Lower Extremity Questions (Select) Chapter 7 Lower Extremity
How do images indicate that a patient has torn ligament affecting the ankle
An increase in the joint space on the side of tthe injury indicates a torn ligament.
Which tarsal bone is located between the calcaneus and the fourth/fifth metatarsal?
Cuboid
Name the tarsal bones that articulate with the metatarsals?
Cuneiforms and Cuboid
Which of the abbreviations refer to the joints of the Hand?
DIP and IP also refer to the joints of the hand
DIP
Distal Interphalangeal
With reference to the lower leg, how should the foot be positioned for the lateral projection?
Dorsiflex the foot to form a 90 degree angle with the lower leg
What other projection term could refer to an AP Projection?
Dorsoplantar
True or false, For the lateral projection of the fifth toe, the patient should lie in the lateral recumbent position on the unaffected side.
False
True or False. The AP PRojection of the leg should demonstrate the fibula without any overlapping the tibia.
False (Proximal and distal articulations of tibia and fibula should have moderate overlapping.)
True or false. The central ray should enter the dorsal surface of the foot for the axial (plantodorsal) projection.
False (The central ray should enter the plantar surface.
True or False? The bases of metatarsals should be included within the image for AP oblique Projections.
False (The distal end "Head" of the Metatarsals should be seen.)
True or false. An image of the lateral (Mediolateral) projection should demonstrate the lateral malleolus free from superimposition by the talus.
False (The distal fibula will appear superimposed with the talus.)
True or false? The plantar surface of the foot should be in contact with the IR for the axial (plantodorsal) projection
False (The heel should be in contact with the IR; The plantar surface should be perpendicular to the IR.)
List the articulations of the tibia
Femorotibial, proximal tibiofibular, tibiotalar and distal tibiofibular
Largest Bone of the Lower Extremity
Femur
Name the largest bone of the Lower Extremity
Femur
Name the Lateral bone of the Leg?
Fibula
Name the smaller of the bones of the leg.
Fibula
What two metatarsal bases appear overlapped in the image of the AP oblique projection, medial Rotation?
First and second
What types of movement do the interphalangeal joints permit?
Flexion and Extension
Which individual toes are best demonstrated using the AP Oblique projection with the foot rotated laterally?
Fourth and fifth (and sometimes, Third)
Superior, Lateral process of femur
Greater Trochanter
What type of joint is an interphalangeal joint?
Hinge
For the lateral projection of the Great toe, the central ray should enter at the ________________ of the Great Toe
IP (Interphalangeal Joint) of the Great Toe
What other term refers to the tibial spine?
Intercondylar Eminence
Between femoral condyles on posterior aspect (two words)
Intercondylar Fossa
IP
Interphalangeal
For lateral projections of the lesser toes, the central ray should enter at the ____________________ joint.
Proximal Interphalangeal Joint
With what do the heads of metatarsals articulate?
Proximal Phalanges
When performing the axial (plantodorsal) projection, what should the radiographer do to demonstrate a complete calcaneus if the anterior portion of the calcaneus is not seen in the image with the same brigthness as the posterior portion?
Two images should be performed to demonstrate the entire calcaneus complete
The placement of the top border of the IR should extend at least __________________ inches (_____________________) above the knee joint to avoid being projected off by beam dirvergence.
1 to 1 1/2; 2.5 to 3.8
What is the name of each group of bones found in each section of the foot?
1) Metatarsals and Phalanges 2) Cuneiforms, Cuboid, and Navicular 3) Talus and Calcaneus
How should the central ray be directed for the best demonstration of tarsometatarsal joints with a dorsoplantar projection?
10 degrees posteriorly (toward the heel)
For an AP and AP Axial Projection of the Toes, What is the central ray orientation if the joint spaces of the toes are primary interest?
15 degrees posteriorly (toward the heel)
For the AP Oblique Projection (Medial Rotation) From the supine position, how many degrees should the lower extremity and foot be rotated to position the ankle for this projection?
15 to 20 Degrees
Where should the distal fibula be seen in images of the lateral projection of the foot?
The distal fibula should overlap the posterior portion of the tibia
Which tarsal bone is lateral from the cuneiforms?
Cuboid
For the AP Oblique Projection of the Knee How many degrees and in what direction should the central ray be directed if the patient measures less than 7 1/2 inches from the ASIS to the Tabletop?
3 to 5 degrees caudal
How many bones are found in one lower extremity?
30
For the AP Oblique projection, the leg should be rotated medially until the plantar surface of the foot forms an angle of ________________________
30 degrees
How many degrees of rotation are needed to rotate the foot properly for the AP Oblique projection of the toes?
30 to 45 degrees
How many degrees and in which direction should the central ray be directed for the axial (plantodorsal) projection
40 degrees cephalad
How many degrees should the leg be rotated for an AP Oblique Lateral Knee?
45 Degrees
How many degrees and in what direction should the leg and foot be rotated for an AP Oblique projection (Medial Rotation) of the Ankle?
45 degrees medially
How many tarsal bones are there?
7
What projection of the foot best demonstrates the lateral tarsals with the least superimposition of structures?
AP Oblique Projection (medial rotation)
Which of the following projections for toes normally does not demonstrate open interphalangeal joints?
AP Projection of the toes with the central ray directed perpendicularly
Where is the intercondylar fossa located?
At the distal end of the posterior femur between the condyles
Largest Tarsal Bone
Calcaneus
What tarsal is the biggest of all tarsal bones?
Calcaneus
Which tarsal bone is called the heel of the foot?
Calcaneus
Processes on proximal Tibia
Condyles
Lateral Tarsal Bone
Cuboid
For patient comfort, which side of the foot (medial or lateral) should be placed in contact with the IR for the lateral projection?
Lateral
Location of fibula in lower leg
Lateral
Name the large bony process that extends both medially and inferiorly from the distal end of the tibia.
Medial Malleolus
For the AP Oblique projection demonstrating all of the toes, which way (medially or laterally) should the foot and lower leg be rotated?
Medially
In which direction (medially or laterally) should the foot be rotated for the AP oblque projection for best demonstration of the cuboid and its related articulations?
Medially
Process on distal end of tibia and fibula
Menisci
Bones of the forefoot
Metatarsals
MTP
Metatarsophalangeal
Alternative name of the ankle joint
Mortise
Tarsal located between talus and cuneiforms
Navicular
How many interphalangeal articulations does one foot have?
Nine
How are metatarsals identified within the foot?
Numbered 1 to 5 from the medial side to the lateral side
Where is the tibial tuberosity located?
On the anterior surface of the tibia, just inferior from the condyles
Sesamoid that protects the knee joint
Patella
What is the name of the kneecap and what is it's bone classification?
Patella, It's also a Sesamoid bone
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 extremity is demonstrated
For an AP and AP Axial Projection of the Toes, 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
For the lateral projection of the leg, should the patella be positioned perpendicular or parallel with reference to the plane of the IR?
Perpendicular
With reference to the plane of the IR, the plantar surface of the foot should be ________________________ for the axial projection.
Perpendicular
Toe Bones
Phalanges
Identify by group name and quantity the bones found in the foot and ankle.
Phalanges: 14 Metatarsals: 5 Tarsals: 7
Articular surfaces on superior Tibia
Plateaus
Most superior tarsal bone
Talus
Which tarsal bone forms part of the ankle joint?
Talus
Which tarsal bones articulates superiorly on the calcaneus?
Talus
With what bone does the undersurface of the tibia articulate?
Talus
For lateral Projections of the toes, what can be done to prevent the superimposition of toes?
Tape all the toes above the affected toe into a flexed position
TMT
Tarsometatarsal
Toward what point of the foot should the central ray be directed for AP and AP Axial Projections?
The Base of the third metatarsal
Which metatarsal has a tuberosity that is prominent at its base?
The Fifth Metatarsal
Which tibial condyle has a facet for articulation with the head of the fibula?
The Lateral Condyle
Which tarsal bone is located between the talus and the cuneiforms?
The Navicular
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?
The intermalleolar plane should be parallel with the IR.
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 that is looped around the foot.
For AP Oblique projections, the central ray should enter the foot at the ____________ Joint.
Third Metatarsophalangeal Joint
Medial Lower Leg Bone
Tibia
Name the two bones of the leg?
Tibia and Fibula
Two joints in the lower leg
Tibiofibular
What's the purpose behind performing an AP Stress study of the ankle
To verify the presence of a ligamentous tear
True or False, For the lateral projection of the great toe, the patient should lie in the lateral recumbent position on the unaffected side.
True
True or False? All phalanges should be seen in the projection of the toes.
True
True or false The Lateral projection of the Tibia and Fibula should demonstrate some interosseous space between the shafts of the fibula and tibia.
True
True or false The tibiotalar joint must be seen in the lateral projection of the foot
True
True or false, Interphalangeal and metatarsophalangeal joint spaces should appear open.
True
True or false. The lateral (mediolateral) projection should demonstrate the fibular over the posterior half of the tibia
True
True or false. The tuberosity and base of the fifth metatarsal should be demonstrated as a lateral projection image of the ankle.
True
