hips Flashcards

1
Q

Where should the center ray enter for a unilateral AP projection of the hip?

A

femoral neck

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2
Q

Which of the following would be another name for the translateral hip projection?

A

All of the above x table lateral, O.R. lateral, inferosuperior projection

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3
Q

When performing a routine AP projection of the pelvis the feet should be …… rotated?

A

internally

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4
Q

The term pelvic girdle refers to the total pelvis including the sacrum and coccyx.

A

false

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5
Q

What are the two parts of the pelvic girdle?

A

Right and left hip bones

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6
Q

If you have high kVp, you will have ______ scale contrast.

A

long

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7
Q

Which anatomical landmarks are used to locate the neck of the femur?

A

Symphysis and ASIS

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8
Q

Which of the following should not be seen in an AP radiograph of the hip if the femur is rotated correctly?

A

lesser trochanter

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9
Q

Which of the following positions/projections should be done if the patient has suspected hip fracture?

A

AP and cross table lateral

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10
Q

What are the three divisions of the hip bone?

A

Ilium, ischium, Pubis

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11
Q

Which boney landmark is found on the most inferior aspect of the posterior pelvis?

A

ischial tubeosity

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12
Q

What forms the anterior, inferior aspect of the lower pelvic girdle?

A

pubis

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13
Q

Which physical sign may indicate that a patient has a hip fracture?

A

Patients foot rotated externally

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14
Q

If trauma is suspected which projection should be taken first and reviewed by a radiologist before attempting to rotate the hip into a lateral position?

A

AP pelvis

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15
Q

Where is the CR placed for an AP pelvis projection?

A

Midway between ASIS and symphysis pubis

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16
Q

Which specfic positioning error is present when the left iliac wing is elongated on an AP pelvis radiograph?

A

Rotation toward the left side / medial rotation

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17
Q

Which specific positioning error is present when the left obturator foramen is more open than the right side on an AP pelvis radiogragh?

A

right rotation / lateral rotation

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18
Q

Which CR angle is required for the “outlet” projection (Taylor Method) for a female?

A

30 to 45 degrees cephalad

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19
Q

What type of central ray angle is required whin using the “outlet” (Taylor method) for male patient?

A

20 to 35 degrees cephaled

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20
Q

How is the pelvis (body) positioned for a PA axial oblique (Teufel Method) projection?

A

PA 35 to 40 degree toward affected side

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21
Q

Which one of the following structures is considered to be the most posterior?

A

Ischial spine

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22
Q

What is the Acetabulum attached to?

A

femoral neck

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23
Q

The ______ pelvis forms the actual birth canal.

A

true

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24
Q

The greater pelvis is also called the _____ pelvis

A

false

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25
When performing an AP pelvis projection (bilateral hips) the CR is perpendicular to IR, directed midway between the level of ASISs and symphysis pubis
true
26
Is the male or female pelvis more wider with the ilia more flared and more shallow from front to back?
female
27
Situation: a patient with a possible pelvic ring fracture from a trauma enters the emergency room. The AP pelvis projection, which was taken to determine whether the right acetabulum is fractured, is inconclusive. Which other radiographic projection can be taken to better visualize the acetabulum?
Posterior oblique- Judet method
28
Situation: A very young child comes to the radiology department with a clinical history of DDH. What is the most common positioning routine for this condition?
AP pelvis and bilateral "frog-leg" (modified Cleaves) projections.
29
Situation: A portable AP and lateral hip study is ordered for a patient who is in recovery following hip replacement surgery. The radiograph of the AP hip reveals that the upper portion of the acetabular prosthesis is slightly cut off but is included on the lateral projection. Should the technologist repeat the AP projection? Why or why not?
Yes. Any orthopedic appliance or prosthesis must be seen in its entirety in both projections.
30
Situation: A patient with hip pain from a fall enters the emergency room. The physician orders a left hip study. When moved to the radiographic table, the patient complained loudly about the pain in the left hip. Which positioning routine should be used for this patient?
AP pelvis and axiolateral left hip.
31
Situation: A patient has just been moved to his hospital room after a bilateral hip replacement surgegy. The surgeon has ordered a postoperative hip routine for both hips. which specific positioning routine should be used? (The patient can be brought to the radiology department.)
AP pelvis and modified axiolateral-Clements-Nakayama method
32
Situation: A radiograph of an AP projection of the pelvis demonstrates that the left obturator foramen is narrowed and the right one is open. What is the specific positioning error present on this radiograph?
Rotation of pelvis toward the patient's left.
33
Which of the following methods will demonstrate the hip in a lateral projection
Lauenstein, Hickey
34
Which of the following methods demonstrate the hip in an axiolateral projection?
Danelius-Miller
35
Where should the IR be centered for an AP hip radiograph?
center to the hip joint (level of the greater trochanter, go two inches medial from the ASIS) drop a 2''-2 1/2 '' line from the "midway between ASIS and symphysis"
36
In order to accurately position the patient for hip radiographs, one must localize two bony points on the pelvis. These two reference points are the: 1. ) superior margin of the symphysis 2. ) greater trochanter of the femur 3. ) anterior superior iliac spine
1 and 3
37
pelvic inlet
40 caudad midline point at level to ASIS
38
pelvic outlet (taylor)
20-35 males 30-45 females
39
Hickey hip
one leg opposite frogged on table | 20-25* cephalic
40
Lauenstein hip
one leg opposite frogged on table | 0*
41
AP oblique femoral necks Modified Cleaves unilateral
frog a leg out 45* | CR 2" distal to the ASIS
42
AP oblique femoral necks Modified Cleaves bilateral
frog 45* legs CR 1" superior to the symphysis
43
Modified cleaves is for
oblique femoral necks
44
Judet external oblique
affected hip towards table | shoot at hip
45
Judet internal oblique | for acetabulum
on 45* sponge affected side up shoot at hip
46
Denellius miller / crosstable hip
opposite leg up | top of film by crest, winged out to 60 degrees
47
Situation: A unilateral frog-leg (modified Cleaves) demonstrates foreshortening of the femoral necks. The physician is unsure if ther is a defect withing the anatomical neck. What can be done to minimize destortion of the neck during a repeat expsoure?
Only abduct the femurs 20º to 30º from the veritcal rather than 45º to minimize distortion of the femoral neck.
48
Situation: A radiograph of an axiolateral (inferosuperior) projection of a hip demonstrates a soft tissue density that is visible across the affected hip and acetabulum. This artifact is obscuring the image of the proximal femur. What is the most likely cause of the artifact, and how can it be prevented from showing up on the repeat exposure?
It is soft tissue from the unaffected thigh. This leg must be flexed and elevated high enough to keep it from superimposing the affected hip.
49
Situation: An initial AP pelvis radiograph reveals possible fractures involving the lower anterior pelvis. The emergency room physician asks for another projection to better demonstrate this area of the pelvis. The patient is traumatized and must remain in a supine position. Which projection should be taken?
The AP axial outlet projection
50
The strongest bone in the body is the:
femur
51
What usually consists of numerous small lytic lesions?
Metastatic Carcinoma
52
An AP pelvis projection using 90 kV and 8 mAs results in a patient dose of approximately 30% less than a projection using 80 kV and 12 mAs (for both males / females) True or False
true
53
How is the CR angled for the Clements-Nakayama?
Angled posteriorly 15-20 degrees from horizontal.
54
This projection is useful for assesment of possible hip fracture or with arthoplasty when patient has limited movement in both lower limbs and theinferosuperior projection can not be obtained.
Clements-Nakayama
55
What is the optimal amount of hip abduction applied for the unilateral "frog-leg" projection to demonstrate the femoral neck without distortion?
20-30 degrees from vertical
56
Where is the CR for the AP Unilateral hip?
perpendicular to IR, 1-2 in distal femoral neck.
57
Generally, gonadal shielding for females cannot be used for an initial AP pelvis for pelvic trauma due to the probability of covering pertinent anatomy.
true
58
The three bones of the hip eventually fuse at what age?
mid-teens
59
Sacroiliac, symphysis pubis, and the acetabulum union joints are all classified as having ____________ mobility
amphiarthrodial
60
Select the correct gender to correspond with the following pelvic characteristics. More oval or heart-shaped pelvic inlet:
male
61
Select the correct gender to correspond with the following pelvic characteristics. Wider and shallow general shape of pelvis:
female
62
Select the correct gender to correspond with the following pelvic characteristics. Obtuse angle of pubic arch:
female
63
Select the correct gender to correspond with the following pelvic characteristics. Round and large pelvic inlet:
female
64
Select the correct gender to correspond with the following pelvic characteristics. Narrower, deeper general shape of pelvis:
male
65
Select the correct gender to correspond with the following pelvic characteristics. Acute angle of pubic arch:
male
66
Situation: Patient enters the ED having sustained trauma to the pelvis. The patient's main complaint is about her left hip. Which of the following projections should be taken first to rule out fracture or dislocation?
AP pelvis
67
If a patient has excessive external rotation of one foot, a fractured hip may be indicated.
true
68
Using the above hip localization method, the femoral head can be located:
1½ inches (4 cm) below the midpoint of the imaginary line between the two bony landmarks.
69
Which of the following bony structures cannot be palpated?
Ischial spine
70
Why must the lower limb be rotated 15 to 20 degrees internally for AP hip projections?
To place the femoral neck parallel to the image receptor
71
What is another name for a Modified Axiolateral projection of the hip and proximal femur when trauma is suspected?
Clements-Nakayama Method
72
Clements-Nakayama Method requires what amount of cephalad angulation?
15-20 cephalad
73
What positioning error is present when the left iliac wing is elongated on an AP pelvis radiograph?
rotation to the left
74
What positioning error is present when the left obturator foramen is more open than the right side on an AP pelvis radiograph?
roattion to the right
75
a fracture resulting from a severe blow to one side of the pelvis
pelvic ring fracture
76
now referred to as developmental dysplasia of the hip
congenital dislocation