Merrill's ch 7 pelvis and proximal femur
Identify the major articulations of the pelvis by name or abbreviation, and give the quantity for each.
1 pubis symphysis 2 hip joints 2 si joints
In the AP oblique femoral neck's modified Cleves method, how many degrees from vertical should the thighs be abducted after the patients knees and hips are flexed?
45°
With reference to the brim of the pelvis, identify the location of the greater (false) pelvis and the lesser "true" pelvis as either "above" or "below" A. Greater pelvis________ B. Lesser pelvis___________
A. Above B. Below
A lateral projection image obtained by the LAUENSTEIN method or the HICKEY method is used to demonstrate the hip joint and the relationship of the head of the femur with the?
ACETABULUM
What are the two palpable bony points of localization for the hip joint?
ASIS and greater trochanter
In a typical adult, in which direction (anterior or posterior) does the femoral neck project away from the long axis of the femur?
Anteriorly
What is the general rule concerning demonstration of any orthopedic appliance with a projection?
Any orthopedic appliance should be completely demonstrated
For the AP oblique femoral necks modified Cleves method how much should the hips and knees be flexed?
As much as possible to get the femora to a near vertical position
Describe an acceptable method for locating the femoral neck
BONTRAGER method
How should the central ray be directed for the HICKEY method of a lateral hip projection
Cephalically 20 to 25°
AP oblique JUDET method. The external oblique position places the affected side____
Down
Describe how the patient's lower limbs should be positioned for an AP projection of the pelvis and proximal femora
Extend and rotate the lower limbs medially 15 to 20°
How should the unaffected lower limb be positioned in a lateral projection of the hip
Extended and supported at the level of the hip
AP projection modified Cleves method true or false. The patient may be position to either supine or upright
False
True or false the greater trochanter should be seen in profile on the lateral side of the proximal femur in the AP oblique projection
False
Axiolateral hip projection. True or false. The foot and lower limb should be rotated laterally 15 to 20°
False-foot rotated medially if patient can
Axiolateral hip projection. True or false. A small area of soft tissue overlap from the thigh of the unaffected lower limb is permitted
False-no part of unaffected thigh
Axiolateral hip projection. True or false. The pelvis should be rotated approximately 15 to 20°
False-no rotation
Axiolateral hip projection. True or false. The entire lesser trochanter should be demonstrated on the lateral surface of the femur
False-only small amount
Which gender (male or female) has a broader and shallower pelvis?
Female
Which gender (male or female) has a pelvis with larger and more rounded outlet?
Female
Describe how the affected thigh and leg should be positioned for lateral projections of the hip
Flex affected knee, draw thigh up to nearly right angle, position relative to affected hip, centered middle of the table
How should the unaffected lower limb be positioned in the axiolateral hip projection
Flex the hip and knee of unaffected side to elevate the thigh in a vertical position then it can be rested on some sort of support
True or false the gonads should not be shielded for the AP oblique projection
Fox
Name the two parts a pelvis is divided into by the brim of the pelvis
Greater (false) pelvis and lesser (true) pelvis
Which process is located at the superolateral aspect of the proximal femoral shaft?
Greater trochanter
Which two large processes are located at the proximal end of the femur?
Greater trochanter and lesser trochanter
With reference to the femoral neck, how should the lead strips of the grid be placed on the axiolateral hip projection
Horizontally, parallel with the long axis of the femoral neck
Describe the placement of the eye are in a axiolateral hip projection
IR is placed in a vertical position with its upper border in the crease above the iliac crest and it's lower border angled away from the body so the IR is parallel with the long axis of the femoral neck
Which two prominent structures found on the ilium are frequently used as radiographic positioning reference points?
Iliac crest and anterior superior iliac spine (ASIS)
What specific portion of the acetabulum and pelvis is demonstrated by the external oblique position of the JUDET method
Ilioischial
What part of the hip bone forms the broad, curved portion called the ala?
Illium
Which bone/portion the hip bone extends inferiorly from the acetabulum and joins with the inferior ramus of the pubic bone?
Ischiunm
What specific portion of the acetabulum and pelvis is demonstrated by the internal oblique position of the JUDET method
It demonstrates the iliopubic column"anterior" of the pelvis and posterior rim of the acetabulum
Why should a firm pillow or folded blanket be placed under the pelvis and an axiolateral hip projection
It elevates the pelvis and provides better centering of the hip to the IR
What is the rationale for positioning of the lower limbs for an AP projection of the pelvis and proximal femora?
It places the femoral neck's parallel with the IR and helps illuminate foreshortening of the femoral neck's
What is the purpose of abducting the thighs for the AP oblique femoral next modified Cleves method?
It places the long axis of the femoral necks parallel with the plane of the IR
AP hip. Which trochanter ,greater or lesser, is not usually demonstrated beyond the border of the femur?
Lesser
Describe how to use the two points identified (ASIS and greater trochanter) to locate the femoral neck (Bontrager method)
Locate ASIS move distally 3 to 4 inches and locate greater trochanter then move 1 to 2 inches medially to the femoral neck.
AP hip describe how to find the centering point where the central ray should enter the patient
Locate ASIS. Move distally 3 to 4 inches and locate the greater trochanter. Move 1 to 2 inches medially to the femoral neck. CR enters the MSP of the femoral neck
Which plane of the body for the AP pelvis should be positioned in the midline of the table and grid
Midsagittal
With reference to the patient, where should the IR be centered for the AP projection of the pelvis
Midway between ASIS and pubic symphysis approximately 2 inches above the pubic symphysis
On the AP oblique projection modified Cleves method where should each lesser trochanter appear in the image?
On the medial side of the femur
The region between the inlet and the oulet of the true pelvis is called the
Pelvic cavity
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
Pelvis
Where should the central ray be directed on the AP oblique modified Cleves method?
Perpendicular mid sagittal plane of patient about 1 inch above the pubic symphysis
How and where should the central ray be directed on an axiolateral hip projection
Perpendicular to the long axis of the femoral neck, entering patient on the medial aspect of affected by near the groin and centered to the IR
How should the central ray be directed for the LAUENSTEIN method of a lateral hip projection
Perpendicularly
AP hip what procedure should help the patient to keep the affected lower leg in the required position?
Place a support under the knee and a sandbag under the ankle
Which bone/portion of the hip bone consists of a body and two rami?
Pubis
8. What bones of the hip bone form the obturator foramen
Pubis and ischium
AP hip. Which positioning maneuver should be performed to place the for moral neck parallel with the plane of the IR?
Rotate the foot and lower limb medially 15 to 20°
What structures form the posterior part of the pelvis?
Sacrum and coccyx
List two common names used to denote the axiolateral projection DANELIUS-MILLER of the hip
Surgical-lateral Cross-table
What breathing instructions should be given to the patient for hip and pelvis projections?
Suspend respiration
How is rotation of the pelvis detected in the AP projection of the pelvis
The alae of the ilia are asymmetrical if the pelvis is rotated.
Name the two areas of the proximal femur that are common sites for fractures in elderly patients.
The femoral neck and intertrochanteric crest
Why should a radiographer ensure that the distance from the ASIS to the table top on each side of the pelvis is the same in an AP projection of the hip
To ensure that the pelvis is not rotated
AP hip. True or false. An initial radiographic study of a fractured hip may include an AP projection of the pelvic girdle and proximal femora to demonstrate bilateral hip joint
True
AP hip. True or false. The entire pubis of the affected side should be demonstrated
True
True or false the AP oblique projection can be modified to demonstrate only one hip area
True
True or false the AP oblique projection should not be performed on a patient who is suspected to have a fractured femoral neck
True
True or false. In the seated position, the weight for the body rests on two ischial tuberosities
True
True or false. The greater sciatic notch is located on the anterior border of the ileum
True
Which bones form the pelvis?
Two hip bones, sacrum, and coccyx only
AP oblique JUDET method. The internal oblique position places the affected side____
Up
What structure of the hip bone is formed by the fusion of three bones?
acetabulum
Which three names refer to the major bone that makes up the right or left half of the pelvis?
llium, pubis, and ischium
