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Bontrager Ch. 7
Femur and Pelvic Girdle
| Question | Answer |
|---|---|
| The largest and strongest bone of the body is the | Femur |
| A small depression located in the center of the femoral head is the | Fovea Capitis |
| The lesser trochanter is located on the _____________ (medial or lateral) aspect of the proximal femur. It projects ___________ (anteriorly or posteriorly) from the junction between the neck and shaft. | Medial; Posteriorly |
| Because of the alignment between the femoral head and pelvis, the lower limb must be rotated ____________ degrees internally to place the femoral neck parallel to the plane of the image receptor to achieve a true AP projection. | 15 - 20 |
| True/False: The terms pelvis and pelvic girdle are not synonymous. | True |
| List the four bones that make up the pelvis | Right and left hip bones, sacrum, and coccyx |
| List the two bones that make up the pelvic girdle | Right and left hip bones |
| List two additional terms used for the right and left hip bones | Ossa coxae and/or innominate bones |
| List the three divisions of the hip bone | Ilium, Ischium, Pubis |
| All three divisions of the hip bone eventually fuse at the _____________ at the age of _______________. | Acetabulum; midteens |
| What are the two important radiographic landmarks found on the ilium? | Iliac Crest & ASIS |
| Which bony landmark is found on the most inferior aspect of the posterior pelvis? | Ischial tuberosity |
| What is the name of the joint found between the superior rami of the pubic bones? | Pubic Symphysis |
| The ____________ of the pelvis is the largest foramen in the skeletal system. | Obturator Foramen |
| The upper margin of the greater trochanter is approximately _____ above the level of the superior border of the pubic symphysis, and the ischial tuberosity is about ______ below. | 1 inch; 1.5 to 2 inches |
| An imaginary plane that divides the pelvic region into the greater and lesser pelvis is called the | Pelvic Brim |
| List the alternate terms for the greater and lesser pelvis | Greater = False Lesser = True |
| List the major function of the greater pelvis and the lesser pelvis | Greater = Supports the lower abdominal organs and fetus Lesser = Forms the actual birth canal |
| List the three aspects of the lesser pelvis, which also describe the birth route during the delivery process | Inlet, Cavity, Outlet |
| Possesses a large tuberosity found at the most inferior aspect of the pelvis... Ilium, Ischium, or Pubis? | Ischium |
| Lesser sciatic notch... Ilium, Ischium, or Pubis? | Ischium |
| Ala... Ilium, Ischium, or Pubis? | Ilium |
| PSIS... Ilium, Ischium, or Pubis? | Ilium |
| Possesses a slightly movable joint... Ilium, Ischium, or Pubis? | Pubis |
| ASIS... Ilium, Ischium, or Pubis? | Ilium |
| Forms the anterior, inferior aspect of the lower pelvic girdle... Ilium, Ischium, or Pubis? | Pubis |
| Articulates with the sacrum to form the SI joint... Ilium, Ischium, or Pubis? | Ilium |
| In the past, which radiographic examination was performed to measure the fetal head in comparison with the maternal pelvis to predict possible birthing problems? | Cephalopelvimetry |
| What imaging modality has replaced Cephalopelvimetry? | Sonography or Ultrasound |
| Wide, more flared ilia... Male or Female? | Female |
| Pubic arch angle of 110 degrees... Male or Female? | Female |
| A heart-shaped inlet... Male or Female? | Male |
| Narrow ilia that are less flared... Male or Female? | Male |
| Pubic arch angle of 75 degrees... Male or Female? | Male |
| Larger and more round-shaped inlet... Male or Female? | Female |
| Crest... Ilium, Ischium, Pubis? | Ilium |
| Ischial Spine... Ilium, Ischium, Pubis? | Ischium |
| Superior Ramus... Ilium, Ischium, Pubis? | Pubis |
| Ischial Tuberosity... Ilium, Ischium, Pubis? | Ischium |
| Inferior Anterior Ramus... Ilium, Ischium, Pubis? | Pubis |
| Greater Sciatic Notch... Ilium, Ischium, Pubis? | Ilium |
| Ischial Spine... Ilium, Ischium, Pubis? | Ischium |
| Inferior Posterior Ramus... Ilium, Ischium, Pubis? | Ischium |
| Ischial Tuberosity... Ilium, Ischium, Pubis? | Ischium |
| Acetabulum... Ilium, Ischium, Pubis? | Ischium, Ilium, and Pubis |
| AIIS... Ilium, Ischium, Pubis? | Ilium |
| Which two bony landmarks need to be palpated for hip localization? | ASIS and Pubic Symphysis or Greater Trochanter |
| From the midpoint of the imaginary line created by the ASIS and the Pubic Symphysis, where would the femoral neck be located? | Approximately 2.5 inches below the midpoint of the line |
| Which structure on an AP pelvis or hip radiograph indicate whether the proximal head and neck are in position for a true AP projection? | Lesser trochanters should not be visible, or only slightly visible |
| Which physical sign may indicate that a patient has a hip fracture? | The patient's foot is rotated externally |
| Which of the following conditions is a common clinical indication for performing pelvic and hip examinations on a pediatric (newborn) patients? A. Osteoporosis B. Developmental dysplasia of hip (DDH) C. Ankylosing spondylitis D. Osteoarthritis | B. Developmental Dysplasia of Hip (DDH) |
| Which of the following imaging modalities can be used on a newborn to assess hip joint stability during movement of the lower limbs? A. Sonography B. CT C. MRI D. Nuc Med | A. Sonography |
| Which of the following imaging modalities is most sensitive in diagnosing early signs of metastatic carcinoma of the pelvis? A. Songraphy B. CT C. MRI D. Nuc Med | D. Nuc Med |
| This is a degenerative joint disease... | Osteoarthritis |
| This is the most common fracture in older patients because of high incidence of osteoporosis or avascular necrosis... | Proximal Hip Fracture |
| This is a malignant tumor of the cartilage of the hip... | Chondrosarcoma |
| This is a disease producing extensive calcification of the longitudinal ligament of the spinal column... | Ankylosing spondylitis |
| This is a fracture resulting from a severe blow to one side of the pelvis... | Pelvic Ring Fracture |
| This is a malignancy spread to bone via the circulatory and lymphatic systems or direct invasion... | Metastatic Carcinoma |
| This is now referred to as developmental dysplasia of the hip... | Congenital Dislocation |
| Which of the following devices will improve overall visibility of the proximal hip demonstrated on an axiolateral (inferosuperior) projection? A. Small Focal Spot B. 6:1 Grid C. Compensating Filter D. Shadow Shield | C. Compensating Filter |
| Which of the following modalities will best demonstrate a possible ring fracture? A. CT B. Nuc Med C. MRI D. Sonography | A. CT |
| Where is the central ray placed for an AP Pelvis projection? | Midway between ASIS and Pubic Symphysis and MSP |
| The central ray for the AP pelvis projection is approximately ____ inch(es) inferior to the level of the ASIS? | 2 inches |
| Which specific positioning error is present when the left iliac wing is elongated on an AP pelvis radiograph? | Rotation toward left side |
| Which specific positioning error is present when the left obturator foramen is more open than the right side on an AP Pelvis radiograph? | Right Rotation |
| Trauma or Non Trauma: Axiolateral, inferosuperior (Danelius-Miller) projection | Trauma |
| Trauma or Non Trauma: Unilateral frog-leg (modified Cleaves method) | Non Trauma |
| Trauma or Non Trauma: AP Bilateral "frog leg" (modified Cleaves method) | Non Trauma |
| Trauma or Non Trauma: Modified axiolateral (Clements-Nakayama method) | Trauma |
| Trauma or Non Trauma: AP axial for pelvic "outlet" | Trauma |
| Which of the following projections is recommended to demonstrate the superoposterior wall of the acetabulum? A. AP Axial "Inlet" B. PA Axial Oblique C. Axiolateral Inferosuperior D. Modified Axiolateral | B. PA Axial Oblique |
| When gonadal shielding is not used, males or females receive a greater gonadal does with an AP Pelvis projection? | Females, because of the location of the reproductive organs |
| How many degrees are the femurs abducted (from the vertical plane) for the bilateral frog-leg projection? | 40 - 45 |
| Where is the central ray placed for a bilateral frog-leg (modified Cleaves method) projection? | 3 inches below ASIS or 1 inch above Pubic Symphysis and MSP |
| Where is the central ray placed for an AP unilateral frog-leg projection? | Femoral Neck |
| Which central ray angle is required for the "outlet" projection (Taylor method) for a female patient? A. 15 - 25 caudad B. 30 - 45 cephalic C. 20 - 35 cephalic D. None (central ray is perpendicular) | B. 30 - 45 cephalic |
| Which type of pathology is best demonstrated with the posterior oblique (Judet method)? A. Acetabular fractures B. Anterior pelvic bone fractures C. Proximal femur fractures D. Femoral neck fractures | A. Acetabular Fractures |
| How much obliquity of the body is required for the posterior oblique projection (Judet method)? A. None (CR is perpendicular) B. 20 degrees C. 30 degrees D. 45 degrees | D. 45 degrees |
| What type of CR angle is used for a PA axial oblique (Teufel) projection? A. 15 cephalic B. 15 to 20 cephalic C. 5 caudad D. 12 caudad | D. 12 degrees cephalic |
| How is the pelvis (body) positioned for a PA axial oblique (Teufel) projection? A. PA with 45 degrees rotated away from affected side B. Prone or erect PA C. PA 35 to 40 degrees toward affected side D. AP with 40 degrees away from affected side | C. PA 35 to 40 degrees toward affected side |
| How is the unaffected leg positioned for the axiolateral hip projection? | It is flexed and elevated to prevent it from being superimposed over the affected hip. |
| Which of the following factors does not apply to an axiolateral (inferosuperior) projection of the hip on a male patient: A. IR parallel to femoral neck B. 80 to 90 kVp C. Use of gonadal shielding D. Use of a stationary grid | C. Use of a gonadal shield |
| The modified axiolateral requires the CR to be angled _____ degrees posteriorly from horizontal? | 15 to 20 degrees |
| Which special projection of the hip demonstrates the anterior and posterior rims of the acetabulum and the ilioischial and iliopubic columns? (Projection and method name please) | Posterior oblique projections of the acetabulum, Judet Method |
| Which central ray angle (if any) is used for the Judet method? | 0 degrees (CR perpendicular) |
| What is the name of a special projection of the pelvis used to assess trauma to pubic and ischial structures? (Projection name and method please) | AP axial outlet projection, Taylor method |
| Another name for the axiolateral projection (inferosuperior)? | Danelius-Miller |
| Another name for the modified axiolateral projection? | Clements-Nakayama |
| Another name for the bilateral or unilateral frog-leg projection? | Modified Cleaves |
| Another name for the PA axial oblique for acetabulum projection? | Teufel |
| Another name for the AP axial for pelvic "outlet" bones projection? | Taylor |
| Another name for the posterior oblique for acetabulum projection? | Judet |
| What is the optimal amount of hip abduction applied for the unilateral "frog-leg" projection to demonstrate the femoral neck without distortion? A. 45 from vertical B. 90 from vertical C. 10 from vertical D. 20 to 30 from vertical | D. 20 to 30 degrees from vertical |
| True or False: The Lauenstein/Hickey method for the unilateral "frog-leg" projection will produce distortion of the femoral neck? | True |
| How much is the IR tilted for the modified axiolateral projection of the hip? | 15 degrees from vertical |
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