Chapter 6 Radiographic Positioning

Helpfulness: 0
Set Details Share
created 5 years ago by rachelcunningham
888 views
Chapter 6 Lower leg, Ankle, and knee
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

1. The three bones of the ankle form a deep socket into which the talus fits. The socket is called the?

ankle mortise

2

2. The distal tibial joint surface forming the roof of the distal ankle joint is called the?

Tibial plafond

3

3. The medial malleolus is approximately 1/2 inch posterior to the lateral malleolus.

False

4

4. The ankle joint is classifies as a synovial joint with _________ type of movement.

sellar

5

5. The ___ is the weight-bearing bone of the lower leg.

Tibia

6

6. 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 of to determine possible rotation of a lateral knee?

Adductor tubercle

7

7. What is the name of the large prominence located on the midanterior surface of the proximal tibia that serves as an attachment for the patellar tendon?

Tibial tuberosity

8

8. A small, triangular depression located on the tibia that helps form the distal tibiofibular joint is called the?

Fibular notch

9

9. The articular facets of the proximal tibia are also referred to as the?

tibial plateau

10

10. The articular facets slope is ____ posteriorly

10 to 15

11

11. The most proximal aspect of the fibula is the

Apex of styloid process

12

12. The extreme distal end of the fibula forms the

lateral malleolus

13

13. Largest sesamoid bone in the body?

Patella

14

14. What are two other names for the patellar surface of the femur?

Intercondylar sulcus and trochlear groove.

15

15. What is the name of the depression located on the posterior aspect of the distal femur?

Intercondylar notch

16

16. Why must the central ray be angled 5 degrees to 7 degrees cephalad for a lateral knee projection.

Because the medial condyle extends lower than the lateral condyle of the femur.

17

17. The slightly raised area located on the posterolateral aspect of the medial femoral condyle is called

Adductor tubercle

18

18. What are the palpable bony landmarks found on the distal femur?

Medial epicondyle and lateral epicondyle

19

19. The general region of the posterior knee is called?

Popliteal region

20

20.True or false. Flexion of 20 degrees of the knee forces the patella firmly against the patellar surface of the femur

false

21

21. True or False: The patella acts like a pivot to increase the leverage of a large muscle found in the anterior thigh.

True

22

22. True or False: The posterior surface of the patella is normally rough

false

23

23. For which large muscle does the patella serve as a pivot to increase the leverage

Quadriceps femoris muscle

24

24. Between the patella and distal femur is what joint

patella femoral

25

25. Between the two condyles of the femur and tibia is what joint

femorotibial

26

26. Four major ligaments of the knee

Fibular collateral, Tibial collateral, Anterior cruciate, posterior cruciate.

27

27. The crescent-shaped fibrocartilage disks that act as shock absorbers in the knee joint are called

medial and lateral menisci

28

28. Two bursa that are found in the knee joint

Suprapatellar and infrapatellar bursa

29

29. Match the following to the correct bone: tibial plafond

Tibia

30

30. Match the following to the correct bone: medial malleolus

Tibia

31

31. Match the following to the correct bone: lateral epicondyle

Distal femur

32

32. Match the following to the correct bone: Patellar surface

Distal femur

33

33. Match the following to the correct bone: articular facets

Tibia

34

34. Match the following to the correct bone: fibular notch

Tibia

35

35. Match the following to the correct bone: styloid process

Fibula

36

36. Match the following to the correct bone: base

Patella

37

37. Match the following to the correct bone: Intercondyloid eminence

Tibia

38

38. Match the following to the correct bone: Neck

Fibula

39

39. Match the following articulations to the correct joint classification or movement type: Ankle Joint

Sellar (saddle)

40

40. Match the following articulations to the correct joint classification or movement type: Patellofemoral

Sellar (saddle)

41

41. Match the following articulations to the correct joint classification or movement type: Proximal tibiofibular

Plane (gliding)

42

42. Match the following articulations to the correct joint classification or movement type: Knee joint

Bicondylar

43

43. Match the following articulations to the correct joint classification or movement type: Distal tibiofibular

Amphiarthrodial (syndesmosis type)

44

44. True or false: The recommendation SID for lower limb radiography is 40 ich

True

45

45. True or false: Multiple images can be placed on the same IR when using analog imaging systems.

True

46

46. T or F: with careful and close collimation, gonadal shielding does not have to be used during lower limb radiography.

False

47

47. T or F: A kV range between 50 and 70 should be used for analog lower limb radiography.

True

48

48. T or F: A kV range for digital imaging is typically lower as compared with film-screen ranges.

False

49

49. Osgood-schlatter disease

An inflammatory condition involving the anterior, proximal tibia

50

50. Also known as osteitis deformans

Paget's disease

51

51. Malignant tumor of the cartilage

chondroscarcoma

52

52. Inherited type of arthritis that commonly affects males

Gout

53

53. Benign, neoplastic bone lesion caused by overproduction of bone at a joint

Exostosis

54

54. Benign bone lesion usually developing in teens or young adults

Osteoid osteoma

55

55. Most prevalent primary bone malignancy in pediatric patients

Ewing's sarcoma

56

56. Benign, neoplastic bone lesion located between the base of the first and second metatarsal

Lisfranc joint injury

57

57. condition affecting the sacroiliac joints and lower limbs of young men, especially the posterosuperior margin of the calcaneus

Reiter's syndrome

58

58. Former name for runners knee

Chondromalacia patella

59

59. Another term for osteomalacia

Ricketts

60

60. Asymmetric erosion of joint spaces with a calcaneal erosion

Reiter's syndrome

61

61. Uric acid deposits in joint spaces

Gout

62

62. Well-circumscribed lucency

Bone cyst

63

63. Small, round/oval density with lucent center

osteoid osteoma

64

64. Narrowed, irregular joint surfaces with sclerotic articular surfaces

Osteoarthritis

65

65. Fragmentation or detachment of the tibial tuberosity

Osgood-Schlatter disease

66

66. Ill-defined area of bone destruction with surronding "onion peel"

Ewing's sarcoma

67

67. Decreased bone density and bowing deformities of weight-bearing limbs

Osteomalacia

68

68. Which calcaneal structure should appear medially on a well-positioned plantodorsal axial projection?

Sustentaculum tali

69

69. Where is the central ray placed for a mediolateral projection of the calcaneus?

1 inch inferior to medial malleolus

70

70. Which joint surface of the ankle is not typically visualized with a correctly positioned AP projection of the ankle

lateral surface of the joint

71

71. Why should AP, 45 oblique, and lateral ankle radiographs include the proximal metatarsals

To demonstrate a possible fracture of the fifth metatarsal tuberosity (a common fracture site)

72

72. How much if any should the foot and ankle be rotated for an AP mortise projection of the ankle?

15 - 20 medially

73

73. Which projection of the ankle best demonstrates a possible fracture of the lateral malleolus

AP oblique with 45 medial rotation

74

74. With a true lateral projection of the ankle, the lateral malleolus is

projected over the posterior aspect of the distal tibia

75

75. Which projections of the ankle require forced inversion and eversion movements

AP stress projections

76

76. What is the basic positioning routine for a study of the tibia and fibula

AP and lateral

77

77. Why is it important to include the knee joint for an initial study of tibia trauma, even if the patient's symptoms involve the middle and distal aspect

A fracture may also be present at the proximal fibula in addition to distal

78

78. To include both joints for a lateral projection of the tibia and fibula for an adult, the technologist may place the cassette _____ in relation to the part.

Diagonal

79

79. What is the recommended central ray angulation for an AP projection of the knee for a patient with thick thighs and buttocks ( greater than 24 cm)

3 to 5 degrees caudad

80

80. Where is the central ray centered for an AP projection of the knee?

1/2 inch distal to apex of patella

81

81. Which basic projection of a knee best demonstrates the proximal fibula free of superimposition

AP oblique, 45 degrees medial rotation

82

82. For the AP oblique projection of the knee, the ____ rotation best visualizes the lateral condyle of the tibia and the head and neck of the fibula

medial

83

83. What is the recommended central ray placement for a lateral knee position on a tall, slender male patient with a narrow pelvis (without support of the lower leg)

5 degree cephalad

84

84. How much flexion is recommended for a lateral projection of the knee

20 - 30 degrees

85

85. Which positioning error is present if the posterior portions of the femoral condyles are not superimposed on a radiograph of a lateral knee on a average patient

Improper angle of CR

86

86. Which positioning error is present if the posterior portion of the femoral condyles are not superimposed on a lateral knee radiograph

Over rotation (towards IR) or under rotation of knee (away from IR)

87

87. Which anatomic structures of the femur can be used to determine which rotation error (over rotated or under rotated) is present on a slightly rotated lateral knee radiograph?

Adductor tubercle on posterior lateral aspect of medial femoral condyle

88

88. Which special projection of the knee best evaluates the knee joint for cartilage degeneration or deformities?

AP or PA weight bearing knee

89

89. What is the best modality to examine ligament injuries to the knee

MRI

90

90. Which special projections of the knee best demonstrates the intercondylar fossa?

Holmblad

91

91. How much flexion of the lower leg is required for the PA axial projection (camp-Coventry method) when the central ray is angled 40 degrees caudad

40 degree flexion

92

92. Why is the PA axial projection for the intercondylar fossa recommended instead of an AP axial projection?

Distortion caused by central ray angle and increased OID for AP axial projection.

93

93. What type of CR angulation is required for the PA axial weight-bearing projection (Rosenberg method)

10 degrees caudad

94

94. How much flexion of the knees is required for the PA axial weight-bearing projection (Rosenberg method)

45 degrees

95

95. How much knee flexion is required for the PA axial projection (Holmblad method)

60-70 degrees

96

96. What type of CR angle is required for the PA axial (Holmblad method)

None. CR is perpendicular to IR

97

97. T or F: To place the interepicondylar line parallel to the IR for a PA projection of the patella, the lower limb must be rotated approximately 5 degrees internally.

True

98

98. How much part flexion is recommended for a lateral projection of the patella

5-10 degrees

99

99. How much central ray angle from the long axis of the femora is required for a tangential (merchant method) bilateral projection

30 degrees from horizontal

100

100. How much part flexion is required for the (Hughston method)

55 degrees

101

101. How much part flexion is required for the (Settegast method)

90 degrees

102

102. What type of CR angle is required for the superoinferior sitting tangential method for the patella?

None. CR is perpendicular to IR

103

103. Knee projection that can be performed using a wheelchair or lowered radiographic table

Holmblad method

104

104. Knee projection with the patient prone; requires 90 knee flexion

Settegast method

105

105. Knee projection with patient prone with 40 to 50 degree knee flexion and with equal 40 to 50 degree caudad CR angle

Camp Coventry method

106

106. Knee projection when the IR is placed on a footstool to minimize OID

Hobbs modification

107

107. Knee projection with the patient prone with 55 degree knee flexion and 15 degree to 20 degree CR angle from long axis of lower leg.

Hughston method

108

108. Knee projection with patient supine with cassette resting on midthighs

Inferosuperior for patellofemoral joint

109

109. Knee projection with patient supine with 40 degree knee flexion and with 30 degree caudad CR angle from horizontal

Merchant method

110

110. Which of the following special projections of the knee must be performed erect.

Rosenberg method

Settegast method

Camp-Coventry method

Hughston Method

Resenburg method

111

111. How much knee flexion is required for the horizontal beam lateral patella projection

None

112

112. A lateral knee radiograph that is overrotated toward the image receptor can be recognized by what?

The fibular head will appear less superimposed by the tibia than a true lateral.

113

113.What CR angle should be used for a lateral projection of the knee on a short, wide-pelvis patient

7-10 degrees cephalad

114

114. Which special position of the knee requires that the patient be placed supine with 40° flexion of knee with CR angled 30 degrees from long axis of femur?

bilateral merchant method

115

115. The posterior visibility of the adductor tubercle on a lateral knee projection indicates:

underrotation of knee toward the IR.

116

116. Situation: A radiograph of a lateral projection of the patella reveals that the femoropatellar joint space is not open. The patella is within the intercondylar sulcus. The most likely cause of this is:

excessive flexion of knee

117

117. Situation: A radiograph of an AP knee reveals rotation with almost total superimposition of the fibular head and the proximal tibia. What must the technologist do to correct this positioning error on the repeat exposure?

rotate knee slightly medial

118

118. Situation: A radiograph of a PA axial projection for the intercondylar fossa does not demonstrate the fossa well. It is foreshortened. The following positioning factors were used: patient prone, knee flexed 40 to 45, CR angled to be perpendicular to the femur, 40-inch SID, and no rotation of the lower limb. Based on the factors used, what changes need to be made to produce a more diagnostic image?

CR must be perpendicular to lower leg

119

119. Situation: A radiograph of a AP mortise projection of the ankle reveals that the lateral malleolus is slightly superimposed over the talus and the lateral joint space is not open. What is most likely the cause for this radiographic outcome?

insufficient medial rotation of foot and ankle

120

120. Situation: A patient comes to radiology with a clinical history of osteoarthritis of both knees. The referring physician wants a projection to evaluate the damage to the articular facets. Which of the following projections will provide the best image of this region of the knee?

PA axial weight-bearing bilateral knee projection (Rosenberg method)

121

121. Situation: A geriatric patient comes to the radiology department for a study of the knee. The patient is unsteady and unsure of himself. Which intercondylar fossa projection would provide the best results without risk of injury to the patient?

camp-coventry method

122

122. Situation: A patient comes to radiology with a history of chondromalacia of the patella. Her physician orders a projection of the patellofemoral joint space. Due to advanced emphysema, the patient cannot lie recumbent for this projection. Which of the following projections would be best for this patient?

Superoinferior sitting tangential method

123

123. For the AP weight-bearing knee projection on an average patient, the CR should be:

perpendicular to image receptor

124

124. Which of the following projections of the patella requires the patient to be placed in a prone position, a 45° flexion of the knee, and a 15° to 20° angle of the CR?

hughston method

125

125. Which of the following knee projection requires the use of a special IR holding device?

bilateral merchant method