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RTE 1513 > Hip/Pelvis > Flashcards

Hip/Pelvis Flashcards

0
Q

lesser trochanter is on (med/lat) aspect of prox femur?

A

med

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1
Q

small depression located near center of femoral head

A

fovea capitis

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2
Q

lesser trochanter projects (ant/post) from the junction btw the neck and the shaft

A

posteriorly

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3
Q

4 bones that make up pelvis

A

R/L hip bones (ossa coxae), sacrum, and coccyx

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4
Q

2 bones that make up pelvic girdle

A

R/L hip bones (ossa coxae)

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5
Q

3 divisions of hip bone

A

ilium, ischium, pubis

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6
Q

3 hip divisions fuse at _____ at age of ______

A

acetabulum; mid-teens

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7
Q

upper margin of greater trochanter is about _____” above the sup. border of pubic symphysis, and the ischial tuberosity is about ____” below

A

1”;

1.5 - 2”

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8
Q

imaginary plane that divides the pelvic region into the greater and lesser pelvis is called

A

the pelvic brim

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9
Q

greater pelvis aka

A

false pelvis

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10
Q

lesser pelvis aka

A

true pelvis

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11
Q

major f(x) of greater pelvis

A

supports lower abdominal organs and fetus

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12
Q

major f(x) of lesser pelvis

A

forms actual birth canal

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13
Q

3 aspects of lesser pelvis, which also describes the birth route

A

inlet (sup. aperture), cavity, outlet (inf. aperture)

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14
Q

what possesses a large tuberosity found at the most inf. aspect of pelvis

A

ischium

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15
Q

what contains the lesser sciatic notch

A

ischium

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16
Q

what contains PSIS

A

ilium

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17
Q

what possesses a slightly moveable joint

A

pubis

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18
Q

what forms the ant., inf. aspect of the lower pelvic girdle

A

pubis

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19
Q

what articulates w the sacrum to form SI joints

A

ilium

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20
Q

what imaging modality has replaced cephalopelvimetry?

A

sonography - U/S

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21
Q

what is the advtg of using 90 kV rather than a lower kV for hip/pelvis XRs on younger pt’s on analog system?

A

reduces pt dose

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22
Q

what is the disadvtg of using 90 kV for hip/pelvis XR, especially. on older osteoperotic pt’s?

A

reduces contrast

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23
Q

whic condition is a common clinical indication for hip/pelvic exams on newborn pt’s?

A

DDH

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24
Q

which imaging modality is most sensitive in diagnosing early signs of metastatic carcinoma of pelvis?

A

nuclear med

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25
Q

degenerative joint disease

A

osetoarthritis

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26
Q

most common fracture in older pt’s bc of high incidxence of osteoporosis/avascular necrosis

A

prox. hip fracture

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27
Q

malignant tumor of hip cartilage

A

chondrosarcoma

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28
Q

disease producing extensive calcification of the longitudinal ligament of the spinal column

A

ankylosing spondylitis (bamboo spine)

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29
Q

fracture resulting from severe blow to one side of the pelvis

A

pelvic ring fracture

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30
Q

malignancy spread to bone via the circulatory and lymphatic systems or direct invasion

A

metastatic carcinoma

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31
Q

aka DDH

A

congenital dislocation

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32
Q

what will improve overall visibility of prox hip shown on an axiolateral (inferosuperior) projection?

A

compensating filter

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33
Q

what modality best shows pelvic ring fracture

A

CT

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34
Q

where is CR centered for AP pelvis?

A

midway btw pubic symphysis and ASIS

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35
Q

what error is present when the L iliac wing is elongated on AP pelvis?

A

rotation toward L side

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36
Q

what error when L obturator foramen is more open than the R side?

A

rotation to R

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37
Q

Is the axiolateral, inferosuperior (Danelius-Miller) XR trauma or nontrauma?

A

T

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38
Q

is unilateral frog (modified cleaves) trauma or non trauma?

A

NT

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39
Q

is modified axiolateral (Clements-Nakayama) trauma or nontrauma?

A

T

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40
Q

is AP axial for pelvis “outlet” trauma or nontrauma?

A

T

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41
Q

what XR best shows the superoposterior wall of acetabulum?

A

PA Axial obl

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42
Q

how many degrees are femurs abducted from vertical for bilat frog?

A

40-45 degrees

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43
Q

where is CR centered for bilat frog?

A

3” below ASIS

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44
Q

where is CR centered for AP unilat frog

A

midfemoral neck

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45
Q

what CR angle is required for “outlet” XR (Taylor method) for female pt?

A

30-45 degree cephalad

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46
Q

what path is best shown w post. obl (Judet method)

A

acetabular fractures

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47
Q

how much body obliquity is required for post obl (Judet method)

A

45 degrees

48
Q

what CR angle is used for PA axial obl (Teufel)?

A

12 degree cephalic

49
Q

how is body positioned for a PA axial obl (Teufel)?

A

PA 35-40 degrees toward affected side

50
Q

how is unaffected leg positioned for the axiolateral hip projection

A

flexed/elevated to prevent from being superimposed over affected hip

51
Q

the modified axiolateral requires the CR to be angled ______ degrees posteriorly from horizontal

A

15-20

52
Q

which hip XR shows the ant. and post. rims of the acetabulum and the ilioischial and iliopubic columns?

A

post obl XRs of acetabulum (Judet method)

53
Q

name of special pelvic XRused to assess trauma to pubic and ischial structures?

A

AP axial outlet (Taylor method)

54
Q

axiolateral (inferosuperior) aka

A

Danelius-Miller

55
Q

modified axiolateral aka

A

Clements-Nakayama (trauma hip)

56
Q

bilat/unilat frog-leg aka

A

modified cleaves

57
Q

PA axial obl for acetabulum aka

A

Teufel

58
Q

AP axial for pelvic “outlet” bones aka

A

Taylor

59
Q

Post. obl for acetabulum aka

A

Judet

60
Q

optimal amount of hip abduction applied for the unilateral frog-leg XR to show the femoral neck w/o distortion?

A

20-30 degrees from vertical

61
Q

how much is the IR tilted for the modified axiolateral XR of hip

A

15 degrees from vertical

62
Q

an axiolateral (inferosuperior) XR shows that the post aspect of the acetabulum and femoral head were cut off at the bottom. What can be done on repeat?

A

elevate pt at least 2” by placing sheets/blankets under pelvis

63
Q

pt enters ER w pelvic injury from MVA. initial AP pelvis shows possible fracture of L acetabulum. no other possible fractures detected and pt can move comfortably. what other XR can show this possible acetabular fracture?

A 
PA axial obl (Teufel method); or
post obl (Judet)
64
Q

when using AEC for AP pelvis, what must be activated?

A

R & L ionization chambers

65
Q

pt w/ hip pn from fall enters ER. Dr. orders L hip study. when moved to table, pt complains loudly. which positioning routine should be used?

A

AP pelvis, and then axiolateral (inferosuperior) L hip

66
Q

pt has just been moved to his hospital room after a bilat hip replacement. surgeon orders a post-op hip routine for both hips. which specific pos routine should be used (pt can be brought to rads dept)

A

AP pelvis & modified axiolateral (Clements-Nakayama)

67
Q

pt w possible pelvic ring fracture from trauma enters ER. AP pelvis XR is inconclusive, what other XR can be taken to better see acetabulum? and what other modality can determine a pelvic ring fracture?

A

post obl Judet method;

CT

68
Q

what is the most common routine for very young child w DDH?

A

AP pelvis and bilat frog

69
Q

shape of male pelvis

A

narrow, deeper, less flared

70
Q

shape of female pelvis

A

wider, more shallow, more flared

71
Q

angle of pubic arch of male

A

acute (< 90 degrees)

72
Q

angle of pubic arch of female

A

obtuse (> 90 degrees)

73
Q

pelvic inlet shape of male

A

more oval, heart-shaped

74
Q

pelvic inlet shape of female

A

rounder, larger

75
Q

where is the femoral neck?

A

1-2” med. and 3-4” dist. to ASIS

76
Q

technique for osteoporosis

A

lower kV

77
Q

external rotation of leg shows:

A

greatly foreshortened femoral necks, lesser trochanters visible in profile internally

78
Q

routine for hip fracture?

A

AP both hips as-is, then inferosuperior (Danelius-MIller method) of affected hip

79
Q

ischial tuberosities are where?

A

1.5 - 2” inf. to pubic symphysis

80
Q

pt who’ve undergone hip replacement should NOT be placed in ______ pos; should perform ______ & _______ post-surgical XR’s

A

frog-leg;

AP & inferosuperior lat

81
Q

initial fusion of SI joints, then calcification of ant. longitudinal ligament

A

aknylosing spondylitis (bamboo spine)

82
Q

what is reqauired to detect a small avulsion fracture?

A

lower kV

83
Q

narrowed R obturator foramen indicates….?

A

rotation to R

84
Q

abduct femora _______ degrees from vertical for bilat frog

A

40-45 degrees

85
Q

abducting femora 20-30 degrees from vertical will show

A

less foreshortening of femoral necks, but foreshortens entire proximal femora

86
Q

how much internal rotation is required of legs for AP pelvis?

A

15-20 degrees

87
Q

small depression located in center of femoral head

A

fovea capitis

88
Q

AP bilat frog-leg shows?

A

most of greater trochanters appear superimposed over femoral necks, which appear foreshortened

89
Q

CR for AP axial outlet (Taylor - anteriorinferior) for male?

A

20-35 degrees cephalad to 1-2” dist. to pubic symphysis

90
Q

CR for AP axial outlet (Taylor - anteriorinferior) for female?

A

CR 30-45 degrees cephalic to 1-2” dist. to pubic symphysis

91
Q

what XR is a bilat trauma view of bilat pubis/ischium?

A

AP Axial Outlet (Taylor - anteriorinferior)

92
Q

CR for AP axial inlet?

A

CR 40 degrees caudad to ASIS

93
Q

AP Axial Inlet pelvis shows?

A

to show pelvic ring/inlet (sup. aperture)

94
Q

trochanters are joined posteriorly by thick ridge called ______

A

intertrochanteric crest

95
Q

sup. and lat. to femoral shaft

A

greater trochanter

96
Q

projects medially and posteriorly from junction of neck & shaft

A

lesser trochanter

97
Q

what is the angle of neck to shaft on avg adult?

A

about 125 degrees +/- 15 degrees

98
Q

longitudinal femoral plane is about ___ degrees from vertical

A

10

99
Q

how much do you obl pt for post obl pelvis - acetabulum - Judet

A

45 degrees

100
Q

what does the downside of post obl pelvis - acetabulum - Judet show

A

ant. rim of acetabulum, post. (ilioischial) cloumn, and iliac wing

101
Q

what does the upside of post obl pelvis - acetabulum - Judet show?

A

post. rim of acetabulum, ant. (iliopubic) column, & obturator foramen

102
Q

CR for downside post. obl pelvis - acetabulum - judet

A

CR perpendicular to 2” dist. & 2” med. to downside ASIS

103
Q

CR for upside post. obl pelvis - acetabulum - judet

A

CR perpendicular 2” dist. to upside ASIS

104
Q

In Judet method, (post obl pelvis), obturator foramen should be _____ for upside obl

A

open

105
Q

In Judet method, (post obl pelvis), obturator foramen should be _____ for downside obl

A

closed

106
Q

what CR shows concave area of fovea capitis & superoposterior wall of acetabulum

A

PA Axial obl - acetabulum (Teufel)

107
Q

pt pos for PA Axial Obl - Acetabulum - Teufel?

A

affected side down, pt in 35-40 degree ant. obl

108
Q

CR for PA Axial Obl - acetabulum - teufel

A

CR 12 degree cephalic to 1” sup. to greater trochanter and 2” lat. to MSP

109
Q

CR for AP Unilat Hip? pt pos?

A

CR perpendicular to 1-2” dist. to midfemoral neck (1-2” med. & 3-4” dist. to ASIS;
int. rotate leg 15-20 degrees

110
Q

where do you place IR for axiolat inferosuperior hip (Danelius-Miller)?

A

IR in crease above iliac crest so it’s parallel to midfemoral neck and perpendicular to IR

111
Q

what is demonstrated on the axiolat inferosuperior Danelius-Miller method?

A

(in place of frog lat) entire femoral head/neck, trochanter and acetabulum. (only most dist. portion of femoral neck should be superimposed by greater trochanter)

112
Q

what do grid lines indicate?

A

incorrect CR/IR alignment

113
Q

what may be impossible on the inferosuperior Danelius-Miller method on pt w thick thighs?

A

demonstrating the most prox. portion of femoral head and acetabulum

114
Q

What is common XR w arthroplasty (Hip prosthesis surgery)

A

Modified Axiolateral - Clements-Nakayama method

115
Q

IR placement for modified axiolateral Clements-Nakayama method?

A

tilt IR 15 degrees from vertical and make sure it’s perpendicular to CR and parallel to midfemoral neck (above iliac crest)

116
Q

CR for modified axiolat Clements-Nakayama method

A

angle CR mediolaterally to make CR perpendicular to midfemoral neck (about 15-20 degrees posteriorly from vertical)

117
Q

what is demonstrated by the modified axiolat Clements-Nakayama method

A

shows the lat obl of acetabulum, trochanteric area, and femoral head/neck

RTE 1513 (15 decks)

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