Lower Limb Exam Ch 6 Flashcards by Donovan Tompkins

Exam Review:
For an AP stress study for an ankle, what would we not do to the foot?
Demonstrate a ligament tear
Rupture ligament
inversion/eversion
demonstrate a fracture of the tib fib

Not move the foot around due to the fracture of the Tibia and fibula
we would look at the ligaments

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Exam Review:
What is the difference between a mortise and an oblique ankle?

Mortise is rotated 15-20 degrees medially
Oblique ankle is rotated 45 degrees

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Exam Review:
Which rotation has the intermalleolar line parallel to the IR?

AP Mortise ankle
15-20 degree internal/medial rotation

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Exam Review:
What type of joint is the ankle?

Saddle or sellar Joint

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Exam Review:
Which Malleoli is superior?

Medial Malleoli

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Exam Review:
Which tarsal bone makes up the mortise?

Talus?

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Exam Review:
What is the CR for calcaneus?
Is it Cephalic or Caudad?

40 degrees Cephalic to the long axis of the foot
CR is at base of third metatarsal

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Exam Review:
When you are positioning for a trauma lateral ankle what is necessary?
A. Ensure the plantar surface is in complete contact of the IR
B. Rotate the leg laterally so the leg is against the table
C. Ensure the plantar surface is perpendicular to the IR
D. Plantarflex the foot

C.
Ensure the plantar surface is perpendicular to the IR

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Exam Review:
When the patient is standing with the metatarsals of the foot in 90 degrees to the leg with a horizontal beam entering the lateral malleolus, which of the following of the weight-bearing projections?

Standing Lateromedial projection
(key: CR is entering in the lateral malleolus)

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Exam Review:
In the axial calcaneus the plantar surface of the foot should be ____ to the image receptor?

Perpendicular

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Exam Review:
The most posterior part of the calcaneus would be?
A. Sinus Tarsi
B. Tuberosity
C. Trochlear
D. Peritoneal

B. Tuberosity

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Exam Review:
How many views for the calcaneus?
What are the names?

2 views
Plantodorsal Axial Calcaneus
Lateral Calcaneus

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Exam Review:
When performing a lateral for the 2nd digit, what side should be closest to the Image receptor?
Why?

Medial side
To reduce OID

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Exam Review:
Where is the sustentaculum tali?

medial proximal calcaneus

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Exam Review: What does the medial cuneiform articulate with distally?

First metatarsal

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Exam Review:
What does the metatarsal articulate with distally?

proximal phalanx

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Exam Review:
Medial oblique foot would show:

sinus tarsi free of superimposition
(also cuboid)

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Exam Review:
What do the heads of the metatarsal articulate with distally?

proximal phalanx

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Exam Review:
Where are the sesamoid bones located?

plantar surface of the first metatarsal

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Exam Review:
What is Pes planus?

Flat foot

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Exam Review:
What does the base of the metatarsal articulate with?

Tarsals

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Exam Review:
If we are looking at a lateral foot, all of these are correct except for?
A. We include at least one inch of the distal tibia fibula
B. we want to visualize the foot from digit to calcaneus
C. The cuboid is free of superimposition
D. The heads of the metatarsals are superimposed

C.
The cuboid is free of superimposition
(we only see the cuboid slightly free of superimposition in mediolateral)
Medial oblique shows the cuboid free of superimposition

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Exam Review:
If we are looking for a foreign body do we angle the central ray?
Why?

No.
An angle can distort the object and elongate it

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Exam Review:
T/F
*The image critique for an oblique foot with lateral rotation we want to see the sinus tarsi free of superimposition.

False
(medial oblique would show the sinus tarsi)

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Exam Review: If the patients foot cannot be flat for an AP projection, what would we do? What is the angle?

We would use a wedge No angle for this

Exam Review: How many tarsal bones are in the foot?

7 tarsal bones

Exam Review: *The lateral oblique foot best shows?

The base of the first metatarsal

Exam Review: In the AP projection of the ankle the: 1. Plantar surface is perpendicular to the IR 2. The Fibula projects more distally than the tibia 3. The calcaneus is well-visualized

1 & 2

Exam Review: AP ankle the plantar surface is ____ to the IR?

Perpendicular

Exam Review: Lateral foot the plantar surface is ____ to the IR? How about standing?

Perpendicular supine Parallel for standing

Exam Review: The second metatarsophalangeal joint is what kind of joint?

ellipsoid or condyloid Synovial Diarthrodial (freely moveable)

Exam Review: Which of the following joints is a fibrous syndesmosis Amphiarthodial (slightly moveable) joint? A. Proximal interphalangeal B. Talonavicular C. Proximal tibiofibular D. Distal Tibiofibular

D. Distal Tibiofibular

Exam Review: When would you best see a medial displacement fracture? (bone protruding towards medial side)

AP view

Exam Review: If there's a posterior displacement, what view would best display that?

Lateral

Exam Review: What is the name of the fracture for the base of the fifth metatarsal?

Jones or nightstand fx

Exam Review: What joint is most affected by gout?

First MTP joint Form of arthritis (execessive blood in joint) that may be hereditary

Exam Review: What is the Don Juan fx?

fx in the calcaneus

Exam Review: Osgood Slatter is?

inflammation of bone/cartilage of anterior proximal tibia (tibial tuberosity) most common in boys 10-15

Exam Review: Inversion: AKA?

Inward turning/bending of the ankle aka Varus

Exam Review: Eversion: AKA?

outward turning/bending of ankle aka valgus

Exam Review: Dorsiflexion:

Dorsal/anterior surface of foot flexed upwards

Exam Review: Plantarflexion:

Posterior/Sole of foot is flexed downwards (tippy toes)

Posterior foot name:

Plantar surface Sole of foot

Anterior foot name:

Dorsum pedis

Exam Review: *During most long bone exams, the part being radiographed should be _____ to the IR and ____ to the CR.

Parallel to IR Perpendicular to CR

Exam Review: What is the superior portion of the foot called?

Dorsum Pedis

Exam Review: Is the dorsum pedis considered anterior or posterior part of the foot?

Exam Review: How many degrees for a lateral knee?

5-7 degrees cephalic

Exam Review: (T/F) The lateral projection of the Tibia and Fibula the image should demonstrate some space in-between the Tibia and fibula.

True (There should be some space in-between the tibia and fibula in lateral view)

Exam Review: *The placement of the top border of the IR should extend at least ___ inches from the knee joint to avoid being projected off due to beam divergence: A. 4 - 4 1/2 inches B. 3 - 3 1/2 inches C. 2 - 2 1/2 inches D. 1 - 1 1/2 inches

D. 1 - 1 1/2 inches

Exam Review: What is the CR for AP foot? What is the angle?

base of 3rd metatarsal 10 degrees posteriorly

Exam Review: Which views do we use for patella?

Inferosuperior Hughston Settegast Merchant (Mayo uses Merchant)

Exam Review: What views do we use for intercondylar fossa?

Rosenburg (PA flexion- for tunnel view)

Exam Review: Which of the following tangential axial projections of the patella is the complete relaxation of the quadricep require for an accurate diagnosis? 1. Supine flexion 45 degrees (merchant) 2. Prone flexion 90 degrees (Settegast) 3. Prone flexion 55 degrees (hughston)

1. Supine flexion 45 degrees (supine keyword, relaxes the Quads)

Exam Review: What is considered a shock absorber between the femoral condyle and the tibial articular casset?

Meniscus

Exam Review: If we are looking to see arthritic changes (arthritis) in the knee we want to see it: 1. recumbent 2. Erect 3. Merchant

AP erect (we want weight bearing)

Exam Review: What knee oblique shows the proximal tibiofibular joint? 8:30

Internal/ medial oblique (shows the head/neck of fibula free of superimposition)

Exam Review: which projections are performed with the tube face is angled and parallel to the flexed tibia? A. Hughston B. Merchant C. Axial intercondylar fossa (BeClere) D. Settegast

C. BeClere

Exam Review: When we are doing a lateral knee, what needs to be seen so we know the lateral is positioned correctly? A. Patella is parallel to the IR B. Femoral condyles are superimposed C. Femoral condyles are perpendicular to the IR D. The proximal tibiofibular articulation is open

B. Femoral condyles are superimposed

Exam Review: What is proximal to the tibial plateau? A. The tibia condyles B. The tibial tuberosity C. intercondylar fossa

C. Intercondylar fossa

Exam Review: In a lateral projection of a normal knee: 1. The fibular head should be somewhat superimposed on the tibia 2. The patellofemoral joint should be visualized 3. The femoral condyles should be superimposed

1, 2 & 3

Exam Review: What is the CR for AP knees?

1/2 distal to the apex of the patella

General knowledge: What is the Settegast Flexion: Position: Angle:

90 degree flexion of knee Prone or Supine Angle and CR is into the patellofemoral joint (PATELLA)

General knowledge: What is the Hughston method Flexion: Position: Angle:

50-60 degree flexion patient prone 45 degrees cephalic (similar to settegast without as much flexion)

General knowledge: What is the BeClere Flexion: Position: Angle:

45 degree flexion supine angle right into the knee joint CR is 1/2 distal to patellar apex (FOR TUNNEL VIEW)

General knowledge: What is the Camp Coventry Flexion: Position: Angle:

Flexion 40-50 degrees patient prone Angle matches the flexion 40 flex= 40 angle (FOR TUNNEL VIEW)

General knowledge: What is the Merchant (Mayo sunrise) Flexion: Position: Angle:

40 degree knee flexion Supine 30 degree Caudad into patellofemoral joint (Mayo's sunrise) (PATELLA)

General knowledge: What is the Rosenberg Flexion: Position: Angle:

(aka PA Flexion) 45 degree flexion Standing 10 degree caudad

Jeopardy: To demonstrate the interphalangeal joint what do you do?

angle 10-15 degrees posteriorly

Jeopardy: What is another name for PA Axial view? What does it best show?

Rosenberg Intercondylar fossa

Know how much to oblique for mortise and oblique and the differences! Revisit anatomy modules before exam!

Jeopardy: The CR should be this to the IR when the patient is 21 cm from ASIS to tabletop for knee projection?

no angle or 0 degrees or Perpendicular

Jeopardy: Patella bone is what type of bone?

Sesamoid (largest sesamoid in the body)

Jeopardy: typical age when patella develops in the tendon of the quadriceps?

3-5 years of age

Jeopardy: Webber classification (fx) is related to this specific structure?

lateral malleolar fracture

Jeopardy: Another name for big toe?

Hallux

Jeopardy: Location of the adductor tubercle?

Medial condyle of femur

Jeopardy: This is the AP projection that best demonstrates the intercondylar fossa?

BeClere

Jeopardy: Fracture of the base of the fifth metatarsal?

Nightstand/Jones fx

Jeopardy: This knee projection best shows arthritic changes?

AP knee weight bearing

Jeopardy: The Osgood Schlatter disease is limited to this location?

Tibial tuberosity

Jeopardy: These extra two bones underneath the first metatarsals?

Sesamoid bones

Jeopardy: This is the name o the fossa on the distal posterior femur?

Intercondylar fossa

Jeopardy: Level of CR for a weight bearing AP projection of the knees?

1/2 inch below the Apex of the patella

General: What is the largest Tarsal? What is the smallest?

Largest Calcaneus Smallest intermediate cuneiform

General: AP projection of foot is called: PA projection of foot is called:

AP= dorsoplantar PA= plantodorsal

General: How much do we oblique Mortise? How much do we oblique a foot?

Mortise: 15-20 medially Medial foot oblique: 30-40 medially

General: What type of joints are the interphalangeal joints?

ginglymus or hinge

General: What kind of joints are the Metatarsophalangeal joints?

ellipsoidal or condyloid (modified)

General: What kind of joints are the Tarsometatarsal joints:

plane or gliding

General: What kind of joints are the Intertarsal joint: (tarsals)

plane or gliding

General: What kind of joints are the ankle joint:

Saddle or sellar

General: What kind of joints are the femorotibial (femur and tibia meet)

Bicondylar

General: What kind of joints are the patellofemoral (joint in-between patella and femur)?

saddle or sellar

General: What kind of joints are the proximal tibiofibular joint:

plane or gliding

General: Distal tibiofibular Classification: Mobility type:

Fibrous Amphiarthrodial (slightly moveable) Syndesmosis

General: What knee rotation frees the tibia and fibula at the proximal end?

internal/medial knee

General: Sustentaculum tali is found on the

Calcaneus

General: Where is the intercondylar fossa located?

distal posterior femur

General: What is a Pott's fx?

displacement of the distal tibia (Colles equivalent)

General: What is the Beclere projection best show? What is the position & CR?

Tunnel view in AP (intercondylar fossa) 40-45 degree flexion of knee (60 degrees for Mayo) patient supine

General: What does the Camp Coventry show? What is position/CR?

PA intercondylar fossa prone flex knee 40-50 degrees CR is 40-50 degrees caudad to match flexion Flexion=angle

What does Holmbald show? What is position/CR?

PA intercondylar fossa patient leans forward 20-30 degrees causing a 60-70 degree flexion in knee Standing or recumbent

What are the 3 alternative tunnel view projections for knees?

Camp Coventry Holmblad Beclere method

What are the 3 sunrise views?

Inferosuperior Hughston Settegast (Mayo’s way is (superioinferior)

What does merchant (sunrise) show? What is CR and position?

Patella 40 degree flexion of knee Supine 30 degree caudad (to femur) CR midway patella

What does inferosuperior show? What is position and angle?

Patella 40-45 flexion of knee 10 to 15 degrees tangential to patellofemoral joint Supine

What does Hughston show? What is position and angle?

Patella knee flexed 50-60 degrees 45 degrees cephalic Prone

What does Settegast show? What is position and angle?

Patella Minimum 90 degrees CR is 15-20 degrees tangential to Patellofemoral joint space

Lower Limb Exam Ch 6 Flashcards

60 questions review (109 cards)