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Positioning II > Hip/Pelvis > Flashcards

Hip/Pelvis Flashcards

1
Q

Pelvis consists of four bones:

A

-right and left innominate (os coxae) or hip bones
-sacrum
-coccyx

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2
Q

Serves as the base for the trunk and a girdle for lower limb

A

pelvis

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3
Q

Composed of only the two hip bones

A

Pelvic Girdle

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4
Q

Other names for pelvic girdle

A

-os coxae
-innominate

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5
Q

These three bones come together to form the acetabulum

A

-illium
-ischium
-pubis

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6
Q

What does Illium, ischium, pubis form

A

acetabulum

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7
Q

-consists of a body and a broad, curved portion called the ala
-Body forms superior two fifths of acetabulum

A

Ilium

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8
Q

Four prominent processes of the Ilium

A

-Anterior superior iliac spine (ASIS)
-anterior inferior iliac spine
-posterior superior iliac spine
-posterior inferior iliac spine

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9
Q

What is the superior margin of the ilium

A

iliac crest

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10
Q

what does the posterior inferior part of the ilium end in

A

the greater sciatic notch

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11
Q

What does the Ischium consist of

A

-body
-ischial ramus

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12
Q

Each bone of the pelvic girdle has three parts which are

A

-ilium
-ischium
-pubis

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13
Q

What is the cup shaped socket that articulates with the head of the femur

A

Pelvic gridle

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14
Q

Forms the posterior two fifths of aceabulum

A

Ischium

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15
Q

what does the ischial ramus join with

A

Ischial ramus joins with inferior ramus of pubis

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16
Q

expanded portion on which the trunk rests when seated

A

ischial tuberosity

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17
Q

located on upper, posterior part of the body

A

Ischial Spine

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18
Q

indentation just below ischial spine

A

lesser sciatic notch

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19
Q

-the area in which the head of the femur articulates
-ball and socket. joint

A

Acetabulum

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20
Q

What can we palpate on the pelvic girdle

A

-ASIS
-Iliac crest

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21
Q

Is the side down elongated or foreshortened

A

Elongated

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22
Q

Is the side up elongated or foreshortened

A

Foreshortened

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23
Q

What helps form the obturator foramen?

A

Ischial Tuberosity

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24
Q

The pubis consists of:

A

-body
-superior ramus
-inferior ramus

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25
Q

The body forms approximately one fifth of anterior acetabulum

A

The body of the Pubis

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26
Q

Formed by junction of ischial ramus and pubis inferior ramus

A

obturator foramen

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27
Q

Four mains parts of the proximal femure

A

Head
neck
Greater trochanter -out to the lateral
lesser trochanter- out to the medial

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28
Q

intertrochanteric line

A

A imaginary line that goes to greater to lesser
on the anterior aspect

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29
Q

Where is the intertrochanteric crest located

A

on the posterior aspect of the proximal femure

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30
Q

-Articulation between the right and left ilia and the sacrum

A

Sacroiliac (SI) joints

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31
Q

-articulation of the head of the femora with the acetabula

A

hip joints

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32
Q

what type of joint is the hip joint

A

-synovial, ball and socket

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33
Q

What type of joint are the SI joints

A

-irregular, gliding type

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34
Q

-junction of right and left pubic bones in the midline
-Cartilaginous, slightly moveable joint

A

Pubic sumphysis

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35
Q

Difference in male and females pelvic anatomy

A

Males
-heavier, narrower, deeper
-angle at pubic symphysis is acute

Females
-wider, shallower, lighter
-angle at pubic symphysis is obtuse

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36
Q

forms superior aperture (opening) or inlet of the true pelvis

A

Brim

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37
Q

what consists of the true pelvis

A

bladder, colon, female reproductive organs

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38
Q

what forms the outlet

A

inferior aperture

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39
Q

what are the bony landmarks

A

-iliac crest
-ASIS
-pubic symphysis
-greater trochanter
-ischial tuberosity
-tip of coccyx

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40
Q

What lies in the same horizontal plane as the midpoint of the hip joint and coccyx

A

Highest point of greater trochanter

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41
Q

what is in the same horizontal plane as the pubic symphysis

A

The most prominent point of greater trochanter

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42
Q

How to localize the hip joint

A

make a imaginary line from the anterior superior iliac spine to the superior margin of the pubic symphysis half way between go down 2 and a half inches and the neck will be right there

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43
Q

Essential projections of the pelvis

A

AP

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44
Q

what should you never do if a foot is straight out to one side

A

NEVER ROTATE A THE LEG that is turned out because at this point you know there is a fractured hip

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45
Q

Patient position for AP pelvis and upper femora

A

Supine

46
Q

how do you rotate the feet for the ap pelvis and upper femora

A

medially rotate the feet and lower limbs 15 to 20 degrees

47
Q

part position for AP pelvis and upper femora

A

-median sagittal plane (MSP) of body centered to midline
-equal ASIS to table distance on both sides

48
Q

what does rotating the feet in medially do in the Ap pelvis and upper femora

A

-places femoral necks parallel to IR so they are not foreshortened

49
Q

CR for Ap pelvis and upper femora

A

perp to IR

50
Q

Where should the IR be for AP pelvis and upper femora

A

Upper border of IR 1 to 1 1/2 inches above crests

51
Q

what is in profile in the ap pelvis and upper femora

A

Greater Trochanter

52
Q

what should be included in the ap pelvis and upper femora

A

-top of crests
-pubic symphysis
-its not necessary to get greater trochanter on
-necks of femur should look parallel without superimposition
-should not see much of the lesser trochanter
-illium is of equal distance
-ischial spine equal distance
sacrum and coccyx is equal distance
-obturator foramen should look equal

53
Q

what does it mean if you see too much of the lesser

A

You did not turn the legs in

54
Q

breathing for AP pelvis and upper femora

A

suspended

55
Q

what happens when there is poor positioning of the feet for AP pelvis and upper femora

A

-the lesser are in profile
-There is foreshortening of the femoral necks

56
Q

Essential projections for the Femoral Necks

A

AP Oblique (modified cleaves method)- do not do this if there is a suspected fracture

57
Q

Patient position for AP Oblique Femoral Necks (Modified Cleaves)

A

Supine

58
Q

SID for AP pelvis

A

40 inches

59
Q

Part position for bilateral AP Oblique Femoral Necks (modified Cleaves)

A

-ASIS equal distance from tabletop
-flex hip and knees
-draw feet up as much as possible
-abduct thighs equally and maximally
-place soles of feet together

60
Q

Where to center for bilateral AP oblique Femoral necks (modified cleaves)

A

Center IR 1 inch above pubic symphysis

61
Q

CR for bilateral AP oblique femoral necks (modified cleaves)

A

-perp to MSP at level 1 inch above pubic symphysis
-Sometimes called the bilateral frog leg

62
Q

CR for unilateral AP oblique Femoral Necks (modified Cleaves)

A

perp to femoral necks

63
Q

Part position for unilateral AP oblique Femoral Necks (modified Cleaves)

A

-center ASIS of affected side to midline of grid
-flex affected hip and knee
-draw foot up to opposide knee as much s possible
-abduct thigh approx. 45 degrees laterally

64
Q

how much should the thigh be abducted in the unilateral AP oblique femoral necks

A

45 degrees laterally

65
Q

essential projections of the Hip :

A

-AP
-Lateral (Lauenstein and Hickey methods)
-Axiolateral (Danelius Miller Method)

66
Q

Patient position for AP Hip

A

Supine

67
Q

Part position for AP hip

A

-ASIS to tabletop distance equal on both sides

68
Q

How much do you rotated the lower limb and foot for AP hip

A

15 to 20 degrees medially

69
Q

what does roatting the feet 15 to 20 degrees medially do in the AP hip

A

places femoral necks parallel to IR

70
Q

CR for AP hip

A

-perp to femoral neck
-use localization technique described previously
adjustment may be necessary if orthopedic device is present

71
Q

Criteria for AP hip

A

-femoral head and seen through the acetabulum
-femoral neck not foreshortened
-greater is in profile to the later
-pubic symphysis must be seen
-does not need iliac crest unless part of protocol
hip joint

72
Q

Patient position for Lateral hip (Lauenstein)

A

rotate slightly toward affected side to an oblique position

73
Q

Part position for Lateral hip (Lauenstein)

A

-center affected hip to midline of grid
-flex affected knee and draw thigh to almost right angle to hip
-body of femur parallel to table
-support opposite hip and knee

74
Q

CR for lateral hip (Lauenstein)

A

-perp through hip
-enters midway between ASIS and pubic symphysis

75
Q

criteria for lateral hip (Lauenstein method)

A

-hip joint, acetabulum, femoral head
-femoral neck overlapped by greater trochanter
-lesser in profile

76
Q

What is in profile for the lateral hip (lauenstein method)

A

Lesser Trochanter

77
Q

What is the part and patient position for the lateral hip (Hickey method)

A

the same as for Lauenstein method

78
Q

CR for lateral hip (hickey method)

A

-angle 20 degrees cephalic
-enters hip joint

79
Q

how much do you angle for the lateral hip (Hickey method) and why do we add an angle

A

20 degrees cephalic and it takes greater off of the neck so the neck is free of superimposition

80
Q

Patient position for Axiolateral Hip (Danelius- Miller)

A

Supine

81
Q

Part position for axiolateral hip (Danelius- Miller)

A

-elevate pelvis for thin patients
-flex knee and hip of unaffected limb to place thigh vertical
-rest unaffected leg and foot on a support
-no rotation of pelvis

82
Q

CR for axiolateral hip (Danelius -Miller)

A

horizontal and perp to long axis of femoral neck

83
Q

position of IR for Axiolateral Hip (Danelius-Miller)

A

-vertical with upper border in crease above iliac crest
-angle lower border away from body until parallel with femoral neck
-Cassete is parallel to neck and perpendicular to beam

84
Q

criteria for axiolater hip (Danelius-Miller)

A

-acetabulum
-ischial tuberosity
-lateral neck is foreshortened
-greater is superimposed over the neck

85
Q

What will you do if pateint cant lift leg for axiolateral hip (Danelius -Miller) or have bilateral fractures of the hip

A

Clements-Nakayama
-limbs remain neutral or external rotated
-grid is parallel to the axis of the femoral neck and tilt top back 15 degrees
-tube will come in angled down 15 degrees it will come in perp with ir in through to the cassette
angle of cassette and tube need to be the same degree of angulation

86
Q

Essential projections for the Acetabulum

A

-AP Oblique (Judet, modified Judet)

87
Q

To demonstrate posterior rim of acetabulum and iliopubic column

A

Internal AP oblique Acetabulum (Judet)

88
Q

Used to demonstrated anterior rim of acetabulum and ilioischial colum

A

External AP oblique acetabulum (Judet)

89
Q

SID for AP hip

A

40 inches

90
Q

breathing for AP hip

A

suspended

91
Q

breathing for unilateral AP oblique femoral necks (modified cleaves)

A

suspended

92
Q

distance for AP oblique Femoral necks (modified cleaves)

A

40 inches

93
Q

Breathing and SID for Axiolateral Hip (Danelius- Miller)

A

suspended
40 inches

94
Q

Breathing, angle and SID for Clements Nakayama

A

-suspended
-15 degrees posteriorly
-40 inches

95
Q

patient position for internal oblique acetabulum (Judet)

A

recumbent 45 degree posterior oblique position with affected side up

96
Q

CR for AP internal oblique acetabulum (Judet)

A

perp to IR
enters 2 inches inferior to ASIS of affected side

97
Q

used to demonstrate posterior rim of acetabulum and iliopubic column

A

internal oblique (Judet Method)

98
Q

Patient position for AP external oblique acetabulum (Judet)

A

recumbent 45 degree posterior oblique position with affected side down

99
Q

CR for external AP oblique Acetabulum (Judet)

A

-perp to IR
-Enters pubic symphysis

100
Q

demonstrate anterior rim of acetabulum and ilioischial column.

A

external oblique Judet Method

101
Q

Pt. position for AP Axial Outlet (Taylor Method)

A

supine

102
Q

CR for males for AP Axial Outlet (Taylor method)

A

20 to 35 degrees cephalic

103
Q

CR for females for AP axial Outlet (Taylor Method)

A

-30 to 45 degrees cephalic

104
Q

where are we centering for AP axial outlet (Taylor Method)

A

entering 2 inches inferior to the superior border of the pubic symphysis

105
Q

For the outlet view how do we angle

A

we angle in to the body

106
Q

for the inlet view how do we angle

A

We angle outside the body

107
Q

Criteria for Taylor method -outlet projection

A

-elongates the superior and inferior rami of the public bone
-ramus of ischium
-nice view of pubic symphysis
-nice view of ischium

108
Q

SID and breathing for outlet view

A

40 inches
suspended

109
Q

Pt. position for Superoinferior axial inlet projection (Bridgeman method)

A

supine

110
Q

CR for superoinferior axia inlet projection (Bridgeman method)

A

CR directed 40 degrees caudal, entering the midline at the level of the ASIS

111
Q

SID and breathing for superoinferior axial inlet projection (Bridgeman method)

A

-40 inches
-suspended

112
Q

Why do we do an inlet view

A

we are look at the brim and elongating it

Positioning II (12 decks)

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