Term
| The ___ is the longest and strongest bone in the body |
|
Definition
|
|
Term
The proximal femur consists of four essential parts, what are they? |
|
Definition
1. head 2. neck 3. greater trochanter 4. lesser trochanter |
|
|
Term
| What is the pit near the center of the head of the femur called? |
|
Definition
|
|
Term
| What ligament is attached from the head of the femur to the fovea capitis? |
|
Definition
| Ligament of the head of the femur, AKA ligament capitis femoris |
|
|
Term
| Where is the greater trochanter located? |
|
Definition
| Superiorly and laterally to the femoral shaft and is palpable |
|
|
Term
| Where is the lesser trochanter located? |
|
Definition
| Medially and posteriorly to junction of neck and shaft of femur. |
|
|
Term
| The trochanters are joined posteriorly by a thick ridge called the ______ |
|
Definition
|
|
Term
| What is the average angle of the neck to the shaft of the femur? |
|
Definition
|
|
Term
| What would the angle of the neck to the shaft of the femur be if a person were long-legged with a narrow pelvis? |
|
Definition
| Increased angle, approximately 140 degrees |
|
|
Term
| What is the longitudinal plane of the femur angle on an average person? |
|
Definition
|
|
Term
| What is the angle of the longitudinal plane on a person with a wide pelvis? |
|
Definition
|
|
Term
| What is the average angle of the neck and head of the femur in relationship to the body of the femur? |
|
Definition
| 15 to 20 degrees anterior angle |
|
|
Term
| The femur and leg must be rotated ___ degrees internally to place the femoral neck parallel to the IR for a true AP projection of the proximal femur. |
|
Definition
|
|
Term
| What are the four bones of the pelvis? |
|
Definition
| two hip bones (ossa coxae, AKA innominate bones), one sacrum, one coccyx |
|
|
Term
| What is the difference between the pelvic girdle and the pelvis? |
|
Definition
Pelvic girdle-consists only of two hip bones Pelvis- includes four bones |
|
|
Term
| What are the three divisions of the hip bone? |
|
Definition
1. Ilium 2. Ischium 3. Pubis |
|
|
Term
| Where and at what age do the hip bones fuse together? |
|
Definition
|
|
Term
| What bone is the largest of the three divisions of the hip bone and where is it located? |
|
Definition
| Ilium ; superior to acetabulum |
|
|
Term
| Where are the ischium and pubis located? |
|
Definition
Ischium- inferior and posterior to acetabulum Pubis- Inferior and anterior to acetabulum |
|
|
Term
| Each ilium is composed of ____ and _____ |
|
Definition
|
|
Term
| Where are the body and ala located in ilium? |
|
Definition
Body- inferior portion (includes upper 2/5 of acetabulum) Ala- thin and flared upper part of ilium |
|
|
Term
| Where is the crest of the ilium located? |
|
Definition
| upper margin of ala that extends from ASIS to PSIS. |
|
|
Term
| In radiographic positioning, the uppermost peak of the crest of the ilium is referred to as _____, but it actually extends between ASIS and PSIS |
|
Definition
|
|
Term
| Below ASIS is less prominent projection known as ______. Inferior to PSIS is ______. |
|
Definition
Anterior inferior iliac spine Posterior inferior iliac spine |
|
|
Term
| What are the two important positioning landmarks of the Ilium? |
|
Definition
|
|
Term
| Each ischium is divided into _____ and ____ |
|
Definition
|
|
Term
| The upper portion of the body of the ischium makes up the ________ of the acetabulum. |
|
Definition
| Posteroinferior two-fifths |
|
|
Term
| The lower portion of the body of the ischium projects caudally and medially from the acetabulum, endind at the ________ |
|
Definition
|
|
Term
| Posterior to the acetabulum is a bony projection of the ischium known as _____ |
|
Definition
|
|
Term
| Directly above the ischial spine is a deep notch termed the _______. Below the ischial spine is a smaller notch termed the ______. |
|
Definition
| Greater sciatic notch ; lesser sciatic notch |
|
|
Term
| ______ bears most of the weight of the body when someone sits. |
|
Definition
|
|
Term
| Where is the body of the pubis located? |
|
Definition
| anterior and inferior to acetabulum and includes anteroinferior 1/5 of acetabulum. |
|
|
Term
| Extending anteriorly and medially from body of each pubis is a ________ |
|
Definition
|
|
Term
| Two superior rami of pubis meet inmidline to form a slightly movable joint known as ____ or _____ |
|
Definition
| symphysis pubis ; pubic symphysis |
|
|
Term
| Each _________ passes down and posterior from symphysis pubis to join ramus of respective ischium. |
|
Definition
|
|
Term
| The ______ is a large opening formed by the ramus and body of each ischium and by the pubis. |
|
Definition
|
|
Term
| The ____ is the largest foramen in human skeletal system. |
|
Definition
|
|
Term
| The prominence of the greater trochanter is about the same level as the upper border of the _______, whereas the ________ is 1 1/2 to 2 inches below symphysis pubis. |
|
Definition
| symphysis pubis ; ischial tuberosity |
|
|
Term
| A plane through the ____ of the pelvis divides the pelvic area into two cavities. |
|
Definition
|
|
Term
| The pelvic brim is defined by the ________ |
|
Definition
| upper part of the symphysis pubis anteriorly and upper, prominent part of sacrum posteriorly. |
|
|
Term
| The general area above or superior to the oblique plane through the pelvic brim is termed the ____ or ____ pelvis |
|
Definition
|
|
Term
| The area inferior to a plane through the pelvic brim is termed the ___ or ___ pelvis |
|
Definition
|
|
Term
| The size and shape of the true pelvis are of greatest imporance during birth process because_____ |
|
Definition
| true pelvis forms the actual birth canal |
|
|
Term
| The oblique plane defined by the brim of the pelvis is termed the ______ or ______ |
|
Definition
| inlet ; superior aperture |
|
|
Term
| The ______ or ___ of true pelvis is defined by the two ischial tuberosities in the tip of the coccyx. |
|
Definition
| outlet ; inferior aperture |
|
|
Term
| The area between the inlet and outlet of the true pelvis is termed the ____ of the true pelvis |
|
Definition
|
|
Term
| During the birth process the baby must travel______ |
|
Definition
| inlet ----> cavity----->outlet |
|
|
Term
| Why are radiographs of pelvis not taken during pregnancy generally? |
|
Definition
| Sensitivity of radiation to fetus |
|
|
Term
| What are cephalopelvimetry exams? |
|
Definition
| Exams where a specific type of metal ruler is placed next to the pelvis for AP and lateral projections. Measurements of babys head could be made and inlet/outlet measurements could be made of mother. |
|
|
Term
In general, the female pelvis is_____, with the ilia more flared and more shallow from front to back than a males. |
|
Definition
|
|
Term
| The first difference between the male pelvis and female pelvis is the difference in the ____ of the pelvis |
|
Definition
|
|
Term
| A secondary major difference between pelvis' of males and females is __________. |
|
Definition
| Angle of pubic arch, formed by inferior rami of pubis below symphysis pubis |
|
|
Term
| What is the angle of the pubic arch in females and males? |
|
Definition
Female- obtuse or greater than 90 Male- acute or less than 90 |
|
|
Term
| The third difference in pelvis' of men and women is ________ |
|
Definition
| Shape of inlet. Female inlet is more round and larger. |
|
|
Term
| What are sacroiliac joints? |
|
Definition
| joints between sacrum and each ilium |
|
|
Term
| What is Symphysis pubis joint? |
|
Definition
| structure between right and left pubic bones |
|
|
Term
| What is union of acetabulum? |
|
Definition
| a temporary growth joint of each acetabulum that solidifies in mid teen years |
|
|
Term
|
Definition
| joints between head of femur and acetabulum of pelvis |
|
|
Term
| Sacroiliac joints require special radiography positioning because_________ |
|
Definition
| They are oddly obliqued angles. |
|
|
Term
| The sacroiliac joint is classified as a _______ joint in that it is enclosed in a fibrous articular capsule containing synovial fluid. |
|
Definition
|
|
Term
| The sacroiliac joints are special synovial joints because they are hardly movable which makes them_____ joints. |
|
Definition
|
|
Term
| Why are sacroiliac joints hardly movable? |
|
Definition
| The joint surfaces are irregularly shaped and interconnecting bones are snugly fitted because they serve a weight-bearing function. |
|
|
Term
| The symphysis pubis is classified as a _______ joint of the ________ in that only limited movement is possible (_________). |
|
Definition
cartilaginous ; symphysis subtype ; amphiarthrodial |
|
|
Term
| What is found in symphysis pubis? |
|
Definition
| fibrocartilage capable of being compressed or partially displaced |
|
|
Term
| The union of acetabulum is a _________joint of the ________, which is immovable or ___________ in an adult. |
|
Definition
| cartilaginous ; synchondrosis subtype ; synarthrodial |
|
|
Term
| Union of acetabulum is similar to joints between ____ and _____ of long bones in growing children. |
|
Definition
|
|
Term
| The hip joint is classified as _____ truly characterized by a large fibrous capsule containing synovial fluid. |
|
Definition
|
|
Term
| The hip joint is freely movable or_______ and is an example of _____ movement type. |
|
Definition
|
|
Term
| What is the traditional method used to locate the femoral head and neck (midpoint line)? |
|
Definition
| Line between the ASIS and symphysis pubis. |
|
|
Term
| Where are the neck and head of the femur located in reference to midpoint of line? |
|
Definition
Neck - 2.5 inches distal and at R. angle to midpoint line Head - 1.5 inches distal and at R. angle to midpoint line |
|
|
Term
| The ____ are shown to be located on the same horizontal line as the symphysis pubis |
|
Definition
|
|
Term
What other reference point can be used to locate femoral head without using symphysis pubis or greater trochanter? |
|
Definition
|
|
Term
| Where is symphysis pubis in relation to ASIS? |
|
Definition
|
|
Term
| Where is femoral neck in relation to ASIS? |
|
Definition
| 1-2 inches medial and 3-4 inches distal to ASIS |
|
|
Term
| When the leg is in the true anatomic position, the proximal femur is actually rotated posteriorly by __________ |
|
Definition
|
|
Term
| The femoral neck appears shortened and the ___________ is visible when the leg and ankle are truly AP. (As in true anatomic position, not AP projection) |
|
Definition
|
|
Term
| By _____ rotating the leg, the proximal femur and hip joint are projected in a TRUE AP projection. |
|
Definition
|
|
Term
| The neck of the femur is ____ to the imaging surface when internally rotating leg. |
|
Definition
|
|
Term
| The _______ is key in determination of correct leg and foot position. |
|
Definition
|
|
Term
| If the entire leg is rotated internally a full 15-20 degrees, what happens to the lesser trochanter on the image? |
|
Definition
| The outline is generally not visible or slightly visible. |
|
|
Term
| If leg is rotated externally, is lesser trochanter visible or not visible? |
|
Definition
|
|
Term
| The ______ is a common fracture site for an older patient who has fallen. |
|
Definition
|
|
Term
| The typical physical sign of a fracture of femoral neck is ________ of the involved foot, where the lesser trochanter is clearly visualized in profile. |
|
Definition
|
|
Term
| What should you do if you expect a hip fracture of a patient? |
|
Definition
| DO NOT try to move them, take picture as is |
|
|
Term
| Shielding is easier for males in that small contact shields can be used on_______ |
|
Definition
|
|
Term
| Top of the shield for males should be placed at __________ to cover testes. |
|
Definition
| Inferior margin of symphysis pubis |
|
|
Term
| Females can sometimes be shielded with______ for pelvic exams |
|
Definition
|
|
Term
| To reduce total radiation dose ________ may be used for pelvic exams. |
|
Definition
Higher kVP about 90 +- 5, except in older patients with osteoperosis |
|
|
Term
| Pelvic and hip radiographic exams are not performed often on children except for newborns with ___________ |
|
Definition
| Developmental dysplasia of hip (DDH) |
|
|
Term
| If a fracture is suspected of a hip, what projection should be taken? |
|
Definition
| An AP of both hips for comparison |
|
|
Term
| Patients who have had hip replacement surgery should NOT be placed in the _______ position for any postsurgical procedures. |
|
Definition
|
|
Term
| ____is a useful modality for studying the relationship of the femoral head to the acetabulum before hip surgery or for a postreduction study of a deelopmental hip dislocation. |
|
Definition
|
|
Term
| ______ is useful for evaluation of newborns for hip dislocations and assessment of joint stability during movement of the lower limbs. |
|
Definition
|
|
Term
| ____________ can be useful to provide early evidence of certain bony pathologic processes such as occult fractures, bone infections, metastatic carcinoma, or other metastatic or primary malignancies. |
|
Definition
|
|
Term
| The ___ projection is considered to be the initial baseline evaluation projection for hip or pelvis. |
|
Definition
|
|
Term
| What is the kV range for AP pelvis projection (AKA bilateral hips) |
|
Definition
|
|
Term
| When positioning for AP pelvis, ensure pelvis is not_____ by making sure distance from _____ to tabletop is equal. |
|
Definition
|
|
Term
| For AP pelvis, rotate legs ____ degrees _____. |
|
Definition
|
|
Term
| Where is CR for AP pelvis? |
|
Definition
| Perpendicular to IR ; midway between level of ASIS and symphysis pubis (2 inches inferior to ASIS) |
|
|
Term
| Respiration during AP pelvis is______ |
|
Definition
|
|
Term
| What structures are shown an an AP pelvis? |
|
Definition
| Pelvic girdle, L5, sacrum, coccyx, femoral heads and neck, greater trochanters |
|
|
Term
| No rotation in AP pelvis is evident by_____ |
|
Definition
| symmetric appearance of iliac ala, ischial spines, and two obturator foramen |
|
|
Term
| A foreshortened or closed obturator foramen indicates rotation_______ |
|
Definition
|
|
Term
| The AP bilateral "frog-leg" projection of pelvis is also called _________ |
|
Definition
|
|
Term
| How are knees positioned for a bilateral frog-leg AP pelvis? |
|
Definition
|
|
Term
| For an AP bilateral frog-leg pelvis, place the plantar surfaces together and abduct _______ from vertical. |
|
Definition
| both femurs 40-45 degrees |
|
|
Term
| During an AP bilateral frog-leg pelvis, you must ensure that ______ are abducted the same amount so that the pelvis is not _____ |
|
Definition
|
|
Term
| Where is CR for AP bilateral frog-leg pelvis? |
|
Definition
| perpendicular to IR 3 inches below level of ASIS |
|
|
Term
| Less abduction of femurs during AP bilateral frog-leg pelvis such as 20 to 30 degrees from vertical provides the least foreshortening of femoral necks, but this placement foreshortens the _________, which may not be desirable. |
|
Definition
|
|
Term
| No rotation during AP bilateral frog-leg pelvis is evident by _____________ |
|
Definition
| symmetric appearance of pelvic bones, especially ala of ilium, two obturator foramina, and ischial spines. Greater trochanters mostly superimposed. |
|
|
Term
| What is another name for the AP axial outlet projection of pelvis? |
|
Definition
|
|
Term
| What conditions are best demonstrated by AP axial outlet projection? |
|
Definition
| bilateral pubes and ischia to assess pelvic trauma for fractures and displacement |
|
|
Term
| How are legs positioned in AP axial outlet plevis? |
|
Definition
|
|
Term
| Where is CR for AP axial outlet pelvis? |
|
Definition
| CR cephalad 20 to 35 degrees for males and 30-45 degrees for females. CR to midline point 1 to 2 inches distal to superior border of symphysis pubis or greater trochanters |
|
|
Term
| __________ respiration during exposure of AP axial outlet pelvis |
|
Definition
|
|
Term
| What structures are shown on AP axial outlet pelvis? |
|
Definition
| Superior and inferior rami of pubes and body and ramus of ischium are demonstrated well, with minimal foreshortening or superimposition. |
|
|
Term
| What pathology is demonstrated in an AP axial inlet projection of pelvis? |
|
Definition
| assessment of pelvic trauma for posterior displacement or inward or outward rotation of anterior pelvis |
|
|
Term
| How are patient's legs positioned for AP axial inlet pelvis? |
|
Definition
|
|
Term
| Where is CR for AP axial inlet pelvis? |
|
Definition
| 40 degrees caudad, CR to midline point at level of ASISs |
|
|
Term
| _______respiration during exposure of AP axial inlet pelvis. |
|
Definition
|
|
Term
| What structures are shown in AP axial inlet pelvis? |
|
Definition
| pelvic ring or inlet (superior aperture) in entirety. |
|
|
Term
| How is proper angling shown in AP axial inlet pelvis on an image? |
|
Definition
| superimposed anterior and posterior portions of pelvic ring. |
|
|
Term
| What is another name for the posterior oblique pelvis-acetabulum? |
|
Definition
|
|
Term
| What pathology is demonstrated by posterior oblique pelvis? |
|
Definition
| evalutates acetabular fracture or hip dislocation. both right and left oblique taken for comparison |
|
|
Term
| What is patient position for posterior oblique pelvis? |
|
Definition
| Patient semisupine, position for affected side up or down, depending on anatomy to be demonstrated. |
|
|
Term
| What is the part position for post. oblique of pelvis? |
|
Definition
| patient in 45 degree post. oblique, both pelvis and thorax at 45 degree from tabletop |
|
|
Term
| Where is CR for post. oblique pelvis? |
|
Definition
When anatomy of interest is downside - CR perp to 2 inches distal and 2 inches medial to downside ASIS When anatomy of interest is upside - CR perp to 2 inches directly distal to upside ASIS |
|
|
Term
| What structures are shown on post. oblique pelvis? |
|
Definition
Downside - anterior rim of acetabulum and posterior ilioischial column, iliac wing Upside - posterior rim and anterior ilioischial column, obturator foramen |
|
|
Term
| How is correct degree of obliquity evident in post. oblique pelvis? |
|
Definition
| open and uniform hip joint space at rim of acetabulum and femoral head. Obturator foramen open for upside, and closed for downside. |
|
|
Term
| What pathology is demonstrated during an AP unilateral hip projection? |
|
Definition
Postoperative exam to demonstrate acetabulum, femoral head, neck and greater trochanter, condition and placement of any existing orthopedic appliance. |
|
|
Term
| What is the part position for AP unilateral hip projection? |
|
Definition
| No roation of pelvis ; rotate affected leg internally 15 to 20 degrees (if possible) |
|
|
Term
| Where is CR for AP unilateral hip projection? |
|
Definition
| Perp to IR, 1 or 2 inches distal to midfemoral neck. Femoral neck located 1 to 2 inches medial and 3 to 4 inches distal to ASIS. |
|
|
Term
| Proximal ____ of femur should be visualized on AP unilateral hip |
|
Definition
|
|
Term
| What is another name for the axiolateral inferosuperior projection of hip and femur? |
|
Definition
|
|
Term
| The axiolateral inferosuperior hip is common for_____ |
|
Definition
| trauma, surgery, and postsurgery patients |
|
|
Term
| Try to ____ pelvis if possible during axiolateral inferosuperior hip |
|
Definition
|
|
Term
| What is part position for axiolateral inferosuperior hip? |
|
Definition
Flex and elevate unaffected leg, out of collimation field. Prevent foot from touching hot collimator. No rotation of pelvis. Place cassette in crease above iliac crest, adjust to be parallel to femoral neck and perp to CR. Internally rotate affected leg 15 to 20 degrees if possible. |
|
|
Term
| Where is CR located on axiolateral inferosuperior hip? |
|
Definition
| CR perp to femoral neck and IR |
|
|
Term
| What structures are shown on an axiolateral inferosuperior hip? |
|
Definition
| entire femoral head and neck, trochanter, and acetabulum. |
|
|
Term
| How should the position be demonstrated during axiolateral inferosuperior hip? |
|
Definition
Only small part if any of lesser trochanter visualized. Only most distal part of femoral neck should be superimposed by greater trochanter. |
|
|
Term
| What is another name for unilateral "frog-leg" projection of hip? |
|
Definition
|
|
Term
| What is part position for unilateral frog leg? |
|
Definition
flex knee and hip of affected side, with sole of foot against opposite leg. Abduct femur 45 degrees from vertical |
|
|
Term
| Where is CR for unilateral frog leg? |
|
Definition
| CR perp to IR directed to midfemoral neck |
|
|
Term
| Best abduction for femoral neck is _____ degrees from vertical, but it results in proximal femur foreshortening. |
|
Definition
|
|
Term
| What structures are shown during a unilateral frog leg projection? |
|
Definition
| lateral views of acetabulum and femoral head and neck, trochanteric area, and proximal one third of femur. |
|
|
Term
| Proper abduction of femur is visible on a radiograph during a unilateral frog leg projection by? |
|
Definition
| femoral neck seen in profile, superimposed by greater trochanter |
|
|
Term
| What is another name for the modified axiolateral projection? |
|
Definition
|
|
Term
| What pathology is demonstrated during modified axiolateral hip? |
|
Definition
| assessment of hip fractures or arthoplasty when patient has limited movement. |
|
|
Term
| How are legs positioned in modified axiolateral hip? |
|
Definition
|
|
Term
What is the part position of modified axiolateral hip? |
|
Definition
Leg in neutral position. Rest cassette on extended bucky tray, bottom of edge of cassette about 2 inches below level of tabletop. Tilt cassette about 15 degrees from vertical, cassette perp to CR |
|
|
Term
| Where is CR for modified axiolateral hip? |
|
Definition
| Angle CR mediolaterally as needed to be perp and centered to femoral neck. Angled posteriorly 15 to 20 degrees from horizontal. |
|
|
Term
| What structures are shown during a modified axiolateral hip? |
|
Definition
| lateral oblique view of acetabulum, femoral head and neck, trochanteric area |
|
|
Term
Correct positioning of modified axiolateral hip is evident by_______ |
|
Definition
Femoral head and neck seen in profile. Lesser trochanter seen projecting post. to femoral shaft. |
|
|
Term
| What pathology is demonstrated for an AP axial projection of SI joints? |
|
Definition
Assessment of fracture and joint dislocation or subluxation of SI joints. |
|
|
Term
| What is kV range for AP axial SI? |
|
Definition
|
|
Term
| What size cassette is used for AP axial SI? |
|
Definition
|
|
Term
| How are patient's legs positioned for AP axial SI? |
|
Definition
|
|
Term
| What is part position for AP axial SI? |
|
Definition
No rotation of pelvis. Center IR to CR. |
|
|
Term
| Where is CR for AP axial SI? |
|
Definition
| CR 30 to 35 degrees cephalad, CR to midline point about 2 inches below ASIS |
|
|
Term
| If patient cannot assume the supine position of AP axial SI, the image can be obtained as a ____ projection with patient prone, using 30 to 35 degree _____ angle. |
|
Definition
| PA ; cadad - CR centered to level of L4, slightly above iliac crest. |
|
|
Term
| What pathology is demonstrated for posterior oblique positions of SI joints? |
|
Definition
| Position demonstrates SI joints farthest from IR to evaluate dislocation or subluxation of SI joint. Both sides are examined for comparison. |
|
|
Term
| What is the part position for post. oblique SI? |
|
Definition
| Turn into 25 to 30 degree post. oblique, side of interest being elevated. |
|
|
Term
| Visualize right joint with ______ and left joint with ______ |
|
Definition
|
|
Term
In post. oblique of SI, elevated knee should be _____ |
|
Definition
|
|
Term
| Where is CR for Post. oblique SI? |
|
Definition
| perp, directed to 1 inch medial to upside ASIS. |
|
|
Term
| To demonstrate inferior or distal part of SI joint more clearly during post. oblique SI, CR may be angled _______ |
|
Definition
| 15 to 20 degrees cephalad. |
|
|
