Test 3 Ch 6, 7 Flashcards
How many bones in the foot?
How many tarsals?
26
7
Th base of the 5th metatarsal has a rough__________, and is the most _____________fracture
Tuberosity
Common
The largest sesame is bone in the body
Patella
What projections would we use to see a fracture in a sesamoid bone?
Tangential projection
The largest and strongest bone of the foot?
Calcaneus
Posterior inferior part of calcaneus ??
The tuberosity
Common site for bone spurs
Largest tendons is the ??
Which contains two processes called
Achilles’ tendon
Medial and lateral process
What is the sustentaculum?
A support for the talus
The talus articulates with 4 bones, what are they?
Tibia
Fibula
Calcaneus
Navicular
The deep depression between the posterior and middle articulate facets?
Calcaneal sulcus
Benign neoplasticism bone lesions filled with clear fluid in knee joint mostly occurring in children
Appear as lucent areas on X-ray
Bone cysts
Also known as runners knee
Softening of cartilage under patella
Chondromalacia patellae
What are Malignant tumors of cartilage that occur in pelvis or long bones
Often seen white on radiograph
Chondrosarcomas
A slow growing benign tumor found in small bones of hands and feet
Radiolucent appearing on radiograph
Enchondroma
Onion peel look on radiograph
Ewing sarcoma
Overproduction of bone at knee joint. Growth stops at epiphyseal plate.
Exostosis
A form of arthritis; hereditary where Uric acid appears excessively
Gout
Initial attack’s at 1st MTP joint of foot
Inflammation of bone and cartilage of anterior proximal tibia
Is good schlatter disease
Common in 10-15 yr old boys
Bone softening.. caused by lack of mineralization
Rickets
Bowing in children’s legs
What is the Tangential projection of toes used for?
For sesamoid bones
Dorsiflex foot
Patient prone position
AP projection of the foot is also known as ?
And we must angle the tube ?
Dorsoplantar
Cr angled at 10 degrees
posteriorly toward heel
Where do we direct CR for Lateral-Mediolateral projections of foot
What position of the foot for an oblique foot projection ??
Cr directed to medial cuneiform.
Used To see foreign bodies
30-40 degrees; using a 45’ radiolucent sponge
Why do we use weight bearing projections of the feet ?
Longitudinal or transverse arches
Or
To see Lisfranic joint injuries
Angle Cr to 15 degrees to midpoint of both feet
What is another name for the Plantodorsal(axial) projection of foot and how do we use it ?
Calcaneus projection
Direct Cr to base of 3rd metatarsal
Angle 40 cephalad
AP ankle
CR - to midway between malleoli
Adjust foot ankle for true AP but do not force foot
Ankle joint space will not be open
What position is the patient for an AP mortise projection ?
What would we use this projection to see?
15-20 degrees medial rotation of lower leg
Entire ankle mortise and the proximal 5th metatarsal; common fracture site.
AP oblique ankle requires the patients leg and foot to rotate how many degrees ?
45 degrees medially
And the calcaneus will be super imposed over the lateral malleolus
AP projection of lower leg requires how many inches be included on both ankle and knee joints
1-2 inches
Place sand bags on foot if needed for stabilization.
14x17 inch IR ; can place leg diagonally
For an AP knee projection, where do we align the CR?
Parallel to articulate facets (tibial plateau)
Average patient is perpindicular
1/2 inch distal or inferior to apex of patella !!!!
Rotate leg how many degrees for a true AP knee??
3-5 degrees
Do an oblique knee projection; Rotate knee how many degrees?
45 degrees medially
Most routine oblique knee projections include mainly the ??
Medial roatation but some places require medial and lateral rotation projection of the knee
For a lateral mediolateral knee projection, what 2 projections are options:
What is the CR angle??
Lateral recumbent -
Which requires a 20-30 degree flex of the knee
Horizontal beam - done for patient unable to flex
5-7 degrees cephalad and 1 inch distal to medial epicondyles
Rosenberg method of the bilateral knee projection.
Position standing 45 degrees PA flexion for weight bearing bilateral knees.
CR angles at 10 degrees caudad between knee joints 1/2 inch below patella
What are the names of the few Tunnel views of the intercondylar fossa ?
Camp Coventry methods = prone (easiest method for pt)
Holmblad method = kneeling
Beclere method= supine
To view intercondykar fossa, knee joint, and articular facet
For an AP of the patella, __________ rotation of the knee by 5 degrees
Internal
What projection would we use to see the intercondylar sulcus of the patella ?
“ Hobbs modification”or superinferor sitting tangential method of patella
The ligament attached to the head of the femur
Capitus femoris
The lesser and greater trochanters are joined posteriorly by a thick ridge called
Intertrochanteric crest
The femur and leg must be angled/rotated medially and internally by?? To get a true AP projection
15-20 degrees
Another name for the 2 hip bones
Innominate bones
Two positioning landmarks that of which is the Ilium are?
Iliac crest
ASIS
Directly superior to the ischial spine is a deep notch called?
Greater sciatic notch
The largest foremen in the body ??
Obturator foramen
The area above or superior to the oblique plane through the pelvic brim?
False pelvis
Forms the actual birth canal ?
True pelvis
Lesser pelvis
The two ischial tuberosities and the top of the coccyx defines the
The Outlet
The area between the inlet and outlet is
The cavity
The 3 divisions of the hip bone (acetabulum) are separate in children until they fuse together by what age
Middle teens
A small depression located in the center of the femoral head
Fovea capitus
Hip joint classification and mobility and movements are:
Synovial
Diathrodial
Ball and socket
What movement type is the acetabulum ??
Non moveable!!!
Synthrodial mobility
Cartilagenous
What physical sign indicates that they have a hip fracture ?
The foot rotates externally!
Which modality would we use to diagnose early signs of metastatic carcinoma of the pelvis ?
Nuclear medicine
Malignancy spread to bone via circulatory and lymphatic systems
Metastatic carcinoma
Which modality will best demonstrate a fracture ring of the pelvis?
CT
Where is the CR placed for an AP pelvis projection ?
Between ASIS and pubis symphysis
If the left iliac wing is elongated on an Ap pelvis, that means the Patient is —
Rotated toward the right
Axiolateral inferosuperior projection (danelius Miller) is trauma or non trauma ??
Trauma
The Frog leg projections are both trauma or non trauma??
Non trauma
Modified axiallateral projection (Clements-Nakayama method)
Is trauma or non trauma
Truama!
And cr is angled 15-20 degrees posteriorly from horizontal
Which pathology is demonstrated for th posterior oblique (Judet method)?
Aceteblar fractures
Body rotated 45 degrees
How is the CR is angled for the PA axial oblique (tuefel) projection ?
12 degree cephalad
The imaginary line that separates the false from the true pelvis?
Pelvic brim
The pubic arch angle on an average male pelvis is an ________ angle and is —
Acute
Less than
Male or female
Iliac wings that are more flared=
Heart shaped inlet=
Female
Male
Which structure is most posterior ?
Ischial spines
Another term for the outlet of the true pelvis ?
Inferior aperture
In a true AP projection, the lesser trochanter will be _______ visible?
Less !
The greater pelvis =
The lesser pelvis=
False pelvis
True pelvis
The roof of the distal ankle joint is called
Tibial plafond
The ankle joint is which type of joint classification and movement?
Synovial joint
Saddle/seller joint
The articular facets of the proximal tibia are also called________
And they slope __________ degrees
Tibial plateau
10-20 degrees posteriorly
The most proximal aspect of the fibula
The extreme distal end of the fibula forms the _______
Styloid process
Lateral malleolus
The posterior aspect of the distal femur ?
Intercondylar fossa
The posterloateral aspect of the medial femoral condylarths is also called
Adductor tubercle
The general region of the posterior knee is
Popliteal
The posterior surface of the patella is normally rough?
No!
The two bursae found in the knee joint?
Infrapatellar
Suprapatellar
The knee joint(femorotibial) is what classification ??
And the patellafemoral joint is??
Bicondylar
Saddle
What is another name for osteomalacia ?
Rickets
Asymmetric erosion of joint spaces with calcaneal erosion?
Reiters syndrome
Small round oval density with lucent center?
Osteoid osteoma
What is the CR angulation for a PA Axial weight bearing projection (Rosenberg Method)?
10 degrees caudad
How much knee flexion is needed for the Homblad method?
60-70 degrees
How much flexion of the knee is recommended for a lateral projection of patella ?
5-10 degrees
Can be performed using a wheel chair or lowered radiographic table
Hobbs Modification
Which projection will best bemonstrate someone with Osgood-schlatter disease ??
Lateral knee projection
To see tibial tiberosity
Where is the CR angled for the frog leg projections ?
3 in below ASIS
Where is the Cr placed for the unilateral frog leg ??
At the midfemoral neck
How much obliquity is required for the posterior oblique(Judet Method)??
45 degrees
Which projections would we use to evaluate the pelvic inlet for possible fracture ?
AP Axial projection
Taking a lateral mediolateral Knee Projection; there are two options.
A lateral recumbent
And Horizontal Beam. How do they differ??
The lateral recumbent is made or patients who can flex their knee 20-30 degrees.
The horizontal beam is for the patient who is unable to flex the knee.
For the lateral knee projections, we always angle the CR how many degrees ?
5-7 degrees cephalad
What is the Merchant bilateral method?
A tangential projection Taken of the Patella
Direct CR midway between what? for a AP Pelvis?
Position legs how many degrees medially?
AsIS and pubis symphysis
Or 2 inch inferior to ASIS
15-20 degrees
For an AP frog leg or (modified Cleaves) projections where do we direct the CR ?
3 inches below ASIS
And flex both knees 90 degrees
Another name for the AP Axial outlet projection?
Taylor method
(Trauma pelvis)
Angle Cr cephalad 20-35 * men 30-45* women
What do we use the Judet method for?? And is there more than one picture?
To picture the Acetabulum!
There are 2 projections right and left obliques
