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Advanced Procedures II (Sir Robert)
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A radiograph of an AP pelvis demonstrates that the right obturator foramen is foreshortened, but the right one is open.What is the positioning error?
right rotation
A radiograph of the AP pelvis reveals that the right iliac wing is foreshortened as compared to the left. What is the positioning problem ?
right rotation
Why must the lower limb be rotated 15-20 degrees internally on an AP pelvis?
to place the femoral neck parallel to the image receptor
What are the 2 bony landmarks that are palpated using the hip localization method?
ASIS and symphysis pubis
Which position best demonstrates the posterior ilioischial column, anterior iliopubic colum of the pelvis?
posterior oblique of the Judet method
Which modality can be performed on an infant when looking at joint stability?
ultrasound
Ischial spines protrude more into the pelvic cavity? M or F
male
narrow and deep shape of pelvis M or F
male
round and large pelvic inlet M or F
male
Wider and more shallow pelvis M or F
male
Oval and heart shaped pelvic inlet? M or F
male
Which bony structure cannot be palpated?
ischial spine
Which bones form the acetabulum?
ischium, ilium, pubis
Which structure is centered most inferiorly or distal?
lesser trochanter
What three landmarks are seen on the upside acetabulum view?
the posterior rim of the acetabulum, anterior iliopubic column and the obturator foramen
What three landmarks are seen on the downside acetabulum view?
anterior rim of acetabulum, posterior illioischial column and iliac wing
Why are both sides done when Judet views are ordered?
comparison
What is seen on an inlet projection?
entire pelvic ring
What is the CR angle and direction for an inlet projection?
40 degree caudal
What four parts of the pelvis are seen on the outlet projection?
Rami of the pubis and and the body and ramus of the ischium
Where is the CR directed for a bilateral frog-leg projection of the pelvis?
at the level of the femoral head with top of IR approximately at the level of the iliac crest
How much are the femora abducted from vertical?
40- 45 degrees
What is the name of the modified-axiolateral projection?
Clements-Nakayama
How much do you abduct the leg for a modified Cleaves method?
45 degrees from vertical
Where is he CR positioned for an AP unilateral hip?
perpendicular to femoral neck (1-2" medial and 3-4" distal to the ASIS)
Where is the CR centered on a Danelius-Miller method?
perpendicular to the IR and centered to femoral neck
What is another name for the axiolateral inferiosuperior projection of the hip?
Danelius-Miller method
How many bones make up the Pelvis ? What are they?
4 total, 2 hip bones, 1 sacrum and 1 coccyx
How should the CR be angled for a Clements-Nakayama?
CR is angled mediolaterally and perpendicular and centered to the femoral neck ( 15-20 degrees)
What is the projection name for the unilateral frog-leg projection?
modified Cleaves
Where is the CR directed for the modified Cleaves method?
perpendicular to the IR directed to the mid femoral neck
What can be performed on an infant to test for joint stability?
an ultrasound
Which landmark can't you palpate?
ischial spine
What is the CR direction on a downside Judet projection?
2 inches distal and medial to downside
Where is the CR direction in an upside Judet projection?
2 inches distal to upside
What is the patient angle for a Judet?
45 degrees
If you want a right upside Judet projection, how is your patient positioned? What is you want a right downside?
they are on their left side in an LPO, they are on their right side in an RPO
What is another name for the PO Acetabulum projection?
Judet
What is the main evaluation criteria for an inlet projection?
ischail spines are seen and equal
Where is the CR directed on an AP axial inlet projection?
at the level of the ASIS
What is the CR angle of the AP axial inlet projection?
40 degrees caudad
How can you tell if a pelvis is rotated?
The obturator foramen are not equal
What is the evaluation criteria for an outlet projection?
elongated pubic and ischial bones and no rotation of pelvis
What are the breathing instructions on an inlet/outlet projection?
hold your breath
What is the kVp for an inlet/ outlet projection?
85
What is the kVp for an AP pelvis?
80
Where is the CR centered on a Taylor projection?
1-2 inches distal to symphysis pubis
What is the CR angle and direction on an outlet projection for a male? Female?
male- 20-35 degrees cephalad, female- 30-45 degrees cephalad
What is another name for the AP axial outlet projection?
Taylor method
What are breathing instructions on an AP pelvis?
hold your breath
Where do you place the marker on an AP pelvis?
Right marker on top of hip above the pelvis on the IR
do you have the patient touch the tips of their toes OR cross their toes on an AP pelvis?
cross their toes
How much are the feet rotated on an AP pelvis?
15-20 degrees inward
Where is the CR directed on an AP pelvis?
2" below the level of the ASIS (between the level of the ASIS and the pubis symphysis
Should you see the lesser trochanters on a pelvis image?
no
What are the four things you should see in an AP pelvis image?
entire pelvis, proximal femurs, no rotation and lesser trochanters not visible
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