HIP/PELVIS I.A. Flashcards
PELVIS CONSISTS OF ____ BONES:
NAMES: ________________________________________
HIP BONE AKA:
DIVISIONS OF PELVIS & LOCATION:
What is the acetabulum?
4 BONES, 2 HIP BONES (INNOMINATE), SACRUM & COCCYX
-HIP = INNOMINATE
ILLEUM - SUPERIOR
ISCHIUM - INFERIOR/POSTERIOR
PUBIS - INFERIOR & ANTERIOR
ACETABULUM = socket of hip joint
WHAT FORMS OBTURATOR FORAMEN?
PROXIMAL FEMUR CONSIST OF: _______, ________, ______ & __________
HEAD & NECK OF FEMUR FORM ______* ANGLE.
________ - LOCATED SUPERIOR/LATERALLY
________-LOCATED MEDIALLY/POSTERIORLY
________- THICK RIDGE JOINS TROCHANTERS
ISCHIUM & PUBIS
-HEAD, NECK, GREATER & LESSER TROCHANTER
15-20* ANTERIOR ANGLE
-GREATER TROCHANTER
-LESSER TROCHANTER
- INTERTROCHANTERIC CREST
AP PELVIS - GUIDELINES
- Greater trochanters in profile
- Lesser trochanters should not be visible /
should be superimposed bY femoral necks - Femoral necks without foreshortening
- Symmetric appearance of the iliac wings
(alae), ischial spines and two obturator
foramina - Iliac wings are partially foreshortened
MALE VS FEMALE PELVIS
FEMALE = WIDER, SHALLOWER, LIGHTER
- FLARED, INLET ROUNDER & ARCH IS 90*<
-OBSTRUCTOR FORAMEN - SMALLER
- PELVIC INLET - LARGER
MALE = NARROWER, DEEPER & HEAVIER
-LESS FARE, ARCH <90*
- PELVIC INLET MORE OVAL/ HEART SHAPED
WHY ROTATE FEET INTERNALLY ON AP PELVIS?
HOW MUCH ROTATION?
WHAT DOES FORESHORTENED OR CLOSED OBTURATOR FORAMEN INDICATE?
SACRUM & COCCYX MOVE IN WHAT DIRECTION WITH ROTATION?
INTERNAL ROTATION BRINGS GREATER TROCHANTER IN PROFILE, AND LESS FORESHORTENED ANATOMY
15*
-ROTATION IN THAT DIRECTION
-OPPOSITE DIRECTION (POINTING TO RIGHT, LEFT ROTATION)
ANAYLZE AP PELVIIS
-ROTATION IN LPO
- RIGHT ILIAC WING FORESHORTEN
- LEFT OBTURATOR FORAMEN MORE FORESHORTEN
- SACRUM & COCCYX ROTATED TOWARD RIGHT HIP
ANALYZE AP PELVIS
-ROTATION IN RPO
- LEFT ILIAC WING FORESHORTEN
- RIGHT OBTURATOR FORAMEN MORE FORESHORTEN
- SACRUM & COCCYX ROTATED TOWARD LEFT HIP
EVALUATE AP PELVIS
-FEET PLACED VERTICALLY
- FEMORAL NECKS PARTIALLY FORESHORTENED
- LESSER TORCHANTER IN PARTIAL PROFILE
EVALUATE AP PELVIS
-FEET EXTERNALLY ROTATED
- FEMORAL NECKS GREATLY FORESHORTEN
- LESSER TROCHANTER IN PROFILE INTERNALLY
COMPARE THREE AP PELVIS’ - FOOT POSITION
IMAGE 1: GOOD** 15-20* MEDIAL ROTATION
- LESSER TROCHANTERS NOT/ MIN. VISIBLE
- FEMORAL NECK NOT FORESHORTENED
IMAGE 2: FEET VERTICAL
- LESSER TROCHANTER PARTIALLY VISIBLE
- FEMORAL NECK PARTIALLY FORESHORTEN
IMAGE 3: FEET EXTERNALLY ROTATED
- LESSER TROCHANTER IN PROFILE
- FEMORAL NECK FORESHORTENED GREATLY
IF DISLOCATION OR FEMORAL FRACTURE, WHAT POSITIONING CHANGES?
IF IMAGING ORTHOPEDIC APPLIANCE, WHAT POSITIONING CHANGES?
DO OT INTERNALLY ROTATE FEET, LEAVE AS IS
INCLUDE ALL EQUIPTMENT - MAY NEED CLIP ILIA
AP FROG-LEG PELVIS GUIDELINES
- Lesser trochanters in profile medially
- Most of greater trochanters superimp. over
femoral necks - Femoral necks foreshortened
ANALYZE AP FROG-LEG PELVIS
-LEFT SIDE ROTATED TOWARD IR (LPO)
- RIGHT ILIUM FORESHORTENED
- LEFT OBTURATOR FORAMEN MORE FORESHORTEN
- SACRUM & COCCYX ROTATED TOWARD RIGHT HIP
AP HIP GUIDELINES
- Greater trochanter in full profile laterally
- Femoral neck in profile w/o foreshortening
- Lesser trochanter superimp. by femoral neck
- Ischial spine is aligned with the pelvic brim
- Obturator foramen is open
ANALYZE AP HIP
-PELVIC ROTATION TOWARD AFFECTED HIP
- OBTURATOR FORAMEN FORSHORTEN
- LEFT ISCHIAL SPINE W/O PELVIC BRIM SUPERIMP
- SACRUM & COCCYX ROTATED AWAY FROM AFFECT HIP
-FOOT EXTERNALLY ROTATED
FORESHORTENED OR CLOSED OBTURATOR FORAMEN INDICATIONS ____________ (AP HIP)
ROTATION TO OPEN SI JOINTS IN OBLIQUE SI JOINT:
ROTATION IN THAT DIRECTION (AP HIP)
25-30*
ANALYZE AP HIP
-PELVIC ROTATION AWAY FROM AFFECTED HIP
- SACRUM & COCCYX ROTATED TOWARD AFFECTED HIP
- OBTURATOR FORAMEN WITH DECREASED FORESHORTEN
- FOOT EXTERNALLY ROTATED
COMPARE AP HIP - FOOT POSITION
IMAGE 1: FOOT EXTERNALLY ROTATED
- LESSER TROCHANTER IN PROFILE
- FEMORAL NECK GREATLY FORESHORTEN
IMAGE 2: FOOT VERTICAL (INSUF. INTERNAL ROT.)
- LESSER TROCHANTER IN PARTIAL PROFILE
- FEMORAL ENCK PARTIALLY FORESHORTENED
- WHAT IS IMPORTANT ABOUT THIS IMAGE?
- What is the joint classification of the symphysis pubis?
- Which bony landmark should NOT be visible on a correctly positioned AP pelvis (nontrauma)?
- The “false pelvis” forms the birth canal in females. T/F
- DISLOCATION - DO NOT INTERNALLY ROTATE LEG
- Amphiarthrodial
- LESSER TROCHANTER
- FALSE
- WHAT IS IMPORTANT ABOUT THIS IMAGE?
- An AP hip with accurate positioning demoS:
- lesser trochanter in profile.
- greater trochanter in profile.
- femoral neck without foreshortening.
- sacrum rotated toward the affected hip.
- An optimal AP pelvis projection demonstrates:
- the sacrum and coccyx aligned with the symphysis pubis.
- the ischial spines aligned with the pelvic brim.
- a narrow right iliac wing and a wider left iliac wing.
- a symmetrically appearing obturator foramen.
- HIP FRACTURE - DO NOT ROTATE
- 2 & 3
- 1, 2 & 4
AP FROG-LEG HIP GUIDELINES
- Lesser trochanter in profile medially
- Most of Greater trochanter superimp. femoral neck
- Femoral neck foreshortened
ANALYZE FROG-LEG HIP
-EXCESIVE FEMORAL ABDUCTION
- FEMORAL NECK GREAT. FORESHORTEN
- GREATER TROCHANTER AT SAME LEVEL AS FEMORAL HEAD
ANALYZE FROG-LEG HIP
-INSUFFICIENT FEMORAL ABDUCTION
- DECREASED FORESHORTEN OF FEMORAL NECK
- GREATER TROCHANTER AT SAME LEVEL AS LESSER TROCHANTER
- State which of the following is true with regard to the female pelvis.
- The ala are narrower than on a male pelvis.
- The overall shape is wider than on a male pelvis.
- The pubic arch angle is larger.
- The pelvis inlet is heart-shaped.
- An AP pelvis obtained with the patient rotated toward the left hip demonstrates:
- left ischial spine without pelvic brim superimp.
- a narrower right iliac wing.
- a narrower left obturator foramen.
- the sacrum & coccyx rotated toward right hip.
- 2 & 3 ONLY
- 1, 2, 3, & 4
- An AP frog-leg hip projection (modified Cleaves method) obtained with the leg abducted almost to the imaging table demonstrates the greater trochanter:
- Same transverse level as the lesser trochanter.
- laterally.
- superimposed by the femoral head.
- demonstrated medially.
- A less than optimal AP hip projection demonstrating the lesser trochanter in partial
profile:
a. was obtained with the leg in internal rotation.
B. will also demonstrate the greater trochanter at the same level as the femoral head.
c. will also demonstrate a foreshortened femoral neck.
- 3 ONLY
- c. will also demonstrate a foreshortened femoral neck.
LABEL THE IMAGE
A. Iliac crest
B. ASIS
C. Body of left ischium
D. Ischial tuberosity
E. Symphysis pubis (pubic symphysis)
F. Inferior ramus of Right pubis
G. Superior ramus of right pubis
H. Right ischial spine
I. Acetabulum
J. Neck of femur
K. Greater trochanter
L. Head of femur
M. Ala or wing
N. Lesser tubercle
LABEL THE IMAGE
A. Iliac (ala) wing
B. Acetabulum
C. Femoral head
D. Femoral neck
E. Greater trochanter
F. Femoral shaft
G. Lesser trochanter
H. Ischial tuberosity
I. Obturator foramen
J. Superior ramus
K. Inferior ramus
L. Symphysis pubis
M. Coccyx
N. Pelvic brim
O. Ischial spine
P. Sacrum
