chapter 6 and 7

How many tarsal bones are in the foot?

7

How many bones are in the foot?

26

Which metatarsal bone of the foot has a prominent tuberosity frequently fractured?

a. Fifth

b. Third

c. Fourth

d. First

a. Fifth

Which term describes the top or anterior surface of the foot?

a. Dorsal

b. Ventral

c. Plantar

d. Dorsal

d. Dorsal

Where would the interphalangeal joint be found in the foot?

a. Between any of the metatarsals and phalanges

b. Between the tarsal bones and phalanges

c. Between the phalanges of the second through fifth digits

d. Between the proximal and distal phalanges of the first digit

d. Between the proximal and distal phalanges of the first digit

Which structure or bone contains the sustentaculum tali?

a. Tibia

b. Base of the fifth metatarsal

c. Calcaneus

d. Talus

c. Calcaneus

How many articular facets make up the subtalar joint?

a. One

b. Two

c. Three

d. Four

c. Three

What are the two arches of the foot?

a. Anterior and longitudinal

b. Longitudinal and transverse

c. Transverse and anterior

d. Instep and cross-step

b. Longitudinal and transverse

The medial malleolus is part of the:

a. talus

b. calcaneus

c. fibula

d. tibia

d. tibia

The ankle joint is a ____ joint with a ____ type of movement.

a. fibrous; plane

b. synovial; sellar

c. fibrous; ginglymus

d. synovial; ginglymus

b. synovial; sellar

Another term for the intercondylar sulcus is the:

a. articular facets

b. patellar surface

c. femoropatellar joint space

d. intercondylar recess

b. patellar surface

T/F: The patella is drawn into the intercondylar sulcus when the knee is overextended.

False

A tear of the tibial (medial) collateral ligament (MCL) caused by a trauma injury is frequently associated with tears of the:

a. anterior cruciate ligament (ACL) and the medial meniscus

b. posterior cruciate ligament (PCL) and the lateral meniscus

c. fibular lateral collateral ligament (LCL) and the patella ligament

d. none of the above

a. anterior cruciate ligament (ACL) and the medial meniscus

Saclike structures found in the knee joint that allow smooth articulation between ligaments and tendons are called:

a. bursa

b. menisci

c. synovial membranes

d. synovial bodies

a. bursa

To decrease the angle between the anterior surface of the foot and anterior surface of the lower leg is described as:

a. plantar flexion

b. inversion

c. dorsiflexion

d. eversion

c. dorsiflexion

The patellofemoral joint is a ____ joint with a ____ type of movement.

a. synovial; ginglymus

b. fibrous; immovable

c. synovial; sellar

d. synovial; bicondylar

c. synovial; sellar

Which tendon attaches directly to the tibial tuberosity?

a. Patellar

b. Quadriceps

c. Soleus

d. Collateral

a. Patellar

The calcaneus articulates with the talus and the:

a. cuboid

b. navicular

c. medial cuneiform

d. lateral cuneiform

a. cuboid

A radiographic appearance of a highly malignant and extensively destructive lesion that usually occurs in long bones and produces a sunburst pattern describes:

a. an osteomalacia

b. an osteogenic sarcoma

c. an osteoclastoma

d. Reiter syndrome

b. an osteogenic sarcoma

The radiographic appearance of a well-circumscribed lucency within bones describes:

a. Gout

b. Ewing's sarcoma

c. Bone cyst

d. Osgood-Schlatter disease

c. Bone cyst

The best method of evaluating injuries to the menisci and ligaments of the knee joint involves:

a. stress views of the knee.

b. anteroposterior (AP), AP oblique, and lateral projections of the knee.

c. intercondylar fossa projections.

d. a magnetic resonance imaging (MRI) procedure.

d. a magnetic resonance imaging (MRI) procedure.

T/F: The adductor tubercle is located on the posterior aspect of the medial femoral condyle.

True

The distal tibiofibular joint is classified as a _____ joint.

a. synovial

b. fibrous

c. diarthrodial

d. synarthrodial

b. fibrous

Which of the following joints is a modified ellipsoidal or condyloid joint?

a. Tarsometatarsal

b. Metatarsophalangeal

c. Proximal tibiofibular

d. Intertarsal

b. Metatarsophalangeal

Extending the ankle joint or pointing the foot and toes downward is called:

a. dorsiflexion

b. inversion

c. eversion

d. plantar flexion

d. plantar flexion

How much central ray (CR) angulation (if any) should be used for an AP projection of the toes?

a. Keep CR perpendicular to IR

b. 5 degrees toward calcaneus

c. 10 to 15 degrees toward calcaneus

d. 20 to 25 degrees toward calcaneus

c. 10 to 15 degrees toward calcaneus

Which of the following routines should be performed for a study of the second toe?

a. AP, AP oblique with lateral rotation, mediolateral projection

b. AP, AP oblique with medial rotation, lateromedial projection

c. AP, AP oblique with lateral rotation, lateromedial projection

d. AP, AP oblique with medial rotation, mediolateral projection

b. AP, AP oblique with medial rotation, lateromedial projection

How much is the foot dorsiflexed with the tangential projection for the sesamoid bones if the CR remains perpendicular to the image receptor?

a. 15 to 20 degrees from vertical

b. No flexion of foot is required.

c. 5 to 7 degrees from vertical

d. 30 to 45 degrees from vertical

a. 15 to 20 degrees from vertical

A lateral knee radiograph that is overrotated toward the image receptor can be recognized by which of the following?

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

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

c. The medial condyle of femur will appear more posterior

d. Both A and C are correct

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

To properly visualize the joint spaces with the AP projection of the foot, the CR must be:

a. parallel to the longitudinal arch.

b. perpendicular to the metatarsals.

c. perpendicular to the longitudinal arch.

d. parallel to the metatarsals.

b. perpendicular to the metatarsals.

Which position of the foot will best demonstrate the lateral (third) cuneiform?

a. AP oblique with medial rotation

b. AP oblique with lateral rotation

c. AP projection

d. Mediolateral projection

a. AP oblique with medial rotation

What is one advantage of the lateromedial projection of the foot?

a. It is more comfortable for the patient.

b. It better demonstrates the intertarsal joints.

c. The foot assumes a more true lateral position.

d. It opens up the subtalar joint.

c. The foot assumes a more true lateral position.

What CR angulation is required for the AP oblique projection of the foot?

a. CR is perpendicular to the image receptor.

b. 10 degrees posterior

c. 15 to 20 degrees posterior

d. 5 to 7 degrees posterior

a. CR is perpendicular to the image receptor.

How much CR angulation to the long axis of the foot is required for the plantodorsal (axial) projection of the calcaneus?

a. 45 to 50 degrees

b. 15 to 20 degrees

c. 30 to 35 degrees

d. 40 degrees

d. 40 degrees

Where is the CR placed for a mediolateral projection of the calcaneus?

a. Base of the fifth metatarsal

b. Trochlear process

c. Base of the third metatarsal

d. 1 inch (2.5 cm) inferior to medial malleolus

d. 1 inch (2.5 cm) inferior to medial malleolus

Which joint surfaces of the ankle joint are open with an AP projection of the ankle?

a. Medial and superior

b. Lateral and medial

c. Superior and lateral

d. Medial, superior, and lateral

a. Medial and superior

How much rotation from an AP position of the ankle will typically produce an AP mortise projection?

a. No rotation is necessary.

b. 45 degrees

c. 15 to 20 degrees

d. 25 to 30 degrees

c. 15 to 20 degrees

Which of the following projections of the ankle will best demonstrate the open joint space of the lateral aspect of the ankle joint?

a. AP oblique with 45 degree rotation

b. AP mortise projection

c. Lateromedial ankle

d. AP projection

c. Lateromedial ankle

The purpose of the AP stress views of the ankle is to demonstrate:

a. possible stress fractures

b. possible joint separations or ligament tear

c. loose bodies in ankle joint

d. tears in the joint meniscus

b. possible joint separations or ligament tear

To ensure that both joints are included on an AP projection of the tibia and fibula on an adult, the technologist should:

a. increase the SID to 60 inches (150 cm)

b. use a Bucky tray

c. turn the image receptor diagonally

d. use a tabletop technique

c. turn the image receptor diagonally

What CR angulation is required for an AP projection of the knee on a patient with an ASIS-to-tabletop measurement of 18 cm?

a. 3 to 5 degree caudad

b. CR is perpendicular to the IR.

c. 3 to 5 degree cephalad

d. 10 to 15 degree cephalad

a. 3 to 5 degree caudad

Which projection of the knee will best demonstrate the neck of the fibula without superimposition?

a. AP

b. Lateral

c. AP oblique with medial rotation

d. AP oblique with lateral rotation

c. AP oblique with medial rotation

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

a. No CR angle is required.

b. 5 degree cephalad

c. 7 to 10 degree cephalad

d. 5 to 10 degree caudad

c. 7 to 10 degree cephalad

What is the major disadvantage of using 45 degree of flexion for the mediolateral projection of the knee?

a. Draws the patella into the intercondylar sulcus

b. Possible injury to the anterior cruciate ligament

c. Prevents superimposition of the distal aspect of the femoral condyles

d. Can distort any visible fat pads

a. Draws the patella into the intercondylar sulcus

T/F: The superoinferior, tangential (Hobbs modification) projection requires a CR angle of 5 to 10 degree posterior.

False

T/F: The AP mortise projection of the ankle is commonly taken in surgery during open reductions.

True

T/F: Follow-up radiographs for a fractured tibia and fibula may include only the joint closest to the site of injury.

True

What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)?

a. 10 degree caudad

b. 5 to 7 degree cephalad

c. 20 to 25 degree caudad

d. None; CR is perpendicular to IR

a. 10 degree caudad

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

a. Bilateral Merchant method

b. PA axial, Camp-Coventry method

c. PA axial, Holmblad method

d. Tangential, Hughston method

a. Bilateral Merchant method

How much flexion of the knee is recommended for the lateral projection of the patella?

a. 5 to 10 degrees or less

b. 20 to 30 degrees

c. 35 to 40 degrees

d. 45 to 50 degrees

a. 5 to 10 degrees or less

What is the recommended SID for the superoinferior sitting tangential (Hobbs modification) method?

a. 30 inches (77 cm)

b. 40 inches (102 cm)

c. 48 to 50 inches (123 to 128 cm)

d. 72 inches (183 cm)

c. 48 to 50 inches (123 to 128 cm)

A radiograph of an AP projection of the second toe reveals that the interphalangeal joints are not open. What is the most likely cause for this radiographic outcome?

a. Rotation of the toes

b. Excessive SID was used

c. AP projection was made; should have performed the PA projection

d. Incorrect CR centering or angle

...d. incorrect CR centering or angle

A radiograph of an AP medial oblique projection of the foot, if positioned correctly, should demonstrate:

a. first through fifth metatarsals free of superimposition

b. third through fifth metatarsals free of superimposition

c. first and second cuneiform joint space is open

d. CR is centered to midshaft of third metatarsal

b. third through fifth metatarsals free of superimposition

A radiograph of an AP ankle projection reveals that the lateral joint space is not open (lateral malleolus is partially superimposed by the talus). The superior and medial joint spaces are open. What should the technologist do to correct this problem and improve the image?

a. Rotate the ankle more laterally

b. Rotate the ankle more medially

c. Nothing; this is an acceptable image

d. Dorsiflex the foot

c. Nothing; this is an acceptable image

T/F: The adductor tubercle is present on the medial, posterior aspect of the femoral condyle and can be used to determine possible rotation of a lateral knee projection.

True

The profile appearance of the adductor tubercle and excessive superimposition of the fibular head and neck on a lateral knee projection indicate:

a. over-rotation of the knee toward the IR.

b. under-rotation of the knee toward the IR.

c. a true lateral knee.

d. the CR should be angled 5 to 7 degrees cephalad.

b. under-rotation of the knee toward the IR.

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:

a. excessive extension of the knee

b. excessive angulation of the CR

c. insufficient angulation of the CR

d. excessive flexion of the knee

d. excessive flexion of the knee

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?

a. Rotate the knee laterally slightly

b. Rotate the knee medially slightly

c. Angle the CR slightly more cephalad

d. Nothing; this is an acceptable image

b. Rotate the knee medially slightly

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 degrees, CR angled to be perpendicular to the femur, 40-inch SID, and no rotation of the lower limb. On the basis of the factors used, what changes need to be made to produce a more diagnostic image?

a. Increase SID to at least 48 inches (123 cm).

b. CR must be perpendicular to lower leg.

c. Rotate lower extremity 10 degree medially.

d. Reduce flexion of the knee to 20 to 30 degrees.

b. CR must be perpendicular to lower leg.

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?

a. Excessive medial rotation of the foot and ankle

b. Insufficient medial rotation of the foot and ankle

c. Excessive plantar flexion of the foot and ankle

d. Excessive dorsiflexion of the foot and ankle

b. Insufficient medial rotation of the foot and ankle

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?

a. Tangential projection (Hughston method)

b. AP axial projection (Béclere method)

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

d. Tangential projection (Settegast Method)

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

T/F: A 3 to 5 degree caudad CR angle should be used for an AP knee projection for patients with an ASIS-to-tabletop measurement of 20 cm.

False

T/F: The correct CR placement for an AP projection of the knee is mid-patella

False

T/F: The tangential projection for the sesamoid bones of the foot should be performed with the patient prone rather than supine to minimize image magnification, if the patient condition allows it.

True

T/F: The foot must be dorsiflexed so that the long axis of the foot is perpendicular to the image receptor for AP and mortise projections of the ankle.

False

T/F: A correctly positioned lateral ankle will demonstrate the lateral malleolus superimposed over the posterior half of the tibia.

True

For the AP weight-bearing feet projection, the CR should be:

a. perpendicular to the image receptor

b. angled 15 degree posteriorly

c. directed horizontal

d. angled 5 degree posteriorly

b. angled 15 degree posteriorly.

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

a. 10 degree caudad

b. 5 to 10 degree cephalad

c. perpendicular to the image receptor

d. CR perpendicular to the image receptor but increase SID to 60 inches (153 cm)

c. perpendicular to the image receptor

A radiograph of an AP oblique foot with medial rotation demonstrates considerable superimposition of the third through fifth metatarsals. How must the original position be changed to eliminate this problem?

a. Increase obliquity of the foot

b. Decrease obliquity of the foot

c. Increase CR angle

d. Decrease CR angle

b. Decrease obliquity of the foot.

T/F: Another term for osteomalacia is rickets.

True

The radiographic hallmark of Reiter's syndrome seen in young men is:

a. erosion of the articular facets.

b. destruction of the patella.

c. fluid in the joints of the foot.

d. erosion of the Achilles tendon insertion.

d. erosion of the Achilles tendon insertion.

Another term for osteochondroma is:

a. Ewing's sarcoma

b. Exostosis

c. Gout

d. Osgood-Schlatter disease

b. Exostosis

Which of the following projections of the patella requires the patient to be placed in a prone position, a 55 degree flexion of the knee, and a 15 to 20 degree angle of the CR?

a. Merchant method

b. Settegast method

c. Hughston method

d. Holmblad method

c. Hughston method

Which of the following knee projections requires the use of a special IR holding device?

a. Bilateral Merchant method

b. Camp-Coventry method

c. Béclere method

d. Hughston method

a. Bilateral Merchant method

How much knee flexion is required for the weight-bearing PA axial projection (Rosenberg method) of the knee?

a. None; the knee is fully extended.

b. 30 degree flexion

c. 45 degree flexion

d. 50 to 60 degree flexion

c. 45 degree flexion

Which of the following structures is not an aspect of the proximal femur?

a. Intertrochanteric crest

b. Fovea capitis

c. Obturator foramen

d. Lesser trochanter

c. Obturator foramen

Which of the following structures is considered to be most inferior or distal?

a. Fovea capitis

b. Lesser trochanter

c. Neck

d. Greater trochanter

b. Lesser trochanter

Why must the lower limb be rotated 15 to 20 degrees internally for AP hip projections?

a. To separate the greater trochanter from the lesser trochanter

b. To place the fovea capitis into a profiled position

c. To open up the femoroacetabular joint

d. To place the femoral neck parallel to the image receptor

d. To place the femoral neck parallel to the image receptor

Which bones fuse to form the acetabulum?

a. Ischium and pubis

b. Ilium and ischium

c. Pubis, ilium, and sacrum

d. Ischium, pubis, and ilium

d. Ischium, pubis, and ilium

Which of the following bony structures cannot be palpated?

a. Ischial spine

b. ASIS

c. Ischial tuberosity

d. Symphysis pubis

a. Ischial spine

Which bone of the pelvic girdle forms the anterior inferior aspect?

a. Ilium

b. Ischium

c. Pubis

d. Sacrum

c. Pubis

The lesser sciatic notch is an aspect of the:

a. ilium

b. ischium

c. sacrum

d. pubis

b. ischium

The sacroiliac joints are classified as ____ joints with ____ mobility.

a. cartilaginous; amphiarthrodial

b. synovial; amphiarthrodial

c. cartilaginous; synarthrodial

d. fibrous; amphiarthrodial

b. synovial; amphiarthrodial

The symphysis pubis provides limited movement during pelvic trauma and during:

a. walking and running

b. flexing and extending

c. labor and delivery

d. voiding

c. labor and delivery

The two bony landmarks that are palpated using the hip localization method are the:

a. Ischial spine and the symphysis pubis.

b. Symphysis pubis and the greater trochanter.

c. ASIS and the crest of ilium.

d. ASIS and the symphysis pubis.

d. ASIS and the symphysis pubis.

Using the hip localization method, the femoral head can be located:

a. 1 inch (2.5 cm) below the midpoint of the imaginary line between the two bony landmarks

b. 1 1/2 inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks

c. 2 1/2 inches (6 to 7 cm) below the midpoint of the imaginary line between the two bony landmarks

d. at the level of the symphysis pubis.

b. 1 1/2 inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks

Select the correct gender to correspond with the following pelvic characteristics. More oval or heart-shaped pelvic inlet:

a. Male

b. Female

a. Male

Select the correct gender to correspond with the following pelvic characteristics. Wider and shallow general shape of pelvis:

a. Male

b. Female

b. Female

Select the correct gender to correspond with the following pelvic characteristics. Obtuse angle of pubic arch:

a. Male

b. Female

b. Female

Select the correct gender to correspond with the following pelvic characteristics. Round and large pelvic inlet:

a. Male

b. Female

b. Female

Select the correct gender to correspond with the following pelvic characteristics. Narrower, deeper general shape of pelvis:

a. Male

b. Female

a. Male

Select the correct gender to correspond with the following pelvic characteristics. Acute angle of pubic arch:

a. Male

b. Female

a. Male

Gonadal shielding of the male patient for the AP pelvis projection requires that the top of the shield is not extend above the level of the:

a. ASIS

b. ischial spine

c. inferior margin of the symphysis pubis

d. none of the above; gonadal shielding cannot be used due to possible covering of pertinent anatomy

c. inferior margin of the symphysis pubis

A common condition of the femur that develops in elderly patients, leading to frequent fractures of the hip (proximal femur):

a. Congenital hip dysplasia.

b. Legg-Calvé-Perthes disease

c. Avascular necrosis

d. Developmental dysplasia of the hip

c. Avascular necrosis

Which of the following conditions will produce the radiographic sign referred to as "bamboo spine"?

a. Osteoarthritis

b. Chondrosarcoma

c. Metastatic carcinoma

d. Ankylosing spondylitis

d. Ankylosing spondylitis

Which of the following pathologic conditions often occurs in males older than the age of 45 years?

a. Developmental dysplasia of the hip

b. Slipped capital femoral epiphysis

c. Chondrosarcoma

d. Osteoporosis

c. Chondrosarcoma

Which of the following pathologic conditions is a common type of aseptic or ischemic necrosis?

a. Legg-Calvé-Perthes disease

b. Ankylosing spondylitis

c. Metastatic carcinoma

d. Osteoarthritis

a. Legg-Calvé-Perthes disease

Which of the following conditions will produce shortening of the epiphyses but widening of the epiphyseal plate?

a. Osteoarthritis

b. Legg-Calvé-Perthes disease

c. Slipped capital femur

d. Chondrosarcoma

c. Slipped capital femur

Where is the CR placed for an AP projection of the pelvis?

a. 1 inch (2.5 cm) above the symphysis pubis

b. At the level of the ASIS

c. At the level of the iliac crest

d. Midway between the ASIS and the symphysis pubis

d. Midway between the ASIS and the symphysis pubis

What is the amount of abduction of the femurs recommended for an AP bilateral frog-leg projection?

a. 10 to 15 degrees

b. 50 to 60 degrees

c. 40 to 45 degrees

d. 90 degrees

c. 40 to 45 degrees