pelvis and femur Flashcards
what are the 4 bones of the pelvis
- sacrum
- illium
- ischium
- pubis
what are the 4 joints of the pelivs
- sacroilliac joint
- pubic symphysis
- sacrococcygeal joint
- hip joint
what type of joint is the sacroiliac, pubic symphysis, sacrococcygeal and hip joint
- sacroiliac = syndical plane
- pubic = fibrocartilaginous
- sacrococcygeal = fibrocartilaginous
- hip = ball and socket
what do you can the bones of the pelvis before and after fusion?
- hemi-pelvis (pre) (left and right pelvis)
- innominate bones (after joining of illium, ischium and pubis)
what are the 4 prominent bony landmarks of the illium bone
- anterior superior/inferior iliac spine
- posterior superior/inferor illac spine
what 2 parts does the ischium consist of
- body
- ischial ramus
how does the ischium join to the pubis
ischial ramus joins with inferior ramus of pubis
what 3 parts make up the pubis
- body
- inferior/superior ramus
what is formed due to the joining of the ischial ramus and pubis inferior ramus
obturator foramen
what do you call the cartilage that joins the pubis, ischium and illium
triradiate cartilage
what is the usual width of the pubic symphysis cartilaginous joint?
3-5mm
what forms the pelvic ring
- the 2 innominate bones (left and right hemi-pelvis) and pelvis spine (sacrum and coccyx)
what are the 5 bony landmarks of the pelvis
- iliac crest
- ASIS
- PSIS
- pubic symphysis
- ischial tuberosity
what 5 areas of the pelvis can you get an avulsion fracture
- iliac crest
- ASIS
- AIIS
- ischial tuberosity
- body of pubis/inferior pubi ramus
what 2 parts of the femur can you get an avulsion fracture
greater and lesser trochanter
what is the longest, strongest and heaviest bone in the body
femur
when doing a pelvic xray, when would it not be suitable to rotate the feet medially for better view of the femoral neck?
if there is trauma or other pathology suspected
what should be seen on a gold standard AP pelvis xray
- coccyx and symohysis are in straight line and positioned in the middle line of image
- both sides of iliac wings and obturator foramen are symmetrical
- distance between the superior border of pubic symphysis and tip of coccyx is between 1 and 3 cm
how can you tell if someones feet is over rotated, adequately rotated or under rotated from a pelvic xray
- no rotation/ external rotation = shortening of femoral neck
- adequate internal rotation = lesser and greater trochanter seen, femoral neck is also visble
- over internal rotation = cannot see lesser trochanter
during HBL pelvis, how must you place the IR to get a good image of the femoral neck
you must angle the lower border of the detector away from the body until it is parallel with the femoral neck
what is a grid used for
- placed between patient and xray film to reduce scattered radiation reaching the detector and thus improve image contrast
when/why would grids be useful
- as scattered radiation is increased in thicker patients and at larger field sizes, grids are useful in such scenarios to improve image contrast
find a diagram and label all the parts of the pelvis and femur
the angle formed at the convergence of the inferior pubic rami has what anatomical name
pubic arch
what ligament connects the sacrum to the ischial spine
sacrospinous
which muscle attaches to the AIIS
RECTUS FEMORIS
which muscle attaches to the ASIS
sartorius
which ligament connects the ilium to the 5th lumbar vertebrae
illiolumbar
the gluteal muscles attach at which bony landmark of the femur
greater trochanter
the psoas muscles attaches at what bony landmark of the femur
lesser trochanter
what is the anatomical name of the longitudinal crest that can be found on the posterior aspect of the femur
linea aspera
the femur is stronger than concrete
what method can be used to locate the hip joint
- find the midpoint of the imaginary diagonal line connecting the ASIS and pubis symphysis
- 2.5cm below that midpoint is the hip joint
what AEC chamber should be selected for a single hip projection
central chamber
what is judets view
- two-part view of the acetabulum
- internal or external oblique used to demonstrate the posterior (internal) or anterior (external) rim of acetabulum and ilio-pubic column
where do you centre for judets view
5cm distal and 5cm medial of ASIS
know what the inlet and outlet of the pelvis looks like
how do you position for an inlet view of pelvis, where do u center
center = midline at level of ASIS
- central ray is angled 25-45 degrees caudal to be perpendicular to plane of pelvic inlet
how do you position for an outlet view of pelvis, where do u center
center = 5cm distal to superior pubic symphysis border
- central ray is angled 25-45 degrees cranially perpendicular to plane of pelvic outlet
what chambers are used for inlet and outlet pelvic views
left and right
what should you see on inlet pelvic scan
- whole pelvic rim central to image with no superimposition
- iliac wings on superior portion of image
- inferior and superior pubic rami are superimposed on inferior part of image
what should you see on outlet pelvic scan
- entirety of bony pelvis imaged from superior of iliac crest to proximal shaft of femur
- pubic symphysis central of image with little to no rotation
- clear demonstration of both anterior and inferior pubic ramps with little to no foreshortening
what specific group of people do frog lateral hip views
paediatric hips
what does SUFE stand for
slipped upper femoral epihysis
what is perthes disease
Blood supply to the head of the femur is disrupted which causes the bone to deteriorate. This can cause pain, limping and limited movement of the hip joint.
- affects 3-11 yr olds
