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Positioning ll (mine) > Hip and Pelvis > Flashcards

Hip and Pelvis Flashcards

1
Q

What four bones does the pelvis consist of?

A
  • right and left innominate ( os coxae) hip bone
  • sacrum
  • coccyx
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2
Q

What serves as the base of the trunk and a girdle for lower limb attachment?

A

Pelvis

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3
Q

How many bones is the pelvic girdle composed of?

A

two hip bones

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4
Q

What does the hip bone consist of?

A
  • llium
  • ischium
  • pubis
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5
Q

What bones join together to form the acetabulum?

A
  • ilium
  • ischium
  • pubis
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6
Q

What type of joint is the acetabulum?

A

A ball and socket joint

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7
Q

What does llium (I) belong to?

A

Belongs to the pelvis

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8
Q

What does lleum (e) belong to?

A

Belongs to the intestine

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9
Q

It consists of a body and a broad, curved portion called the ala
- Body forms superior two fifths of acetabulum

A

llium

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10
Q

What does “ala” mean?

A

Wing

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11
Q

What are the four prominent processes of the ilium?

A
  • anterior superior iliac spine (ASIS)
  • anterior inferior iliac spine
  • posterior superior iliac spine
  • posterior inferior iliac spine
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12
Q

What is the superior margin of the llium called?

A

iliac crest

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13
Q

What does the posterior inferior iliac spine end in?

A

the greater sciatic notch

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14
Q

What does the ischium consist of?

A
  • body
  • ischial ramus (superior and inferior)
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15
Q

What forms the posterior two fifths of the acetabulum?

A

ischium

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16
Q

What does the ischial ramus join with?

A

The inferior ramus of pubis

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17
Q

What are the only places that you are able to palpate on the pelvic girdle?

A
  • anterior superior iliac crest (ASIS)
  • iliac crest
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18
Q

Expanded portion on which the trunk rests when seated (what we sit on)?

A

ischial tuberosity

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19
Q

Located on the upper, posterior part of the ischium body?

A

ischial spine

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20
Q

Is the indentation located just below the ischial spine?

A

Lesser sciatic notch

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21
Q

What does the pubis consist of?

A
  • body
  • superior ramus
  • inferior ramus
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22
Q

Is the side down elongated or foreshortened?

A

Elongated

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23
Q

Is the side up elongated or foreshortened?

A

Foreshortened

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24
Q

What forms approximately one fifth of the anterior acetabulum?

A

The body of the pubis

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25
Q

Formed by junction of the ischial ramus and pubis inferior ramus

A

Obturator foramen

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26
Q

What helps form the obturator foramen?

A

Ischial tuberosity

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27
Q

Tell tail sign if there’s a fracture

A

Obturator foramen

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28
Q

What does the proximal femur consist of?

A
  • head
  • neck
  • greater trochanter ( out to the lateral)
  • lesser trochanter ( out to the medial)
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29
Q

An imaginary line that goes from greater to lesser on the anterior aspect?

A

Intertrochanteric line

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30
Q

Located on the posterior aspect of the proximal femur that is actually grooved in?

A

Intertrochanteric crest

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31
Q

Articulation between the right and left ilia and the sacrum?
- expand during pregnancy

A

Sacroiliac (SI) joint

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32
Q

The Sacroiliac (SI) joint is considered a?

A

irregular, gliding type

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33
Q

Articulation of the head of the femur with the acetabulum?

A

Hip joint

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34
Q

What is the hip joint considered to be?

A

Synovial, ball and socket type

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35
Q

How much do you need to turn your feet in to see the neck of the femur?

A

20 degrees

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36
Q

Junction of right and left pubic bones in the midline?

A

Pubic symphysis

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37
Q

What joint is the pubic symphysis considered to be?

A

Cartilaginous, slightly movable joint

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38
Q

At what angle do the (SI) joints come in?

A

Angles of 25 to 30 degrees

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39
Q

Can we palpate the pubic symphysis?

A

Yes but we do not touch the pubic symphysis

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40
Q

Pelvic anatomy
- heavier, narrower, and deeper
- angle at pubic symphysis is acute

A

Males pelvis

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41
Q

Pelvic anatomy
- wider, shallower and lighter
- angle at pubic symphysis is obtuse

A

Females pelvis

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42
Q

Forms the superior aperture or inlet of the true pelvis?

A

Brim of the pelvis

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43
Q

What does the inferior aperture form of the pelvis

A

The outlet

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44
Q

The region above the brim is called the?

A

false or greater pelvis

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45
Q

The region below the brim is called the?

A

true or lesser pelvis

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46
Q

The bony landmarks used in a radiography of the hip and pelvis?

A
  • iliac crest
  • ASIS
  • pubic symphysis
  • greater trochanter of the femur
  • ischial tuberosity
  • tip of the coccyx
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47
Q

What consists of the true pelvis?

A

bladder, colon, female reproductive organs and rectum

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48
Q

Lies in the same horizontal plane as the midpoint of the hip joint and coccyx?

A

Highest point of greater trochanter

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49
Q

What is in the same horizontal plane as the pubic symphysis?

A

The most prominent point of the greater trochanter

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50
Q

What three joints lie on the same horizontal plane?

A

greater trochanter, tip of coccyx, and the pubic symphysis

51
Q

How to localized hip joint?

A

Make an imaginary line from the anterior superior iliac spine (ASIS) to the superior margin of the pubic symphysis draw a right angle and go down 2 1/2 inches and the neck will be right there. For the head of the femur go down 1 1/2 inches and the head will be there

52
Q

What is the essential projection of the pelvis?

A

AP

53
Q

What should you never do if there is a foot straight out to one side?

A

Never rotate the leg because that’s an indication that they have a broken or fractured hip

54
Q

What is the patient position for an AP Pelvis and Upper Femora?

A

Supine

55
Q

How much should you rotate the feet for an AP Pelvis and Upper Femora?

A

Medially rotate the feet and lower limbs 15 to 20 degrees allowing for the foot to touch each other

56
Q

When we medially rotate the feet 15 to 20 degrees in the AP Pelvis, what happens?

A

It allows for the femoral necks to be parallel with IR so that they are not foreshortened

57
Q

What is the part position for the AP Pelvis and upper femora?

A
  • Median sagittal plane (MSP) centered to midline
  • Equal ASIS to table distance on both sides
58
Q

What is the CR for AP Pelvis?

A

Perpendicular to IR enters 2 inches superior to symphysis pubis or 2 inches below ASIS

59
Q

Where should the IR be for AP Pelvis?

A

Upper border of IR 1 to 1/2 inches above crests

60
Q

What is in profile in the AP Pelvis and upper femora?

A

Greater trochanter

61
Q

What should be included in the AP Pelvis and upper femora?

A
  • top of crests
  • pubic symphysis
  • necks of femur should be parallel
  • llium of equal shape
  • ischial spine equal distance
  • sacrum and coccyx equal distance
  • obturator foramen should look equal
  • full wings on both side
  • all the Ischial tuberosity
  • SI joint to outer wing looks equal
62
Q

What happens if you see too much of the lesser in profile in an AP Pelvis and that the femoral necks are foreshortened?

A

You did not turn your feet in medially 15 to 20 degrees

63
Q

What is the breathing technique for AP Pelvis and upper femora?

A

Suspended breathing (respiration) or hold your breath

64
Q

What happens when there is poor positioning of the feet for the AP Pelvis and Upper Femora?

A
  • the lesser will be in profile instead of the greater
  • there is foreshortening of the femoral necks
65
Q

What is the essential projection of the femoral neck?

A

AP oblique (modified cleaves method)
- we do not do this if there is a suspected fracture
- oblique of hip joint

66
Q

What is the patient position for AP Oblique Femoral Necks (Modified Cleaves)?

A

Supine

67
Q

What is the other name for the AP Oblique Femoral Necks (Modified Cleaves)?

A

Bilateral frog leg

68
Q

What is the SID for AP Pelvis?

A

40 inches

69
Q

What is the part position for AP Oblique Femoral Necks (Modified Cleaves)?

A
  • flex hip and knees
  • draw feet as much as possible
  • abduct thighs equally and maximally 45 degrees from table
  • places soles of feet together
70
Q

How many degrees oblique is the AP Oblique Femoral Necks (Modified Cleaves)?

A

45 degrees

71
Q

Where do we center for the AP Oblique Femoral Necks (Modified Cleaves)?

A

Center 1 inch above pubic symphysis

72
Q

What is the CR for bilateral AP Oblique Femoral Necks (Modified Cleaves)?

A

Perpendicular to MSP at level 1 inch above pubic symphysis

73
Q

What is the CR for unilateral for AP Oblique Femoral Necks (Modified Cleaves)?

A

Perpendicular to femoral neck

74
Q

What is the part position for unilateral AP Oblique Femoral Necks (Modified Cleaves)?

A
  • center ASIS of affected side to midline of grid
  • flex affected hip and knee
  • draw a foot up to opposing knee as much as possible
  • abduct thigh approximately 45 degrees laterally
75
Q

How much should the thigh be abducted in the unilateral AP Oblique Femoral Necks (Modified Cleaves)?

A

45 degrees laterally

76
Q

What happens if the leg is completely flat in an unilateral AP Oblique Femoral Necks (Modified Cleaves)?

A

It will be considered a lateral projection not an oblique

77
Q

What are the essential projections of the Hip

A
  • AP
  • Lateral (Lauenstein and Hickey methods) mediolateral
  • Axiolateral (Danelius-Miller method) crosstable
78
Q

What is the patient position for AP Hip?

A

Supine

79
Q

What is the part position for AP Hip?

A

Make sure the ASIS-to-tabletop distance is equal on both sides

80
Q

How much do you rotate the lower limb and foot for the AP Hip?

A

15 to 20 degrees medially which places femoral necks parallel to the IR

81
Q

What is the CR for AP Hip?

A

perpendicular to femoral neck
- adjustment may be necessary if orthopedic device is present

82
Q

What is the criteria for AP Hip?

A
  • femoral head and seen through the acetabulum
  • femoral neck not foreshortened
  • greater trochanter in profile to the lateral
  • pubic symphysis must be seen
  • ischial tuberosity
  • don’t need crest unless protocol
83
Q

What is the patient position for lateral hip (lauenstein method)?

A

Rotate slightly toward affected side to an oblique position supine position

84
Q

What is the part position for lateral hip (Lauenstein method)?

A
  • center affected hip to midline of grid
  • flex affected knee and draw thigh to almost right angle to hip
  • body of femur parallel to table
  • support opposite hip and knee
85
Q

What is the CR for Lateral hip (Lauenstein method)?

A

Perpendicular through hip enters midway between ASIS and pubic symphysis center at the neck of the femur

86
Q

Criteria for lateral hip (lauenstein method)?

A
  • hip joint, acetabulum and femoral head
  • femoral neck overlapped by greater trochanter
  • lesser in profile to the medial
  • pubic symphysis
  • greater is over the neck
87
Q

What is the part and patient position for the lateral hip (hickey method)?

A

the same as for lauenstein method

88
Q

CR for lateral hip (hickey method)?

A

Angled 20 degrees cephalic
- enters hip joint

89
Q

Why do we do an lateral hip (hickey method) and put an angle?

A

Allows for the greater trochanter to be off the neck so the neck is free of superimposition

90
Q

What is the patient position for Axiolateral Hip (Danelius-Miller)?

A

Supine

91
Q

The Axiolateral Hip (Danelius-Miller) is also known as?

A

The cross table hip

92
Q

What is the part position for Axiolateral Hip (Danelius-Miller)?

A
  • elevate pelvis for thin patients
  • flex knee and hip of unaffected limb to place thigh vertical
  • rest unaffected leg and foot on a support
  • no rotation of pelvis
93
Q

What is the CR for Axiolateral Hip (Danelius-Miller)?

A

Horizontal and peripendicular to long axis of femoral neck

94
Q

In Axiolateral Hip (danelius- miller) CR is what?

A

Cr perpendicular to neck and cassetee
- cassetee parallel to neck of femur
- perpendicular to beam

95
Q

Criteria for Axiolateral Hip (danelius -Miller)?

A
  • hip joint with acetabulum
  • greater is superimposed over the neck
  • ischial tuberosity below femoral head and neck
96
Q

What will you do if the patient can’t lift leg for axiolateral hip (Danelius -Miller) or have bilateral fractures of the hip?

A

Clements- Nakayama

96
Q

For the crosstable hip

A

You will need to use a manual technique

97
Q

What is the part position for Clements-Nakayama?

A
  • Limbs remain neutral or external rotated
  • grid is parallel to the axis of the femoral neck and tilt back 15 degrees
97
Q

What is the CR for Clements-Nekayama?

A

Directed 15 degrees posteriorly and aligned peripendicular to the femoral neck and IR and beam perpendicular to cassette
- cassette and central ray need to be in the same degree of angulation

98
Q

What is the essenetial projection for the Acetabulum?

A

AP oblique (Judet; modified Judet)

98
Q

What is in profile in the Clements-Nakayama?(lateral hip)

A

Lesser in profile

98
Q

In Clements-Nekayama the cassette and Tube is what?

A

Cassette tilt back 15 degrees while the tube will angle down 15 degrees perpendicular to IR they need to be in the same degree of angulation

99
Q

To demonstrate posterior rim of acetabulum and iliopubic column?

A

Internal AP Oblique Acetabulum (Judet)

99
Q

The 3 P’s

A

Posterior iliopubic Up
(side up)
Internal oblique

100
Q

Used to demonstrate anterior rom of acetabulum and ilioischiel column?

A

External AP Oblique Acetabulum (Judet)
(side down)

100
Q

Patient position for Internal Oblique Acetabulum (Judet)?

A

Recumbent 45 degrees posterior oblique position with affected side up (LPO)

101
Q

CR for AP Internal Oblique Acetabulum (Judet)?

A

Perpendicular to IR
- Enters 2 inches inferior to ASIS of affected side

101
Q

Patient position for AP Exteral Oblique Acetabulum (Judet)?

A

Recumbent 45 degrees posterior oblique position with affected side down (RPO)

101
Q

Used to demonstrate posterior rim of acetabulum and iliopubic column

A

Internal Oblique (Judet Method)

102
Q

Demonstrate anterior rim of acetabulum and ilioischial column?

A

External Oblique (Judet Method)

102
Q

CR for AP Oblique External Acetabulum (Judet)?

A

Perpendicular to IR
-Enters pubic symphysis

103
Q

Patient position for AP Axial Outlet (Taylor Method)?

A

Supine

104
Q

Where are we centering for AP Axial Outlet (Taylor Method)?

A

Enters 2 inches inferior to the superior border of the pubic symphysis

104
Q

CR for males for AP AXial Outlet (Taylor Method)?

A

20 to 35 degrees cephalic

105
Q

CR for females for Ap Axial Outlet (Taylor Method)?

A

30 to 45 degrees cephalic

106
Q

For the outlet view how do we angle?

A

We angle in to the body

106
Q

For the inlet view how do we angle?

A

We angle outside the body

107
Q

Criteria for Taylor Method outlet projection?

A

-elongates the superior and inferior rami of the pubic bone
- ramus of ischium
- nice view of pubic symphysis
- nice view of ischium

108
Q

Patient position for superoinferior axial inlet projection (Bridgeman method)?

A

Supine

108
Q

Why do we do an inlet view?

A

We are looking at the brim and elongating it, as well as the ischial spines

108
Q

What is the rule of shielding?

A

Shield for reproductive years, do not shield if covering anything of necessity

108
Q

What is the rule for Hip Dysplasia?

A
  • AP
  • Frog leg
    table top
    normally done on little kids
  • remove diaper, any power or diaper cream
109
Q

CR for Superoinferior Axial Inlet Projection (Bridgemean method)?

A

CR directed 40 degrees caudal, entering the midline at the level of ASIS

Positioning ll (mine) (16 decks)

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