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Positioning 1 > Ch. 6 Lower Limb > Flashcards

Ch. 6 Lower Limb Flashcards

1
Q

To turn the foot inward

A

inversion (varus)

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2
Q

To turn the foot outward

A

eversion (valgus)

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3
Q

kVp adjustment for a small to medium plaster cast

A

increase 5-7 kVp

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4
Q

kVp adjustment for a large plaster cast

A

increase 8-10 kVp

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5
Q

kVp adjustment for a fiberglass cast

A

increase 3-4 kVp

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6
Q

What is CR for AP toes

A

angled 10-15 degrees toward calcaneus, to MTP joint

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7
Q

What is part positioning for a tangential projection of the toes - sesamoid bones

A

dorsiflex the foot until forms 15-20 degree angle from vertical position, pt can be either prone or supine

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8
Q

what is CR for an AP foot

A

tube angle 10 degrees posteriorly (toward calcaneus), perp to metatarsals, to base of 3rd metatarsal

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9
Q

What is part positioning for an AP oblique foot

A

medially rotate foot until plantar surface is 30-40 degrees to IR, dorsum plane of foot should be parallel to IR

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10
Q

What should you see on a good oblique foot

A

open sinus tarsi

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11
Q

What is part positioning for a lateral foot

A

plantar surface needs to be perp to IR, need to lift knee slightly to prevent over rotation, dorsiflex the foot in a good L

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12
Q

What is CR for lateral foot

A

medial cuneiform (base of 3rd metatarsal)

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13
Q

Recommended collimation for foot

A

collimate to outer skin margins and include 1” proximal ankle joint

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14
Q

What is CR for weight-bearing feet projection

A

angle 15 degrees posteriorly toward calcaneus and toward midpoint between feet at base of metatarsal level

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15
Q

Best way to see longitudinal arch

A

Weight bearing lateral projection

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16
Q

What do we use weight-bearing feet projections for

A

condition of longitudinal arches and injury to ligaments such as Lisfranc joint injury

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17
Q

what is the CR for the plantodorsal (axial) projection of the calcaneus

A

angled 40 degrees cephalad from long axis of foot (40 from vertical if foot is perp to IR), direct to base of 3rd metatarsal and exit just distal to lateral malleolus

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18
Q

What is part positioning for plantodorsal (axial) projection of the calcaneus

A

dorsiflex foot so plantar surface is perp to IR

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19
Q

What do we want to see on the axial calcaneal projection

A

talocalcaneal joint, 5th metatarsal’s tuberosity and sustentaculum tali

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20
Q

What side is the sustentaculum tali on

A

medial side

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21
Q

If a patient cant dorsiflex their foot on the axial calcaneus projection how is your tube angle going to look

A

more degree of angulation from the 40 degrees

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22
Q

CR for lateral calcaneus

A

directed 1” below medial malleolus

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23
Q

part positioning for lateral calcaneus

A

put ankle in a true lateral, dorsiflex foot into an L,

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24
Q

What is CR for AP ankle

A

direct midway between malleoli

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25
Q

What is part positioning for an ankle mortise

A

internally rotate leg and foot medial 15-20 degrees

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26
Q

What is part positioning for an AP oblique of ankle

A

rotate leg and foot medial 45 degrees, foot can not be plantar flexed more than 10-15 degrees from vertical

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27
Q

Who is allowed to do stress views

A

only the doctor/physician, not us

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28
Q

CR for AP knee

A

1/2” distal to apex of patella, parallel to tibial plateau

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29
Q

If the patient has thick thighs and butt, what is your CR for an AP knee

A

angled 5 degrees cephalad

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30
Q

if the patient has very thin thighs and butt what is your CR for an AP knee

A

angled 5 degrees caudad

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31
Q

What is CR for a lateral knee

A

angled 5-7 degrees cephalad, directed 1” distal to medial epicondyle

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32
Q

What is part positioning for a lateral knee

A

flex knee 20-30 degrees, patella should be perp to IR

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33
Q

On a lateral knee what does superior to inferior misalignment of the condyles of the femur indicate

A

no tube angle

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34
Q

On a lateral knee what does right to left misalignment of the condyles of the femur indicate

A

rotation of the knee

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35
Q

if you see the adductor tubercle on the posterior side of the knee on a lateral knee what does that tell you

A

knee is underrotated

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36
Q

What are we looking at on a weight-bearing knee projection

A

femorotibial joint spaces

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37
Q

What position do you need in order to get a good intercondylar fossa tunnel view

A

CR perp to tibia and fibula angle

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38
Q

a true AP of knee or patella requires what kind of positioning

A

internal rotation 3-5 degrees

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39
Q

What is part positioning for a lateral patella

A

flex knee 5-10 degrees, patella perp to IR, knee in true lateral

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40
Q

how many phalanges in the foot

A

14

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41
Q

how many metatarsals (instep) of the foot

A

5

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42
Q

how many tarsals in the foot

A

7

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43
Q

how many bones are in the foot total

A

26

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44
Q

when counting digits of the foot which side do we start on

A

medial to lateral

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45
Q

how many phalanges in the first digit of the foot

A

2

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46
Q

what are the two big differences between phalanges of the foot and phalanges of the hand

A

phalanges of foot are smaller adn their movement is more limited

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47
Q

bones of the instep of the foot

A

metatarsals

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48
Q

base of 5th metatarsal expands laterally into this to provide for attachment of a tendon

A

tuberosity

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49
Q

common trauma site of the foot

A

proximal portion of 5th metatarsal - tuberosity

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50
Q

small detached bones, often found in the feet or hands

A

sesamoid bones

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51
Q

extra bones embedded in tendons and often present near joints

A

sesamoid bones

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52
Q

where are sesamoid bones most commonly found in the hand

A

palmar surface near MCP joint or IP joint

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53
Q

where are sesamoid bones most commonly found in the lower limb

A

almost always present on the plantar surface at the head of the 1st metatarsal near 1st MTP joint

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54
Q

what is the sesamoid bone on the plantar, medial side of the head of the 1st metatarsal

A

tibial sesamoid bone

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55
Q

what is the sesamoid bone on the plantar, lateral side of the head of the 1st metatarsal

A

fibular sesamoid bone

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56
Q

large bones of the proximal foot

A

tarsals

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57
Q

what is another name for the calcaneus

A

os calcis

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58
Q

what is another name for talus

A

astragalus

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59
Q

what is another name for the navicular

A

scaphoid

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60
Q

largest and strongest bone of the foot

A

calcaneus

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61
Q

posterior portion of the calcaneus

A

heel bone

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62
Q

most posterior-inferior part of the calcaneus contains a process called

A

tuberosity

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63
Q

common site for bone spurs in the foot

A

tuberosity of the calcaneus

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64
Q

sharp outgrowths of bone that can be painful on weight bearing

A

bone spurs

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65
Q

largest tendon of foot which attaches to the tuberosity of the calcaneus

A

Achilles tendon

66
Q

larger process of the posterior calcaneus

A

lateral process

67
Q

smaller, less pronounced process of the posterior calcaneus

A

medial process

68
Q

ridge of bone on the calcaneus visualized laterally on an axial projection

A

peroneal trochlea (trochlear process)

69
Q

larger, more prominent bony process of the calcaneus on the medial proximal aspect

A

sustentaculum tali

70
Q

what bones does the calcaneus articulate with

A
  • anteriorly with the cuboid
  • superiorly with the talus
71
Q

what does the articulation between the talus and calcaneus form

A

subtalar (talocalcaneal) joint

72
Q

deep depression between the posterior and middle articular facets of the calcaneus

A

calcaneal sulcus

73
Q

opening in the middle of the subtalar joint formed by the calcaneal sulcus and similar depression of the talus

A

sinus tarsi

74
Q

second largest tarsal bone

A

talus

75
Q

what bones does the talus articulate with

A
  • superiorly with the tibia and fibula
  • inferiorly with the calcaneus
  • anteriorly with the navicular
76
Q

flattened, oval bone of the foot located on the medial side

A

navicular

77
Q

what bones does the navicular articulate with

A
  • posteriorly with the talus
  • laterally with the cuboid
  • anteriorly with the 3 cuneiforms
78
Q

wedge shaped bones located on the mid medial aspect of the foot

A

3 cuneiforms

79
Q

largest cuneiform

A

medial cuneiform

80
Q

smallest cuneiform

A

intermediate cuneiform

81
Q

what bones does the medial cuneiform articulate with

A
  • proximally with the navicular
  • distally with the 1st and 2nd metatarsal
  • laterally with the intermediate cuneiform
82
Q

what bones does the intermediate cuneiform articulate with

A
  • proximally with the navicular
  • distally with the 2nd metatarsal
  • between both the medial and lateral cuneiform
83
Q

what bones does the lateral cuneiform articulate with

A
  • proximally with the navicular
  • distally with the 2nd, 3rd, 4th metatarsal
  • medially with the intermediate cuneiform
  • laterally with the cuboid
84
Q

bones located on the mid lateral aspect of foot

A

cuboid

85
Q

what bones does the cuboid articulate with

A
  • proximally with the calcaneus
  • medially with the lateral cuneiform and navicular
  • distally with the 4th and 5th metatarsal
86
Q

where does most of the longitudinal arch of the foot occur

A

medial and mid aspects of the foot

87
Q

where is the transverse arch primarily located

A

along plantar surface of distal tarsals and the tarsometatarsal joints (primarily 2nd and 3rd cuneiform)

88
Q

The ankle joint is formed by what 3 bones

A
  • talus
  • tibia and fibula
89
Q

expanded distal end of the fibular extending along the talus

A

lateral malleolus

90
Q

medial elongated process of the tibia that extends alongside the medial talus

A

medial malleolus

91
Q

inferior portions of the tibia and fibula form a deep socket/3-sided opening called

A

ankle mortise

92
Q

what position is performed in order to see the ankle mortise

A

15 degree internal rotation AP oblique of the ankle (mortise position)

93
Q

expanded process at the distal anterior and lateral tibia that is shown to articulate with the superolateral talus while partially overlapping the fibular anteriorly

A

anterior tubercle

94
Q

distal concave tibial joint surface that forms the roof of the ankle mortise joint

A

tibial plafond

95
Q

a true lateral of the ankle joint shows the fibula in what position compared to the tibia

A

3/8” (1cm) posterior to the tibia

96
Q

a true lateral of the foot, ankle or lower leg requires the malleolus to be

A

slightly off center from each other, not superimposed; lateral malleolus slightly posterior

97
Q

a horizontal plane drawn through the malleoli (intermalleolar plane) would be how far off from the coronal plane

A

15-20 degrees

98
Q

what type of joint is the ankle

A

synovial - saddle (sellar)

99
Q

weight bearing bone of the lower leg

A

tibia

100
Q

two large processes that make up the medial and lateral aspects of the proximal tibia

A

medial and lateral condyles

101
Q

two small prominence located on the superior surface of the tibial head between the condyles

A

intercondylar eminence (tibial spine); medial and lateral intercondylar tubercles

102
Q

upper articular surface of the condyles which articulate with the femur; smooth and concave portions

A

articular facets (tibial plateau)

103
Q

how are the articular facets positioned

A

slope posteriorly 10-20 degrees

104
Q

rough-textured prominence located on the mid-anterior surface of the tibia just distal to the condyles

A

tibial tuberosity

105
Q

distal attachment of the patellar tendon

A

tibial tuberosity

106
Q

in a young person when the tibial tuberosity separates from the body of the tibia

A

Osgood-schlatter disease

107
Q

sharp ridge along the anterior surface of the body of the tibia, extending from the tibial tuberosity to the medial malleolus

A

anterior crest/border

108
Q

lateral aspect of distal tibia forms this for articulation with the distal fibula

A

fibular notch

109
Q

the proximal fibula expands into this

A

head of fibula

110
Q

extreme proximal aspect of the head of the fibula

A

apex

111
Q

tapered area just below the head of the fibula

A

neck

112
Q

largest sesamoid bone in the body

A

patella

113
Q

when the lower leg is fully extended where is the distal portion of the patella in relation to the knee joint

A

most distal portion is 1/2” superior/proximal to the actual knee joint

114
Q

smooth, shallow, triangular depression at the distal portion of the anterior femur that extends up under the lower part of the patella

A

patellar surface (intercondylar sulcus) (trochlear groove)

115
Q

rounded distal portions of the posterior aspect of the femur which articulate with the tibia

A

medial and lateral condyles

116
Q

keep notch on the posterior aspect of the distal femur which separates the condyles

A

intercondylar fossa

117
Q

which condyle of the femur extends more distally

A

medial condyle

118
Q

when in an erect position how is the femoral shaft positioned

A

angled 5-15 degrees from vertical position

119
Q

when the femoral shaft is vertical to the IR how must the tube be angle for a lateral knee

A

5-7 degrees cephalad

120
Q

slightly raised area area that receives the tendon of the adductor muscle

A

adductor tubercle

121
Q

where is the adductor tubercle located

A

on the posterolateral aspect of the medial condyle

122
Q

rough prominences for attachment of the medial and lateral collateral ligaments located on the outermost potions of the condyles on the distal femur

A

medial and lateral epicondyles

123
Q

which epicondyle of the femur is more prominent

A

medial epicondyle

124
Q

what tendon is the patella embedded in

A

tendon of the large quadriceps femoris muscle

125
Q

articulation between the patella and the femur

A

patellofemoral joint

126
Q

posterior surface of the distal femur just proximal to the intercondylar fossa

A

popliteal surface

127
Q

how big is the patella in diameter

A

2” (5 cm)

128
Q

what part of the patella is located on the inferior border

A

apex

129
Q

what part of the patella is located on the superior border

A

base

130
Q

the patella acts as a pivot to increase the leverage of what muscle

A

large quadriceps femoris muscle

131
Q

the patella only articulates with what bone

A

femur, NOT tibia

132
Q

the knee joint primarily involves what

A

femorotibial joint

133
Q

These ligaments are strong bands of the knee that prevent adduction and abduction movements of the knee

A

medial and lateral (tibial and fibular) collateral ligaments

134
Q

these ligaments prevent anterior and posterior movements within the knee joint

A

anterior and posterior cruciate ligaments

135
Q

part of the tendon of insertion of the large quadriceps femoris muscle, extending over the patella to the tibial tuberosity

A

patellar ligament

136
Q

posterior to the patellar ligament, aids in protecting the anterior aspect of the knee joint

A

infrapatellar fat pad

137
Q

largest joint space of the human body

A

articular cavity of the knee joint

138
Q

what is the total knee enclosed in

A

articular capsule/bursa

139
Q

articular cavity/bursa of the knee joint that extends upward, under and superior to patella

A

suprapatellar bursa

140
Q

articular cavity/bursa of the knee joint that extends distal to the patella that is separated by the large infrapatellar fat pad

A

infrapatellar bursa

141
Q

crescent-shaped fibrocartilage disks between the articular facets of the tibia and the femoral condyles

A

medial and lateral mesisci

142
Q

these produce synovial fluid to lubricate the articulating ends of the femur and tibia

A

synovial membrane and menisci

143
Q

tear of the tibial MCL is frequently associated with what other injuries

A

tear of ACL and tear of the medial meniscus

144
Q

imaging modality used to visualize soft tissue structures such as tears in ligaments or menisci

A

MRI or arthrography

145
Q

what type of joint is the distal tibiofibular joint

A

fibrous joint (amphiarthrodial) of the syndesmosis type

146
Q

top/anterior surface of foot

A

dorsum

147
Q

posterior/sole of the foot

A

plantar surface

148
Q

another name for inversion

A

varus

149
Q

another name for eversion

A

valgus

150
Q

lifting toes up

A

dorsiflexion

151
Q

pointing toes down

A

plantar flexion

152
Q

what type of joint is the ankle joint

A

saddle (sellar)

153
Q

what type of joint the femorotibial joint

A

bicondylar

154
Q

what type of joint is the patellofemoral joint

A

saddle (sellar)

155
Q

what type of joint is the proximal tibiofibular joint

A

plane (gliding)

156
Q

kVp change for small-medium plaster cast

A

5-7 kVp

157
Q

kVp change for large plaster cast

A

8-10 kVp

158
Q

kVp change for fiberglass cast

A

3-4 kVp

159
Q

imaging modality used to evaluate soft tissue involvement in lesions or determine extend of fractures and evaluate bone mineralization

A

CT

160
Q

used to evaluate bone loss in geriatric or patients with lytic (bone-destroying) disease

A

bone densitometry

161
Q

uses radioisotopes injected into the bloodstream

A

nuclear medicine

162
Q

particularly useful in showing osteomyelitis and metastatic bone lesions

A

nuclear medicine

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