows flex ion, abdusction, adduction, and circumduction
* example: radiocarpal (wrist) joint
Describe the saddle joint
- allows movement similar to ellipsoid
- difference is in the shape of the articular surfaces
- example: carpometacarpal joint between trapezium and first metacarpal
Describe the ball and socket joint
- permits widest range of motion
* examples: hip and shoulder
Which of the following joint classifications is freely moveable?
A. Amphiarthroses
B. Synarthroses
C. Diarthroses
D. Synovial
C. Diarthroses
Bone markings and features
• Processes and projections - extend beyond and project out from the main body of a bone • depressions - hallow or depressed areas • fractures - a break in the bone
Processes and projections
Condyle
Rounded process at an articular end
Processes and projections
Caracoid or coronoid
Beaklike or crownlike process
Processes and projections
Crest
Ridgelike process
Processes and projections
Epicondyle
Projection above a condyle
Processes and projections
Facet
Small, smooth-surfaced articular process
Processes and projections
Hamulus
Hook-shaped process
Processes and projections
Head
Expanded end of a long bone
Processes and projections
Horn
Hornlike process
Processes and projections
Line
Linear elevation’ not as prominent as a crest
Processes and projections
Malleolus
Club-shaped process
Processes and projections
Protuberance
Projecting prominence
Processes and projections
Spine
Sharp process
Processes and projections
Styloid
Long, pointed process
Processes and projections
Trochanter
Either of the two large, rounded, and elevated processes of the proximal femur
Processes and projections
Tubercle
Small ,rounded, and elevated process
Processes and projections
Tuberosity
Large, rounded, and elevated process
Depressions
Fissure
Cleft or deep groove
Depressions
Foramen
Hole in a bone for transmission of vessels and nerves
Depressions
Fossa
Pit, fovea, or hollow space
Depressions
Groove
Shallow linear channel
Depressions
Meatus
Tubelike passageway
Depressions
Notch
Indentation in the border of a bone
Depressions
Sinus
Recess, groove, cavity, or hallow space
Depressions
Sulcus
Furrow or trench
What types of fractures are there
- closed
- open
- nondisplaced
- displaced
Common classifications of fractures
- compression
- compound (open)
- simple
- greenstick
- transverse
- spiral or oblique
- comminuted
- impacted
Many fractures fall into more than one category
Which of the following is defined as a hole in a bone for transmission of blood vessels and nerves?
A. Fissure
B. Groove
C. Sinus
D. Foramen
D. Foramen
Anterior (ventral)
Forward or front part of the body or of a part
Posterior (dorsal)
Back part of body or part
Caudad
Parts away from the head of the body
Cephalad
Parts toward the head
Superior
Nearer the head or situated above
Inferior
Nearer the feet or situated below
Central
Mid area or main part of an organ
Peripheral
At or near the surface, edge, or outside of another body part
Medial
Toward the median plane of the body or toward the middle of a body part
Lateral
Away from the median plane or away from the middle of a part
Superficial
Near the skin or surface
Deep
Far from the surface
Distal
Farthest from the point of attachment or origin
Proximal
Nearer to the point of attachment or origin
External
Outside the body or part
Internal
Inside the body or part
Parietal
The wall or lining of a body cavity
Visceral
The covering of an organ
Ipsilateral
Parts on the same side of the body
Contralateral
Parts on the opposite side of the body
Palmar
Palm of the hand
Plantar
Sole of the foot
Dorsum
Anterior, or top, of the foot or back of the hand
Radiographic positioning terminology
Projection
Defined as the path of the CR(central Ray) as it exits the X-ray tube, passing through the patient to the IR(image receptor)
Identified by the entrance and exit points of the body
Radiographic positioning terminology
Position
Overall posture of the patient or general body position
Also refers to the specific placement of the body or part in relation to the table or IR
Radiographic positioning terminology
View
Used to describe the body part as seen by the IR
Exact opposite of projection, the preferred term in the United States
Radiographic positioning terminology
Method
Refers to a specific radiographic projection developed by an individual
AP
CR enters in the anterior surface and exits the posterior
PA
CR enters the posterior surface and exits the anterior
Axial
Longitudinal angle of the CR of 10 degrees or more
Tangential
CR directed along the outer margin of a curved body surface
Lateral
CR enters one side of the body, passing transversely along the coronal plane
Oblique
CR enters from side angle
Entrance and exit surfaces still specified (e.g. , AP oblique)
General body positions
Upright
Erect or vertical
General body positions
Seated
Upright, but sitting on a stool
General body positions
Recumbent
Lying down in any position
General body positions
Supine
Lying on the back
General body positions
Prone
Lying face down
General body positions
Trendelenburgs position
Supine with the head lower than the feet
General body positions
Fowlers position
Supine with the head elevated
General body positions
Sim’s position
Recumbent with patient lying on left anterior side with left leg extended and right knee and thigh partially flexed
General body positions
Lithotomy position
Supine with knees and hips flexed and thighs abducted and rotated externally, supported by ankle supports
General body positions
Lateral position
Named according to the side of the patient that is placed closer to the IR
Oblique position
Body is rotated so that the coronal plane is not parallel with the table or IR
Angle of rotation is specific for anatomy of interest
Named according to side and surface of body closer to table or IR
Abbreviations: RPO, LPO, RAO, and LAO
Decubitus position
Recumbent position with a horizontal CR
Named according to the body surface on which the patient is lying
Lordotic position
Upright position in which the patient is leaning backward
Body Movement Terminology
Abduct or Abduction
Movement of a part away from the central axis of the body
Body Movement Terminology
Adduct or adduction
Movement of a part toward the central axis of the body
Body Movement Terminology
Extension
Straightening of a joint
Body Movement Terminology
Flexion
Bending do a joint
Body Movement Terminology
Hyperextension
Forced or excessive extension
Body Movement Terminology
Hyperflexion
Forced overflexion
Body Movement Terminology
Evert/eversion
Outward turning of the foot at the ankle
Body Movement Terminology
Invert/inversion
Inward turning of the foot at the ankle
Body Movement Terminology
Pronate/pronation
Rotation of forearm so that the palm is down
Body Movement Terminology
Supinate/supination
Rotation of forearm so that the palm is up
Body Movement Terminology
Rotate/rotation
Turning of the body or part around its axis
Rotation of a limb is either medial(toward midline) or lateral (away from midline)
Body Movement Terminology
Circumduction
Circular movement of a limb
Body Movement Terminology
Tilt
Tipping or slanting a body part slightly
Body Movement Terminology
Deviation
A turning away from the regular or standard course
Define anatomy
The science of the structure of the body
Define physiology
The study of the function of the body organs
Define osteology
The detailed study of the body of knowledge relating to the bones of the body
Describe the anatomic position
Body standing erect, face and eyes directed forward, arms extended by the sides with the palms of the hands facing forward, heels together, and the toes pointing anteriorly with the great toes touching
List the four fundamental planes of the body
Sagittal
Coronal
Horizontal
Oblique
Any plane passing vertically through the body from front to back and dividing the body into right and left segments is called a(n)____________ plane.
Sagittal
Any plane passing vertically through the body from side to side and dividing the body into anterior and posterior segments is called a(n)_____________ plane
Coronal
The plane that passes vertically through the midline of the body from side to side and divides the body into equal anterior and posterior segments is called the ________________plane
Midcoronal
Also referred to as the midaxillary plane
The plane passing through the midline of the body and dividing it into equal right and left halves is known as the_________________plane
Midsagittal
A plane that passes crosswise through the body and divides the body into superior and inferior segments is a(n)______________plane or______________plane
Horizontal, transverse, axial
What are the two major cavities of the torso
Thoracic and abdominal
What structures are found in the thoracic cavity?
Lungs
Heart
Trachea
Esophagus
What structures are found in the abdominal cavity?
Liver
Spleen
Ureters
What structures are found in the pelvic cavity?
Uterus
Rectum
Ovaries
What landmark corresponds to C1?
Mastoid tip
What landmark corresponds to c3, C4?
Hyoid bone
What landmark corresponds to C5?
Thyroid cartilage
What landmark corresponds to C7, T1?
Vertebra prominens
What landmark corresponds to T2, T3?
Level of jugular notch
What landmark corresponds to T4, T5?
Level of the sternal angle
What landmark corresponds to T7?
Level of the inferior angles of scapulae
What landmark corresponds to T9, T10?
Level of xiphoid process
What landmark corresponds to L2,L3?
Inferior costal margin
What landmark corresponds to L4, L5?
Level of superior most aspect of iliac crest
What landmark corresponds to S1, S2?
Level of anterior superior iliac spines
What landmark corresponds to coccyx?
Level of pubic symphysis
How many bones comprise the typical adult skeleton?
206
List the two main skeletal divisions that make up the bony framework of the body.
Appendicular
Axial
What are the four main parts of the appendicular skeleton?
A. Ribs B. Pelvic girdle C. Shoulder girdle D. Vertebral column E. Upper limbs (extremities) F. Lower limbs (extremities)
B
C
E
F
Circle the four main parts of the axial skeleton.
A. Neck B. Skull C. Thorax D. Vertebral column E. Upper limbs (extremities) F. Lower limbs (extremities)
A
B
C
D
What is the outer layer of bony tissue?
Compact bone
what is the Inner trabeculated portion of the bone?
Spongy bone
What is the central cylindrical canal of long bones?
Medullary cavity
What is the tough, fibrous membrane that covers the bone (except where bone is covered by articular cartilage)?
Periosteum
What are the five classifications of bones?
Flat Long Short Irregular Sesmoid
What kind of bone is the Tibia?
Long bone
What kind of bone is the Lunate?
Short bone
What kind of bone is the radius?
Long bone
What kind of bone is patella?
Sesamoid
What kind of bone is the scapula?
Flat bone
What kind of bone is the maxilla?
Irregular bone
What kind of bone is the vertebrae?
Irregular bone
Define long bone
Long bones consist of a body and two articular ends
Define short bone
Short bones consist mainly of spongy tissue and have only a thin outer layer of compact bone
Define flat bone
Flat bones consist mainly of compact bone in the form of two plates that enclose a layer of spongy tissue
Define irregular bone
Irregular bones, because of their peculiar shape, cannot be classified as long, short, or flat bones
Define Sesamoid bone
Sesamoid bones are small oval bones that develop in and near tendons and function to protect tendons from excessive wear.
List the two classifications of joints.
Functional
Structural
List the three structural classifications of articulations
Fibrous
Cartilaginous
Synovial
What kind of movement does a synovial joint have?
Freely movable
What kind of movement does a fibrous joint have?
Immovable
What kind of movement does a cartilaginous joint have?
Limited or slight movement
Define Bursae
Fluid-containing sacs that are interposed between sliding surfaces to reduce friction
Define meniscus
Fibrocartilaginous disk pad located between the ends of bones in some synovial joints
Define symphysis
Joining together of two midline bones in the body by a plate of fibrocartilage
Define synovial fluid
Lubricant and nutrient compound found within synovial joints
Define synchondrosis
Joint in which two bones are joined by hyaline cartilage
Define articular capsule
Fibrous envelope that encloses a synovial joint
What kind of movement does a gliding (plane) synovial joint have?
Sliding
Gliding
What kind of movement does a hinge (ginglymus) synovial joint have?
Flexion
Extension
What kind of movement does a pivot (trochoid) synovial joint have?
Rotation
What kind of movement does a ellipsoid (condyloid) synovial joint have?
Flexion Extension Abduction Adduction Circumduction
What kind of movement does a saddle (sellar) synovial joint have?
Flexion Extension Abduction Adduction Circumduction
What kind of movement does a ball and socket (spheroid) synovial joint have?
Flexion Extension Rotation Abduction Adduction Circumduction
What articulation does the synovial type joint, the hip, have?
Ball and socket (spheroid)
What articulation does the synovial type joint, the knee, have?
Hinge (ginglymus)
What articulation does the synovial type joint, the elbow, have?
Hinge (ginglymus)
What articulation does the synovial type joint, the wrist, have?
Ellipsoid (condyloid)
What articulation does the synovial type joint, the shoulder, have?
Ball and socket (spheroid)
What articulation does the synovial type joint, c1 and c2, have?
Pivot (trochoid)
What articulation does the synovial type joint, intertarsal, have?
Gliding (plane)
What articulation does the synovial type joint, interphalangeal, have?
Hinge(ginglymus)
What articulation does the synovial type joint, metacarpophalangeal, have?
Ellipsoid (condyloid)
What articulation does the synovial type joint, carpometacarpal joint of the thumb, have?
Saddle(sellar)
Fossa
Pit, fovea, or hollow
Sinus
Recess, groove, cavity, or hollow space
Sulcus
Furrow, trench, or fissurelike depression
Groove
Shallow, linear depression
Fissure
Cleft or groove
Foramen
Hole in a bone for transmission of blood vessels and nerves
Spine
Sharp process
Protuberance
Bony projection
Coracoid
Beaklike process
Crest
Ridgelike process
Malleolus
Club-shaped process
Hamulus
Hook-shaped process
Styloid
Long, pointed process
Epicondyle
Projection above a condyle
Horn
Hornlike process ion a bone
Head
Expanded end of a long bone
Tubercle
Small, rounded, elevated process
Tuberosity
Large, rounded, elevated process
Condyle
Rounded process at an articular extremity
Facet
Small, smooth-surfaced, process for articulation
Trochanter
Large, rounded, elevated process located at the junction of the neck and shaft of the femur
Refers to the sole of the feet
Plantar
Refers to the palm of the hand
Palmar
Refers to the covering of an organ
Visceral
Refers to parts far from the surface
Deep
Refers to a part near the skin or surface
Superficial
Refers to nearer the feet or situated below
Inferior
Refers to nearer the head or situated above
Superior
Refers to parts toward the head of the body
Cephalad
Refers to a part on the same side of the body
Ipsilateral
Refers to the back part of the body or an organ
Posterior, dorsal
Refers to parts away from the head of the body
Caudad
Refers to the middle area or main part of the organ
Central
Refers to a part within or on the inside of an organ
Internal
Refers to a part or parts on the opposite side of the body
Contralateral
Refers to a part outside of an organ or on the outside of the body
External
Refers to parts at or near the surface, edge, or outside
Peripheral
Refers to the forward or front part of the body or to the forward part of the organ
Anterior, ventral
Refers to parts toward the median plane of the body or toward the middle of a body part
Medial
Refers to parts nearest the point of attachment, point of reference, origin, or beginning
Proximal
Refers to parts farthest from the point of attachment, point of reference, origin, or beginning
Distal
Refers to the top or anterior surface of the foot or to the back or posterior surface of the hand
Dorsum
Refers to parts away from the median plane of the body or away from the middle of a part to the right or the left
Lateral
Define Tilt
Movement of a part so that the sagittal (longitudinal) plane is angled so that it is not parallel with the long axis of the body
Define rotate
To turn around an axis
Define flexion
Bending movement of a joint whereby the angle between contiguous bones is diminished
Define pronate
To turn the forearm so that the palm of the hand faces backward
Define eversion
Movement of the foot when it is turned outward at the ankle joint
Define supinate
To turn the forearm so that the palm of the hand faces forward
Define deviation
A turning away from the regular standard course
Define extension
Straightening of a joint
Define inversion
Movement of the foot when it is turned inward at the ankle joint
Define abduction
Movement of a part away from the central axis of a body or body part
Define adduction
Movement of a part toward the central axis of a body or body part
Define hyperflexion
Forced or excessive flexion of a joint or part
Define circumduction
Circular movement of a limb
Define hyperextension
Forced or excessive straightening of a joint
Define Dorsiflexion
Flexion of the foot toward the leg