Rad 111 - Chapter 7

Front 1

The longest and strongest bone in the body

Back 1

Femur

Front 2

The proximal femur consists of what four essential parts?

Back 2

The head, neck, greater trochanter, lesser trochanter

Front 3

The part of the femur that is rounded and smooth for articulation with the hip bones

Back 3

Head

Front 4

The depression near the center of the head of the femur

Back 4

Fovea capitis

Front 5

The major ligament that is attached to the head of the femur

Back 5

Ligament capitis femoris

Front 6

A strong pyramidal process of bone that connects the head with the body in the region of the trochanters

Back 6

Neck of femur

Front 7

Large prominence that is located superiorly and laterally to the femoral shaft and is palpable as a bony landmark

Back 7

Greater trochanter

Front 8

Small, blunt, conical eminence that projects medially and posteriorly from the junction of the neck and shaft of the femur

Back 8

Lesser trochanter

Front 9

A thick ridge that connects the trochanters posteriorly

Back 9

Intertrochanteric crest

Front 10

The angle of the femoral neck to the shaft on an average adult

Back 10

125 degrees, with a variance of 15 degrees depending on the width of the pelvis and length of the lower limbs

Front 11

The longitudinal plane of the femur is about how many degrees from vertical?

Back 11

10 degrees

Front 12

In relation to the body of the femur, what is the anterior angle of the head and neck?

Back 12

15 to 20 degrees

Front 13

What does the word pelvis mean?

Back 13

Basin

Front 14

What are the four bones of the pelvis?

Back 14

Two hip bones, one sacrum, one coccyx

Front 15

What is another name for the hip bones?

Back 15

Innominate bones

Front 16

What articulates to form the lumbosacral joint?

Back 16

The sacrum articulates superiorly with the 5th lumbar vertebrae

Front 17

What articulates to form the sacroiliac joints?

Back 17

The right and left iliac bones articulate posteriorly with the sacrum

Front 18

What are the three divisions of the hip bones?

Back 18

Ilium, ischium, pubis

Front 19

A deep, cup-shaped cavity that accepts the head of the femur to form the hip joint

Back 19

Acetabulum

Front 20

The ilium is composed of what two parts?

Back 20

A body and an ala (wing)

Front 21

The superior margin of the ala

Back 21

Iliac crest

Front 22

A less prominent projection below the ASIS

Back 22

Anterior inferior iliac spine

Front 23

The part of the hip bone that lies inferior and posterior to the acetabulum

Back 23

Ischium

Front 24

The two parts of the ischium

Back 24

A body and a ramus

Front 25

Projects anteriorly from the ischial tuberosity

Back 25

Ramus of the ischium

Front 26

The rounded roughened area near the junction of the lower body and the inferior rami

Back 26

Ischial tuberosity

Front 27

A bony projection posterior to the acetabulum. A small part of this is visible on a frontal view of the pelvis

Back 27

Ischial spine

Front 28

A deep notch directly superior to the ischial spine

Back 28

Greater sciatic notch

Front 29

A small notch inferior to the ischial spine

Back 29

Lesser sciatic notch

Front 30

Bears most of the weight of the body when an individual sits

Back 30

Ischial tuberosities

Front 31

The relation of the body of the pubis to the acetabulum

Back 31

Anterior and inferior

Front 32

Extending anteriorly and medially from the body of each pubis

Back 32

Superior ramus

Front 33

Formed when the two superior rami meet in the midline to form an amphiarthrodial Joint

Back 33

Symphysis pubis

Front 34

Passes down and posterior from the symphysis pubis to join the ramus of the respective ischium

Back 34

Inferior ramus

Front 35

A large opening formed by the ramus and body of each ischium and by the pubis

Back 35

Obturator foramen

Front 36

The largest foramen in the human skeletal system

Back 36

Obturator foramen

Front 37

Defined by the superior portion of the symphysis pubis anteriorly and by the superior prominent part of the sacrum posteriorly

Back 37

Pelvic Brim

Front 38

The bony portion of the pelvis

Back 38

False pelvis, or greater pelvis

Front 39

The part of the pelvis that is a cavity and is completely surrounded by bony structures

Back 39

True pelvis, or lesser pelvis

Front 40

This forms the actual birth canal

Back 40

True pelvis

Front 41

The oblique plane defined by the brim of the pelvis

Back 41

Inlet, or Superior aperture

Front 42

Define by the two ischial tuberosities and the tip of the coccyx

Back 42

Outlet, or inferior aperture

Front 43

The area between the inlet and outlet of the true pelvis

Back 43

Cavity of the true pelvis

Front 44

Which gender has the wider pelvis, with the ilia more flared and more shallow from front to back?

Back 44

Female pelvis

Front 45

Which gender has the pelvis that is narrower, deeper, and less flared with a heart-shaped pelvic Inlet?

Back 45

Male pelvis

Front 46

What is the angle of the pubic arch in a female?

Back 46

Between 80 and 85 degrees

Front 47

What is the angle of the pubic arch in a male?

Back 47

50 to 60 degrees

Front 48

Which gender has a more protruding pelvic Inlet?

Back 48

Male

Front 49

What classification of joints is the SI joint?

Back 49

Synovial

Front 50

What is the mobility type of a sacroiliac joint?

Back 50

Amphiarthrodial, limited movement

Front 51

What is the classification of joints for the symphysis pubis?

Back 51

Cartilaginous joint

Front 52

What is the mobility type for the symphysis pubis joint?

Back 52

Amphiarthrodial, limited movement

Front 53

What is the classification of joints for the union of acetabulum?

Back 53

Cartilaginous

Front 54

What is the mobility type of the Union of acetabulum?

Back 54

Synarthrodial, non movable

Front 55

What is the classification of joints for the hip joint?

Back 55

Synovial

Front 56

What is the mobility type for the hip joint?

Back 56

Diarthrodial, ball and socket

Front 57

How much movement does the sacroiliac joint have?

Back 57

Limited movement

Front 58

How much movement does the symphysis pubis have?

Back 58

Limited movement

Front 59

How much movement does the union of the acetabulum have?

Back 59

No movement

Front 60

What is the traditional method used to locate the femoral head and neck?

Back 60

Draw an invisible line between the ASIS and the symphysis pubis, determine the midpoint between these two landmarks. The neck is approximately 2.5 inches and the head is 1.5 inches distal and at right angles to the midpoint of this line

Front 61

The greater trochanter are shown to be located on the same horizontal line as what landmark?

Back 61

Symphysis pubis

Front 62

What is a better way to find the femoral neck on an obese patient when you cannot locate the greater trochanters?

Back 62

Find the ASIS, and the level of the symphysis pubis should be between 3 and 4 in inferior to this. Therefore, the femoral neck can readily be located as being 1-2 inches medial and 3-4 in distal to the ASIS

Front 63

What is the degree that the head and neck of the femur project anteriorly with respect to the femur and the lower leg?

Back 63

15° - 20°

Front 64

What happens when the entire lower limb is rotated internally?

Back 64

The proximal femur and hip joint our position and a true AP projection. The neck of the femur is now parallel to the IR and will not appear foreshortened

Front 65

On a radiographic image, what is key in determining the correct leg and foot position?

Back 65

The lesser trochanter will not be visible at all, or is only slightly visible if the entire leg is rotated internally of full 15 to 20 degrees. If the leg is straight AP or when it is externally rotated, the lesser trochanter is visible

Front 66

A common fracture site for an older patient who has fallen

Back 66

Femoral neck

Front 67

What is the typical physical sign for a fracture of the femoral neck?

Back 67

External rotation of the involved foot

Front 68

What is the SID for femur and pelvic girdle projections?

Back 68

40 in

Front 69

What is the IR size for projections of the femur?

Back 69

14 x 17 in

Front 70

What is the kvp range for projections of the femur?

Back 70

75 to 85

Front 71

How many degrees should the leg be rotated internally for an AP projection of the mid-distal femur?

Back 71

5 degrees internally

Front 72

What is the lower IR margin on an AP projection of the mid - distal femur?

Back 72

Approximately 2 in below knee joint

Front 73

What is the CR method for an AP projection of the mid to distal femur?

Back 73

CR perpendicular to femur and IR

Front 74

For a lateral projection of the mid - distal femur, do we usually use mediolateral or lateromedial?

Back 74

Mediolateral

Front 75

When is the lateromedial projection of the mid to distal femur done?

Back 75

For a trauma patient who cannot rotate their femur

Front 76

How is the medial lateral projection of the mid and distal femur positioned?

Back 76

Flex knee approximately 45 degrees with patient on affected side and align femur to mid-line of table or IR. Place on affected leg behind affected leg. Adjust IR to include knee joint. A second IR to include the proximal femur and hip generally will be required on an adult

Front 77

How is a trauma lateromedial projection of the mid and distal femur positioned?

Back 77

Play support under affected leg and knee and support foot and ankle in true AP position. Place IR on edge against medial aspect of thigh to include knee, with horizontal x-ray beam directed from lateral side

Front 78

How is a mediolateral projection of the mid and proximal femur positioned?

Back 78

Flex affected knee about 45 degrees and align femur to mid-line of table. Extend and support unaffected leg behind affected knee and have patient roll back about 15 degrees to prevent superimposition of proximal femur and hip joint. Adjust IR to include hip joint

Front 79

What is the kvp range for projections of the pelvis?

Back 79

80 to 90 kvp

Front 80

What is the IR size for projections of the pelvis?

Back 80

14 x 17

Front 81

How is an AP pelvis projection positioned?

Back 81

Ensure that pelvis is not rotated by making sure that the ASIS's on each side are equal. Separate legs and feet, then internally rotate feet and entire lower limb 15 to 20 degrees.

Front 82

What is the CR method for an AP pelvis projection?

Back 82

CR is perpendicular to IR. Directed midway between level of ASIS and the symphysis pubis. This is approximately 2 in inferior to level of ASIS

Front 83

What Anatomy is demonstrated an AP pelvis projection?

Back 83

Pelvic girdle, L5, sacrum and coccyx, femoral head and neck, and greater trochanters

Front 84

What method is this?

Back 84

Modified Cleaves Method

Front 85

What is the modified Cleaves method, or the AP bilateral frog leg projection, used to find?

Back 85

Developmental dysplasia of hip, also known as congenital hip dislocation

Front 86

How is the AP bilateral frog leg projection positioned?

Back 86

Flex both knees approximately 90 degrees. Place the plantar surfaces of feet together and abduct both femora 40 to 45 degrees from vertical. Ensure that both femora are abducted the same amount and that pelvis is not rotated

Front 87

What Anatomy is demonstrated on the modified Cleaves method?

Back 87

Femoral heads and necks, acetabulum, and trochanteric areas are visible

Front 88

What method is this?

Back 88

Taylor Method

Front 89

What is the Taylor method, or AP axial Outlet projection of the pelvis, done to demonstrate?

Back 89

Bilateral view of the bilateral pubis and ischium to allow assessment of pelvic trauma for fractures and displacement

Front 90

What is the CR method for the modified Cleaves method?

Back 90

CR is perpendicular to IR. Directed to a point 3 in below level of ASIS above symphysis pubis

Front 91

How is the Taylor method positioned?

Back 91

Patient lays supine, with legs extended. Place support under knees for comfort.

Front 92

What is the CR method for the Taylor method?

Back 92

CR is cephalad 20 to 35 degrees for males, and 30 to 45 degrees for females. CR is directed to a midline point 1 to 2 in distal to the superior border of the symphysis pubis/greater trochanters

Front 93

What is the respiration method for the modified Cleaves method?

Back 93

Suspend respiration during exposure

Front 94

What is the respiration method for the Taylor method?

Back 94

Suspend respiration during exposure

Front 95

What method is this?

Back 95

Clements-Nakayama Method

Front 96

What is the Clements Nakayama method done to demonstrate?

Back 96

Possible hip fracture or with arthroplasty when patient has limited movement in both lower limbs and the inferosuperior projection cannot be obtained

Front 97

What is the IR size for the Clements Nakayama method?

Back 97

10 x 12 landscape

Front 98

What is the kvp range for the Clements Nakayama method?

Back 98

80 to 90

Front 99

How is the Clements Nakayama method positioned?

Back 99

Legos maintained in neutral position. Rest I are on extended Bucky tray, or use grid. Tilt IR about 15 degrees from vertical and adjust alignment of IR to ensure that face of IR is perpendicular to CR.

Front 100

What is the CR method for the Clements Nakayama method?

Back 100

CR is angled mediolaterally as needed so that it is perpendicular to and centered to femoral neck. Angled posteriorly 15 to 20 degrees from horizontal

Front 101

What is the AP axial Inlet projection of the pelvis done to find?

Back 101

Assessment of pelvic trauma for posterior displacement or inward / outward rotation of the anterior pelvis

Front 102

How is the AP axial Inlet projection of the pelvis positioned?

Back 102

Patient is supine with legs extended, support placed under knees for comfort.

Front 103

What is the CR method for the AP axial Inlet projection?

Back 103

CR angled 40° caudad (near perpendicular to plane of Inlet). CR directed to a midline point at level of ASIS

Front 104

What Anatomy is demonstrated in the AP axial Inlet projection?

Back 104

The pelvic ring in its entirety

Front 105

What method is this?

Back 105

Judet Method

Front 106

What is the Judet method done to find?

Back 106

Acetabular fracture or pelvis injury. Right and left oblique projections are generally taken for comparison

Front 107

What is the IR size for the Judet method?

Back 107

10 x 12 portrait, or 14-17 landscape if both hips must be seen on each projection

Front 108

How is the posterior oblique projection of the acetabulum positioned?

Back 108

Patient supine, placed in a 45-degree posterior oblique, with both pelvis and thorax 45° from tabletop. Affected side up or down. Align femoral head and acetabulum of interest to midline of tabletop and IR

Front 109

What is the CR method for the right posterior oblique projection of the acetabulum?

Back 109

Affected side down. Direct CR perpendicular and centered to 2in distal and 2 inches medial to downside ASIS

Front 110

What is the CR method for a left posterior oblique projection of the acetabulum?

Back 110

Affected side up. Direct CR perpendicular and centered to 2 in directly distal to upside ASIS

Front 111

What is the respiration method for the AP axial Inlet projection?

Back 111

Suspend respiration during exposure

Front 112

What is the respiration method for the Judet method?

Back 112

Suspend respiration for the exposure

Front 113

What method is this?

Back 113

Teufel Method

Front 114

What is the Teufel method done to find?

Back 114

Acetabular fracture, especially the superoposterior wall of the acetabulum

Front 115

How is the PA axial oblique projection of the acetabulum positioned?

Back 115

Patient is laying prone at a 35 to 40 degree anterior oblique, with both pelvis and thorax 35 to 40 degrees from tabletop. Align femoral head and acetabulum of interest to midline of tabletop

Front 116

What is the CR method for the Teufel method?

Back 116

CR is angled 12° cephalad. CR is directed perpendicular and center to 1 inch superior to the level of the greater trochanter, approximately 2 inch lateral to the midsagittal plane

Front 117

What is demonstrated in the PA axial oblique projection of the acetabulum?

Back 117

The superoposterior wall of the acetabulum

Front 118

What is the AP unilateral hip projection taken to find?

Back 118

Post-op or follow-up exam to demonstrate the acetabulum, femoral head, neck, and greater trochanter. Also to evaluate condition and placement of any existing orthopedic Appliance

Front 119

How is the AP unilateral hip projection positioned?

Back 119

Affected leg is rotated internally 15 to 20 degrees

Front 120

What is the CR method an AP unilateral hip projection?

Back 120

CR is perpendicular to the femoral head. Femoral neck can also be localized about 1-2 in medial and 3-4 in distal to ASIS

Front 121

What anatomy should be demonstrated in an AP unilateral hit projection?

Back 121

Proximal 1/3 of the femur, acetabulum, and adjacent parts of the pubis, ischium, and ileum

Front 122

What is the IR size for the DM Hip?

Back 122

10 x 12 landscape

Front 123

What is the kvp range for the DM hip method?

Back 123

85 to 95 kvp

Front 124

What is the Danelius-Miller method done to find?

Back 124

Fracture or dislocation assessment in trauma hip situations when affected leg cannot be moved

Front 125

What is another name for the Danelius Miller method?

Back 125

Axiolateral inferiosuperior projection of the hip and proximal femur

Front 126

How's the Danelius Miller method positioned?

Back 126

Pelvis is elevated 1 to 2 in by placing supports under pelvis. Flex and elevate unaffected leg so that size near vertical position and outside collimation field. Place IR in crease above iliac crest and adjust so that it is parallel to femoral neck and perpendicular to CR. Use cassette holder if available. Internally rotate affected leg 15 to 20 degrees unless contraindicated by possible fracture

Front 127

What is the CR method for the DM hip?

Back 127

CR is perpendicular to femoral neck and to IR.

Front 128

What is the respiration method for the DM hip?

Back 128

Suspend respiration during exposure

Front 129

What anatomy is demonstrated in a DM hip?

Back 129

Entire femoral head and neck, trochanter, and acetabulum

Front 130

What method is this?

Back 130

Danelius-Miller method

Front 131

What method is this?

Back 131

Modified Cleaves Method

Front 132

What is the modified Cleaves method done to find?

Back 132

A lateral view to assess hip joint in proximal femur for non-traumatic hip situations

Front 133

What is the IR size for the modified Cleaves method?

Back 133

10 by 12 landscape

Front 134

What is the kvp range for the modified Cleaves method?

Back 134

75 to 85

Front 135

How is the unilateral frog leg projection of the hip and proximal femur positioned?

Back 135

Flex knee and hip on affected side of the sole of foot against in side of opposite leg, near me if possible. Abduct femur 45 degrees from vertical for general proximal femur region. Center affected femoral neck to CR and midline of IR on table top

Front 136

What is the CR method for the modified Cleaves method?

Back 136

CR is perpendicular to IR, directed to mid femoral neck

Front 137

What anatomy is demonstrated on the modified Cleaves method?

Back 137

Lateral views of acetabulum and femoral head and neck, trochanteric area, and proximal 1/3 of femur

Front 138

How can you tell when you have a good AP projection of the distal femur?

Back 138

Femoral and tibial condyles should appear symmetric in size and shape with the outline of the patella slightly toward medial side of femur. Medial half of fibular head should be superimposed by tibia.

Front 139

How can you tell when you have a good lateral projection of the distal femur?

Back 139

Knee joint will not appear open, and distal margins of the femoral condyles will not be superimposed because of Divergent x-ray beam. Anterior and posterior margins of medial and lateral femoral condyles should be superimposed and aligned with open patellofemoral joint space.

Front 140

How can you tell when you have a good lateral projection of the proximal femur?

Back 140

Superimposition of the greater and lesser trochanter is by the femur, with only a part of the trochanter is visible on medial side.

Front 141

How can you tell when you have a good AP pelvis projection?

Back 141

Lesser trochanter is not visible at all, or only the tips are visible. Greater trochanter is equal in size and shape. Symmetric appearance of the allae, ischial spines, and the two obturator foramina

Front 142

How can you tell when you have a good modified Cleaves method projection?

Back 142

The femoral heads and necks , and greater and lesser trochanter should appear symmetric if both thighs were abducted equally.

Front 143

How can you tell when you have a good Taylor method projection?

Back 143

Superior and inferior ramus of pubis and body are demonstrated well, with minimal foreshortening or superimposition. Obturator foramina and bilateral ischia are equal in size and shape. Midpoint of symphysis joint should be at Center of collimated field

Front 144

How can you tell when you have a good AP axial Inlet projection of the pelvis?

Back 144

Ischial spines fully demonstrated and equal in size and shape. Superimposed anterior and posterior portions of the pelvic ring

Front 145

How can you tell when you have a good AP unilateral hip projection?

Back 145

Greater trochanter and femoral head and neck should be in full profile without foreshortening. Lesser trochanter should not project beyond medial border of femur

Front 146

How can you tell when you have a good DM hip projection?

Back 146

Entire femoral head and neck, trochanter, and acetabulum should be visualized along with any Orthopedic prosthetic device.

Front 147

How can you tell when you have a good Clements Nakayama projection?

Back 147

Femoral head and neck should be seen in profile with only minimal superimposition by greater trochanter. Lesser trochanter is seen projecting posterior to femoral shaft