Deck 6: Lower Limb

Question 1

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.

Answer 1

dorsiflexion.

Question 2

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

A)Palmar
B)Dorsum
C)Volar
D)Plantar

Answer 2

Dorsum

Question 3

Another term for the intercondylar sulcus is the:

A)articular facets.
B)patellar surface.
C)intercondylar fossa.
D)intercondylar recess.

Answer 3

patellar surface.

Question 4

Which tendon attaches directly to the tibial tuberosity?

A)Patellar
B)Quadriceps
C)Soleus
D)Collateral

Question 5

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

A)the anterior cruciate ligament (ACL) and the medial meniscus.
B)the posterior cruciate ligament (PCL) and the lateral meniscus.
C)the fibular lateral collateral ligament (LCL) and the patella ligament.
D)none of the above.

Question 6

The medial malleolus is part of the:

A)talus.
B)calcaneus.
C)fibula.
D)tibia.

Question 7

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

Question 8

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

A)synovial; ginglymus
B)fibrous; immovable
C)synovial; saddle
D)synovial; bicondylar

Question 9

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

A)fibrous; plane
B)synovial; saddle
C)fibrous; ginglymus
D)synovial; ginglymus

Question 10

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

A)bursae.
B)menisci.
C)synovial membranes.
D)synovial bodies.

Question 11

Which of these labeled structures or bones identifies the navicular?

A)B
B)C
C)D
D)I

Question 12

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

A)First
B)Third
C)Fourth
D)Fifth

Question 13

How many tarsal bones are found in the foot?

A)7
B)14
C)5
D)26

Question 14

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 procedure.

Question 15

How many articular facets make up the subtalar joint?

A)One
B)Two
C)Three
D)Four

Question 16

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

A)gout.
B)Ewing's sarcoma.
C)a bone cyst.
D)Osgood-Schlatter disease.

Question 17

The calcaneus articulates with the talus and the:

A)cuboid.
B)navicular.
C)medial cuneiform.
D)lateral cuneiform.

Question 18

Which structure or bone contains the sustentaculum tali?

A)Calcaneus
B)Talus
C)Base of the fifth metatarsal
D)Tibia

Question 19

Where would the interphalangeal joint be found in the foot?

A)Between the phalanges of the second through fifth digits
B)Between the tarsal bones and phalanges
C)Between the phalanges of the first digit
D)Between any of the metatarsals and phalanges

Question 20

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.

Question 21

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

A)Tarsometatarsal
B)Metatarsophalangeal
C)Proximal tibiofibular
D)Intertarsal

Question 22

This radiograph represents which of the following positions?

A)Mediolateral projection of the knee, but overextended
B)Mediolateral projection of the knee, but underrotated toward the IR
C)Mediolateral projection of the knee, but overrotated toward the IR
D)Correctly positioned mediolateral projection of the knee, but underexposed

Question 23

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

Question 24

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.

Question 25

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

A)CR is perpendicular to the image receptor.
B)10° posterior
C)15° to 20° posterior
D)5° to 7° posterior

Question 26

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

A)dorsiflexion.
B)inversion.
C)eversion.
D)plantar flexion.

Question 27

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° from vertical
B)No flexion of the foot is required.
C)5° to 7° from vertical
D)30° to 45° from vertical

Question 28

Which one of the labeled structures is the medial condyle of the femur?

A)A
B)B
C)C
D)D
E)E

Question 29

The distal tibiofibular joint is classified as a ____ joint.

A)synovial
B)fibrous
C)diarthrodial
D)synarthrodial

Question 30

Which of these labeled structures or bones identifies the metatarsophalangeal joint?

A)E
B)F
C)G
D)H

Question 31

Which of the labeled structures is the adductor tubercle?

A)A
B)B
C)C
D)D
E)E

Question 32

Which of these labeled structures or bones identifies the talus?

A)A
B)B
C)I
D)J

Question 33

A mediolateral 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 the femur will appear more posterior.
D)Both A and C are correct.

Question 34

How much central ray (CR) angulation (if any) should be used for an AP projection of the toes (without elevation of forefoot)?

A)Keep CR perpendicular to IR.
B)5° toward calcaneus
C)10° to 15° toward calcaneus
D)20° to 25° toward calcaneus

Question 35

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

Question 36

Which of these labeled structures or bones identifies the lateral (third) cuneiform?

A)B
B)C
C)D
D)I

Question 37

Which projection and/or position of the foot is represented by this drawing of the foot?

A)AP projection, no rotation
B)AP oblique, 15° to 20° medial rotation
C)AP oblique, 45° lateral rotation
D)AP oblique, 45° medial rotation

Question 38

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 truer lateral position.
D)It opens the subtalar joint.

Question 39

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°
B)15° to 20°
C)30° to 35°
D)40°

Question 40

Which of the labeled structures is the lateral condyle of the femur?

A)A
B)B
C)C
D)D
E)E

Question 41

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.

Question 42

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.

Question 43

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 or inadequate CR centering or angle.

Question 44

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° rotation
B)AP mortise projection
C)Lateromedial ankle
D)AP projection

Question 45

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

A)No CR angle is required.
B)5° cephalad
C)7° to 10° cephalad
D)5° to 10° caudad

Question 46

Which special position of the knee requires that the patient be placed supine with 40° flexion of the knee and the CR angled 30° 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

Question 47

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

A)5° to 10°
B)20° to 30°
C)35° to 40°
D)45° to 50°

Question 48

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

A)Draws the patella into the intercondylar sulcus.
B)May cause injury to the anterior cruciate ligament.
C)Prevents superimposition of the distal aspect of the femoral condyles.
D)Can distort any visible fat pads.

Question 49

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

A)AP
B)Lateral
C)AP oblique with medial rotation
D)AP oblique with lateral rotation

Question 50

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

Question 51

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

A)3° to 5° caudad
B)CR is perpendicular to the IR.
C)3° to 5° cephalad
D)10° to 15° cephalad

Question 52

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

A)overrotation of the knee toward the IR.
B)underrotation of the knee toward the IR.
C)a true lateral knee.
D)the CR should be angled 5° to 7° cephalad.

Question 53

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

A)possible stress fractures.
B)possible joint separations or ligament tears.
C)loose bodies in ankle joints.
D)tears in the joint meniscus.

Question 54

A radiograph of a mediolateral 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.

Question 55

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

A)No rotation is necessary.
B)45° to 60° lateral
C)15° to 20° medial
D)25° to 30° medial

Question 56

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)

Question 57

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.

Question 58

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

A)10° caudad
B)5° to 7° cephalad
C)20° to 25° caudad
D)None.CR is perpendicular to IR.

Question 59

Which joint surfaces of the ankle joint are most commonly 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

Question 60

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

A)increase the SID to 60 inches (150 cm).
B)use a Bucky tray.
C)turn the image receptor diagonally to the lower leg.
D)use a tabletop technique.

Question 61

A radiograph of a plantodorsal (axial) projection of the calcaneus reveals foreshortening.The technologist used 60 kV, 6 mAs, 40-inch (102-cm) SID, and a 25° cephalad CR angle from the long axis of the foot.Which of the following modifications will produce a more diagnostic image of the calcaneus?

A)Plantarflex the foot.
B)Increase CR angulation.
C)Decrease CR angulation.
D)Increase kV to 70.

Question 62

Which one of the following projections will best demonstrate signs of Osgood-Schlatter disease?

A)Plantodorsal (axial) and lateral calcaneus
B)AP, lateral, and oblique ankle
C)AP bilateral weight-bearing knees
D)AP and lateral knee

Question 63

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)

Question 64

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.

Question 65

Which of the following imaging modalities and/or procedures will provide the best assessment for osteomyelitis of the foot?

A)Nuclear medicine
B)Ultrasound
C)Computed tomography
D)Arthrography

Question 66

A patient comes to the radiology department for a knee study with special interest in the region of the proximal tibiofibular joint and the lateral condyle of the tibia.Which of the following positioning routines should the technologist obtain?

A)AP and lateral knee
B)AP, lateral, and lateral oblique knee
C)AP, lateral, and medial oblique knee
D)AP, lateral, and PA axial intercondylar fossa

Question 67

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

A)10° caudad.
B)5° to 10° cephalad.
C)perpendicular to the image receptor.
D)perpendicular to the image receptor, but SID should be increased to 60 inches (153 cm).

Question 68

A patient comes to radiology with an infection involving the sesamoid bones of the foot.Beyond the routine foot projections, which one of the following projections can be performed to best demonstrate these structures?

A)PA axial Camp-Coventry method
B)AP weight-bearing foot projection
C)Lateral weight-bearing projection
D)Tangential projection

Question 69

A radiograph of an 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 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

Question 70

A patient enters the ED with an injury near the base of the first and second metatarsals.The basic foot projections are inconclusive on demonstrating a fracture to the medial cuneiform.Which of the following projections would best demonstrate this bone?

A)AP oblique with increased medial rotation
B)AP oblique with lateral rotation
C)AP weight-bearing projection
D)Lateral weight-bearing projection

Question 71

A patient comes to radiology with a history of chondromalacia of the patella.The orthopedic surgeon is concerned about possible loose bodies within the patellofemoral joint space.She wants the best projection to demonstrate this joint space.What projection should be performed?

A)Camp-Coventry method
B)Settegast method
C)AP axial projection
D)Merchant method

Question 72

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

A)asymmetrical narrowing of femoropatellar joint.
B)destruction of the patella.
C)fluid in the joints of the foot.
D)erosion of the Achilles tendon insertion.

Question 73

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?

A)Tangential projection-Settegast method
B)Tangential projection-Merchant method
C)AP axial projection-Béclere method
D)Superoinferior sitting tangential method-Hobbs modification

Question 74

A patient comes to radiology with a clinical history of a Lisfranc joint injury.Which of the following projections would best demonstrate this condition?

A)Weight-bearing foot series
B)AP weight-bearing knee projection
C)Tangential projection for patella
D)AP stress views of the ankle

Question 75

A patient enters radiology with a possible ligament tear to the lateral aspect of the ankle.Initial ankle radiographs are negative for fracture or dislocation.Because the clinic is in a rural setting, the patient cannot have an MRI performed to evaluate the ligaments of the ankle.Which of the following techniques may provide an assessment of the soft tissue structures of the ankle?

A)AP weight-bearing projections
B)AP mortise projection
C)AP stress positions
D)Axial plantodorsal projection

Question 76

A patient enters the emergency department (ED) with a possible transverse fracture of the patella.Which of the following routines would safely provide the best images of the patella?

A)AP and horizontal beam lateral, no flexion of knee
B)AP and 5° to 10° flexion lateral
C)AP and Merchant method (tangential projection)
D)PA and 45° PA oblique with medial rotation

Question 77

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

A)perpendicular to the image receptor.
B)angled 15° posteriorly.
C)directed horizontal.
D)angled 5° posteriorly.

Question 78

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?

A)Holmblad method
B)Hughston method
C)Camp-Coventry method
D)Rosenberg method

Question 79

A patient comes to radiology for an evaluation of the longitudinal arch of the foot.Which of the following projections would provide the best information about the arch?

A)Routine foot series
B)Plantodorsal (axial) projection
C)AP and lateral weight-bearing projections of foot
D)Sesamoid bone series projection

Question 80

A radiograph of a PA axial projection for the intercondylar fossa (Camp-Coventry method) 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?

A)Increase SID to at least 48 inches (123 cm).
B)CR must be perpendicular to lower leg.
C)Rotate lower extremity 10° medially.
D)Reduce flexion of the knee to 20° to 30°.