Ch. 7 Femur and Pelvic Girdle Flashcards
longest and strongest bone in the body
femur
proximal femur consists of 4 essential parts:
head, neck, greater trochanter, and lesser trochanter
depression/pit near the center of the head of the femur
fovea capitis
fovea capitis provides attachment for what
ligament of the head of the femur/ligament capitis femoris
strong, pyramidal process of bone that connects the head with the body or shaft in the region of the trochanters on the femur
neck
larger prominence located superiorly and laterally to the femoral shaft and is palpable as a bony landmark
greater trochanter
smaller, blunt, conical eminence that projects medially and posteriorly from the junction of the neck and shaft of the femur
lesser trochanter
the trochanters are joined posteriorly by a thick ridge called
intertrochanteric crest
what is the angle of the neck to the shaft of a femur on an average adult
125 degrees with variation of 15 degrees
in a long legged person with a narrow pelvis how would the angle of the femur change
femur would be more vertical, increasing angle of neck (140)
in a shorter person with a wider pelvis how would the angle of the neck of the femur change
angle would be less (110-115)
on an average adult in the anatomic position, the longitudindal plane of the femur is
10 degrees from vertical
what does the vertical angle of the femur look like on a shorter person with a wide pelvis
more of a vertical angle (15 degrees)
what does the vertical angle of the femur look like on a taller person with a narrow pelvis
less of an angle from vertical (5 degrees)
how is the head and neck of the femur placed in relation to the body of the femur
15-20 degrees anteriorly angled
how must the patient be positioned in order to get the femoral neck parallel to the IR and get a true AP projection of the proximal femur
femur and lower leg rotated 15-20 degrees internally
serves as the base of the trunk and forms the connection between the vertebral column and lower limbs
complete pelvis
what four bones do the pelvis consists of
2 hip bones (innominate bones/ossa coxae), sacrum, coccyx
what does the sacrum articulate with superiorly
5th lumbar vertebra
what does the sacrum and 5th lumbar vertebra form
lumbosacral joint (L5-S1 joint)
the right and left hip (iliac) bones articulate posteriorly with what
sacrum
what does the right and left hip (iliac) bones and the sacrum form
sacroiliac joints
which two bones are also considered part of the distal vertebral column
sacrum and coccyx
3 divisions of the hip bones
ilium, ischium, pubis
when do your hip bones fuse together as one bone
middle teens
what area does the fusion of the 3 sections of the hip bone occur
area of the acetabulum
deep, cup-shaped cavity that accepts the head of the femur to form the hip joint
acetabulum
largest of the 3 divisions of the hip bone
ilium
section of the hip bone located superior to the acetabulum
ilium
section of the hip bone located inferior and posterior to the acetabulum
ischium
section of the hip bone located inferior and anterior to the acetabulum
pubis
the ilium is composed of what
a body and an ala/wing
what part of the ilium is the body
more inferior portion near the acetabulum, includes the superior 2/5ths of the acetabulum
thin flared superior part of the ilium
wing/ala of the ileum
superior margin of the ala
crest of the ilium, extending from ASIS to posterior superior iliac spine (PSIS)
upper most peak of the crest of the ilium
iliac crest
below the ASIS is a less prominent projection referred to as
anterior inferior iliac spine
inferior to the PSIS
posterior inferior iliac spine
two important positioning landmarks on the ilium
iliac crest and ASIS
part of the hip bone that lies inferior and posterior to the acetabulum
ischium
what is the ischium divided into
body and a ramus
superior portion of the body of the ischium makes up this
posteroinferior 2/5ths of the acetabulum
the lower portion of the body of the ischium is formerly called what
superior ramus
portion of the ischium that projects caudally and medially from the acetabulum, ending at the ischial tuberosity
lower portion of the body of the ischium
projecting anteriorly from the ischial tuberosity
ramus of the ischium
rounded roughened area near the junction of the lower body and the inferior rami is a landmark called
tuberosity of the ischium; ischial tuberosity
posterior to the acetabulum is a bony projection termed what
ischial spine
T/F a small part of the ischial spine is visible on a frontal view of the pelvis
true
directly superior to the ischial spine is a deep notch termed what
greater sciatic notch
inferior to the ischial spine is a smaller notch termed what
lesser sciatic notch
what bears most of the weight of the body when sitting
ischial tuberosity
anterior and inferior to the acetabulum and includes the anteroinferior 1/5th of the acetablulum
body of the pubis/pubic bone
extending anteriorly and medially from the body of each pubis
superior ramus
the two superior rami meet in the midline to form this
symphysis pubis; pubic symphysis
what type of joint is the symphysis pubis
amphiarthrodial joint
each inferior ramus passes down and posterior from the symphysis pubis to joint this
ramus of the respective ischium
large opening formed by the ramus and body of each ischium and by the pubis
obturator foramen
largest foramen in the human skeleton
obturator foramen
commonly used to check for rotation of the pelvis and/or lower abdomen by determination of whether the distance between them and the tabletop is equal on both sides
ASIS
prominence of the greater trochanter is at about the same level as what
superior border of the symphysis pubis
where are the ischial tuberosities in relation to the symphysis pubis
1 1/2 - 2” (4-5 cm) below the symphysis pubis, but vary between males and females
a plane through this part of the pelvis divides the pelvic area into two cavities
brim of the pelvis
the superior portion of the symphysis pubis anteriorly and the superior, prominent part of the sacrum posteriorly forms this
pelvic brim
general area above or superior to the oblique plane through the pelvic brim
greater/false pelvis
these form the lateral and posterior limits of the false pelvis
flared portion of the pelvis, formed primarily by the alae/wings of the ilia
these define the anterior limits of the false pelvis
abdominal muscles of the anterior wall
the lower abdominal organs and the fetus within a pregnant uterus rest on this
floor of the greater pelvis/false pelvis
the area inferior to a plane through the pelvic brim
lesser/true pelvis
cavity that is completely surrounded by bony structures
true pelvis
size and shape of the true pelvis are of greatest important during what
the birth process due to the true pelvis forming the actual birth canal
the oblique plane defined by the brim of the pelvis is termed what of the true pelvis
inlet/superior aperture
the oblique plane defined by the ischial tuberosities and the tip of the coccyx of the true pelvis
outlet or inferior aperture
what are the 3 sides of the triangularly shaped outlet formed by
line between ischial tuberosities and a line between each ischial tuberosity and the coccyx
what is the area between the inlet and outlet of the true pelvis termed
cavity of the true pelvis
during routine delivery what does the baby’s head travel through in order
pelvic inlet, midcavity, pelvic outlet
what is used if dimensions of the birth canal of the pelvis are in question during pregnancy
ultrasound
describing the sturdy, ringlike structure formed by the union of the ilium, ischium, and pubic bones, along with the sacrum and coccyx
pelvic ring
round shape of human pelvic inlet
gynecoid
wider right to left than anterior to posterior human pelvic inlet
platypelloid
heart shaped human pelvic inlet
android
wider anterior to posterior than right to left human pelvic inlet
anthropoid
this pelvis is wider, with the ilia more flared and more shallow from font to back
female pelvis - gynecoid or platypelloid
this pelvis is more narrow, and deeper, less flared with a heart-shaped pelvic inlet
male pelvis - anthropoid or android
angle of the pubic arch of a female pelvis
80-85 degreses
angle of the pubic arch of a male pelvis
50-60 degrees
whose ischial spines project more medially
males
ischial spines are more visible along the lateral margins of the pelvic cavity in the AP pelvis projection in who
males
joints between the sacrum and each ilium
sacroiliac joints
structure between the right and left pubic bones
symphysis pubis
temporary growth joint of each acetabulum that solidifies in the midteen years
union of acetabulum
joints between the head of the femur and the acetabulum of the pelvis
hip joints
what type of joint is the sacroiliac joint
synovial - irregular gliding
what type of joint is the symphysis pubis
cartilaginous - symphysis, amphiarthrodial type
what type of joint is the union of the acetabulum
cartilaginous - synchondrosis, synarthrodial (non movable)
what type of joint is the hip joint
synovial - ball and socket (spheroidal)
thickest part of the articular capsule surrounding the hip joint
superior portion
how long is the neck of the femur
2 1/2” (6-7 cm)
how far is the head of the femur in relation to the midline between ASIS and pubic symphysis
1 1/2” (4 cm)
long-standing traditional method to locate femoral head and neck
draw straight line between ASIS and pubic symphysis, halfway and at a right angle and distal to this line you can locate the head - 1 1/2” and the neck - 2 1/2” from this point
where is the femoral neck in relation to ASIS
1-2” (3-5 cm) medial and 3-4” (8-10 cm) distal to ASIS
when the leg is in a true anatomic position, true AP leg, how is the proximal femur positioned
proximal femur is rotated posteriorly 15-20 degrees and the lesser trochanter is visible
how do you get the proximal femur and hip joint into a true AP position
internally rotate entire lower leg so that the neck of the femur is parallel with the IR
when the lesser trochanter isn’t visible or is only slightly visible what does this indicate
entire leg is internally rotated full 15-20 degrees (true AP of proximal femur/hip joint)
common fracture site for an older patient who has fallen
femoral neck
physical sign for a femoral neck fracture
external rotation of foot involved - lesser trochanter is clearly visualized in profile
if evidence of a hip fracture is present how should the radiograph be taken
AS IS, do not attempt to rotate the leg internally
what position visualizes the femoral head and neck in profile
15-20 internal rotation of feet
what position greatly foreshortens the femoral necks
external rotation of feet
what position partially foreshortens the femoral necks
anatomic position
what position puts the feet an a normal relaxed position
external rotation of feet
what position visualizes the lesser trochanters in profile
external rotation of feet
patients who have undergone hip replacement surgery should not be place in this position for any postsurgical procedures
frog-leg position
this modality is useful for evaluating soft tissue involvement of lesions or determining the extent of fractures
CT
this modality is useful for studying the relationship of the femoral head to the acetabulum before hip surgery or for performing a postreduction study of a developmental hip dislocation
CT
this modality can be useful for imaging the lower limb or pelvis when soft tissue injuries or possible abnormalities related to joints are suspected
MRI
this modality is useful for evaluating newborns for hip dislocations and for assessing joint stability during movement of the lower limbs
sonography
sonography is usually selected during what time of infancy
first 4-6 months
this modality can be useful in providing early evidence of certain bony pathologic processes, such as occult fractures, bone infections, metastatic carcinoma, or other metastatic or primary malignancy
nuclear medicine
