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Positioning test prep > PELVIS AND PROXIMAL FEMORA > Flashcards

PELVIS AND PROXIMAL FEMORA Flashcards

1
Q

Found above the acetabulum

A

Ilium

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2
Q

Has a body and two rami

A

Pubis

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3
Q

Hip socket

A

Acetabulum

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4
Q

Serves as a base for the trunk

A

Pelvis

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5
Q

Opening in bone

A

Foramen

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6
Q

Hip bone

A

Innominate

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7
Q

Projects from the pubic bone

A

Ramus

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8
Q

Winglike portion of ilium

A

Ala

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9
Q

Large opening

A

Obturator

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10
Q

Posterior pelvic articulations

A

Sacroiliac

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11
Q

Articulates with the sacrum

A

Coccyx

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12
Q

Forms posterior aspect of pelvis

A

Sacrum

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13
Q

Sharp bony process

A

Spine

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14
Q

Ridgelike process

A

Crest

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15
Q

Loss of bone density

A

Osteoporosis

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16
Q

Increased density of atypically soft bone

A

Osteopetrosis

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17
Q

Form of arthritis marked by progressive cartilage deterioration in synovial joints and vertebrae

A

Osteoarthritis

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18
Q

Thick, soft bone marked by bowing and fractures

A

Paget disease

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19
Q

Malignant tumor arising from cartilage cells

A

Chondrosarcoma

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20
Q

Proximal portion of femur dislocated from distal portion at the proximal epiphysis

A

Slipped epiphysis

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21
Q

Malignant neoplasm of plasma cells involving the bone marrow and causing destruction of bone

A

Multiple myeloma

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22
Q

Rheumatoid arthritis variant involving the sacroiliac(SI) joints and spine

A

Ankylosing spondylitis

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23
Q

Malformation of the acetabulum causing displacement of the femoral head

A

Congenital hip dysplasia

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24
Q

Flattening of the femoral head as a result of vascular interruption

A

Legg-calve-perthes disease

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25
Q

The structure of the body that serves as a base for the trunk and as a girdle for the attachment of the lower limbs is known as the…

A

Pelvis

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26
Q

Which bones form the pelvis

A

Two hip bones, sacrum and coccyx

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27
Q

Which three names refer to the major bone that makes up the right or left half of the pelvis?

A

Ilium
Pubis
Ischium

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28
Q

Which two prominent structures found on the ilium are frequently used as radiographic positioning reference points?

A

Iliac crest

ASIS

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29
Q

Which bone/portion of the hip bone extends inferiorly from the acetabulum and joints with the inferior ramus of the pubic bone?

A

Ischium

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30
Q

Essential projection: AP pelvis

A
  • collimate to 17 x 14
  • patient supine, shoulders and hips in same plane: lower limbs internally rotated 15 to 20 degrees.
  • ASIS equidistant from table; MSP aligned with long axis of table
  • central ray perpendicular to MSP at level midway between ASIS and symphysis pubis
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31
Q

Essential projection: AP oblique, femoral necks (modified cleaves)

A
  • collimate to 17x14
  • patient supine: shoulders and hips on same plane: ASIS equidistant from table: hips and knees flexed with feet drawn up as much as possible: thighs abducted
  • ASIS equidistant from table: MSP aligned with long axis of table
  • CR perpendicular to MSP at level 1 inch superior to the pubic symphysis
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32
Q

Describe how the patients lower limbs should be positioned for the AP projection of the pelvis and proximal femora.

Why do we do this?

A

Extend and rotate the lower limbs medially 15 to 20 degrees

This places the femoral necks parallel with the plane of IR

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33
Q

How is rotation of the pelvis detected in an AP projection image?

A

The alae of the ilia are asymmetrical if the pelvis is rotated

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34
Q

Which plane of the body should be positioned on the midline of the table and grid?

A

Midsagittal

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35
Q

With reference to the patient, where should the IR be centered for an AP projection of the pelvis?

A

Midway between the ASIS and the pubic symphysis

36
Q

What other name commonly refers to the AP oblique projection, modified cleaves method?

A

Bilateral frog leg

37
Q

How much should the hips and knees be flexed for a modified cleaves?

A

As much as possible to get the femora to a near-vertical position

38
Q

Modified cleaves: after the patients knees and hips are flexed, how many degrees from vertical should the thighs be abducted?

A

45 degrees

39
Q

On a modified cleaves, describe how and where the central ray should be directed.

A

PERPENDICULAR TO A POINT ON THE MIDLINE OF THE PATIENT ABOUT 1 INCH ABOVE THE SYMPHYSIS PUBIS

40
Q

On a modified cleaves, where should each lesser trochanter appear on the image?

A

On the medial side of the femur

41
Q

Essential projection hip: AP

A
  • 10x12
  • patient supine: shoulders and hips in same plane: ASIS equidistant from table: affected lower limb internally rotated 15 to 20 degrees
  • MSP aligned with long axis of table
  • CR perpendicular to MSP at the femoral neck
42
Q

Essential projection hip: lateral(lauenstein, hickey)

A
  • 12 inches wide 10 inches long
  • patient supine and slightly obliqued toward affected hip; flex knee and draw thigh up to right angle to hip; abduct thigh
  • lauenstein method: CR perpendicular to hip joint, located halfway between ASIS and pubic symphysis
  • hickey method: 20 to 25 degrees cephalic enters hip joint
43
Q

Essential projection hip: axiolateral (Danelius-miller)

A
  • 12x10
  • patient supine with unaffected lower limb elevated enough to avoid being imaged; if not contraindicated, internally rotate affected limb 15 to 20 degrees
  • IR is vertically placed parallel to femoral neck of affected hip; no rotation of pelvis
  • CR horizontal; enters mid thigh perpendicular to IR and femoral neck.
44
Q

Which positioning maneuver should be performed to place the femoral neck parallel with the plane of the IR?

A

Rotate the foot and lower limb medially 15 to 20 degrees

45
Q

Describe how to find the centering point where the CR should enter the patient on an AP pelvis

A

Locate a point about 2 1/2 inches distal on a line drawn perpendicular to the midpoint of a line between the ASIS and symphysis pubis

46
Q

Which trochanter (greater or Lesser) is not usually demonstrated beyond the border of the femur on AP projections of the hip?

A

Lesser

47
Q

Should the entire pubis of the affected side be demonstrated on an AP projection of the hip?

A

Yes

48
Q

On an AP projection of the hip should the exposure be performed with the patient breathing shallowly?

A

No. breathing should be suspended

49
Q

Describe how the affected thigh and leg should be positioned for lateral projections of the hip.

A

Flex the affected knee and draw the thigh up to a nearly right-angle position relative to the affected hip centered to the midline of the table.

50
Q

Describe how the unaffected lower limb should be positioned for a lateral projection of the hip

A

The unaffected leg should be extended and supported at the level of the hip.

51
Q

How should the central ray be directed for the lauenstein method of a lateral hip projection?

A

Perpendicularly

52
Q

How should the central ray be directed for the hickey method of a lateral hip projection

A

Cephalically 20-25 degrees

53
Q

List two common names used to denote the axiolateral projection (Danelius-Miller) of the hip

A

Cross-table lateral

Sergical lateral

54
Q

The entire lesser trochanter should be demonstrated on the lateral surface of the femur for an axiolateral projection, Danalius-Miller method

A

False, only a small amount of the lesser trochanter should be seen on the posterior surface of the femur

55
Q

A small area of soft tissue overlap from the thigh of the unaffected lower limb is permitted i a axiolateral projection, DANELIUS- Miller method

A

False. No part of the unaffected thigh should superimpose the femur

56
Q

Essential projection for demonstrating the Acetabulum

AP oblique(Judet method)

A
  • 10x12
  • Internal Oblique: 45 degree posterior oblique position with affected side elevated
  • external oblique: 45 degree posterior oblique position with affected side down
  • MSP at 45 degree angle to plane of IR
  • CR perpendicular for both obliques

Internal enters at 2 inches inferior to ASIS of affected side

External enters at pubic symphysis

57
Q

What does the internal Oblique used to demonstrate on an AP oblique Acetabulum(JUdet) projection?

A

It demonstrates the posterior rim of the acetabulum and iliopubic column

58
Q

What does the external oblique demonstrate on an AP oblique acetabulum(judet) projection?

A

It demonstrates anterior rim of acetabulum and ilioischial column

59
Q

How much angulation on a pelvis inlet projection?

A

40 degrees caudal

CR to asis

60
Q

How much angulation for an AP axial outlet projection

A

10-35 degrees cephalad for males

30-45 degrees cephalad for females

Cr 2 inches distal to Symphysis pubis

61
Q

Which structure of the pelvis articulates with the femur?

A

Acetabulum

62
Q

Which bones of the pelvis compose the acetabulum?

A

Pubis, ischium, and ilium

63
Q

On which bone is the ala located?

A

Ilium

64
Q

Which of the following pelvic structures is not used as a positioning palpation point?

A. Iliac crest
B. Ischial spine
C. Pubic symphysis
D. ASIS

A

B. Ischial spine

65
Q

Which portions of the hip bone join to form the obturator foramen?

A

Pubis and ischium

66
Q

What is the name of the border that extends on the hip bone from the posterior superior iliac spine to the ASIS?

A

Iliac crest

67
Q

What is the name of the process that separates the greater sciatic notch from the lesser sciatic notch on the hip bone?

A

Ischial spine

68
Q

Which parts of the hip bones support the weight of the body when a person is in the sitting position?

A

Ischial tuberosities

69
Q

Where in the pelvis is the body of the pubis located?

A

It forms part of the acetabulum

70
Q

In average-sized patients, where should the IR be centered for the AP projection of the pelvis?

A

About 2 inches inferior to ASIS and 2 inches superior to pubic symphysis

71
Q

Where on the midline of the patient should the central ray enter for the AP projection of the pelvis?

A

2 inches above pubic symphysis

72
Q

Which positioning maneuver should be performed to place the femoral necks parallel with the IR for an AP projection of the pelvis?

A

Rotate the lower limbs medially 15-20 degrees

73
Q

How should the central ray be directed for the AP oblique projection(modified cleaves) to demonstrate bilateral hips?

A

Perpendicularly

74
Q

For which projection of the lower limbs or pelvis should the hips be flexed and the femora be abducted from the midline of the patient?

A

AP oblique projection(modified cleaves) for femoral necks

75
Q

Where on the midline of the patient should the central ray be directed for the AP oblique projection(modified cleaves)

A

1 inch above the pubic symphysis

76
Q

All of the following projections can be used to image a patient with a suspected intertrochanteric fracture except for the:

A. AP projection of the hip
B. AP projection of the pelvis
C. Lateral projection(lauenstein method) of the hip
D. Axiolateral projection(danelius-miller) of the hip

A

C. Lateral projection (lauenstein method) of the hip

77
Q

For the AP oblique projection (modified cleaves), what is the purpose of abducting the femora the required number of degrees?

A

To position the femoral necks parallel with the IR

78
Q

Which structure should be centered to the midline of the table when the AP oblique projection (modified cleaves) is adapted to demonstrate only one hip?

A

ASIS

79
Q

For which projection of an individual hip should the unaffected hip be flexed and the thigh be raised out of the way of the central ray?

A

Axiolateral projection (danelius-Miller method)

80
Q

For which projection of the hip should the central ray be directed horizontally into the medial aspect of the affected thigh?

A

Axiolateral projection (danelius-Miller method)

81
Q

Which of the following best demonstrates suspected fractures of the acetabulum?

A

AP oblique projection (judet method)

82
Q

Which of the following positions would be used to demonstrate the posterior rim of the left acetabulum?

A

45 degree RPO

83
Q

What specific portion of the acetabulum is demonstrated by the AP oblique projection, external oblique (JUDET METHOD)

A

Anterior rim

84
Q

Which of the following would best demonstrate the pubic and ischial rami without foreshortening

A. AP axial “inlet” projection (bridgeman method)
B. AP axial “outlet” projection (taylor method)
C. AP oblique projection (judet method)
D. Axiolateral projection( danelius-miller method)

A

B. AP axial “outlet” projection (taylor method)

85
Q

What is the proper central ray orientation for the AP axial projection (taylor method) for female patients?

A

30-45 degrees cephalad

Positioning test prep (4 decks)

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