week 12: toes-tib/fib Flashcards
size of IR and orientation of IR for toe exams
8x10 inches, landscape
where is the CR centered for AP toe?
MTP joint in question
where is the CR centered for oblique toe?
MTP joint in question
without a wedged, for AP toe exams, how is the CR angled?
10-15 degrees towards calcaneus (CR perpendicular to phalanges)
with a wedge, for AP toe exams, how is the CR angled?
if 15 degree wedge is used, CR is perpendicular to IR
how would you rotate for AP Oblique toe digits 1, 2, and 3?
medially
how would you rotate for AP Oblique toe digits 4 and 5?
laterally
where is the CR centered for AP Oblique toes?
at MTP joint, perpendicular to IR
for AP oblique toes, the metatarsal heads should appear (open/closed)
open
for a lateral foot exam, the foot ____________; __________ needs to be lateral
needs to be in the same plane, entire leg
how is the CR angled in lateral toe exam?
perpendicular to IR
where is the CR centered for lateral toe exams?
CR directed to interphalangeal joint for 1st digit and to PIP joint for 2-5th digits
general AP foot CR angle
10 deg posteriorly (towards heel); CR perpendicular to metatarsals
AP foot CR angle for high arch
15 degrees
AP foot CR angle for low arch
5 degrees
AP foot CR angle for foreign body
no angle, CR perpendicular to IR
where is the CR centered in AP foot exams?
base of third metatarsal
IR size and orientation for AP foot
10x12 inches, portrait
IR size and orientation for AP Oblique foot
10x12 inches, portrait
note: AP projection of foot could be more accurately called…
AP Axial Foot
in an AP foot, the MTP joints are generally ____
open
how is the CR angled for an AP Oblique foot?
perpendicular (0 angulation)
where is the CR directed for AP Oblique foot?
base of third metatarsal
for an AP Oblique foot, rotate foot _____ to place ____ surface 30-40 (more likely __) degrees to plane of IR
medially, plantar, 40
why is 40 deg. preferred over 30 degrees for an AP Oblique foot?
40 deg demonstrates tarsals and proximal metatarsals best relatively free of superimposition
what is the angle of the CR for lateral foot?
perpendicular to IR
where is the CR directed in a lateral foot?
medial cuneiform (at the level of the base of the 3rd metatarsal)
Plantar surface is _______ to IR in a lateral foot exam
perpendicular
what is the CR angle for plantodorsal (axial) projection for calcaneus x-ray?
CR 40 deg. Cephalad from long axis of foot (40 degrees from vertical if long axis of foot is perpendicular)
where is the CR directed for plantodorsal (axial) projection for calcaneus x-ray?
Direct CR to base of third metatarsal to emerge at a level just distal to lateral malleolus (approx. curve of the arch of the foot)
what is the CR angle for lateral (mediolateral) projection for calcaneus x-ray?
perpendicular to IR
where is the CR directed for lateral (mediolateral) for calcaneus x-ray?
directed to a point 1 inch inferior to medial malleolus
where is the CR directed for an AP ankle x-ray?
point midway between malleoli
what is the CR angle for an AP ankle x-ray?
perpendicular to the IR
for an AP ankle x-ray, the intermalleolar line (should/should not) be parallel to IR because ______________
should not, the malleoli are not parallel to each other
the lateral malleolus is _________________
approximately 15 deg. more posterior
evaluation criteria of AP ankle
Distal ⅓ of tibia and fibula
Proximal ½ of metatarsals included
Medial and superior aspect of ankle joint open
for an AP Mortise ankle x-ray, __________ rotate entire leg and foot _____ deg until ________________
internally, 15-20, intermalleolar line is parallel to IR
where is the CR directed for an AP Mortise ankle x-ray?
midway between malleoli
what is the CR angle for an AP Mortise ankle x-ray?
perpendicular to the IR
evaluation criteria for AP Mortise ankle x-ray
Entire ankle mortise open
Distal ⅓ of tibia and fibula
Proximal ½ of metatarsals included
Optimal exposure factors
in an AP 45 deg. Oblique ankle x-ray, you rotate the patient’s ____________
leg and foot medially
where is the CR directed for a AP 45 Oblique ankle x-ray?
midway between malleoli
what is the CR angle for a AP 45 Oblique ankle x-ray?
perpendicular to IR
Biggest difference between Mortise and 45 deg Oblique evaluation criteria
45 oblique is going to de-superimpose the tib/fib (thus closing the mortise)
what is the CR angle for a lateral ankle x-ray?
perpendicular to the IR
where is the CR directed for a lateral ankle x-ray?
medial malleolus
45 Oblique ankle x-ray evaluation criteria
Distal tibiofibular joint open
Distal ⅓ of tibia and fibula
Proximal ½ of metatarsals included
lateral ankle x-ray evaluation criteria
Entire talus and calcaneus
Lateral malleolus superimposed over posterior half of tibia
Optimal exposure factors
where is the CR directed for an AP tib/fib x-ray?
directed to midpoint of lower leg
what is the angle of the CR for an AP tib/fib x-ray?
perpendicular to the IR
what is the angle of the CR for a lateral tib/fib x-ray?
perpendicular to the IR
where is the CR directed for a lateral tib/fib x-ray?
directed to midpoint of lower leg
evaluation notes for AP tib/fib
-Femoral and tibial epicondyles in profile with intercondylar eminence centered within intercondylar fossa
-some overlap of fib and tib is visible at both proximal and distal ends
what is the projection of a lateral tib/fib x-ray?
mediolateral projection
the plane of the patella for a lateral tib/fib x-ray is going to be ________
perpendicular to the IR
