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RTE2563 Exam 2 Ch 7
Pelvis
| 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 Posterior |
| 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 anteroposterior (AP) projection. | 15 to 20 |
| The terms pelvis and pelvic girdle are not synonymous. | True |
| List the four bones that make up the pelvis. | Rt & Lt hip bones, sacrum, coccyx |
| List the two bones that make up the pelvic gridle. | Right and Left hip bones |
| List two additional terms used for the pelvic gridle bones. | ossa coxae or innominate bones |
| List the three divisions of the hip bone | Ilium, Ischium and Pubis |
| All three divisions of the hip boneeventually fuse at the ________ at the age of _______. | Acetabulum midteens |
| what are the 2 important radiographic landmarks found on the ilium? | Iliac crestand 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? | symphysis pubis |
| the _____ of the pelvis is the largest foramen in the skeletal system | obturator foramen |
| the upper margin of the greater trochanter is approximately _____ inches above the level of the superior border of the symphysis pubis, andthe ischial tuberosity is about _____ inches below | A. 1 inch B. 1 1/2 - 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. A. Greater pelvis ______ B. Lesser pelvis _______ | A. False Pelvis B. True Pelvis |
| List the major function of the greater pelvis and the lesser pelvis. A. Greater pelvis_____ B. Lesser pelvis _____ | A. Support the lower abdominal organs and fetus B. Forms the actual birth canal |
| List the three aspects of the lesser pelvis, which also describe the birth route during the delivery process | A. Inlet (superior aperture) B. Cavity C. Outlet (inferior aperture) |
| Chatacteristics of the female pelvis | wide, more flared ilia pubich arch angle of 110 degrees ischial spines protruding less into pelvic inlet |
| Characteristics of the male pelvis | a heart-shaped pelvic inlet narrow ilia that are less flared pubic arch angle of 75 degrees |
| List the four bones that make up the pelvis | Right and left pel |
| Which two bony landmarks need to be palpated for hip localization? | A. ASIS B. Symphysis pubis (or greater trochanter if palpation of this landmark is not permitted by institution) |
| From the midpoint of the imaginary line created by the two landmarks identified in the previous question, where would the femoral neck be located? | Approximately 2.5 inches (6to 7 com) below the midpoint of the line |
| A second method for locating the femoral head is to palpate the______ and go ____ inches (____ cm) medial at the level of the _____, which is ____ inches (____ cm) distal to the original palpation point. | ASIS; 1 to 2 inches (3 to 5 cm); symphysis pubis and/or greater trochanter; 3 to 4 inches (8 to 10 cm) |
| To achieve a true AP position of the proximal femur, the lower limb must be rotated ______ internally. | 15 to 20˚ |
| Which structures on an AP pelvis or hip radiograph indicate whether the proximal head and neck are in position for a true AP projection? | Lesser trochanter should not be visible, or should only be slightly visible, on the radiograph. |
| Which physical sign may indicate that a patient has a hip fracture? | The pt's foot is rotated externally |
| Which projection should be taken first and reviewed by a radiologist before attempting to rotate the hip into a lateral position (if trauma is suspected)? | AP pelvis |
| Gonadal shielding should be used for all patients of reproductive age, unless _______ | It covers anatomic structures of primary interest |
| Should a gonadal shield be used for a hip study on a young female? ___________ If yes, describe how it should be placed on the patient. | Yes. Use a shaped ovarian shield with top of shield at level of ASIS and bottom at symphysis pubis. |
| Should a gonadal shield be used for a hip study on a young male? ______ If yes, describe how it should be placed on the patient. | Yes. The top of the shield should be placed at the inferior margin of the symphysis pubis. |
| What is the advantage of using 90 kV rather than a lower kV range for hip and pelvis studies with an analog imaging system on younger patients? | It reduces pt dose |
| What is the disadvantage of using 90 kV for hip and pelvis studies with an analog imaging system, especially for older patients with some bone mass loss? | It reduces radiographic contrast |
| Which of the following conditions is a common clinical indication for performing pelvic and hip examinations on a pediatric (newborn) patient? A. Osteoporosis B. Developmental dysplasia of hip (DDH) C. Ankylosing spondylitis D. Osteoarthritis | B. Developmental dysplasia of hip (DDH) |
| Geriatric patients are often more prone to hip fractures because of their increased incidence of osteoporosis. | True |
| The soft-tissue of an obese patient is indicative of the actual size of the bony pelvis. | False (The size of the bony pelvis is not proportional to the girth and dimensions of the soft tissue that surrounds it) |
| 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 |
| Both joints must be included on an AP and lateral projection of the femur even if a fracture of the proximal femur is evident. | True |
| Where is the central ray placed for an AP pelvis projection? | Midway between ASIS and symphysis puis. |
| The central ray for the AP pelvis projection is approximately _____ inch(es) (cm) inferior to the level of the ASIS. | 2 inches (5cm) |
| 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? | Rotation toward right side |
| 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 | PA axial oblique |
| when gonadal shielding is not used, ______ (males or females) receive a greater gonadal dose with an AP pelvis projection | Females (because of location of CR and reproductive organs) |
| How many degrees are the femurs abducted (from vertical plane) for the bilateral frog-leg projection? | 40 to 45˚ |
| where is the central ray placed for a bilateral frog-leg (modified Cleaves method) projection? | 3 inches (7.5 cm) below level of ASIS (1 inch bove symphysis pubis) |
| which size of analog image receptor should be used for an adult bilateral frog-leg projection? | 14x17 inches |
| where is the central ray placed for an AP unilateral frog-leg projection? | Midfemoral neck |
| Which CR angle is required for the AP axial outlet (Taylor Method) projection for a female patient? A. 15 to 25˚ caudad B. 30 to 45˚ cephalad C.20 to 25˚ cephalad D. None (central ray is perpendicular) | B. 30 to 45˚ cephalad |
| which type of pthology is best demostrated 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 perpendicular) B20˚ C. 30˚ D. 45˚ | D. 45˚ |
| what type of CR angle is used for a PA axial oblique (Teufel) projection. A. 15˚ cephalad B. 15 to 20 ˚ cephalad C. 5˚ caudad D. 12˚ cephalad | D. 12˚ cephalad |
| 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—no rotation C. PA 35 to 40˚ toward affected side D. AP with 40˚ away from affected side. | C. PA 35 to 40˚ toward affected side |
| Any orthopedic device or appliance of the hip should be seen in its entirety on an AP hip radiograph. | True |
| The axiolateral (inferosuperior) projection is designed for _________ (traumatic or nontraumatic) situtions. | Traumatic |
| How is the unaffected leg positioned for the axiolateral hip projection? | It's 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 kV C. Use of gonadal shielding D. Use of a stationary grid | C. use gonadal shielding |
| An AP pelvis projection using 90 kV and 8 mAs results in less patient dose than a projection using 80 kV and 12 mAs (for both males and females). | True |
| The unaffected foot during an axiolateral (inferosuperior) projection can be burned if allowed to rest on the collimator. | True |
| The modified axiolateral (Clements-Nakayama method) projection requires the CR to be angled ______ degrees posteriorly from horizontal. | 15 to 20 |
| Which special projection of the hip demonstrates the anterior and posterior rims of the acetabulum and the ilioischial and iliopubic columns? (Include the projection name and the method name.) A. ______________________ B. which CR angle is used? _______ | A. Posterior oblique projecrtions of acetabulum (Judet Method) B. 0˚ (perpendicular) |
| What is the name of a special projection of the pelvis used to assess trauma to pubic and ischial structures? (Include the projection name and the method name.) | AP axial outlet projection (Taylor Method) |
| 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. 20-30˚ from vertical. | D. 20-30˚ from vertical |
| 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˚ from vertical |
| Gonadal shielding can be used for males for the axiolateral (inferosuperior) projection of the hip. | False |
| A radiograph of an AP pelvis projection shows that the lesser trochanters are readily demonstrated on the medial side of the proximal femurs. The patient is ambulatory but has a history of early osteoarthritis in both hips. Which positioning modification | Rotate the lower limbs 15 to 20˚ internally to place the proximal femurs in a true AP position. (With general chronic pain, the lower limbs usually can be rotated safely.) |
| A radiograph of an AP pelvis shows that the right iliac wing is foreshortened as compared with the left side. Which specific positioning error was made? | The patient is rotated toward the left- LPO |
| A radiograph of a unilateral frog-leg (modified Cleaves) projection produces distortion of the femoral neck. Based on the AP hip projection, the radiologist suspects a nondisplaced fracture of the femoral neck. What can the technologist do to define this | Repeate the exposure and only abduct the femur 20 to 30˚ from vertical (it will produce less distortion of the femoral neck) |
| A radiograph of an axiolateral (inferosuperior) projection shows that the posterior aspect of the acetabulum and femoral head were cut off of the bottom of the image. The emergency room physician requests that the position be repeated. What can be done to | If possible elevate the pt at least 2 inches by placing sheets or blankets beneath the pelvis. |
| A radiograph of an AP axial projection for anterior pelvic bones shows that the pubic and ischial bones are not elongated sufficiently. The following analog factors were used for this study: 86 kV, 7 mAs, Bucky, 20 to 30 degrees central ray cephalad angle | A greater central ray angle is required. Female patients require a central ray angle of 30 to 45˚ |
| A patient enters the ER with a pelvis injury resulting from a motor vehicle accident. The initial AP pelvis projection demonstrates a possible defect or fracture of the left acetabulum. No other fractures are detected and the patient is able to move comfo | The PA axial oblique (Teufel method) or posterior oblique (Judet Method) can be taken to demostrate aspect of the acetabullum more completely. |
| A radiograph of an AP pelvis shows overall that the image is underexposed (underpenetrated). The following analog factors were used: 80-kV, 40-inch (102-cm) SID, Bucky, and AEC with the center chamber activated. Which of these factors should be changed to | When using AEC for an AP pelvis projection, the left and right ionization chambers must be activated. The center chamer is over the less dense pelvic cavity, which may lead to an underexposed image. |
| A radiograph from a modified axiolateral projection of the hip shows excessive grid lines on the image, which also appears underexposed. What can be done to avoid this problem during the repeat exposure? | Ensure that the central ray is centered to near the midline of the grid cassette and the face of the IR is perpendicular to the CR |
| A portable AP and lateral hip study is ordered for a patient who is in recovery following hip replacement surgery. The radiograph of the AP hip shows that the upper portion of the acetabular prosthesis is slightly cut off but is included on the lateral pr | Yes. Any orthopedic appliance or prosthesis must be seen in its entirety in both projections. |
| A patient with hip pain from a fall enters the emergency room. The physician orders a left hip study. When moved to the radiographic table, the patient complains loudly about the pain in the left hip. Which positioning routine should be used for this pati | AP pelvis and axiolateral (inferosuperior) left hip. The AP pelvis radiograph should be taken initially without leg otation, the radiograph must be reviewed by the physician and checked for fractures or dislocations before attempting an interal rotation o |
| A patient has just been moved to his hospital room after a bilateral hip replacement surgery. The surgeon has ordered a postoperative hip routine for both hips. Which specific positioning routine should be used? (The patient can be brought to the radiolog | AP pelvis and modified axiolateral (Clements-Nakayama method) |
| A patient with a possible pelvic ring fracture from a trauma enters the emergency room. The AP pelvis projection, which was taken to determine whether the right acetabulum was fractured, is inconclusive. Which other radiographic projection can be taken to | Posterior oblique (Judet method). CT is often judget superior in detecting pelvic ring fraqctures. |
| A physician orders a study for inlet and outlet projections of the pelvis. Which projections could be performed to meet this request? | AP axial for pelvic "outlet" (Taylor method) and AP axial for pelvic "inlet" projections and possibly the posterior oblique (Judet method) projections to provide another perspective of the inlet and outlet regions of the pelvis. (if unsure of the request |
| A technologist notices that his AP pelvis projections often demonstrate a moderate degree of rotation. What positioning technique can the technologist perform to eliminate (or at least minimize) rotation on his AP pelvis projections? | Palpate ASIS and ensure they are equal distance from the tabletop. To verify no rotation is still present, ensure that the iliac wings are symmetric, as seen on the radiograph. |
| A very young child comes to the radiology department with a clinical history of DDH. What is the most common positioning routine for this condition? | AP pelvis and bilateral "frog-leg" (Modified Cleaves) projections |
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Jenn99
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