Hip/Pelvis Flashcards
1
Q
Pelvis consists of four bones:
A
-right and left innominate (os coxae) or hip bones
-sacrum
-coccyx
2
Q
Serves as the base for the trunk and a girdle for lower limb
A
pelvis
3
Q
Composed of only the two hip bones
A
Pelvic Girdle
4
Q
Other names for pelvic girdle
A
-os coxae
-innominate
5
Q
These three bones come together to form the acetabulum
A
-illium
-ischium
-pubis
6
Q
What does Illium, ischium, pubis form
A
acetabulum
7
Q
-consists of a body and a broad, curved portion called the ala
-Body forms superior two fifths of acetabulum
A
Ilium
8
Q
Four prominent processes of the Ilium
A
-Anterior superior iliac spine (ASIS)
-anterior inferior iliac spine
-posterior superior iliac spine
-posterior inferior iliac spine
9
Q
What is the superior margin of the ilium
A
iliac crest
10
Q
what does the posterior inferior part of the ilium end in
A
the greater sciatic notch
11
Q
What does the Ischium consist of
A
-body
-ischial ramus
12
Q
Each bone of the pelvic girdle has three parts which are
A
-ilium
-ischium
-pubis
13
Q
What is the cup shaped socket that articulates with the head of the femur
A
Pelvic gridle
14
Q
Forms the posterior two fifths of aceabulum
A
Ischium
15
Q
what does the ischial ramus join with
A
Ischial ramus joins with inferior ramus of pubis
16
Q
expanded portion on which the trunk rests when seated
A
ischial tuberosity
17
Q
located on upper, posterior part of the body
A
Ischial Spine
18
Q
indentation just below ischial spine
A
lesser sciatic notch
19
Q
-the area in which the head of the femur articulates
-ball and socket. joint
A
Acetabulum
20
Q
What can we palpate on the pelvic girdle
A
-ASIS
-Iliac crest
21
Q
Is the side down elongated or foreshortened
A
Elongated
22
Q
Is the side up elongated or foreshortened
A
Foreshortened
23
Q
What helps form the obturator foramen?
A
Ischial Tuberosity
24
Q
The pubis consists of:
A
-body
-superior ramus
-inferior ramus
25
The body forms approximately one fifth of anterior acetabulum
The body of the Pubis
26
Formed by junction of ischial ramus and pubis inferior ramus
obturator foramen
27
Four mains parts of the proximal femure
Head
neck
Greater trochanter -out to the lateral
lesser trochanter- out to the medial
28
intertrochanteric line
A imaginary line that goes to greater to lesser
on the anterior aspect
29
Where is the intertrochanteric crest located
on the posterior aspect of the proximal femure
30
-Articulation between the right and left ilia and the sacrum
Sacroiliac (SI) joints
31
-articulation of the head of the femora with the acetabula
hip joints
32
what type of joint is the hip joint
-synovial, ball and socket
33
What type of joint are the SI joints
-irregular, gliding type
34
-junction of right and left pubic bones in the midline
-Cartilaginous, slightly moveable joint
Pubic sumphysis
35
Difference in male and females pelvic anatomy
Males
-heavier, narrower, deeper
-angle at pubic symphysis is acute
Females
-wider, shallower, lighter
-angle at pubic symphysis is obtuse
36
forms superior aperture (opening) or inlet of the true pelvis
Brim
37
what consists of the true pelvis
bladder, colon, female reproductive organs
38
what forms the outlet
inferior aperture
39
what are the bony landmarks
-iliac crest
-ASIS
-pubic symphysis
-greater trochanter
-ischial tuberosity
-tip of coccyx
40
What lies in the same horizontal plane as the midpoint of the hip joint and coccyx
Highest point of greater trochanter
41
what is in the same horizontal plane as the pubic symphysis
The most prominent point of greater trochanter
42
How to localize the hip joint
make a imaginary line from the anterior superior iliac spine to the superior margin of the pubic symphysis half way between go down 2 and a half inches and the neck will be right there
43
Essential projections of the pelvis
AP
44
what should you never do if a foot is straight out to one side
NEVER ROTATE A THE LEG that is turned out because at this point you know there is a fractured hip
45
Patient position for AP pelvis and upper femora
Supine
46
how do you rotate the feet for the ap pelvis and upper femora
medially rotate the feet and lower limbs 15 to 20 degrees
47
part position for AP pelvis and upper femora
-median sagittal plane (MSP) of body centered to midline
-equal ASIS to table distance on both sides
48
what does rotating the feet in medially do in the Ap pelvis and upper femora
-places femoral necks parallel to IR so they are not foreshortened
49
CR for Ap pelvis and upper femora
perp to IR
50
Where should the IR be for AP pelvis and upper femora
Upper border of IR 1 to 1 1/2 inches above crests
51
what is in profile in the ap pelvis and upper femora
Greater Trochanter
52
what should be included in the ap pelvis and upper femora
-top of crests
-pubic symphysis
-its not necessary to get greater trochanter on
-necks of femur should look parallel without superimposition
-should not see much of the lesser trochanter
-illium is of equal distance
-ischial spine equal distance
sacrum and coccyx is equal distance
-obturator foramen should look equal
53
what does it mean if you see too much of the lesser
You did not turn the legs in
54
breathing for AP pelvis and upper femora
suspended
55
what happens when there is poor positioning of the feet for AP pelvis and upper femora
-the lesser are in profile
-There is foreshortening of the femoral necks
56
Essential projections for the Femoral Necks
AP Oblique (modified cleaves method)- do not do this if there is a suspected fracture
57
Patient position for AP Oblique Femoral Necks (Modified Cleaves)
Supine
58
SID for AP pelvis
40 inches
59
Part position for bilateral AP Oblique Femoral Necks (modified Cleaves)
-ASIS equal distance from tabletop
-flex hip and knees
-draw feet up as much as possible
-abduct thighs equally and maximally
-place soles of feet together
60
Where to center for bilateral AP oblique Femoral necks (modified cleaves)
Center IR 1 inch above pubic symphysis
61
CR for bilateral AP oblique femoral necks (modified cleaves)
-perp to MSP at level 1 inch above pubic symphysis
-Sometimes called the bilateral frog leg
62
CR for unilateral AP oblique Femoral Necks (modified Cleaves)
perp to femoral necks
63
Part position for unilateral AP oblique Femoral Necks (modified Cleaves)
-center ASIS of affected side to midline of grid
-flex affected hip and knee
-draw foot up to opposide knee as much s possible
-abduct thigh approx. 45 degrees laterally
64
how much should the thigh be abducted in the unilateral AP oblique femoral necks
45 degrees laterally
65
essential projections of the Hip :
-AP
-Lateral (Lauenstein and Hickey methods)
-Axiolateral (Danelius Miller Method)
66
Patient position for AP Hip
Supine
67
Part position for AP hip
-ASIS to tabletop distance equal on both sides
68
How much do you rotated the lower limb and foot for AP hip
15 to 20 degrees medially
69
what does roatting the feet 15 to 20 degrees medially do in the AP hip
places femoral necks parallel to IR
70
CR for AP hip
-perp to femoral neck
-use localization technique described previously
adjustment may be necessary if orthopedic device is present
71
Criteria for AP hip
-femoral head and seen through the acetabulum
-femoral neck not foreshortened
-greater is in profile to the later
-pubic symphysis must be seen
-does not need iliac crest unless part of protocol
hip joint
72
Patient position for Lateral hip (Lauenstein)
rotate slightly toward affected side to an oblique position
73
Part position for Lateral hip (Lauenstein)
-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
74
CR for lateral hip (Lauenstein)
-perp through hip
-enters midway between ASIS and pubic symphysis
75
criteria for lateral hip (Lauenstein method)
-hip joint, acetabulum, femoral head
-femoral neck overlapped by greater trochanter
-lesser in profile
76
What is in profile for the lateral hip (lauenstein method)
Lesser Trochanter
77
What is the part and patient position for the lateral hip (Hickey method)
the same as for Lauenstein method
78
CR for lateral hip (hickey method)
-angle 20 degrees cephalic
-enters hip joint
79
how much do you angle for the lateral hip (Hickey method) and why do we add an angle
20 degrees cephalic and it takes greater off of the neck so the neck is free of superimposition
80
Patient position for Axiolateral Hip (Danelius- Miller)
Supine
81
Part position for axiolateral hip (Danelius- Miller)
-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
82
CR for axiolateral hip (Danelius -Miller)
horizontal and perp to long axis of femoral neck
83
position of IR for Axiolateral Hip (Danelius-Miller)
-vertical with upper border in crease above iliac crest
-angle lower border away from body until parallel with femoral neck
-Cassete is parallel to neck and perpendicular to beam
84
criteria for axiolater hip (Danelius-Miller)
-acetabulum
-ischial tuberosity
-lateral neck is foreshortened
-greater is superimposed over the neck
85
What will you do if pateint cant lift leg for axiolateral hip (Danelius -Miller) or have bilateral fractures of the hip
Clements-Nakayama
-limbs remain neutral or external rotated
-grid is parallel to the axis of the femoral neck and tilt top back 15 degrees
-tube will come in angled down 15 degrees it will come in perp with ir in through to the cassette
**angle of cassette and tube need to be the same degree of angulation**
86
Essential projections for the Acetabulum
-AP Oblique (Judet, modified Judet)
87
To demonstrate posterior rim of acetabulum and iliopubic column
Internal AP oblique Acetabulum (Judet)
88
Used to demonstrated anterior rim of acetabulum and ilioischial colum
External AP oblique acetabulum (Judet)
89
SID for AP hip
40 inches
90
breathing for AP hip
suspended
91
breathing for unilateral AP oblique femoral necks (modified cleaves)
suspended
92
distance for AP oblique Femoral necks (modified cleaves)
40 inches
93
Breathing and SID for Axiolateral Hip (Danelius- Miller)
suspended
40 inches
94
Breathing, angle and SID for Clements Nakayama
-suspended
-15 degrees posteriorly
-40 inches
95
patient position for internal oblique acetabulum (Judet)
recumbent 45 degree posterior oblique position with affected side up
96
CR for AP internal oblique acetabulum (Judet)
perp to IR
enters 2 inches inferior to ASIS of affected side
97
used to demonstrate posterior rim of acetabulum and iliopubic column
internal oblique (Judet Method)
98
Patient position for AP external oblique acetabulum (Judet)
recumbent 45 degree posterior oblique position with affected side down
99
CR for external AP oblique Acetabulum (Judet)
-perp to IR
-Enters pubic symphysis
100
demonstrate anterior rim of acetabulum and ilioischial column.
external oblique Judet Method
101
Pt. position for AP Axial Outlet (Taylor Method)
supine
102
CR for males for AP Axial Outlet (Taylor method)
20 to 35 degrees cephalic
103
CR for females for AP axial Outlet (Taylor Method)
-30 to 45 degrees cephalic
104
where are we centering for AP axial outlet (Taylor Method)
entering 2 inches inferior to the superior border of the pubic symphysis
105
For the outlet view how do we angle
we angle in to the body
106
for the inlet view how do we angle
We angle outside the body
107
Criteria for Taylor method -outlet projection
-elongates the superior and inferior rami of the public bone
-ramus of ischium
-nice view of pubic symphysis
-nice view of ischium
108
SID and breathing for outlet view
40 inches
suspended
109
Pt. position for Superoinferior axial inlet projection (Bridgeman method)
supine
110
CR for superoinferior axia inlet projection (Bridgeman method)
CR directed 40 degrees caudal, entering the midline at the level of the ASIS
111
SID and breathing for superoinferior axial inlet projection (Bridgeman method)
-40 inches
-suspended
112
Why do we do an inlet view
we are look at the brim and elongating it
