Procedures Fall 2024 Final

which bone of the leg is considered the longest, strongest, and heaviest bone

femur

how many articular ends are on the femur

2

what is the main shaft of the femur called

body

due to the medial condyle bone slightly lower than the lateral condyle, we should angle how much for a lateral projection of the knee to best superimpose the two structures and open the knee joint space

5 degrees cephalic

the head of the femur articulates the _____ of the pelvis to form the hip joint

acetabulum

the distal end of the femur is comprised of

medial and lateral condyles/epicondyles

the area on the anterior/distal femur where the patella sets is called

patellar surface

the area on the posterior/distal femur that separates the condyles is called

intercondylar fossa

the slight prominence that is located above each condyle are called

epicondyles

the proximal end of the femur contains not only a head and neck but 2 _______ these are named:

greater and lesser trochanter

what is the small indention in the center of the femoral head called

fovea capitis

what is the purpose of the fovea capitis

for ligament attachment

what is the prominent ridge extending between the trochanters at the base of the neck on the posterior surface on the body called

intertrochanteric crest

there is a less prominent ridge located anteriorly and it is called

intertrochanteric line

what is particularly important to know about the neck of the femur

common fracture site for elderly

the pelvis serves as a ____

base for the trunk and a girdle for the attachment of the lower limbs

what 4 bones comprise the pelvis

2 hip bones, sacrum, coccyx

the hip bone is also referred to as what 2 other names

coxae or innominate

the hip bone consists of 3 regions what are they

illium, pubis, ischium

the 3 bones: illium, pubis, ischium come together to form the

acetabulum

describe the acetabulum

cup shaped socket that the head of the femur sits in

the hip bone is sometimes described as “columns” what are these 2 areas called

iliopubic column and ilioischial column

what is the purpose of the iliopubic and ilioischial columns

help identify fractures around acetabulum

what is the broad curved portion of the ilium called

ala

the Ala is comprised of 4 prominent projections what are they

anterior superior iliac spine, anterior inferior iliac spine, posterior superior iliac spine, posterior inferior iliac spine

what are the 3 palpable landmarks of the pelvic girdle

iliac crests, ASIS, pubic symphysis

describe the arcuate line

smooth, arc shaped ridge that forms part of the circumference of pelvic brim

how does the arcuate line pass through in its junction with the pubis

obliquely, inferiorly, medially

what is the auricular surface

large round surfaces of inferior/posterior portions of wings for articulation with sacrum

the pubis is comprised of what parts

body, superior ramus, inferior ramus

the ischium consists of what parts

body and ischial ramus

what is the ischial tuberosity and its purpose

expanded portion from the acetabulum projects posteriorly/inferiorly. Purpose is to bear weight when sitting

the posterior union of the pubis and ischial rami form the _____

obturator foramen

where is the ischial spine located on the ischium

superoposteriar border of body prominent projection

what notch is located just below the ischial spine

lesser sciatic notch

central ray for AP femur

perpendicular to mid femur

when including the hip on the AP femur you should place the top of the IR at the level of the _____

ASIS

when including the knee on the femur you should place the bottom of the IR how many inches below the knee

2 inches below the knee

how many degrees do we turn the leg in for this projection? What does it do to the neck of the femur (AP femur)

10-15 degrees internally to put femur neck in profile

how will the femoral epicondyles be in relationship to the IR in a AP femur

parallel

will the lesser trochanter be seen in an AP femur

no/slightly

what do you do if the patient has an orthopedic appliances in AP femur

make sure its completely seen

how should we see the femoral neck on AP femur

no foreshortening

central ray for lateral femur

perpendicular to mid femur

is the patella in profile in a lateral femur

yes

is there open patellofemoral jt. space in a lateral femur

yes

central ray for an AP hip

perpendicular to femoral neck

you turn the lower limb in how much? What will this do to the femoral neck on AP hip

15-20 degrees medially. Femoral neck is seen without foreshortening

what is in profile in an AP hip

greater trochanter

do you see the lesser trochanter in an AP hip projection

slightly

an axiolateral projection of the hip (danelius-miller method) is also called what?

cross table lateral/surgical lateral

what does the patient do with their unaffected leg in an axiolateral (danelius-miller method) (cross table hip)

raise upward toward ceiling

the central ray should pass through the ______ in an axiolateral (danelius-miller) (cross table hip)

long axis of femoral neck

do we need to use a grid for an axiolateral (danelius-miller) (cross table hip)

yes

we do an axiolateral (danelius-miller) (cross table hip) if a patient has a suspected _____

fracture

upper border of the IR placed where for an axiolateral projection (danelius-miller) (cross table hip)

in crease above iliac crest, centered to most prominate greater trochanter

the IR should be _____ with the femoral neck in an axiolateral (danelius-miller) (cross table hip)

parallel

the entire _____ joint should be seen in an axiolateral (danelius-miller) (cross table lateral)

hip joint

will the greater trochanter be overlapping the femoral neck in an axiolateral (danelius-miller) (cross table hip)

no

the lesser trochanter is seen on the _____ surface of the femur on a axiolateral (danelius-miller) (cross table hip)

posterior

greater trochanter is seen where on the finished image of an axiolateral (danelius-miller) (cross table hip)

anterior/posterior surface of proximal femur

what is the central ray for an AP pelvis

perpendicular to 2 inches below ASIS

how much do you turn in the lower limbs and why for an AP pelvis

15-20 degrees medially, places the necks of femurs parallel with the IR

the top of the IR should be placed how many inches above the iliac crest for AP pelvis

1-1 ½ above crest

are the lesser trochanters seen in an AP pelvis

slightly/not at all

what is shown in profile in AP pelvis

greater trochanter, entire femoral necks

what structures will be symmetric - ensuring no rotation on AP pelvis

Ilia, obturator foramen are symmetric. Sacrum and coccyx in line with pubic symphysis

what is the central ray for an AP and Lateral humerus

perpendicular to mid humerus

how do you position the part for an AP humerus

center mid humerus to IR, abduct arm, supinate hand

how do you position the part for a lateral humerus

center mid humerus to IR, internally rotate arm, flex elbow 90 degrees

where do you place the top of the IR

1 ½ inches above humeral head

how are the epicondyles in relationship to the IR in an AP humerus

parallel

how are the epicondyles in relationship to the IR in a lateral humerus

perpendicular

what is demonstrated in profile in an AP humerus

greater tubercle and humeral head

what is demonstrated in profile in a lateral humerus

lesser tubercle

where will the greater tubercle be seen on the lateral view of humerus

superimposed by humeral head

why would we do a AP neutral trauma humerus instead of a regular AP humerus

unable to rotate it/possible fracture

how do you position the part for an AP neutral humerus

rest palms by sides

where do you place the top of the IR in an AP neutral trauma humerus

1 ½ inches above shoulder

what is the central ray for an AP neutral humerus and shoulder girdle

perpendicular to 1” below coracoid process

how are the epicondyles to the IR in an AP neutral humerus

45 degrees to the IR

is the humeral head seen in profile for an AP neutral trauma humerus

partially

where will you place the IR for a lateral humerus (mid and distal trauma)

close to the axilla (in armpit)

what is the central ray for a lateral humerus (mid and distal trauma)

perpendicular to mid humerus

how would we like the epicondyles to be positioned in a lateral humerus (mid and distal trauma)

perpendicular

what is the central ray for an AP internal/external/neutral rotation humerus

perpendicular to 1 inch below coracoid process

the scapula needs to be ____ to the IR on an AP internal/external/neutral rotation humerus

parallel

how do you position the arm for an internal rotation AP humerus

arm rotated internally, back of hand against hip

how do you position the arm for an external rotation AP humerus

arm abducted, hand supinated

how do you position the arm for a neutral rotation AP humerus

rest palm of hand by side

what joint does the AP internal/external/neutral rotation humerus demonstrate

shoulder joint

what is seen in profile for an external rotation AP humerus

humeral head, greater tubercle on lateral aspect of humerus

what is seen in profile for an internal rotation AP humerus

lesser tubercle

which position shows the humeral head in partial profile

neutral rotation AP humerus

which position is the true lateral of the humerus

internal

when would you use the transthoracic lateral trauma (Lawerence method)

trauma, arm cannot be rotated

which arm does the patient raise above their head for a trans thoracic lateral trauma (Lawerence method)

unaffected

what is the central ray for a trans thoracic lateral trauma

perpendicular to surgical neck and MCP

what type of respiration is best for the trans thoracic lateral trauma

continuous breathing

where is the unaffected clavicle for a trans thoracic lateral trauma

above affected humerus