Transcript Chapter 7
Chapter 7 Hip and Pelvis Pelvis • Connects lower extremities to the axial skeleton • Consists of – ____________ – 1 sacrum – ____________ • _____________ – 2 hip bones only Hip Bones • _________ • Ischium • ________ • ____________ – The area of fusion for the 3 bones. Ilium • _______ – Large winged area • Body – Inferior to the Ala. Includes superior acetabulum • ____________ • _______, AIIS, PSIS, PIIS. Ischium • Inferioposterior to acetabulum. • ___________ – Posterior acetabulum to ischial tuberosity • __________ – Anterior portion off of ischial tuberosity Ischium • Ischial ____________ – Rounded, rough area at the border of lower body and Ramus • Ischial ____________ – Posterior bony protrusion off acetabulum • Greater/Lesser _____________ – Depression superior and inferior to ischial spine Pubis • Anterioinferior to acetabulum. • ________ – Anteriorinferior acetabululum to superior ramus • Superior __________ – Anterior medial extensions meeting to form symphysis pubis. • Inferior ___________ – Inferioposterior extension off symphysis pubis to Ischial Ramus • _______________ – Hole formed by ischium and pubis True and False Pelvis • ___________ – Area surrounded by bone – _______to pelvic brim – Birth Canal – Inlet and Outlet • ____________ – Area formed by Alae – ______ to pelvic brim Male vs. Female Pelvis • Male – Narrower – Deeper – ___________ – ______pubic arch – Narrow inlet – ______Obturator Foramen • Female – Wider – ___________ – ______pubic arch – Larger inlet – _______ Obturator Foramen Joints of the Pelvis • Sacroiliac Joint ________ – Amphiarthrodial synovial, sacrum to pelvis • ____________ Pubis – Amphiarthrodial cartilaginous. Rt and Lt pubic bones • Union of Acetabulum – Synarthrodial cartilaginous. 3 fused hip bones • _____________ – Diarthrodial synovial spheroid. Imaging the Pelvis Routine • • • • AP 14 x 17 XW 40” SID 75 kV AP Pelvis • Pt __________ • Internally rotate legs ___________ • Center Midline between _______ and __________Pubis • Top of Cassette ____________Crest • Collimate to skin • If Trauma do not rotate legs ***** Proximal Femur • __________ – Round process • ___________ – Depression in the center of the head • Neck – Area between shaft and head • Acetabulum – Cavity for head of femur Proximal Femur • Greater _______________ – Superiolateral prominence • Lesser _______________ – Medioposterior prominence inferior to greater trochanter. • Intertrochanteric Crest – Depression between trochanters Femur Angle • Not ________ • Angle of positioning importance – Head and neck = ___________angle. • Rotate legs Internally (Pigeon Toe) to get ______________ Fracture Sign • Look at the _________ – For symmetry • If one is _________ and one is _______rotated, possible fracture. Hip Imaging Routine • AP Pelvis • AP Unilateral Hip • Lateral – Frog Leg – X-table lateral • 40” SID • 75 kV AP Hip • • • • Patient Supine Rotate Leg ____________ CR directed __________to femoral neck ___medial and ___ distal to _______ Frog leg Lateral • • • • Pt Supine Flex knee and externally ____________ A sponge may help Center to Femoral Neck – Draw ___________between ASIS and Symphysis Pubis and _________ perpendicular to line X-table Hip • Pt Supine • Do not move __________ • Unaffected Leg ______________. Can put leg on collimator • Use _____________grid parallel to femoral neck • Adjust collimator to be __________ to cassette. Sacroiliac Joint Imaging • Place patient into ____________ Posterior Oblique • The joint of interest is _________ – ______ for left SI joint • Direct CR ____ medial to upside ASIS