Ch 6 - Lower Limb Flashcards
(123 cards)
1
Q
Conical projection at the head of the fibula
A
Apex
2
Q
Known as the anterior border of the tibia
A
Crest
3
Q
Larger of the two bones of the leg
Medial lower leg bone
A
Tibia
4
Q
Lateral bone of the leg
Smaller of the bones of the leg
A
Fibula
5
Q
Two prominent processes on the proximal end of the tibia
Two large eminences on the distal end
A
Condyles
6
Q
Two peaklike processes arising from the intercondylar eminence
A
Tubercles
7
Q
Prominent process on the anterior surface of the tibia, just below the condyles
A
Tuberosity
8
Q
Large, rounded eminence on the superior end of the fibula
A
Head
9
Q
Constricted portion just inferior from the head of the fibula
A
Neck
10
Q
Enlarged distal end of the fibula
A
Lateral malleolus
11
Q
Large process that extends both medially and inferiorly from the distal end of the tibia
A
Medial malleolus
12
Q
Deep depression between the condyles
TIbial spine
A
Intercondylar eminence
13
Q
3 types of movement in the knee
A
Flexion
Extension
Slight rotation
14
Q
2 types of movement in the ankle
A
Flexion
Extension
15
Q
Type of movement in the intertarsal joints
A
Gliding
16
Q
2 types of movement in the interphalangeal joints
A
Flexion
Extension
17
Q
4 types of movement in the tarsometatarsal joints
A
Flexion
Extension
Abduction
Adduction
18
Q
Type of movement in the distal tibiofibular joint
A
Syndesmosis (slight movement)
19
Q
Type of movement in the proximal tibiofibular joint
A
Gliding
20
Q
4 types of movement in the metatarsophalangeal joint
A
Flexion
Extension
Abduction
Adduction
21
Q
Incomplete separation or avulsion of the tibial tuberosity
A
Osgood-Schlatter disease
22
Q
3 groups of bones found in the foot and ankle and quantity (26)
A
7 tarsals
5 metatarsals
14 phalanges
23
Q
How many interphalangeal articulations does one foot have?
A
9
24
Q
What type of joint is an interphalangeal joint?
A
Hinge
25
With what do the heads of the metatarsals articulate?
Phalanges
26
How are metatarsals identified within the foot?
1-5 medial to lateral
27
With what do the heads of the metatarsals articulate?
Phalanges
28
How are metatarsals identified within the foot?
Numbered 1 through 5 medial to lateral
29
Which metatarsal has a tuberosity that is prominent at its base?
5th
30
7 tarsal bones
```
Calcaneus
Talus
Navicular
Cuboid
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
```
31
Comprises the heel of the foot
| Largest tarsal bone
Calcaneus
32
Tarsal bone that articulates superiorly on the calcaneus
Forms part of the ankle joint
Articulates with the undersurface of the tibia
Most superior tarsal bone
Talus
33
Tarsal bone that is located between the calcaneus and the fourth and fifth metatarsals
Lateral tarsal bone
Cuboid
34
Tarsal bone that is located between the talus and the cuneiforms
Navicular
35
4 tarsal bones that articulate with metatarsals
Medial, intermediate and lateral cuneiforms
| Cuboid
36
2 bones of the leg
Tibia
| Fibula
37
Tibial condyle that has a facet for articulation with the head of the fibula
Lateral
38
Where specifically is the tibial tuberosity located?
Anterior surface below the condyles
39
Bones of the forefoot
5 numbered 1-5 beginning at medial aspect/great toe side
Consist of body (shaft) and two articular extremities
Metatarsals
40
Articular surfaces on superior tibia
Plateaus
41
Toe bones
14, 2 in great toe and 3 in each of the lesser toes
Named by location
Phalanges
42
Sesamoid that protects knee joint
| "Kneecap"
Patella
43
DIP
Distal interphalangeal joint
44
TMT
Tarsometatarsal joint
45
MTP
Metatarsophalangeal joint
46
IP
Interphalangeal joint
47
What is the central ray orientation of the joint spaces if the toes are of primary interest?
15 degrees posteriorly (toward heel)
48
How should the central ray be directed to demonstrate toes when the plantar surface of the affected foot is in contact with a foam wedge, which should be inclined 15 degrees so that the toes are elevated above a horizontally placed IR?
Perpendicular
49
What projection for the toes normally does NOT demonstrate open interphalangeal joints?
AP projection of the toes with the central ray directed perpendicular
50
For the AP oblique projection demonstrating all of the toes, which way (medially or laterally) should the foot and lower leg be rotated?
Medially
51
How many degrees of rotation are needed to rotate the foot properly for the AP oblique projection with the foot rotated laterally?
4th and 5th
52
Where should the central ray enter the foot for AP oblique projection of the toes?
3rd MTP
53
True or false: the bases of the metatarsals should be included within the image for AP oblique projections of the toes
False, heads
54
True or false: all phalanges should be seen in the image in an AP oblique of the toes
True
55
For lateral projections of the toes, what can be down to prevent the superimposition of toes?
Tape
56
Where should the central ray enter the foot for the lateral projection of the great toe?
Metatarsophalangeal joint
57
Where should the central ray enter the foot for the lateral projection of the lesser toes?
Proximal phalangeal joint
58
True or false: for the lateral projection of the 5th toe, the patient should lie in the lateral recumbent position on the unaffected side
False, affected
59
True or false: for the lateral projection of the great toe, the patient should lie in the lateral recumbent position on the unaffected side
False, affected
60
True or false: interphalangeal and metatarsophalangeal joint spaces should appear open on the lateral projection of the toes
True
61
What other projection refers to the AP projection of the foot?
Dorsoplantar
62
How should the central ray be directed for best demonstration of tarsometatarsal joints with a dorsoplantar projection of the foot?
CR angled 10 degrees posteriorly
63
Toward what point of the foot should the central ray be directed for AP and AP axial projections of the foot?
Base of the third metatarsal
64
In which direction (medially or laterally) should the foot be rotated for the AP oblique projection of the foot to best demonstrate the cuboid and its related articulations?
Medially
65
What projection of the foot best demonstrates the lateral tarsals with the least superimposition of structures?
AP oblique projection with medial rotation
66
For the ap oblique projection of the foot, the leg should be rotated medially until the plantar surface of the foot forms an angle of what with the IR?
30 degrees
67
What two metatarsal bases appear overlapped in the image of the AP oblique projection, medial rotation of the foot?
1st and 2nd
68
For patient comfort, which side of the foot (medial or lateral) should be placed in contact with the IR for the lateral projection of the foot?
Lateral
69
With reference to the lower leg, how should the foot be positioned for the lateral projection of the foot?
Dorsiflex the foot to form a 90 degree angle with the lower leg
70
Where should the distal fibula be seen in images of the lateral projection of the foot?
Fibula overlapping the posterior portion of the tibia
71
True or false: the tibiotalar joint must be seen in the lateral projection of the foot
True
72
With reference to the IR, how should the plantar surface of the foot be for the axial projection of the calcaneus?
Perpendicular
73
How many degrees and in what direction is the CR angled for an AP axial projection of the heel?
40 degrees cephalad
74
True or false: the plantar surface of the foot should be in contact with the IR in the axial projection of the calcaneus
False
75
True or false: the central ray should enter the dorsal surface of the foot for axial projection of the calcaneus
False
76
Where on the medial surface of the foot should the central ray enter the calcaneus for the lateral projection of the calcaneus?
1 inch distal to the medial malleolus at the subtalar joint
77
Which projection of the calcaneus best demonstrates the sinus tarsi?
Lateral
78
True or false: the AP projection of the ankle should demonstrate the joint space between the medial malleolus and the talus without any overlapping of structures
True
79
True or false: the AP projection of the ankle should demonstrate the distal third of the fibula without superimposition with the talus or tibia
False
80
True or false: the AP projection should demonstrate the lateral and medial malleoli
True
81
Why is dorsiflexion of the foot required for the lateral (mediolateral) projection of the ankle?
Prevents lateral rotation of the ankle
82
True or false: the lateral (mediolateral) projection of the ankle should demonstrate the fibula over the posterior half of the tibia
True
83
True or false: the tuberosity and base of the fifth metatarsal should be demonstrated as a lateral projection image of the ankle
True
84
How many degrees and in what direction should the leg and foot be rotated?
45 degrees medially
85
3 structures demonstrated in the image of the AP oblique ankle
Talus
Distal tibia
Distal fibula
86
What articulation is demonstrated in the image of the AP oblique ankle?
Tibiofibular
87
From the supine position, how many degrees should the lower limb and foot be rotated to position the ankle for this projection?
15-20 degrees medially
88
With reference to the position of the patient's leg and foot during the procedure, how is it determined that the leg has been rotated the correct number of degrees?
Intermalleolar plane parallel with IR
89
True or false: the talofibular joint space should be demonstrated in profile in the AP oblique projection (medial rotation) of the ankle without any bony superimposition
True
90
True or false: the foot should be plantar flexed to place the long axis of the foot parallel with the IR in the AP oblique projection (medial rotation) of the ankle
True
91
The placement of the top border of the IR should extend at least how many inches above the knee joint to avoid being projected off by beam divergence for the AP projection of the leg?
1 to 1.5
92
What should the radiographer do if the leg is too long to demonstrate the knee and the ankle joint with the same exposure for the AP projection of the leg?
Perform two AP projections to ensure that the entire lower limb is demonstrated
93
True or false: the AP projection of the leg should demonstrate the fibula without any overlapping with the tibia
False
94
What procedure should the radiographer perform if the patient is unable to turn from the supine position toward the affected side to position a fractured leg on the IR for the lateral projection?
Perform a cross table lateral projection by placing an IR vertically between the patients legs and directing a horizontal central ray to the leg
95
If a radiographer positions the lower limb very carefully to ensure that femoral condyles are physically superimposed, but they do not appear to be well superimposed on the radiograph, what could have caused the image to appear that way?
The natural divergence of the beam may prevent the femoral condyles from appearing superimposed
96
True or false: the lateral projection should demonstrate some interosseous space between the shafts of the fibula and tibia
True
97
2 factors that should be considered when deciding whether or not to use a grid for AP projections of the knee
Size
| Preference
98
With reference to the knee, where is the centering point used for positioning the IR or centering the collimated field to the knee on the AP projection of the knee?
1/2 inch below the apex of the patella
99
Where is the patella be located on a correctly positioned AP projection of the knee?
Slightly off center to the medial side of the femur
100
On an image of a correctly positioned AP projection of the knee, the patella should be demonstrated?
Completely superimposed on the femur
101
True or false: the AP projection image of a normal knee should demonstrate a femorotibial joint space with equal distance on both sides
True
102
For the lateral projection of the knee, should the patella be parallel or perpendicular to the IR?
Perpendicular
103
For the lateral projection of the knee, how many degrees should the knee be flexed?
20-30
104
For the lateral projection of the knee, the knee should be flexed no more than how many degrees when a new or healing fracture is present?
10
105
What could occur if a patient with healing fracture flexes the knee more than the recommended number of degrees?
Fragment separation
106
How many degrees and in what direction should the central ray be directed for the lateral projection of the knee?
5-7 degrees cephalad
107
Why is the central ray angled cephalad for the lateral projection of the knee?
Prevents the joint space from being obscured by the magnified image of the medial femoral condyle
108
Where should the central ray enter the patient 1 inch distal to for the lateral projection of the knee?
Medial epicondyle
109
Which positioning maneuver relaxes the muscles and shows the maximum volume of the joint cavity for the lateral projection of the knee?
Flexing the knee 20 to 30 degrees
110
True or false: the femoral condyles should appear superimposed on the lateral projection of the knee
True
111
True or false: the lateral projection of the knee demonstrates the patella with slight overlapping with the femoral cavities
False
112
For a patella tangential projection, settegast method, why is it preferable to place the patient in the prone position for the tangential projection?
The knee can usually be flexed to a greater degree, and immobilization is easier
113
What projection of the patella should be performed before a tangential projection is attempted? Why?
Lateral because of the danger of fragment displacement by the acute knee flexion; rule out transverse fracture of the patella
114
When the patient is placed in the prone position for a patella tangential projection, settegast method, and is unable to maintain a steady lower leg after flexing the knee, what can be done to help the patient hold the position?
Instruct the patient to hold over his or her shoulder a long strip of bandage that is looped around the ankle or foot
115
For a patella tangential projection, settegast method, how and where the central ray should be directed?
Perpendicular to the patellofemoral joint space, central ray angulation will be 15 to 20 degrees
116
For a patella tangential projection, settegast method, what determines the number of degrees the central ray is angled?
The degree of flexion of the knee
117
True or false: the patellofemoral articulation is seen in slight overlap with the anterior surfaces of the femoral condyles on the patella tangential projection, settegast method
False
118
True or false: the patella should be seen in profile on the patella tangential projection, settegast method
True
119
True or false: the bony detail of the femoral condyles should be demonstrated on the patella tangential projection, settegast method
True
120
Joints named by location in the distal foot; synovial, diarthrodial hinge type
Interphalangeal (IP) joints
121
Proximal end of the metatarsals
Base
122
Distal end of the metatarsals
Head
123
3 articulations the ankle joint is formed by between the talus tarsal
Lateral malleolus of fibula
Inferior surface of tibia
Medial malleolus of tibia
