Ch. 6 Lower Limb Flashcards
(162 cards)
1
Q
To turn the foot inward
A
inversion (varus)
2
Q
To turn the foot outward
A
eversion (valgus)
3
Q
kVp adjustment for a small to medium plaster cast
A
increase 5-7 kVp
4
Q
kVp adjustment for a large plaster cast
A
increase 8-10 kVp
5
Q
kVp adjustment for a fiberglass cast
A
increase 3-4 kVp
6
Q
What is CR for AP toes
A
angled 10-15 degrees toward calcaneus, to MTP joint
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
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
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
10
Q
What should you see on a good oblique foot
A
open sinus tarsi
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
12
Q
What is CR for lateral foot
A
medial cuneiform (base of 3rd metatarsal)
13
Q
Recommended collimation for foot
A
collimate to outer skin margins and include 1” proximal ankle joint
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
15
Q
Best way to see longitudinal arch
A
Weight bearing lateral projection
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
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
18
Q
What is part positioning for plantodorsal (axial) projection of the calcaneus
A
dorsiflex foot so plantar surface is perp to IR
19
Q
What do we want to see on the axial calcaneal projection
A
talocalcaneal joint, 5th metatarsal’s tuberosity and sustentaculum tali
20
Q
What side is the sustentaculum tali on
A
medial side
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
22
Q
CR for lateral calcaneus
A
directed 1” below medial malleolus
23
Q
part positioning for lateral calcaneus
A
put ankle in a true lateral, dorsiflex foot into an L,
24
Q
What is CR for AP ankle
A
direct midway between malleoli
25
What is part positioning for an ankle mortise
internally rotate leg and foot medial 15-20 degrees
26
What is part positioning for an AP oblique of ankle
rotate leg and foot medial 45 degrees, foot can not be plantar flexed more than 10-15 degrees from vertical
27
Who is allowed to do stress views
only the doctor/physician, not us
28
CR for AP knee
1/2" distal to apex of patella, parallel to tibial plateau
29
If the patient has thick thighs and butt, what is your CR for an AP knee
angled 5 degrees cephalad
30
if the patient has very thin thighs and butt what is your CR for an AP knee
angled 5 degrees caudad
31
What is CR for a lateral knee
angled 5-7 degrees cephalad, directed 1" distal to medial epicondyle
32
What is part positioning for a lateral knee
flex knee 20-30 degrees, patella should be perp to IR
33
On a lateral knee what does superior to inferior misalignment of the condyles of the femur indicate
no tube angle
34
On a lateral knee what does right to left misalignment of the condyles of the femur indicate
rotation of the knee
35
if you see the adductor tubercle on the posterior side of the knee on a lateral knee what does that tell you
knee is underrotated
36
What are we looking at on a weight-bearing knee projection
femorotibial joint spaces
37
What position do you need in order to get a good intercondylar fossa tunnel view
CR perp to tibia and fibula angle
38
a true AP of knee or patella requires what kind of positioning
internal rotation 3-5 degrees
39
What is part positioning for a lateral patella
flex knee 5-10 degrees, patella perp to IR, knee in true lateral
40
how many phalanges in the foot
14
41
how many metatarsals (instep) of the foot
5
42
how many tarsals in the foot
7
43
how many bones are in the foot total
26
44
when counting digits of the foot which side do we start on
medial to lateral
45
how many phalanges in the first digit of the foot
2
46
what are the two big differences between phalanges of the foot and phalanges of the hand
phalanges of foot are smaller adn their movement is more limited
47
bones of the instep of the foot
metatarsals
48
base of 5th metatarsal expands laterally into this to provide for attachment of a tendon
tuberosity
49
common trauma site of the foot
proximal portion of 5th metatarsal - tuberosity
50
small detached bones, often found in the feet or hands
sesamoid bones
51
extra bones embedded in tendons and often present near joints
sesamoid bones
52
where are sesamoid bones most commonly found in the hand
palmar surface near MCP joint or IP joint
53
where are sesamoid bones most commonly found in the lower limb
almost always present on the plantar surface at the head of the 1st metatarsal near 1st MTP joint
54
what is the sesamoid bone on the plantar, medial side of the head of the 1st metatarsal
tibial sesamoid bone
55
what is the sesamoid bone on the plantar, lateral side of the head of the 1st metatarsal
fibular sesamoid bone
56
large bones of the proximal foot
tarsals
57
what is another name for the calcaneus
os calcis
58
what is another name for talus
astragalus
59
what is another name for the navicular
scaphoid
60
largest and strongest bone of the foot
calcaneus
61
posterior portion of the calcaneus
heel bone
62
most posterior-inferior part of the calcaneus contains a process called
tuberosity
63
common site for bone spurs in the foot
tuberosity of the calcaneus
64
sharp outgrowths of bone that can be painful on weight bearing
bone spurs
65
largest tendon of foot which attaches to the tuberosity of the calcaneus
Achilles tendon
66
larger process of the posterior calcaneus
lateral process
67
smaller, less pronounced process of the posterior calcaneus
medial process
68
ridge of bone on the calcaneus visualized laterally on an axial projection
peroneal trochlea (trochlear process)
69
larger, more prominent bony process of the calcaneus on the medial proximal aspect
sustentaculum tali
70
what bones does the calcaneus articulate with
- anteriorly with the cuboid
- superiorly with the talus
71
what does the articulation between the talus and calcaneus form
subtalar (talocalcaneal) joint
72
deep depression between the posterior and middle articular facets of the calcaneus
calcaneal sulcus
73
opening in the middle of the subtalar joint formed by the calcaneal sulcus and similar depression of the talus
sinus tarsi
74
second largest tarsal bone
talus
75
what bones does the talus articulate with
- superiorly with the tibia and fibula
- inferiorly with the calcaneus
- anteriorly with the navicular
76
flattened, oval bone of the foot located on the medial side
navicular
77
what bones does the navicular articulate with
- posteriorly with the talus
- laterally with the cuboid
- anteriorly with the 3 cuneiforms
78
wedge shaped bones located on the mid medial aspect of the foot
3 cuneiforms
79
largest cuneiform
medial cuneiform
80
smallest cuneiform
intermediate cuneiform
81
what bones does the medial cuneiform articulate with
- proximally with the navicular
- distally with the 1st and 2nd metatarsal
- laterally with the intermediate cuneiform
82
what bones does the intermediate cuneiform articulate with
- proximally with the navicular
- distally with the 2nd metatarsal
- between both the medial and lateral cuneiform
83
what bones does the lateral cuneiform articulate with
- proximally with the navicular
- distally with the 2nd, 3rd, 4th metatarsal
- medially with the intermediate cuneiform
- laterally with the cuboid
84
bones located on the mid lateral aspect of foot
cuboid
85
what bones does the cuboid articulate with
- proximally with the calcaneus
- medially with the lateral cuneiform and navicular
- distally with the 4th and 5th metatarsal
86
where does most of the longitudinal arch of the foot occur
medial and mid aspects of the foot
87
where is the transverse arch primarily located
along plantar surface of distal tarsals and the tarsometatarsal joints (primarily 2nd and 3rd cuneiform)
88
The ankle joint is formed by what 3 bones
- talus
- tibia and fibula
89
expanded distal end of the fibular extending along the talus
lateral malleolus
90
medial elongated process of the tibia that extends alongside the medial talus
medial malleolus
91
inferior portions of the tibia and fibula form a deep socket/3-sided opening called
ankle mortise
92
what position is performed in order to see the ankle mortise
15 degree internal rotation AP oblique of the ankle (mortise position)
93
expanded process at the distal anterior and lateral tibia that is shown to articulate with the superolateral talus while partially overlapping the fibular anteriorly
anterior tubercle
94
distal concave tibial joint surface that forms the roof of the ankle mortise joint
tibial plafond
95
a true lateral of the ankle joint shows the fibula in what position compared to the tibia
3/8" (1cm) posterior to the tibia
96
a true lateral of the foot, ankle or lower leg requires the malleolus to be
slightly off center from each other, not superimposed; lateral malleolus slightly posterior
97
a horizontal plane drawn through the malleoli (intermalleolar plane) would be how far off from the coronal plane
15-20 degrees
98
what type of joint is the ankle
synovial - saddle (sellar)
99
weight bearing bone of the lower leg
tibia
100
two large processes that make up the medial and lateral aspects of the proximal tibia
medial and lateral condyles
101
two small prominence located on the superior surface of the tibial head between the condyles
intercondylar eminence (tibial spine); medial and lateral intercondylar tubercles
102
upper articular surface of the condyles which articulate with the femur; smooth and concave portions
articular facets (tibial plateau)
103
how are the articular facets positioned
slope posteriorly 10-20 degrees
104
rough-textured prominence located on the mid-anterior surface of the tibia just distal to the condyles
tibial tuberosity
105
distal attachment of the patellar tendon
tibial tuberosity
106
in a young person when the tibial tuberosity separates from the body of the tibia
Osgood-schlatter disease
107
sharp ridge along the anterior surface of the body of the tibia, extending from the tibial tuberosity to the medial malleolus
anterior crest/border
108
lateral aspect of distal tibia forms this for articulation with the distal fibula
fibular notch
109
the proximal fibula expands into this
head of fibula
110
extreme proximal aspect of the head of the fibula
apex
111
tapered area just below the head of the fibula
neck
112
largest sesamoid bone in the body
patella
113
when the lower leg is fully extended where is the distal portion of the patella in relation to the knee joint
most distal portion is 1/2" superior/proximal to the actual knee joint
114
smooth, shallow, triangular depression at the distal portion of the anterior femur that extends up under the lower part of the patella
patellar surface (intercondylar sulcus) (trochlear groove)
115
rounded distal portions of the posterior aspect of the femur which articulate with the tibia
medial and lateral condyles
116
keep notch on the posterior aspect of the distal femur which separates the condyles
intercondylar fossa
117
which condyle of the femur extends more distally
medial condyle
118
when in an erect position how is the femoral shaft positioned
angled 5-15 degrees from vertical position
119
when the femoral shaft is vertical to the IR how must the tube be angle for a lateral knee
5-7 degrees cephalad
120
slightly raised area area that receives the tendon of the adductor muscle
adductor tubercle
121
where is the adductor tubercle located
on the posterolateral aspect of the medial condyle
122
rough prominences for attachment of the medial and lateral collateral ligaments located on the outermost potions of the condyles on the distal femur
medial and lateral epicondyles
123
which epicondyle of the femur is more prominent
medial epicondyle
124
what tendon is the patella embedded in
tendon of the large quadriceps femoris muscle
125
articulation between the patella and the femur
patellofemoral joint
126
posterior surface of the distal femur just proximal to the intercondylar fossa
popliteal surface
127
how big is the patella in diameter
2" (5 cm)
128
what part of the patella is located on the inferior border
apex
129
what part of the patella is located on the superior border
base
130
the patella acts as a pivot to increase the leverage of what muscle
large quadriceps femoris muscle
131
the patella only articulates with what bone
femur, NOT tibia
132
the knee joint primarily involves what
femorotibial joint
133
These ligaments are strong bands of the knee that prevent adduction and abduction movements of the knee
medial and lateral (tibial and fibular) collateral ligaments
134
these ligaments prevent anterior and posterior movements within the knee joint
anterior and posterior cruciate ligaments
135
part of the tendon of insertion of the large quadriceps femoris muscle, extending over the patella to the tibial tuberosity
patellar ligament
136
posterior to the patellar ligament, aids in protecting the anterior aspect of the knee joint
infrapatellar fat pad
137
largest joint space of the human body
articular cavity of the knee joint
138
what is the total knee enclosed in
articular capsule/bursa
139
articular cavity/bursa of the knee joint that extends upward, under and superior to patella
suprapatellar bursa
140
articular cavity/bursa of the knee joint that extends distal to the patella that is separated by the large infrapatellar fat pad
infrapatellar bursa
141
crescent-shaped fibrocartilage disks between the articular facets of the tibia and the femoral condyles
medial and lateral mesisci
142
these produce synovial fluid to lubricate the articulating ends of the femur and tibia
synovial membrane and menisci
143
tear of the tibial MCL is frequently associated with what other injuries
tear of ACL and tear of the medial meniscus
144
imaging modality used to visualize soft tissue structures such as tears in ligaments or menisci
MRI or arthrography
145
what type of joint is the distal tibiofibular joint
fibrous joint (amphiarthrodial) of the syndesmosis type
146
top/anterior surface of foot
dorsum
147
posterior/sole of the foot
plantar surface
148
another name for inversion
varus
149
another name for eversion
valgus
150
lifting toes up
dorsiflexion
151
pointing toes down
plantar flexion
152
what type of joint is the ankle joint
saddle (sellar)
153
what type of joint the femorotibial joint
bicondylar
154
what type of joint is the patellofemoral joint
saddle (sellar)
155
what type of joint is the proximal tibiofibular joint
plane (gliding)
156
kVp change for small-medium plaster cast
5-7 kVp
157
kVp change for large plaster cast
8-10 kVp
158
kVp change for fiberglass cast
3-4 kVp
159
imaging modality used to evaluate soft tissue involvement in lesions or determine extend of fractures and evaluate bone mineralization
CT
160
used to evaluate bone loss in geriatric or patients with lytic (bone-destroying) disease
bone densitometry
161
uses radioisotopes injected into the bloodstream
nuclear medicine
162
particularly useful in showing osteomyelitis and metastatic bone lesions
nuclear medicine
