CH. 7 & 8

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mbuckley
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15758
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CH. 7 & 8
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2010-04-22 20:01:21
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bontrager radiology lower limb pelvic girdle
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Ch 7 & 8 Review Lower Limb Femur and Pelvic Girdle
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  1. What are the two differences in the phalanges of the foot as compared with the phalanges of the hand?
    • 1. phalanges of the foot are smaller
    • 2. movements are limited
  2. Which tuberosity of the foot is palpable and a common site of foot trauma?
    base of the 5th metatarsal
  3. Where are the sesamoid bones of the foot most commonly located?
    plantar surface at the head of the first metatarsal
  4. What is the largest and strongest tarsal bone?
    calcaneus
  5. What is the name of the joint found between the talus and calcaneus?
    subtalar joint
  6. For a small to medium plaster cast, how much would you increase the exposure?
    increase mAs 50% to 60% or +5 to 7 kV
  7. For a large plaster cast, how much would you increase the exposure?
    increase mAs 100% or +8 to 10 kV
  8. For a fiberglass cast, how much would you increase the exposure?
    increase mAs 25% to 30% or +3 to 4 kV
  9. True or False
    The cuboid articulates with the four bones of the foot.
    True
  10. The calcaneus articulates with the talus and the:
    cuboid
  11. What are the two arches of the foot?
    • 1. longitudinal
    • 2. transverse
  12. Which three bones make up the ankle joint?
    • 1. talus
    • 2. tibia
    • 3. fibula
  13. The three bones of the ankle form a deep socket into which the talus fits. This socket is called the ____________.
    ankle mortise
  14. The distal tibial joint surface forming the roof of the distal ankle joint is called the
    tibial plafond
  15. True or False
    The medial malleolus is approximately 1/2 inch (1 cm) posterior to the lateral malleolus.
    False.
  16. The ______ is the weight-bearing bone of the lower leg.
    tibia
  17. What is the name of the large prominence located on the midanterior surface of the proximal tibia that serves as a distal attachment for the patellar tendon?
    tibial tuberosity
  18. What is the name of the small prominence located on the posterolateral aspect of the medial condyle of the femur that is an identifying landmark to determine possible rotation of a lateral knee?
    adductor tubercle
  19. A small, triangular depression located on the tibia that helps form the distal tibiofibular joint is called the
    fibular notch
  20. The articular facets of the proximal tibia are also referred to as the
    tibial plateau
  21. The articular facets slope _________ degrees posteriorly.
    10 to 15 degrees
  22. The most proximal aspect of the fibula is the
    apex or styloid process
  23. The extreme distal end of the fibula forms the
    lateral malleolus
  24. What is the name of the largest sesamoid bone in the body?
    patella
  25. What are two other names for the patellar surface of the femur?
    • 1. intercondylar sulcus
    • 2. trochlear groove
  26. What is the name of the depression located on the posterior aspect of the distal femur?
    intercondylar fossa
  27. Why must the CR be angled 5 to 7 degrees cephalad for a lateral knee position?
    the medial condyle extends lower than the lateral condyle
  28. The slightly raised area located on the posterolateral aspect of the medial femoral condyle is called the
    adductor tubercle
  29. What are the two palpable bony landmarks found on the distal femur?
    • 1. medial epicondyle
    • 2. lateral epicondyle
  30. The general region of the posterior knee is called the
    popliteal region
  31. True or False
    Flexion of 20 degrees of the knee forces the patella firmly against the patellar surface of the femur.
    false
  32. True or False
    The patella acts like a pivot to increase the leverage of a large muscle found in the anterior thigh.
    true
  33. True or False
    The posterior surface of the patella is normally rough.
    False
  34. List the two bursae found in the knee joint.
    • 1. suprapatellar bursa
    • 2. infrapatellar bursa
  35. inward turning or bending of ankle
    inversion (varus)
  36. decreasing the angle between the dorsum pedis and anterior lower leg
    dorsiflexion
  37. extending the ankle or pointing the foot and toe downward
    plantar flexion
  38. outward turning or bending of ankle
    eversion (valgus)
  39. True or False
    The recommended SID for lower limb is 40 inches.
    true
  40. True or False
    To reduce scatter radiation during table top procedures, the Bucky tray should be positioned over the lower limb being radiographed.
    false
  41. True or False
    During DR, lead masking should be placed on the regions of the IR, not within the collimation field.
    true
  42. True or False
    A kV range between 50 and 70 should be used for film-screen lower limb radiography.
    true
  43. True or False
    kV range for CR and DR is typically lower as compared with film-screen ranges.
    false
  44. an inflammatory condition involving the anterior, proximal tibia
    Osgood-Schlatter disease
  45. also known as osteitis deformans
    Paget's disease
  46. malignant tumor of the cartilage
    chondrosarcoma
  47. inherited type of arthritis that commonly affects males
    Gout
  48. benign, neoplastic bone lesion caused by overproduction of bone at a joint
    exostosis
  49. benign bone lesion usually developing in teens or young adults
    osteoid osteoma
  50. most prevalent primary bone malignancy in pediatric patients
    Ewing's sarcoma
  51. benign, neoplastic bone lesion filled with clear fluid
    bone cyst
  52. injury to a large ligament located between the bases of the first and second metatarsal
    lisfranc joint injury
  53. condition affecting the sacroiliac joints and lower limbs of young men, especially the posterosuperior margin of the calcaneus
    Reiter's syndrome
  54. The formal name for "runner's knee" is
    chondromalacia patellae
  55. What is another name for osteomalacia?
    rickets
  56. asymmetric erosion of joint spaces with calcaneal erosion
    reiter syndrome
  57. uric acid deposits in joint spaces
    gout
  58. well-circumscribed lucency
    bone cyst
  59. small, round/oval density with lucent center
    osteoid osteoma
  60. narrowed, irregular joint surfaces with sclerotic articular surfaces
    osteoarthritis
  61. fragmentation or detachment of the tibial tuberosity
    Osgood-Schlatter disease
  62. ill-defined area of bone destruction with surrounding "onion peel"
    Ewing's sarcoma
  63. decreased bone density and bowing deformities of weight-bearing limbs
    osteomalacia
  64. Why is the CR angled 10 to 15 degrees toward the calcaneus for an AP projection of the toes?
    opens up the IP and MTP joints
  65. Where is the CR centered for an AP oblique projection of the foot?
    base of the third metatarsal
  66. Which projection is best for demonstrating the sesamoid bones of the foot?
    Tangential
  67. The foot should be dorsiflexed so that the plantar surface of the foot is __________ degrees from vertical for the sesamoid projection.
    15 to 20
  68. Why should the CR be perp to the metatarsals for an AP projection of the foot?
    opens up the MTP and certain intertarsal joints
  69. Rotation can be determined on a film of an AP foot projection by the near-equal distance between the _______ metatarsals.
    2nd - 5th
  70. Which oblique projection of the foot best demonstrates the majority of the tarsal bones?
    AP oblique with medial rotation
  71. Which oblique projection of the foot best demonstrates the navicular and the first and second cuneiforms with minimal superimposition?
    AP oblique with lateral rotation
  72. Which projection tends to place the foot into a truer lateral position: mediolateral or lateromedial?
    lateromedial
  73. Which type of study should be performed to best evaluate the condition of the longitudinal arches of the foot?
    AP & lateral weight-bearing projections
  74. How should the CR be angled from the long axis of the foot for the plantodorsal axial projection of the calcaneus?
    40 degree cephalad
  75. Which calcaneal structure should appear medially on a well-positioned plantodorsal projection?
    sustentaculum tali
  76. Where is the CR placed for a lateral projection of the calcaneus?
    1" inferior to medial malleolus
  77. Which joint surface of the ankle is not typically visualized with a correctly positioned AP projection of the ankle?
    lateral surface of joint
  78. Why should AP, 45 degree oblique, and lateral ankle radiographs include the proximal metatarsals?
    to demonstrate a possible fracture of the 5th metatarsal tuberosity
  79. How much (if any) should the foot and ankle be rotated for an AP mortise projection of the ankle?
    15 to 20 degrees medially
  80. Which projection of the ankle best demonstrates a possible fracture of a lateral malleolus?
    45 degree AP oblique with medial rotation
  81. What is the basic positioning routine for a study of the tibia and fibula?
    AP & lateral
  82. To include both joints for a lateral projection of the tibia and fibula for an adult, the tech may place the IR ________ in relation to the part.
    diagonally
  83. Where is the CR centered for an AP projection of the knee?
    1/2 inch distal to apex of patella
  84. What is the recommended CR angulation for an AP projection of the knee for a patient with thick thighs and buttocks?
    3 to 5 degrees cephalad
  85. Which basic projection of a knee best demonstrates the proximal fibula free of superimposition?
    AP oblique, 45 degree medial rotation
  86. What is the recommended CR placement for a lateral knee position on a tall, slender male patient with a narrow pelvis?
    5 degree cephalad
  87. How much flexion is recommended for a lateral projection of the knee?
    20 to 30 degrees
  88. Which positioning error is present if the distal borders of the femoral condyles are not superimposed on a radiograph of a lateral knee?
    improper angle of the CR
  89. Which positioning error is present if the posterior portions of the femoral condyles are not superimposed on a lateral knee radiograph?
    overrotation or underrotation of the knee
  90. Which special projection of the knee best demonstrates the intercondylar fossa?
    Holmblad
  91. How much flexion of the lower leg is required for the Camp-Coventry projection when the CR is angled 40 degrees caudad?
    40 degree flexion
  92. How much knee flexion is required for the PA axial projection (Holmblad method)?
    60 to 70 degrees
  93. What type of CR angle is required for the PA axial (Holmblad method)?
    None. CR is perp to IR.
  94. How much part flexion is recommended for a lateral projection of the patella?
    5 to 10 degrees
  95. How much CR angle from the long axis of the femora is required for a Merchant bilateral projection?
    30 degrees from horizontal
  96. How much part flexion is required for the following methods?
    a. Hughston method
    b. Settegast method
    • a. 45 to 55 degrees
    • b. 90 degrees
  97. What type of CR angle is required for the superoinferior sitting tangential method for patella?
    none
  98. can be performed using a wheelchair or lowered radiographic table
    Holmblad method (variation)
  99. patient prone; requires 90 degree knee flexion
    Settegast method
  100. patient prone with 40 to 50 degree knee flexion and with equal 40 to 50 degree caudad CR angle
    Camp-Coventry method
  101. IR is placed on a foot stool to minimize the OID
    superoinferior sitting tangential method
  102. patient prone with 45 degree knee flexion and 10 to 20 degree cephalad CR angle from long axis of lower leg
    Hughston method
  103. patient supine with IR resting on midthighs
    inferosuperior axial for patellofemoral joint
  104. patient supine with 40 degree knee flexion and with 30 degree caudad CR angle from horizontal
    Merchant method
  105. Which projection of the intercondylar fossa recommends using a curved cassette?
    Beclere method
  106. A radiograph of an AP projection of the foot reveals that the metatarsophalangeal joints are not open and the metatarsals are somewhat foreshortened. What was the positioning error involved?
    CR is not angled correctly
  107. A radiograph of an AP oblique-medial rotation projection of the foot reveals that the proximal third to fifth metatarsals are superimposed. What type of positioning error led to this radiographic outcome?
    overrotation of foot
  108. A radiograph of a plantodorsal axial projection of the calcaneus reveals considerable foreshortening of the calcaneus. What type of positioning modification is needed on the repeat exposure?
    increase cephalad angle of the CR to correctly elongate the calcaneus
  109. A patient with a possible Lisfranc joint injury. Which radiographic position(s) would best demonstrate this type of injury?
    AP and lateral weight-bearing projections
  110. A radiograph of a mediolateral knee projection demonstrates that the medial femoral condyle is projected inferior to the lateral condyle. What can the tech do to correct this problem during the repeat exposure?
    angle the CR 5 to 7 cephalad
  111. Where are the sesamoid bones of the foot most commonly located?
    plantar surface near head of first metatarsal
  112. What is the name of the tarsal bone found on the medial side of the foot between the talus and three cuneiforms?
    navicular
  113. Which tarsal bone is considered to be the smallest?
    intermediate cuneiform
  114. What is another term for the talocalcaneal joint?
    subtalar joint
  115. The distal tibial joint surface is called the
    tibial plafond
  116. The largest and strongest bone of the body is the _________
    femur
  117. A small depression located in the center of the femoral head is the ____________
    fovea capitis
  118. The lesser trochanter is located on the ___________ aspect of the proximal femur. It projects ____________ from the junction between the neck and shaft.
    medial; posteriorly
  119. List the four bones comprising the pelvis.
    • right hip bone
    • left hip bone
    • sacrum
    • coccyx
  120. List the two bones comprising the pelvic girdle.
    • right hip bone
    • left hip bone
  121. List the three divisions of the hip bone.
    • ilium
    • ischium
    • pubis
  122. All three divisions of the hip bone eventually fuse at the ___________ at the age of mid teens.
    acetabulum
  123. What are the two radiographic landmarks found on the ilium?
    • iliac crest
    • ASIS
  124. Which bony landmark is found on the most inferior aspect of the posterior pelvis?
    ischial tuberosity
  125. The ____________ of the pelvis is the largest foramen in the skeletal system.
    obturator foramen
  126. An imaginary plane that divides the pelvic region into the greater and lesser pelvis is called the
    pelvic brim
  127. Alternate term for the greater pelvis
    false pelvis
  128. Alternate term for the lesser pelvis
    true pelvis
  129. List the three aspects of the lesser pelvis, which also describe birth route during the delivery process.
    • inlet
    • cavity
    • outlet
  130. In the past, which radiographic examination was performed to measure the fetal head in comparison with the maternal pelvis to predict possible birthing problems?
    cephalopelvimentary exams
  131. List the characteristics of the male pelvis.
    • heart-shaped inlet
    • narrow ilia that are less flared
    • pubic arch angle of 75 degrees
  132. List the characteristics of the female pelvis.
    • wide, more flared ilia
    • pubic arch angle of 110 degrees
    • larger and more round-shaped inlet
  133. To achieve a true AP position of the proximal femur, the lower limb must be rotated _________ internally.
    15 to 20 degrees
  134. Which structures on an AP pelvis or hip radiograph indicate whether the proximal head and neck are in position for a true AP projection?
    lesser trochanter should not be visible
  135. Which physical sign may indicate that a patient has a hip fracture?
    involved foot is externally rotated
  136. Which condition is a common clinical indication for performing pelvic and hip examinations on a pediatric (newborn) patient?
    developmental dysplasia of hip (DDH)
  137. a degenerative joint disease
    osteoarthritis
  138. most common fracture in older patients because of high incidence of osteoporosis or avascular necrosis
    proximal hip fracture
  139. a malignant tumor of the cartilage of hip
    chondrosarcoma
  140. a disease producing extensive calcification of the longitudinal ligament of the spinal column
    ankylosing spondylitis
  141. a fracture resulting from a severe blow to one side of the pelvis
    pelvic ring fracture
  142. malignancy spread to bone via the circulatory and lymphatic systems or direct invasion
    matastatic carcinoma
  143. now referred to as developmental dysplasia of the hip
    congenital dislocation
  144. Where is the CR placed for an AP pelvis projection?
    midway between the ASIS and symphysis pubis
  145. Which specific positioning error is present when the left iliac wing is elongated on an AP pelvis radiograph?
    rotation toward left side
  146. Which specific positioning error is present when the left obturator foramen is more open than the right side on an AP pelvis radiograph?
    right rotation
  147. Trauma or Non trauma

    a. Danelius-Miller projection
    b. unilateral frog-leg
    c. modified Cleaves (bilateral frog-leg)
    d. Clements-Nakayama
    e. anterior pelvic bones
    • a. trauma
    • b. non trauma
    • c. non trauma
    • d. trauma
    • e. trauma
  148. Which projection is recommended to demonstrate the superoposterior wall of the acetabulum?
    PA axial oblique
  149. How many degrees are the femurs abducted (from the vertical plane) for the bilateral frog-leg projection?
    40 to 45 degrees
  150. Where is the CR placed for a unilateral frog-leg projection?
    midfemoral neck
  151. Where is the CR placed for an AP bilateral frog-leg projection?
    • 3" below level of ASIS
    • 1" superior to the symphysis pubis
  152. Which CR angle is required for the "outlet" projection (Taylor method) for a female patient?
    30 to 45 degrees cephalad
  153. Which type of pathologic feature is best demonstrated with the Judet method?
    acetabular fractures
  154. How much obliquity of the body is required for the Judet method?
    45 degrees
  155. What type of CR angle is used for a PA axial oblique (Teufel) projection?
    12 degrees cephalad
  156. How is the pelvis (body) positioned for a PA axial oblique (Teufel) projection?
    PA 35 to 40 degrees toward affected side
  157. How is the unaffected leg positioned for the axiolateral hip projection?
    flexed and elevated
  158. The modified axiolateral requires the CR to be angled __________ degrees posteriorly from horizontal.
    15 to 20
  159. Which special projection of the hip demonstrates the anterior and posterior rims of the acetabulum and the ilioischial and iliopubic columns?
    Posterior Oblique of Acetabulum (Judet method)
  160. What is the name of a special AP axial projection of the pelvis used to assess trauma to pubic and ischial structures?
    AP Axial Outlet Projection (Taylor method)
  161. Axiolateral (inferosuperior)
    Danelius-Miller
  162. modified axiolateral
    Clements-Nakayama
  163. bilateral or unilateral frog-leg
    modified Cleaves
  164. PA axial oblique for acetabulum
    Teufel
  165. AP axial for pelvic "outlet" bones
    Taylor
  166. posterior oblique for acetabulum
    Judet
  167. What is the optimal amount of hip abduction applied for the unilateral "frog-leg" projection to demonstrate the femoral neck without distortion?
    20 to 30 degrees from vertical
  168. How much is the IR tilted for the modified axiolateral projection of the hip?
    15 degrees from vertical
  169. A radiograph of an AP pelvis projection reveals that the lesser trochanters are readily demonstrated on the medial side of the proximal femurs. The patient is ambulatory but has a history of early osteoarthritis in both hips. Which positioning modification needs to be made to prevent this positioning error?
    rotate the lower limbs 15 to 20 degrees internally to place the proximal femurs in a true AP position
  170. A radiograph of an AP pelvis reveals that the right iliac wing is forshortened as compared with the left side. Which specific positioning error has been made?
    the patient is rotated toward the left - LPO
  171. A very young child comes to the radiology dept. with a clinical history of DDH. What is the most common positioning routine for this condition?
    AP pelvis & bilateral "frog-leg" projections

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