Toes, Foot, Ankle Flashcards
The foot consists of ____ bones.
__ phalanges, __ metatarsals, and __tarsals
26, 14, 5, 7
The superior surface of the foot is termed the ___ or ___ surface
Dorsum or dorsal
The hindfoot includes the ____
Talus and Calcaneus
The midfoot includes the ____
Includes 5 tarsal bones:
Cuneiforms, Navicular, and Cuboid Bones
The forefoot includes the ____
Phalanages (toes) and Metatarsals
The inferior or posterior aspect of the foot is termed the ___
Planter surface
Each foot has 14 phalanges, __ in the great toe, and __ in each of the others
2, 3
The ____ is the largest and strongest tarsal bone. It is also called the __
Calcaneus, os calcis
The talus articulates with what four bones?
tibia, fibula, calcaneus, and navicular
The enlarged distal end of the fibula is the _. It is pyramidal in shape and is marked by several _ at its inferior and posterior surface
Lateral malleolus, depressions
An avulsion fracture at the base of the fifth metatarsal is commonly called a _ fracture
Jones
For a foot radiograph, The CR is __ to the ___ joint when it isn’t critical to demonstrate the joint spaces.
Perpendicular, 3rd MTP (metatarsophalangeal)
To open the joint spaces on a toe radiograph; direct the CR 15 degrees posteriorly through the ___ joint or elevate the foot on a __ foam wedge
- 3rd MTP Joint
- 15 Degree
Position the IP under the toes and _ rotate the lower leg and foot. Adjust the plantar surface of the foot to form a _ angle from the plane of the IR, and center the _ to the IR. (AP Medial Oblique)
Medially, 30-45 degrees, toes
For the great toe and the 2nd toe place the patient on the _ and place an IR under the _ of the foot centered to the _
Unaffected side, medial side, affected toe
For the 3rd-5th toes place the patient on the _ and place the IR under the _ side of the foot and center it to the toes
Affected side, lateral side
For an AP Foot projection, the central ray is directed _ to the IR entering at the _
perpendicular, base of 3rd metatarsal
For an AP axial foot projection, the CR is angled ___ ____ entering at the _. This angle is used to _. It also shows the __ joint spaces of the midfoot better
10-degrees, posteriorly (towards the heel), base of the third metatarsal, reduces foreshortening, TMT joints of the mid foot are also seen better
Eval criteria for AP foot:
- Anatomy from toes to tarsals, may include portions of the talus and calcaneus
- No rotation of the foot
- Overlap of 2nd through 5th metatarsal bones
- Open joint spaces between medial and intermediate cuneiforms
For a foot radiograph, Adjust collimation to _ on the sides and _ past the calcaneus and distal tip of the toes
1 inch, 1 inch
For an AP medial oblique foot, Rotate the patient’s leg _ until the plantar surface of the foot forms an angle of _ to the plane of the IR
medially, 30 degrees
The phalanges of the great toe are termed ________ and ________. The phalanges of the other toes are termed _____, _____, and ______.
distal, proximal
proximal, middle, distal
The __________________ functions as a shock absorber to distribute the weight of the body in all directions.
longitudinal axis
Each phalanx is composed of a body and two expanded articular ends the proximal and the distal _____
Head
The five metatarsals are numbered 1-5 beginning at the __________________ side of the foot.
medial or great toe side
The metatarsals consist of a _________ and two articular ends. The expanded proximal end is called the _______ and the small, rounded distal end is termed the ______.
body, base, head
The five metatarsal heads form the
ball of foot
(Metatarsals)
The _______ is the shortest and thickest. The _______ ________ is the longest. The _____________ contains a prominent tuberosity, which is a common site of fractures.
first metatarsal, second metatarsal, base of the 5th metatarsal
List the 7 tarsal bones:
Calcaneus, Talus, Navicular, Cuboid, Medial Cuneiform, Intermediate Cuteiform, Lateral Cuneiform
The _______ is the largest and strongest tarsal bone. It is also called the _________
calcaneus, os calcis
The posterior and inferior portions of the calcaneus contain the posterior tuberosity for attachment of the
Achilles tendon
The medial aspect of the calcaneus extends outward as a shelf-like overhang and is termed the
sustentacalum tali
The _____ is irregular in form, occupies the superior most portion of the foot, and is the second largest tarsal bone.
Talus
The talus articulates with what four bones?
tibia, fibula, calcaneus, navicular bone
The _______ bone lies on the lateral side of the foot between the calcaneus and the fourth and fifth metatarsals.
cuboid
Which projection is the sinus tarsi best seen on?
Oblique
The _____ bone lies on the medial side of the foot between the talus and the three cuneiforms.
Navicular
The ______ lie at the central and medial aspect of the foot between the navicular bone and the first, second, and third metatarsals.
cuneiforms
The _____ cuneiform is the largest and the _______ is the smallest of the three.
Medial, Intermediate
Beneath the head of the first metatarsal are two small bones called ________ bones. They are a common _________ and must be shown radiographically.
- Sesamoid Bones
- Fracture Site
The leg has two bones, the ______ and the _______.
tibia and fibula
The _____ is slightly posterior to the tibia on the _______ side of the leg and does not bear any body weight.
Fibula, Lateral
The ______ is the second largest bone in the body.
It sits on the ______ side of the leg and is a weight-bearing bone.
Tibia, Medial
The distal end of the tibia is broad, and its medial surface is prolonged into a large process called the:
Medial Malleolus
Its anterolateral surface of the tibia contains the __________ which overlays the fibula.
anterior tubercle
(Ankle)
The lateral surface of the tibia is flattened and contains the triangular ___________ for articulation with the fibula.
fibular notch
Viewed axially, the lateral malleolus lies approximately _______ more posterior than the medial malleolus.
15 to 20 degrees
The enlarged distal end of the fibula is the _______. It is pyramidal in shape and is marked by several ___________ and its inferior and posterior surfaces.
Lateral Malleolus, Depressions
The ____________ articulations between the phalanges are _______ joints that only allow flexion and extension.
- Interphalangeal Joints (IP)
- Synovial Hinge Joints
The joints between the distal and middle phalanges are the __________ joints.
Distal IP
Articulations between the middle and proximal phalanges are the __________ joints
Proximal IP Joints
With only two phalanges in the great toe, the joint is known as the ______ joint.
IP Joint
The distal heads of the metatarsals articulate with the proximal ends of the phalanges at the ______________ articulations to form ___________________ joints.
metatarsophalangeal (MTP)
synovial ellipsoidal
The proximal bases of the metatarsals articulate with one another to form the _____________ articulations and with the tarsals to form the _____________ articulations. These articulations are ________________ joints.
- intermetatarsal
- tarsometatarsal
- synovial gliding
The intertarsal articulations are classified as _________ or __________ joints.
synovial gliding
synovial ball and socket
What is the proper amount of rotation for an AP mortise joint projection?
15 - 20 Degrees of the ankle
The calcaneus supports the talus and articulates with it to form the _______ joint, which is classified as a _______ joint.
subtalar
synovial gliding
Anteriorly, the calcaneus articulates with the cuboid at the _______ joint, a _________ joint
calcane-o-cuboid
synovial gliding
The ________ rests on top of the calcaneus. It articulates with the navicular bone anteriorly, supports the tibia above, and articulates with the malleoli of the tibia and fibula at its sides.
Talus
The ankle joint is commonly called the _________ or _______ joint.
It is formed by the articulations between the _________ of the fibula and the ________________ of the tibia.
ankle mortise, mortise
lateral malleolus
inferior surface and medial malleolus
The mortise joint is often divided into the _______________ and _______________ joints.
talofibular
tibiofibular
The primary action of the ankle joint consists of _____________ and ___________ or _____________.
- Dorsiflexion
- Plantar Flexion
- Extension
The mortise joint also allows ______ and ______ of the foot.
inversion and eversion
The _________ articulates with the tibia at its distal and proximal ends. The distal ___________ joint is a ____________ joint allowing slight movement
- Fibula
- tibiofibular
- fibrous syndesmosis
Disruption in the continuity of a bone is called a ________ .
Fracture
An avulsion fracture of the medial malleolus with loss of the ankle mortise is called a ______ fracture.
Pott
An avulsion fracture of the base of the fifth metatarsal is called a ____ fracture.
Jone
The displacement of a bone from the joint space is called a:
Dislocation
Due to the natural curvature of the toes, the _____ are not best shown on an AP projection. When demonstration of the joint spaces IS critical, an _____ projection is recommended to reduce foreshortening.
- IP Joints Spaces
- AP Axial
For an AP or AP axial projection of the toes have the patient _______ or placed _______ on the radiographic table.
Seated or Supine
(For an AP or AP axial projection of the toes)
Once the patient is positioned, ____________________, separate the feet about ______, and ____________ together for immobilization.
- Flex Knees
- 6 Inches
- Touch Knees
(For an AP or AP axial projection of the toes)
Center the _________ to the IR, adjust the IR with its midline __________ to the long axis of the foot, and center to the _____ joint.
- Toes
- Parallel
- 3rd MTP Joint
(For an AP or AP axial projection of the toes)
The central ray is __________ to the ________ joint when it isn’t critical to demonstrate the joint spaces
- Perpendicular
- 3 MTP Joint
(For an AP or AP axial projection of the toes)
To open the joint spaces, direct the central ray _______ posteriorly through the ______ joint or elevate the foot on a ________ foam wedge.
- 15 Degrees
- 3rd MTP Joint
- 15 Degrees
What structures are shown on the AP and AP axial projections of the toes?:
14 phalanges of the toes; the distal portions of the metatarsals; IP joints
Some evaluation criteria for toes:
Bony trabecular detail and surrounding soft tissues
Entire toes, including the distal ends of the metatarsals
Toes separated from each other
No rotation of phalanges
For an AP medial oblique projection of the toes, place the patient in the _______ or _______ position on the radiographic table and ___________ of the affected side enough to have the _____________ resting on the table.
- Supine or Seated
- Flex knee
- Sole of the foot
( Toes- AP Oblique Medial Rotation)
Position the IP under the toes and _________ the lower leg and foot. Adjust the plantar surface of the foot to form a _________ angle from the plane of the IR, and _____________ to the IR.
- Medially Rotate
- 30 - 45 degree angle
- Center the Toes
(Toes- AP Oblique Medial Rotation)
The central ray enters perpendicular to the _______ joint. Adjust collimation to ______ on all sides of the toes, including _______ proximal to the MTP joint.
- 3rd MTP Joint
- 1 inch
- 1 inch
Structures shown on an AP medial oblique projection of the phalanges include:
toes and the distal portion of the metatarsals rotated medially
Some evaluation criteria for AP oblique projection of toes
- Entire toes including the distal ends of the metatarsals
- Toes separated
- Proper rotation of toes
- Open IP Joints and second through fifth metatarsophalangeal joints spaces
- First MTP joint (not always open)
For a lateral projection of the toes have the patient lie in the ___________ position, support the ________________ on sandbags, and adjust until comfortable.
- Lateral Recumbent position
- Affected Extremity
(Lateral projection of the toes)
To prevent superimposition _______________________; a __________ may also be used to separate toes.
- tape the toes above the one being examined
- gauze pad
(Lateral Projection)
For the great toe and the 2nd toe place the patient on the ______________ and place an IR under the _______ of the foot centered to the __________.
- Unaffected Side
- Medial Side
- Affected toe
(Lateral Projection, Great and second toe)
Grasp the patient’s extremity by the _______ and ________ and adjust its position to place the toe in _______ position. Adjust the long axis of the IR so that it is _________ with the long axis of the ________.
- heel
- knee
- true lateral
- parallel
- toe
For a lateral projection of the 3rd-5th toes place the patient on the ________ and place the IR under the ___________ side of the foot and center it to the toes
-affected side
- lateral side
For a lateral projection of the 3rd-5th toes
Grasp the patient’s extremity by the _____ and _______ and adjust its position to place the toe in ___________ position. Adjust the long axis of the IR so that it is ________ with the long axis of the ________ and support the _________ on a _______ or ________ for immobilization.
heel
knee
true lateral
parallel
toe
elevated heel
sandbag
sponge
For a lateral projection of the toes
The central ray enters perpendicular to the plane of the IR at the ________ of the great toe or the _________ of the lesser toes.
IP joint
proximal IP
Some evaluation criteria for lateral projection of toes:
- Entire toe, without superimposition of adjacent toes, when superimposition cannot be avoided, the proximal phalanx must be shown
Structures shown on a lateral projection of the phalanges include:
lateral projection of the phalanges of the toe and the IP articulations projected free of other toes
Foot radiographs may be taken in either an AP or AP axial projection. Place the patient in the _______ or ______ position and __________ of the affected side enough to rest the ______ of the foot firmly on the radiographic table.
- Supine or Seated
- Flex the knee
- Sole
(AP or AP axial foot projection)
Position the IR under the patient’s foot, center it to the __________, and align the IR long axis __________ with the long axis of the foot.
- Base of the 3rd metatarsals
- Parallel
For an AP projection of the foot, the central ray is directed __________ to the IR entering the ___________.
- perpendicular
- base of the 3rd metatarsal
For a Foot AP axial projection, the central ray is angled ___________ (toward the heel) entering the _________. This angle is used to _________. It also shows the _________ joint spaces of the midfoot better.
- 10 Degrees
- Base of the 3rd metatarsal
- Reduce foreshortening
- TMT
Structures shown for an AP projection of the foot include:
tarsals anterior to the talus, metatarsals, and phalanges. This projection is used for localizing foreign bodies and determining the locations of fragment fractures of the metatarsals and anterior tarsals
Evaluation criteria for an AP projection of the foot
- anatomy from toes to tarsals, may include portions of talus and calcaneus
- overlap of the 2nd - 5th metatarsal bases
- Open joint spaces between the medial and intermediate cuneiforms
- Axial Projection results in improved joint spaces
For the AP medial oblique projection, the patient is positioned the same as for the AP position. The IR is placed under the patient’s foot ________ with its long axis, and _________ of the foot at the level of the ___________.
- Parallel
- Center to the midline
- base of the 3rd metatarsal
For the AP medial oblique projection of the foot, rotate the patient’s leg _______ until the plantar surface of the foot forms an angle of _________ to the plane of the IR.
-Medially
- 30 Degrees
Structures shown on a medial oblique of the foot
joint spaces between the cuboid and calcaneus; the cuboid and the 4th and 5th metatarsals; the cuboid and the lateral cuneiform; and the talus amd te navicular bone.
For the AP medial oblique projection of the foot, the central ray enters ___________ to the _________ metatarsal. Adjust collimated field to ________ on all sides and _________ beyond the calcaneus and distal tip of the toes.
- Perpendicular
- Base of the 3rd metatarsal
- 1 inch
- 1 inch
Evaluation criteria for a medial oblique projection of the foot:
- The entire foot from the toes to the heel
- tuberosity of the 5th mt
- lateral tmt and intertarsal joints
- sinus tarsi best seen in an oblique but can see on a lateral!
For a lateral projection of the foot, elevate the patients _______ enough to place the ________ perpendicular to the horizontal plane and adjust a ________ support under the knee. The ______ should not touch the IR, and the ______ surface of the foot should be _______ with the plane of the IR.
- Knee
-patella
sandbag
heel
medial
parallel
For a lateral projection of the foot, have the patient lie on the radiographic table and turn ___________________ until the ______________________. Place the opposite leg ________ the affected leg.
- Towards the affected side
- Leg and Foot are lateral
- Behind
For a lateral projection of the foot, adjust the foot to place the __________ of the forefoot __________ to the IR.
plantar surface
perpendicular
For a lateral projection of the foot, Center the IR to the midfoot and align the IR long axis _________ with the long axis of the foot. _______ the foot to form a _____ angle with the lower leg.
parallel
dorsiflex
90 degrees
For a lateral projection of the foot, The central ray enters ________ to the __________, and adjust the collimation to _______ on all side of the shadow of the foot including the medial malleolus.
perpendicular
base of the 3rd mt
1 inch
Structures shown on Lateral projection of the foot:
entire foot in profile, ankle joint, and distal ends of tibia and fibula
Evaluation criteria for a lateral projection of the foot:
-Entire foot and distal leg
- Superimposed plantar surfaces of metatarsal heads
- Fibula overlapping the posterior portion of the tibia
- Tibiotalar Joint
For an AP projection of the ankle place the patient in the _______ or _______ position with affected extremity __________.
- supine or seated
- fully extended
For an AP projection of the ankle, Adjust the ankle joint in the anatomic position to obtain a ______. ______ the ankle and foot enough to place the long axis of the foot in the _________ position.
True AP
Flex
Vertical
For an AP projection of the ankle, The central ray enters _______ to the ankle joint at a point ____________ of the malleoli. Adjust the collimation to _______ on the sides of the ankle and _______ lengthwise to include the heel.
perpendicular
midway between
1 inch
8 inch
Structures shown on an AP projection of the ankle:
distal ends of the tibia and fibula and the proximal portion of the talus
Evaluation criteria for an AP projection of the ankle:
- ankle joint centered to the exposure area
- medial and lateral malleoli
- Talus
- No rotation of the ankle
For an AP Oblique Projection of the ankle place the patient in the __ or ___ position with affected extremity ___.
- Supine or Seated
- Fully Extended
For an AP Oblique Projection of the ankle, Center the IR to the ankle joint _____________ and adjust the IR so that its long axis is ___________ with the long axis of the leg.
midway between malleoli
parallel
For an AP Oblique Projection of the ankle, Dorsiflex the foot enough to place the ankle at nearly ____________, and rotate the patient’s __________ for all oblique projections of the ankle by _________ area with one hand and the _______ with the other.
- Right angle flexion
- entire leg
- grasping the lower femur
- foot
For an AP Oblique Projection of the ankle, Internally rotate the _______ together until the _______ oblique position is achieved.
entire leg and foot
45 degrees
For an AP Oblique Projection of the ankle, The central ray is directed _________ to the ankle joint, entering ____________________. Adjust the collimation to _____ on the sides of the ankle and ________ lengthwise to include the heel.
- Perpendicular
- Midway between the malleoli
- 1 inch
- 8 inch
Structures shown on an AP oblique projection of the ankle:
- The 45-degree medial oblique protection shows the distal ends of the tibia and fibula
tibiofibular articulation
Evaluation criteria for an AP Oblique projection of the ankle
- ankle joint centered to the exposure area
- distal tibia, fibula, and talus
- proper 45 degree rotation of ankle
Distal tibia and fibula overall some of the talus
For a lateral projection of the ankle, have the patient lie on the radiographic table and turn _____________ until the ______________
toward the affected side
extended leg is lateral
For a lateral projection of the ankle, Place the long axis of the IR ______ with the long axis of the patient’s leg and center is to the ___________
parallel
ankle joints
For a lateral projection of the ankle, Ensure the _________ of the foot is in contact with the IR.
_____________ the foot and adjust it in the lateral position.
lateral surface
dorsiflex
For a lateral projection of the ankle, The central ray is directed ___________ to the ankle joint, entering at the _____________. Adjust the collimation to _____ on the sides of the ankle and _________ lengthwise to include the heel and base of the 5th metatarsal.
perpendicular
medial malleolus
1 inch
8 inches
Structures shown on a lateral projection of the ankle
True Lateral of the lower third of the tibia and fibula; the ankle joint; and the tarsals, including the base of the fifth metatarsal
Evaluation criteria for a lateral projection of the ankle
- Ankle joint centered to exposure field
- distal, tibia and fibula talus, calcaneus and adjacent tarsals
- Ankle in true lateral position
- fifth metatarsal base in tuberosity should be seen to check for Jones fracture
the proximal bases of the metatarsals articulate with one another to form the _________ articulations
intermetatarsal articulations
the proximal bases of the metatarsals articulate with the tarsals to form the ______ articulations.
tarsometatarsal (TMT)
