Lower Limb Flashcards
(158 cards)
1
Q
Alternative name of the ankle joint
A
Mortise
2
Q
Cushions between tibia and femur
A
Menisci
3
Q
Between femoral condyles on posterior aspect
A
Intercondylar Fossa
4
Q
Tarsal located between talus and cuneiforms
A
Navicular
5
Q
Most superior tarsal bone
A
Talus
6
Q
Lateral tarsal bone
A
Cuboid
7
Q
Superior, lateral process of femur
A
Greater trochanter
8
Q
Articular surfaces on superior tibia
A
Plateaus
9
Q
Two joints in the lower leg
A
Tibiofibular
10
Q
Process on distal end of tibia and fibula
A
Malleolus
11
Q
Processes on proximal tibia
A
Condyles
12
Q
Sesamoid that protects knee joint
A
Patella
13
Q
How much angulation on an AP axial projection of toes?
A
15 degrees
14
Q
What is the central ray orientation if the joint spaces of the toes are of primary interest?
A
15 degrees posteriorly (toward the heel)
15
Q
How many degrees of rotation are needed to rotate the foot properly for the AP oblique projection of toes?
A
30 to 45 degrees
16
Q
Which individual toes are best demonstrated using the AP oblique projection with the foot rotated laterally?
A
Fourth and fifth ( sometimes the third)
17
Q
How much angulation on an AP axial projection of the foot?
A
10 degrees
18
Q
For the AP oblique projection, the leg should be rotated medially until the plantar surface of the foot forms an angle of…
A
30 degrees
19
Q
Degrees of Angulation for plantodorsal axial projection of the calcaneus
A
40 degrees cephalic. CR enters base of third metatarsal
20
Q
How many bones in the foot?
How many parts are they divided into?
A
There are 26 bones divided into three parts
Tarsus or tarsal bones
Metatarsals(bones of the instep)
Phalanges
21
Q
Name the tarsal bones
A
Calcaneus
Talus
Navicular
Cuboid
Internal cuneiform
Middle cuneiform
External cuneiform
22
Q
Essential projection of the Calcaneus: Plantodorsal axial
A
- collimate to 1 inch on three sides of the calcaneous shadow.
- patient seated or supine with leg extended; posterior surface of foot resting on IR; foot dorsoflexed so plantar surface is vertical and not rotated.
- malleoli parallel with plane of IR; plantar surface vertical
- CR angled 40 degrees cephalic; enters base of third metatarsal
23
Q
Essential projection of calcaneus: lateral
A
- collimate to 1 inch past posterior and inferior heel shadow; include medial malleolus and 5th metatarsal base
- Patient seated or supine with knee flexed and lateral surface of calcaneus centered to collimated field; leg rotated laterally to place plantar surface of calcaneus perpendicular to IR.
- long axis of calcaneus aligned with long axis of IR
- CR perpendicular; enters 1 inch distal to medial malleolus
24
Q
ESSENTIAL PROJECTION FOR THE ANKLE: AP
A
- collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
- patient seated or supine with knee extended; dorsal surface of ankle centered to IR/collimated field; ankle in anatomic position; foot dorsiflexed to right ankle.
- malleoli in anatomic position; plantar surface of foot positioned vertical.
- CR perpendicular; enters ankle joint midway between malleoli
25
Essential projection for the ankle: Lateral
* collimate to 1 inch on all sides of the ankle and 8 inches long to include heel and 5th metatarsal base
* patient turned on affected side until ankle is resting on lateral surface; ankle resting on lateral surface and centered to IR/collimated field; foot dorsiflexed and lateral
* Malleoli superimposed and perpendicular to IR
* CR perpendicular; enters medial malleolus
26
Essential projection for the ankle: AP oblique- medial rotation
* collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
* patient seated or supine with knee extended; lower limb rotated medially 45 degrees; ankle centered to IR; foot dorsiflexed
* coronal plane of lower limb and malleoli at 45 degree angle with IR
* CR perpendicular; enters ankle joint midway between the malleoli
27
Essential projection for the ankle: AP oblique- medial rotation for mortise
* collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
* patient seated or supine with knee extended; lower limb rotated medially 15-20 degrees; ankle centered to IR; foot dorsiflexed
* coronal plane of lower limb at 15-20 degree angle with IR; intermalleolar plane parallel with IR
* CR perpendicular; enters ankle joint midway between the malleoli
28
Essential projection for the ankle: AP stress
* collimate to 1 inch on all sides of the ankle and 8 inches long to include the heel
* patient seated or supine with knee extended; ankle in anatomic position while foot is forcibly held in inversion and eversion stress for two separate exposures.
* malleoli in anatomic position; foot inverted and everted
* CR perpendicular; enters ankle joint midway between the malleoli
29
The AP projection should demonstrate the joint space between the medial malleolus and the talus without any overlapping of structures
True
30
The AP projection should demonstrate the distal third of the fibula without superimposition with the talus or tibia
False
Some overlapping of the distal fibula with the talus and tibia is expected
31
The AP projection should demonstrate the lateral and medial malleoli
True
32
Why is dorsiflexion of the foot required for the lateral(mediolateral projection of the ankle?
To prevent rotation
33
The lateral (mediolateral) projection of the ankle should demonstrate the fibula over the posterior half of the tibia
True
34
An image of the lateral (mediolateral) projection of the ankle should demonstrate the lateral malleolus free from superimposition by the talus
False
The distal fibula will appear superimposed with the talus
35
The tuberosity and base of the fifth metatarsal should be demonstrated on a lateral projection of the ankle
True
36
How many degrees and in what direction should the leg and foot be rotated for an AP oblique projection (medial) of the ankle
45 degrees medially
37
From the supine position, how many degrees should the lower limb and foot be rotated to position the ankle for the medial AP oblique projection
15-20 degrees
38
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 for an AP oblique mortise
The intermalleolar plane should be parallel with the IR
39
The talofibular joint space should be demonstrated in profile without any bony superimposition on an Ap oblique mortise
True
40
The foot should be plantar flexed to place the long axis of the foot parallel with the IR for an AP oblique mortise
False
The foot should be dorsiflexed to place the long axis of the foot perpendicular to the IR
41
State the purpose of performing AP stress studies of the ankle
To verify the presence of a ligament out tear
42
How can the patient hold the foot in the stress position during AP stress studies?
The patient may be instructed to pull on a strip of bandage looped around the foot
43
How do images indicate that's a patient has a torn ligament affecting the ankle?
An increase in the joint space on the side of the injury indicates a torn ligament.
44
Essential projection for the leg: AP
* collimate to 1 inch on all sides and 1.5 inches beyond ankle and knee joints
* patient supine or seated with knee extended; knee extended; ankle and foot dorsiflexed
* femoral condyles parallel to IR
* CR perpendicular to center of leg
45
Essential projection of the leg: lateral
* collimate to 1 inch on all sides and 1.5 inches beyond ankle and knee joints
* patient lying on affected side with leg extended; leg resting on lateral surface; knee may be slightly flexed
* femoral condyles and patella perpendicular to IR
* CR perpendicular to midpoint of leg
46
What should the radiographer do if the leg is too long to demonstrate the knee and the ankle joint with the same exposure?
Perform two AP projections to ensure that the entire lower limb is demonstrated
47
The AP projection of the leg should demonstrate the fibula without any overlapping with the tibia.
False
Proximal and distal articulations of tibia and fibula should have moderate overlapping
48
For the lateral projection of the leg, should the patella be positioned perpendicular or parallel with reference to the plane of the IR?
Perpendicular
49
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 patient's legs and directing a horizontal CR to the leg
50
The lateral projection should demonstrate some interosseous space between the shafts of the fibula and tibia
True
51
Essential projection of the knee: AP
• collimate to 10x12
• patient supine or seated w/ knee extended; 1/2 inch below patellar apex in center of IR
• femoral condyles parallel to IR
• according to ASIS to tabletop measurement
<19 cm- 3-5 degrees caudad
19-24 cm perpendicular
>24 cm 3-5 degrees cephalad
52
Essential projection for the knee: lateral
* collimate to 10x12
* patient lying on affected side with opposite limb on table for support: normal knee flexed 20-30 degrees; flexed knee resting on lateral side; ankle supported to lie in same plane if necessary
* femoral condyles superimposed and perpendicular to IR; patella perpendicular to IR
* CR angled 5-7 degrees cephalad; enters 1 inch distal to medial epicondyle
53
Essential projection for knee: AP standing (weight bearing)
* collimate to 14x17
* patient standing upright facing x-ray tube; posterior surface of knee in contact with IR; standing straight; knee extended with weight equally distributed
* tibial condyles parallel to IR; 1/2 inch below apex of patella at center of IR
* CR horizontal and perpendicular to 1/2 inch below patellar apex
54
Essential projection of the knee: AP oblique in lateral rotation position
• collimate to 10x12
• patient supine; knee extended; lower limb externally rotated 45 degrees
• tibial condyle at a 45 degree angle to IR; 1/2 inch below apex of patella at center of IR
• CR according to ASIS to tabletop measurement
<19cm 3-5 degrees caudad
19-24cm perpendicular
>24cm 3-5 degrees cephalad
55
Essential projection for the knee: AP oblique in medial rotation position
• collimate to 10x12
• patient supine; knee extended; lower limb internally rotated 45 degrees
• tibial condyles at a 45 degree angle to IR; 1/2 inch below apex of patella at center of IR
• CR according to ASIS to tabletop measurement
<19cm 3-5 degrees caudad
19-24cm perpendicular
>24cm 3-5 degrees cephalad
56
Where is the patella located on a correctly positioned Ap projection of the knee
Slightly off center to the medial side of the femur
57
On an image of a correctly positioned AP projection of the knee, the patella should be demonstrated...
Completely superimposed one the femur
58
The AP projection image of a normal knee should demonstrate a femorotibial joint space with equal distances on both sides
True
59
In a lateral projection of the knee how much flexion should you have?
20-30 degrees
60
On a lateral projection when a new or healing fracture is present, the knee should be flexed no more than...
10 degrees
61
On a lateral projection of the knee, how many degrees and in what direction should the CR be directed?
5-7 degrees
62
Why is the CR angled cephalad for the lateral projection?
To prevent the joint space from being obscured by the magnified shadow of the femoral condyle
63
On the lateral projection of the knee the CR should enter the patient 1 inch distal to the...
Medial epicondyle
64
The femoral condyles should appear superimposed on a lateral projection of the knee.
True
65
The lateral projection of the knee demonstrates the patella with slight overlapping with the femoral condyles
False
66
Essential projection of the patella and patellofemoral joint: PA
* 6 x 6 collimation
* patient prone: patella parallel to IR; heel rotated laterally 5 to 10 degrees
* Patella parallel and in center of IR
* CR perpendicular to midpopliteal area; exits patella lateral
67
Essential projection of the patella and patellofemoral joint: lateral
* collimate to 4x4 inches
* patient lateral recumbent on affected side: knee flexed 5 to 10 degrees; patella perpendicular to IR
* femoral condyles superimposed and patella perpendicular
* CR perpendicular; enters patellofemoral joint space
68
Essential projection of the patella and patellofemoral joint: tangential (Settegast)
• single patella- collimate to 4 x 4
Bilateral- collimate to 4 x 10
• Patient supine or prone; knee flexed as much as possible
• tibial condyles parallel to IR
• CR angled 15 to 20 degrees cephalic to enter perpendicular to patellofemoral joint space
69
For a lateral projection of the patella, the knee should be flexed no more than how many degrees?
10 degrees
70
What might occur if the patient flexes the knee more than the recommended number of degrees in regard to a lateral patella projection
Reduction in the femoropatellar joint space
71
What projection of the patella should be performed before a tangential projection is attempted? Explain why
Lateral
Rules out a transverse fracture
72
Describe how the lesser trochanter should appear in the AP projection of the proximal femur
The lesser trochanter should not be seen beyond the medial border of the femur, or only a very small portion of the lesser trochanter should be seen
73
How many and what kind of bones comprise the foot and ankle?
14 phalanges, 5 metatarsals, and 7 tarsals
74
Which bone classification are tarsals?
Short bones
75
What is the most distal part of a metatarsal?
Head
76
Where in the foot is the tuberosity that is easily palpable?
Proximal portion of the fifth metatarsal
77
Which tarsal bone is the most superior tarsal bone?
Talus
78
Which tarsal bone is the largest of the tarsal bones
Calcaneus
79
Which tarsal bone is located on the lateral side of the foot between the calcaneus and the fourth and fifth metatarsals
Cuboid
80
Which tarsal bone is located on the medial side of the foot between the talus and the three cuneiforms?
Navicular
81
Which bone articulates medially with the cuboid?
Lateral cuneiform
82
Which bones comprise the midfoot?
Navicular, cuboid, and cuneiforms
83
Which bone articulates with the superior surface of the calcaneus?
Talus
84
Which bones articulate dismally with the tarsal navicular?
Cuneiforms
85
Which bones articulate distally with the three cuneiforms?
Metatarsals
86
Which bones articulate with the metatarsals?
Cuneiforms and cuboid
87
Which cuneiform is the largest?
Medial
88
Where in the foot are the cuneiforms located?
Between the navicular and the metatarsals
89
What articulation is an ellipsoid-type joint?
Metatarsophalangeal
90
Which articulation of the foot is a gliding-type joint?
Intertarsal
91
Which two tarsal bones articulate with each other by way of three facets?
Talus and calcaneus
92
Which part of the talus articulates with the distal tibia?
Trochlea
93
Which type of joint is the ankle joint?
Hinge
94
Where is the medial malleolus located in the leg?
Distal tibia
95
Where is the lateral malleolus located in the leg?
Distal fibula
96
What structure is located on the proximal end of the fibula?
Apex
97
Where is the intercondylar eminence located?
Proximal tibia
98
On which border of the tibia is the crest located?
Anterior
99
Which term refers to the sharp ridge on the anterior border of the tibia?
Crest
100
Which term refers to the prominent process on the anterior surface of the proximal tibia that is just inferior to the condyles?
Tuberosity
101
Which joint is formed by the articulation of the head of the fibula with the lateral condyle of the tibia?
Proximal tibiofibular
102
Which type of joint is the proximal tibiofibular joint?
Gliding
103
Which structure is located on the head of the fibula?
Apex
104
With which structure does the head of the fibula articulate?
Lateral tibial condyle
105
Which term refers to the inferior tip of the patella?
Apex
106
Which part of the patella is the base?
Superior border
107
Where on the femur is the greater trochanter located?
Lateral and superior
108
Where on the femur is the lesser trochanter located?
Medial and posterior
109
Where is the fovea capital located?
Distal femur
110
Which femoral structures articulate with the tibia?
Condyles
111
With which structure does the head of the femur articulate?
Acetabulum
112
How many degrees and in what direction should the CR be directed for the AP axial projection of the toes
15 degrees cephalad
113
How many degrees and in what direction should the foot be rotated for the AP oblique projection to demonstrate the second toe?
30-45 degrees medially
114
How and toward what centering point should the CR be directed for the AP oblique projection to demonstrate all five toes?
Perpendicular to the third MTP joint
115
How many degrees and in what direction should the foot be rotated for the AP oblique projection for the best demonstration of the great toe?
30-45 degrees medially
116
What other projection term refers to the AP projection of the foot?
Dorsoplantar
117
How many degrees and in what direction should the CR be directed for the AP axial projection of the foot?
10 degrees cephalad
118
Which projection of the foot best demonstrates the cuboid and its articulations?
AP oblique (medial rotation)
119
How many degrees and in what direction should the foot be rotated for the AP oblique projection of the foot?
30 degrees medially
120
What is the appropriate collimated field size for the AP projection of the foot?
1 inch on all sides, including 1 inch beyond the calcaneus and distal tips of the toes
121
Where should the central ray be directed for the AP oblique projection of the foot?
To the base of the third metatarsal
122
Regardless of the condition of the patient, which positioning maneuver should be performed to position the foot for the lateral projection?
Ensure that the plantar surface is perpendicular to the IR
123
How should the CR be directed for the best demonstration of the tarsometatarsal joint spaces of the midfoot for the AP projection of the foot?
10 degrees posteriorly (toward heel)
124
Which projection of the foot best demonstrates the sinus tarsal?
AP oblique projection(medial rotation)
125
Which projection of the foot best demonstrates most of the tarsals with the least amount of superimposition?
AP oblique projection (medial rotation)
126
Which projection of the foot best demonstrates the bases of the fourth and fifth metatarsals free from superimposition?
AP oblique projection (medial rotation)
127
Which projection of the foot should demonstrate the metatarsals nearly superimposed on each other?
Lateral projection
128
Which two projections comprise the typical series that best demonstrates the calcaneous?
Axial(plantodorsal) and lateral projections
129
How many degrees and in what direction should the CR be directed for the axial (plantodorsal) projection of the calcaneus?
40 degrees cephalad
130
What procedural compensation is required for the plantodorsal axial projection of the calcaneus when the patient cannot dorsiflex the foot sufficiently to place the plantar surface vertical?
Elevate the leg on sandbags to achieve the correct position
131
At which level on the plantar surface should the central ray enter the foot for the axial(plantodorsal) projection of the calcaneus?
Base of the third metatarsal
132
Where should the CR be directed for the lateral projection of the calcaneus?
Toward the midpoint of the calcaneus
133
Where should the CR enter for the lateral projection of the ankle?
At the medial malleolus
134
How many degrees and in which direction should the foot and leg be rotated for the best demonstration of the mortise joint for the AP oblique projection of the ankle?
15-20 degrees medially
135
Which projection of the ankle best demonstrates the talofibular joint space free from bony superimposition?
AP oblique projection (medial rotation)
136
Which articulation should be seen in profile with the AP oblique projection(medial rotation) of the ankle?
Talofibular
137
With reference to the plane of the IR, how should the malleoli be positioned for the AP oblique projection of the ankle for the best demonstration of the mortise joint spaces open?
Perpendicular
138
Which projection of the ankl;e should be performed for the best demonstration of a ligamentous tear?
AP projection with inversion
139
How long should the collimated field be for the AP and AP oblique projections of the ankle?
8 inches
140
Which projection of the knee best demonstrates the femorotibial joint space open if the patient measures more than 10 inches (24cm) between the ASIS and the tabletop?
AP projection with the CR angled 3 to 5 degrees cephalad
141
For the lateral projection of the knee, how many degrees should the knee be flexed?
20-30 degrees
142
How many degrees of angulation should be formed between the femur and the radiographic table for the PA axial projection (holmblad method) of the knee?
70 degrees
143
Which of the following projections of the knee best demonstrates the intercondylar fossa?
PA axial projection (holmblad method)
144
How many degrees and in what direction should the CR be directed for the lateral projection of the knee?
5-7 degrees cephalad
145
Which structure of the knee is best demonstrated with the tangential projection?
Patella
146
Which structure of the knee is best demonstrated with the PA axial projection (the Holmblad Method)?
Femoral intercondylar fossa
147
Which projection of the knee best demonstrates the proximal tibiofibular articulation without bony superimposition?
Ap oblique projection (medial rotation)
148
Which projection of the knee best demonstrates the femoropatellar space open?
Lateral projection
149
Which of the following evaluation criteria indicates that the knee is properly positioned for a lateral projection?
The femoral condyles are superimposed
150
What should be done to prevent the knee joint space from being obscured by the magnified shadow of the medial femoral condyle when the lateral projection of the knee is performed?
Direct the CR 5-7 degrees cephalad
151
Which of the following evaluation criteria indicates that the knee is properly positioned for the Ap projection?
The femorotibial joint space is open
152
Where should the patella be demonstrated on the image of the AP oblique projection of the knee with medial rotation?
Over the medial condyle of the femur
153
Where should the patella be demonstrated on the image of the AP oblique projection of the knee with lateral rotation?
Over the lateral femoral condyle
154
For the lateral projection of the patella, which positioning maneuver reduces the femoropatellar joint space?
Flexing the knee more than 10 degrees
155
Which area of the knee should the CR enter for the PA axial projection (Holmblad method)?
Posterior
156
Which of the following projections of the knee best demonstrates the femoral intercondylar fossa?
PA axial projection (Camp-Coventry method)
157
Which projection of the knee should be used to demonstrate the patella completely superimposed on the femur?
AP projection
158
Which projection of the knee should be used to demonstrate the patella in profile?
Lateral projection
