Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
RAD-Lower Extremes
RAD141 - Lower Extremities
| Question | Answer |
|---|---|
| Where should the flasher be positioned on all lower extremities? | heel should be placed towards flasher |
| What should be done if only a portion of a film will be used for an exposure? | the other part of the film should be blocked off with lead |
| What is proper collimation for foot projections? | include ankle |
| What film sizes s/b used for foot projections? | 1/2 of 10 x 12 for all, except use 8 x 10 for lateral |
| Where should the CR be positioned for foot projections? | base of 3rd metatarsal for AP and medial oblique; medial cuneiform (at level of base of 3rd metatarsal) for lateral; PIP or IP for lateral toe |
| Should a CR tube angle be used for foot projections? | the AP foot s/b 10 deg cephalic; the AP weight-bearing s/b 15 deg cephalic; for all other foot projections, the CR s/b perpendicular |
| How should the foot be rotated for a medial oblique foot? | normally, a mortise projection is required -> 15 deg medial rotation; a 45 deg medial rotation may sometimes be requested |
| How can you tell if the foot is rotated 15 deg medially? | if you can place one finger under the foot |
| Fot a lateral toe, when should medial rotation be used? Lateral rotation? | medial rotation for 1st-3rd digits; lateral rotation for 4th & 5th digits |
| For a lateral foot, what s/b done to ensure a true lateral position? | the knee s/b flexed 45 deg and slightly elevated, using sponge if necessary; plantar surface of foot s/b perpendicular to IR |
| In general, how should the foot be positioned for all foot/ankle projections? | if the ankle is included, foot s/b dorsiflexed (not for AP or oblique foot) |
| What foot projections are used to demonstrate the arches of the foot? | AP weight-bearing for horizontal; lateral weight-bearing for longitudinal arch |
| How should ankle projections be collimated? | should include base of 5th metatarsal |
| Where should the CR be directed for ankle projections? | for all but lateral, midway between the malleoli; for lateral, thru ankle joint, directed to medial malleolus |
| What should be done to confirm that a mortise ankle is properly aligned? | put fingers (or thumbs) on malleoli and check if parallel; s/b medially rotated 15 - 20 deg |
| When critiquing a lateral ankle image, what demonstrates proper positioning? | the malleoli s/b superimposed |
| When should a 45 deg medial oblique ankle be performed? | routinely for trauma; demonstrates distal fibula & tibia free of superimposition of talus |
| Which projections are routine for the foot? Supplementary? | routine foot -> AP, lateral, medial oblique (15 deg); supplementary -> lateral toe, 45 deg medial oblique, weight-bearing feet (lateral & AP) |
| Which projections are routine for the ankle? Supplementary? | routine ankle -> AP, lateral, mortise (15 deg medial oblique); supplementary --> 45 deg medial oblique (routine for trauma) |
| What are the 3 calcaneus projections? | lateral, axial tangential (plantodorsal), and posterior tangential (aka Harris Method) |
| Which fillm sizes are used for ankle projections? | 8 x 10 for single exposures; 1/2 of 10 x 12 for AP, mortise, or 45 deg oblique; 1/3 11 x 14 for AP |
| How is a lateral calcaneous performed? | foot and ankle in lateral position, centered to film; CR centered at the posterior 1/3 of foot; collimate to include junctions w/tarsal bones |
| How is the axial tangential (plantodorsal) calcaneus performed? | leg extended, ankle centered to film lengthwise; hyperflex ankle, using linen to ensure plantar surface is perpendicular to IR; angle tube 40 deg cephalic (to plane of foot) at posterior 1/3 of foot, level w/base of 5th metatarsal; inc technique |
| How is the posterior tangential calcaneus performed? | aka Harris method; patient erect, foot flat, calcaneus centered to cassette; patient takes small step w/unaffected foot; CR angled 45 deg anterior and enters at posterior aspect of flexed ankle and exits at base of 5th metatarsal |
| How should tib-fibs be collimated? | both the ankle and knee joints s/b included; if they don't both fit, make a clean break of one joint and get the other joint on a separate film |
| What film size s/b used for tib-fibs? | 7 x 17 or 1/2 14 x 17 |
| What are the routine tib-fib projections? supplementary? | routine tib-fib -> AP and lateral; supplementary -> medial & lateral obliques (45 deg) |
| Where should the CR be positioned for a tib-fib? Any angulation? SID? | CR is positioned perpendicular to the mid-point of the tib-fib; minimum SID is 40 inches |
| What is correct patient position for a tib-fib? | patient s/b supine w/leg extended for AP and obliques; on affected side w/knee flexed and patella perpendicular to film for a lateral; foot s/b dorsi-flexed for all tib-fibs |
| What do the medial and lateral tib-fib obliques demonstrate? | medial oblique demonstrates the proximal & distal tibiofibular articulations (max space seen between tib-fib); lateral demonstrates the tibial plateau |
| How should a lateral tib-fib be modified for trauma? | have 2 people raise the leg, building it up w/sheets; take cross-fire lateral using a horizontal CR |
| What are the routine projections for the knee? supplementary? | routine knee -> AP, lateral; supplementary -> medial & lateral oblique |
| How should knee projections be collimated? Should a tube angle be used? Film size? | collimation should include the distal femur and proximal tib-fib; tube s/b angles 5-7 deg cephalad; film size -> 10 x 12 |
| Where should the CR be positioned for knee projections? | 1/2 inch inferior to the apex of the patella for all but lateral; for lateral, 1 inch distal to medial epicondyle |
| How should the patient be positioned for AP & oblique knee projections? | supine w/leg extended & foot dorsiflexed; AP -> femoral condyles s/b parallel to IR & 15 deg medial rotation of foot; obliques -> leg s/b rotated 45 deg in requested direction |
| How should the patient be positioned for a lateral knee projection? | lateral recumbent on affected side; knee flexed 30 deg; patella perpendicular to film |
| What do the different knee projections demonstrate? | AP -> open tibiofemoral join space; lateral -> superimposed condyles, open joint space between patella & femur; medial oblique -> proximal tib-fib articulation (rotates fib away from tib); lateral oblique -> tibial plateau |
| What is another name for interchondyloid fossa projections? | tunnel-views |
| How should interchondyloid fossa projections be collimated? Where should the CR be pointed? | to include the distal femur and proximal tib-fib; CR s/b positioned at the joint space |
| What are the interchondyloid fossa methods and brief description for each? | Camp-Coventry -> prone, knees flexed to form 40 deg angle w/table; Holmblad -> hands & knees; Beclere -> AP projection onto curved cassette |
| Describe the Camp-Coventry Method: | a tunnel view of the knee with PA projection; patient prone, knee flexed to form 40 deg angle w/table (can be supported w/pillows or blankets); CR perpendicular to tib-fib -> 40 deg caudad |
| Describe the Holmblad Method: | patient on hands & knees w/film under affected knee; patient leans forward so femur forms a 70 deg angle from the table |
| Describe the Beclere Method: | patient supine, knee slightly bent; curved cassette placed under affected knee; CR perpendicular to long axis of tibia |
| What are the various patella projections? | PA, lateral, obliques, and Tangential (Settegast Method, Merchant Method, Hughston Method) |
| What film size s/b used for PA, lateral and oblique patella projections? for tangential? | PA, lateral, oblique -> 8 x 10, lengthwise; tangential -> either 8 x 10 crosswise, or 10 x 12 crosswise |
| How should patella projections be collimated? | to include the patella and knee joint |
| What is the SID for patella projections? | for all projections except Merchant, SID = 40 inches; Merchant Method is 48 - 72 inches |
| How should a patella projection be handled for a patient who cannot lie prone? | seat patient at table end w/knee flexed as much as possible; patient holds cassette firmly on femur , extending beyond the femur distally; CR perpendicular to joint space btw patella & femoral condyles, deg of angulation dependent on knee flexion |
| What is patient and CR position for a PA patella? | patient prone, legs extended, foot & knee medially rotated 5-10 deg; CR perpendicular to mid-popliteal area |
| What are patient and CR position for lateral patella? | patient in lateral recumbent position, affected side down; true lateral position (patella perpendicular to plane of IR); flex knee very slightly (5-10 deg); CR perpendicular, directed at mid-femoropatellar joint |
| What are patient and CR position for the Settegast method? What is the Settegast method used for? | Settegast -> tangential patella projection (sunrise/skyline); patient prone, knee flexed until patella is perpendicular to table; patient holds onto gauze/tape to maintain position; CR perpendicular, directed btw patella & femoral condyles |
| What is the patient position for Merchant Method? | patient supine, leg flexed 40 deg over the end of the table, feet resting on leg support; quadriceps muscle must be relaxed |
| What is the CR position and SID for the merchant method? | CR 30 deg caudad, positioned midway between patella (bilateral study); SID -> 48-72 inches |
| What are the patient and CR position for the Hughston method? | patient prone; knee flexed 50-60 deg (book has 45 deg); CR perpendicular, directed to midfemoropatellar joint |
| What are the femur projections? | AP and lateral |
| How should femur projections be collimated? | include knee joint; for AP projection, also include hip if possible; if not, include AP hip on a 10 x 12; if fracture is obvious, the joint closest to the fracture s/b on the 14 x 17 and the opposite joint on 10 x 12 |
| What are patient and CR position for an AP femur? | patient supine, legs extended; medially rotate foot 15 deg (for true AP projection of femoral neck); CR perpendicular thru mid-shaft |
| What are patient and CR position for a lateral femur? | lateral recumbent on affected side; patella perpendicular to IR; flex knee slightly; CR perpendicular thru mid-shaft |
| What must always be done with a lateral femur? | an axiolateral hip (on a 10 x 12 film) |
| What are the joints in the foot and what type are they? | all are synovial, diarthrodial; interphalangeal -> ginglymus (hinge); metatarsophalangeal -> modified ellipsoidal (condyloid); tarsometatarsal -> plane (glliding); intertarsal -> plane (gliding); ankle -> ginglymus (hinge) |
| What are the joints in the lower leg and knee and what types are they? | knee: femorotibial -> ginglymus (hinge) and patellofemoral -> sellar (saddle); proximal tibiofibular joint -> plane (gliding); distal tibiofibular -> fibrous, amphiarthrodial -> syndesmosis |
| What are the hip projections (non-trauma)? | AP and frogleg lateral (aka modified Cleaves Method - i.e. unilateral) |
| What size film is used for non-trauma hip projections? SID? Grid? | 10 x 12" film, with a grid; SID = 40 inches |
| What is patient and CR position for an AP hip? Are there any special instructions? | patient supine w/affected hip centered to the midpoint of the table; feet inverted 15 degrees; CR perpendicular; special instructions -> expiration |
| What anatomy must be present on an AP hip? | femoral head, neck, trochanters, and proximal third of the femoral shaft |
| What is the difference between a "true" Cleaves Method and the modified version we use in class? | a "true" Cleaves Method is a bilateral hip study; the modified Cleaves Method used in class is unilateral |
| What is the Lauenstein method? | the modified Cleaves Method (i.e. unilateral) with the femur parallel to the table |
| When are the Cleaves or Lauenstein methods used? | for non-trauma patients; mainly for arthritis |
| What is patient and CR position for a unilateral Frogleg Lateral hip? | patient supine, leg bent approx 90 deg, rotated out onto table; top of film between ASIS and iliac crest; CR perpendicular |
| What anatomy s/b present on a Frogleg lateral hip? | axial projection of the femoral head, neck, and trochanters |
| Where should the CR be directed for an AP hip? for a frogleg lateral hip (unilateral)? | AP hip -> 1-2 inches medial and 3-4 inches distal to the ASIS; frogleg -> in the crease of the leg, midway between the ASIS and pubic symphysis |
| What is patient position for a Bilateral frog-leg hip projection? | patient supine, arms crossed on chest; no pelvis rotation; center IR to CR at level of femoral heads, top of IR approx at level of iliac crest; flex both knees 90 deg; place plantar surfaces of feet together; abduct femurs 40-45 deg from vertical |
| In a bilateral frog-leg hip projection, how do you ensure that the pelvis is not rotated? | there should be equal distance of ASISs to tabletop |
| Where is CR directed for a frog-leg bilateral hip? Any angulation? | CR is perpendicular to IR, to a point 3 inches below level of ASIS (i.e. 1 inch above symphysis pubis |
| What film size s/b used for Cleaves Method hip? SID? grid? | 10 x 12" w/grid; 40" SID |
| When is the axiolateral hip - crossfire projection done? | for hip trauma |
| What is patient position for an axiolateral hip - cross-fire; | patient supine, hands resting on upper chest; elevate entire pelvis; flex the unaffected leg up & out of the way |
| Where should the CR be directed for an axiolateral hip - cross-fire? | draw imaginary line from ASIS to symphysis pubis and draw a point at the center of that line; mark one inch distal to the most prominent portion of the greater trochanter; draw a line connecting these 2 points & mark its center -> aim CR here |
| For an axiolateral hip, crossfire, how should the CR be angled? Where should the film be? | the CR s/b perpendicular (horizontal) to the hip join with the grid and cassette perpendicular to the table centered to the centering mark |
| What anatomy s/b demonstrated on an axiolateral hip - crossfire? | the femoral head, neck, and trochanters; as much of the femoral neck s/b seen as possible; the acetabulum s/b seen; any orthopedicu device s/b included in its entirety (may need to use a 14 x 17) |
Created by:
debmurph
Popular Biology sets