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MRT Year 2 > X-table Hip Comp > Flashcards

X-table Hip Comp Flashcards

1
Q

What is the longest and strongest bone in the body?

A

Femur

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2
Q

What ligament attaches to the femoral head?

A

Ligament capitus

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3
Q

What is the area in between the 2 trochanters called?

A

Intertrochanteric crest

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4
Q

Angle of the neck to the shaft?

A

125 degrees +/- 15 degrees depending on width of pelvis and length of legs

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5
Q

Does the angle of the neck to the shaft increase or decrease with a short and wide pelvis?

A

Less angle for short and wide

More angle for long and narrow

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6
Q

How does the femur sit compared to vertical?

A

10 degrees medial

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7
Q

How does the angle of the femur change for short and wide vs long and narrow?

A

Short and wide: more angle

Long and narrow: less angle

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8
Q

How the femur sits from vertical affects what positioning?

A

CR for lateral knee

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9
Q

How do the head and neck of femur sit?

A

15-20 anterior

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10
Q

What does the pelvis do?

A

Served as a base of trunk and forms the connection between the vertebral column and lower limbs

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11
Q

What is the pelvis made up of?

A
  • 2 hip bones
  • 1 sacrum
  • 1 coccyx
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12
Q

Another name for hip bones?

A
  • ossa coxae

- innominate bones

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13
Q

What portion of the acetabulum does the ilium make up?

A

Superior 2/5ths

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14
Q

What portion of the acetabulum does the ischium make up?

A

Inferior and posterior 2/5ths

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15
Q

What portion of the acetabulum does the pubis make up?

A

Inferior and anterior 1/5th

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16
Q

When doe the ilium, ischium, and pubis fuse?

A

Middle teens at the acetabulum

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17
Q

Where is the crest of the ilium located?

A

Between the ASIS and PSIS

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18
Q

What bears the most weight when sitting?

A

Ischial tuberosities

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19
Q

What is the obturator foramen formed by?

A

The ramus/body of ischium and by pubis

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20
Q

What is the largest foramen in the human body?

A

Obturator foramen

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21
Q

Area above the superior symph to superior sacrum (pelvis brim)

A

Greater, false pelvis

-iliac alae and abdominal muscles = borders

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22
Q

What rest on the floor of the greater/false pelvis?

A

Lower abdominal organs and fetus

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23
Q

Area below the pelvis brim?

A

Lesser, true pelvis

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24
Q

What does the true pelvis form?

A

Birth canal

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25
Q

Parts of the birth canal?

A

Inlet, midcavity, outlet

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26
Q

What is cephalopelvimetry?

A
  • measurement of the babys head and inlet/outlet of mother’s pelvis
  • colcher-sussman ruler
  • not used anymore
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27
Q

Male pelvis characteristics?

A
  • narrower, deeper, less flared
  • pubic arch is an acute angle
  • inlet is narrower, more oval/heart shaped
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28
Q

Female pelvis characteristics?

A
  • wider, shallow, flared
  • pubic arch is and obtuse angle
  • inlet is larger, more round
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29
Q

Sacroiliac joints?

A
  • joined by SI ligaments
  • synovial
  • amphiarthrodial
  • limited movement
30
Q

Symphysis pubis (disk thicker in females)

A
  • cartilagenous
  • amphiarthrodial
  • limited movement
31
Q

Union of acetabulum?

A
  • cartilaginous
  • synarthrodial (in adults)
  • no movement
  • synchondrosis
32
Q

Hip joint

A
  • synovial
  • diarthrodial
  • spheroid/ball and socket
  • flexion/extension, abuction/adduction, medial/lateral rotation, circumduction
33
Q

When is the proximal femur and hip joint in true AP?

A

15-20 degrees medial rotation

34
Q

What is the evidence of a hip fracture?

A

External rotation

35
Q

Exposure factors?

A

80-85kVp
AP: 16mAs
Lat: 20mAs

36
Q

Ankylosing spondylitis?

A

(Bamboo spine)

  • inflammation/fusing of joints
  • most often males
  • SI joints first, then vertebral column
37
Q

Avulsion fracture of pelvis?

A
  • use a lower kVP to detect
  • adolescent athletes
  • tendons/muscles pulling
  • AIIS, ASIS, superior corner of symph, iliac crest
38
Q

Chondrosarcoma?

A
  • malignant tumor of cartilage in pelvis and long bones

- men 45+

39
Q

Developmental displasia of the hip (congenital dislocation of the hip CDH)

A
  • present at birth

- hip dislocations

40
Q

Legg-Calve-Perthes disease

A
  • most common aseptic or ischemic necrosis
  • typically involve hip
  • 5-10yr old boys, limp is first sign
  • flattened femoral head
  • disruption of blood flow to the head of the femur
41
Q

Metastatic carcinoma?

A
  • malignancy spreads via circulatory or lymphatic system or direct invasion
  • more common than primary malignancy
  • bones that contain red bone marrow more common (pelvis, spine, skull, ribs, femora)
42
Q

Osteoarthritis

A

Degenerative joint disease

  • weightbearing joints (hips, knees etc.)
  • most common arthritis
  • osteophytes
43
Q

Pelvic ring fracture

A

-severe blow/trauma to one side of the pelvis may result in a fracture site away from primary trauma site

44
Q

Hip fractures

A

-most common in geriatrics with osteoporosis or avascular necrosis

45
Q

Slipped capital femoral epiphysis (SCFE)

A
  • 10-16yr old during rapid growth
  • minor trauma can precipitate its development
  • epiphysis appears shorter and epiphyseal plate wider with smaller margins
46
Q

Intertrochanteric fracture

A

-between greater and lesser trochanter

47
Q

AP bilateral frog leg pelvis is also known as?

A

Modified cleaves

48
Q

When should you not perform a modified cleaves (pelvis)?

A

Do not attempt on patient with destructive hip disease or potential hip fracture/dislocation

49
Q

How much do you abduct legs for modified cleaves?

A

40-45 degrees

50
Q

What does 20-30 degree abduction do for a modified cleaves?

A
  • least amount of femoral neck foreshortening

- but foreshortening of entire proximal femora

51
Q

What happens to the greater trochanter as abduction increases?

A

Greater trochanter moves superior towards femoral head (at 45 deg abduction it is between the lesser trochanter and femoral head which is what we want)

52
Q

Ap axial outlet projection also known as?

A

Taylor method

53
Q

What is seen on the AP axial outlet projection?

A

Pubis and ischium

54
Q

Angling for AP outlet projection?

A

Males: 20-35 degrees cephalad
Females: 30-45 degrees cephalad
CR 1-2” below symph

55
Q

Ap axial inlet pelvis-what is seen?

A

-for posterior displacement or inward/outward rotation of anterior pelvis

56
Q

Angle for AP axial inlet projection?

A

40 degrees causes

CR at ASIS

57
Q

Posterior oblique pelvis-acetabulum-also known as?

A

Judet view

58
Q

What is seen on the judet view?

A

Acetabular fracture?

59
Q

How much do we oblique for the judet view? What rims are seen when?

A

45 degrees
Downside: anterior rim/iliac wing
Upside: posterior rim/obturator foramen

60
Q

Pa axial oblique-acetabulum- also known as? What is it for?

A

Teufel method

  • acetabular fracture (superior rim)
  • affected side down
  • 35-40 degree anterior oblique
  • 1” above greater trochanter, 2” lateral to MSP
  • concave fovea capitus, open obturator foramen
61
Q

Another name for the axiolateral inferosuperior trauma hip? When is it used?

A

Danelius-miller method

-when the leg cant be moved

62
Q

What is the difference between the modified cleaves and the lauenstein hickey method?

A

Lauenstein foreshortens the neck, but demonstrates the head and acetabulum well (pt rotated on side to bring femur down onto table)

63
Q

Modified axiolateral -possible trauma-Celements/Nakayama method

A
  • when inferosuperior cant be obtained
  • IR tilted 15 degrees and placed 2” below tabletop
  • CR 15-20 degrees posterior (down, pt is on back), centered to femoral neck on the upside
  • lateral oblique views of the acetabulum, femoral head, and neck
64
Q

Fat planes in the pelvis and their locations?

A
  1. Obturator internus: within the pelvis inlet next to the medial brim
  2. Iliopsoas: medial to lesser trochanter
  3. Pericapsular: superior to femoral neck
  4. Gluteal: superior to the pericapsular fat plane
65
Q

What do the fat planes demonstrate, if visualized?

A

Aids in the detection of intra-articular and peri-articular disease

66
Q

On a lateral, as the leg is abducted, what happens to the greater trochanter?

A

The greater trochanter moved towards the femoral head as the abduction increases

67
Q

AP: as the distal femur is elevated, what happens to the greater trochanter?

A

As elevation increases, the greater trochanter moved medially

68
Q

How to find the femoral neck and head?

A

Femoral head: CR 1.5” distal to the line connected ASIS and symph
Femoral neck: CR 2.5” distal

OR

CR 1-2” medial and 3-4” distal to ASIS

69
Q

Axiolateral inferosuperior (X-table) hip: what happen if the IR is not parallel to the femoral neck? Angle to large or too small?

A

Foreshortening
Too large angle: greater trochanter proximal to lesser, over femoral neck
Too small angle: greater trochanter distal to lesser trochanter

70
Q

X-table hip: what happens if leg is in external rotation?

A
  • greater trochanter posterior

- lesser trochanter superimposing femoral neck

71
Q

X-table hips special considerations for obese patients?

A

-IR higher than crests to get acetabulum and femoral head on x ray

72
Q

AP Pelvis: when will the lesser trochanters be in profile?

A

Legs externally rotated so feet are at 45 degrees (femoral epicondyles 60-65 degrees), femoral neck demonstrated on end

MRT Year 2 (18 decks)

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