Ch 7 Hips and Pelvis Exam review Flashcards by Donovan Tompkins

Exam review:
what is not a palpable landmark?
1. pubis symphysis
2. greater trochanter
3. femoral neck
4.

1,2,4
Femoral neck is not one of them

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Exam review:
What is the angulation between the neck and medial shaft of the femur in the average adult?

125 degrees

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Exam review:
what should be parallel to the image receptor when performing an inferosuperior axial hip? (cross table)
A. Knee joint
B. Central Ray
C. Tube Face
D. Femoral epicondyles

C. Tube Face

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Exam review:
Central ray is always ________

Perpendicular

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Exam review:
(t/f)
In an AP axial projection (frog) the femoral neck is parallel to the image receptor
How many degrees?
Vertically or horizontally?

True
30-40 degrees
Vertically
(Book says 40-45)

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Exam review:
How much do you oblique for Judet views?

45 degrees?
LPO/ RPO

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Exam review:
What do you see on the upside of the Judet views?

posterior rim of the acetabulum
anterior iliopubic column

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Exam review:
Is the Acetabulum in the Ilium, pubis, or ischium?

all three
The joint is separated into anterior, posterior, and superior portions.

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Exam review:
What do you see on the downside Judet view?

anterior rim of the acetabulum
posterior ilioschial column

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Exam review:
How do we position for an downside Judet view?

patient supine
45 degree oblique LPO/RPO
2 inches inferior + 2 inches medial to downside ASIS

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Exam review:
What makes up the pelvis?

2 hips (left and right)
Sacrum
Coccyx

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Exam review:
How do we position for an upside Judet view?

patient supine
45 degree oblique LPO/RPO
2 inches inferior to ASIS

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Exam review:
What do we see in an upside Judet view?

posterior rim of the acetabulum
anterior iliopubic column

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Exam review:
what is the superior portion of the hip?

Ilium

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Exam review:
What is the posterior portion of the hip?

Ischium
(itchy bum)

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Exam review:
What is the anterior portion of the hip?

Pubis

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Exam review:
What is the main difference between a female pelvis and a male pelvis?

Male is <90 (less than 90 degrees, shaped more like a heart)
Female is >90 (mainly due to birthing reasons)
Male is acute angle
Female is obtuse angle

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Exam review: What view/rotation best shows the lesser trochanters in profile?

external oblique/rotation

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Exam review:
what position best displays an anterior/posterior fracture?

Lateral projection

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Exam review:
What view best shows the greater trochanter in profile?

internal oblique/rotation

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Exam review:
What view best shows a lateral fracture?

an anterior/posterior (AP) projection

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Exam review:
Axial lateral horizontal beam projection of the hips (cross table) requires the image receptor to be placed:
1. parallel to the central ray
2. parallel to the long axis of the femoral neck
3. in contact with the lateral surface of the body

2 bc internal rotation makes the femoral neck parallel
3 bc we have patients lateral side closer to IR to reduce OID
cannot be no. 1 because the central ray is ALWAYS perpendicular to the image receptor

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Exam review:
In a frog position the femoral neck is _____ to the image receptor

parallel

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Exam review:
what part of the innominate bone makes up the obturator foramen?

Ischium
Pubis
(where the posterior and anterior meet to create the hole aka obturator foramen)

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Exam review: where is the innominate bone located at? also known as?

at the hips (left or right there are two) ossa coxae

Exam review: Where is the adductor tubercle located?

distal medial femur (Near medial epicondyle)

Exam review: right posterior oblique Judet position of the right acetabulum will demonstrate the: 1. anterior rim of right acetabulum 2. right iliac wing 3. right anterior iliopubic column (will change the answer choices)

1+2

Exam review: How many degrees are the medial and lateral condyles of the femur are separated from each other?

5-7 degrees (why we angle on knees) (Medial extends more Distally than lateral)

Exam review: What does the femur articulate with distally?

Patella tibia

Exam review: When would we not rotate the femur for hip views?

if there is a suspected fx or we want to see specific trochanters

Exam review: The femoral neck can be located: A. Parallel to the femoral shaft B. Perpendicular to the femoral shaft C. Perpendicular to the line drawn from the ASIS to the pubis symphysis D. Perpendicular to the line drawn from the iliac crest to the pubis symphysis (will change these answer choices)

could be either C or D

Exam review: How much does the femur slant in?

5-15 degrees?

Exam review: What does the femur articulate with proximally?

acetabulum?

Exam review: When would we rotate the femur for hip projections?

all hip projections to remove lesser trochanter from profile Internal= greater trochanter External= lesser trochanter

Exam review: When would we use the Nakayama method? What does it replace?

Trauma views it replaces our crosstable

Exam review: What can we use for a cross table lateral projection to improve the quality of the image?

add filter & grid

Exam review: What is the central ray for the AP pelvis?

2 inches inferior to ASIS midway point between ASIS and Pubis symphysis (15–20-degree internal rotation of affected leg)

Exam review: What is osteoporosis? How does it appear on an x-ray? What demographic is it most common in?

reduction in bone more radiolucent (whiter) common in geriatric patients

Exam review: What is the CR for inlet?

40 degrees caudad CR ASIS

Exam review: What is the CR for outlet? (Taylor method)

20-35 degrees cephalic for men 30-45 degrees cephalic for women CR 1-2 inches inferior to pubis symphysis

General: The outlet refers to the ______ portion of the true pelvis Outlet aka?

inferior inferior aperture

General: The inlet refers to the ______ portion of the true pelvis Inlet aka?

superior superior aperture

General: What are other names for cross table?

axiolateral? inferosuperior? Danelius-miller projection

General: If we need a proximal lateral femur projection how are positioning the patient?

Similar to lateral knee without the angle

General: What is the CR for bilateral frogs?

3 inches inferior of ASIS

General: What does Nakayama view replace?

lateral hip (cross table) Trauma view

General: What does positioning look like for nakayama lateral?

tilt IR 15 degrees from vertical (to get CR perpendicular to IR) angle posteriorly 15-20 degrees horizontally (like cross table)

General: What forms the actual birth canal?

true pelvis

General: what divides the pelvis from the greater/false pelvis and the lesser/true pelvis?

the brim

General: The obturator foramen is:

large opening formed by the ramus & body of each ischium

General: the two rami (ramus) meet in the midline to form the:

pubis symphysis

General: The ischial tuberosity is 1 1/2 - 2 inches ________ to the pubis symphysis

inferior

General: The superior portion of the pubis symphysis is at the same level as the:

greater trochanter

(Tips) Be able to label anatomy with picture. Know your Judet views. know all the names of the views and their angles/anatomy. 4 picture for femur Do anatomy modules! Which condyle is the abductor tubercle? How many degrees slants in? (femur)

General: The greater trochanter is located ________ & ________ compared to the femoral neck.

superiorly laterally (is palpable landmark)

General: The lesser trochanter is located ________ & ________ compared to the femoral neck.

posteriorly medially

General: What is the angle of the neck to the shaft of an average adult?

125 degrees (with 15 degrees of variance)

General: To produce a true AP position of the femur what must we do?

rotate leg/femur 15 degrees internally

General: The lesser and greater trochanter are joined together by a thick crest called:

intertrochanteric crest

General: What are the parts of the pelvis?

2 hip bones (innominate bones) 1 sacrum 1 coccyx

General: What are the parts of the hip? What is there location?

Ilium (superiorly) Pubis (anteriorly) Ischium (posteriorly)

General: Ilium consists of two parts:

body Ala (wing)

General: Palpable superior portion of the hip is:

Iliac crest

General: Palpable anterior portion of the hip is:

ASIS (anterior superior iliac spine)

General: Ischium is divided into two parts:

body ramus

General: pubic arch for women: Pubic arch for men

80-85 degrees 50-60 degrees

General: Sacroiliac joint is:

synovial Amphiarthrodial (limited movement)

General: Pubis symphysis joint is:

cartilaginous Amphiarthodial (limited)

General: Union of acetabulum joint is:

Cartilaginous synarthrodial (non-moveable)

General: Hip joint is:

Synovial Diarthrodial ball and socket joint

General: Internal rotation gives a ____ projection of proximal femur

General: What is a common fracture site for older patients who have fallen?

Femoral neck

General: Internal rotation shows _____ in profile:

greater trochanter

General: External rotation shows the _______ in profile

lesser trochanter

General: In a lateral projection of the proximal femur/hip what trochanter is seen in profile free of superimposition?

Lesser trochanter? not really lol

Exam review: The right posterior oblique of the right acetabulum would be:

Downside Judet

Exam review: The left posterior oblique (LPO) of the right acetabulum would be:

Upside

Exam review: The right posterior oblique (RPO) of the left acetabulum would be:

Upside

Exam review: The left posterior oblique (LPO) of the left acetabulum would be:

Downside

General: What is a good way to remember oblique positioning on Judet views for acetabulum?

If the oblique is the same as the acetabulum then it is downside Ex: LPO + left acetabulum= downside RPO + right acetabulum = downside

What is the CR for bilateral frogs? Unilateral frog?

Bilateral: 3 inches from ASIS 40-45 degrees vertical Unilateral: mid-femoral neck 45 degrees from vertical

For Nakayama why is the angle 15-20 degrees horizontally?

Patient is unable to rotate 15-20 degrees internally due to trauma (possibly)

Where is the femoral neck located?

3-4 inches inferior 1-2 inches medial to ASIS

Pubis symphysis is located at?

3-4 inches inferior to ASIS

Pubis symphysis is located at?

3-4 inches inferior to ASIS

General: PA axial oblique Teufel method shows what?

Acetabulum (superoposterior wall)

General: What is the position for the Tuefel method? AKA?

12 cephalad 35-40 anterior oblique 1 inch superior of greater trochanter 2 inches to lateral side AKA: PA axial oblique

General: How does female pelvis appear?

ilia more flared wider & rounder >90

General: how does a male pelvis appear?

narrower less flared shaped like heart <90

Pathology: most common fx for geriatric patients?

proximal femur fx (femoral neck to be exact)

Pathology: Ankylosing spondylitis:

fusion of the SI joints

Pathology: Chondrosarcoma:

malignant tumor of the cartilage men older than 45

Pathology: Developmental dysplasia of the hip (DDH):

hip dislocation from birth

Pathology: Osteoarthritis:

known as degenerative joint disease causes pain and stiffness

Pathology: pelvic ring fx:

severe blow to one side of pelvis that may lead to one-sided fx

Pathology: slipped capital femoral epiphysis (SCFE):

the epiphyseal plate appears shorter and wider occurs in 10–16-year-olds

What are the alternative method names for these projects: what do they also show? AP bilateral frog AP axial outlet projection Posterior oblique projection PA axial oblique axiolateral inferosuperior

Clements (lateral hip) Taylor method (outlet) Judet method (shows rims) Teufel method (acetabulum) Danelius-Miller method (x-table)