Which projection is used to demonstrate the hip joint and the relationship of the femoral head to the acetabulum?

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Positioning Upper Leg, Knee, and Pelvis

Terms in this set (85)

A middle-aged patient complains of knee pain without excessive exercise or stress. Her physician is concerned about arthritis. What projection would be best to demonstrate early arthritic changes in the knee joints?

AP knees, weight-bearing position

The AP axial projection (Béclère method) is a special projection used to demonstrate the

Intercondylar fossa

Which essential projection demonstrates the patella in profile and an open patellofemoral joint?

Tangential projection (Settegast method)

Which of the following methods are used to demonstrate the intercondylar fossa?
(1) Holmblad (PA axial)
(2) Camp-Coventry (PA axial)
(3) Settegast (tangential)

1 and 2

Valgus and varus deformities of the knee can be evaluated with which of the following projections? a. AP b. AP oblique c. PA, bilateral weight-bearing d. AP, bilateral weight-bearing

AP, bilateral weight-bearing

Which special projection is useful in providing a lateral image of the hip joint in trauma cases where the unaffected limb has limited mobility?

Modified axiolateral projection (Clements-Nakayama method)

All of the following projections are used to demonstrate the anterior pelvic bones, except the: a. PA axial oblique (Teufel method) b. PA c. AP axial (Taylor method) d. Superoinferior axial (Bridgeman method)

PA axial oblique (Teufel method) -The PA axial oblique projection (Teufel method) demonstrates the acetabulum.-

What are the central ray angle and direction for the superoinferior axial projection (Bridgeman method)?

40 degrees caudad

What patient position is required to demonstrate the left ilium in an AP oblique projection?

40-degree RPO -The patient is positioned with the unaffected side elevated on the AP oblique projection of the ilium. A 40-degree RPO would demonstrate the left ilium in an AP oblique projection.-

The fovea capitis is demonstrated on the:

PA axial oblique projection (Teufel method)

Which of the following projections demonstrates the anterior pelvic bones with less foreshortening than other projections? a. PA b. AP axial (Taylor method) c. Superoinferior axial (Bridgeman method) d. Modified axiolateral (original Cleaves method)

AP axial (Taylor method)

What is the central ray angle orientation for the PA axial oblique projection (Teufel method)?

12 degrees cephalad

Which of the following criteria is used to evaluate the axiolateral projection (Danelius-Miller method) of the hip? A. Ischial tuberosity demonstrated below the femoral head B.Lesser trochanter visible on the medial side of the femur C. Femoral neck overlapped by the greater trochanter D. Hip joint demonstrated open

Ischial tuberosity demonstrated below the femoral head

All of the following criteria are used to evaluate the AP projection of the pelvis except: A. Ischial spines equally demonstrated B. Ilia equidistant to the edge of the radiograph C. Greater trochanters in profile D. Lesser trochanters in profile on the medial side of the femora

Lesser trochanters in profile on the medial side of the femora

The three portions of the hip bone are the:

Ilium, ischium, and pubis

Where is the spine of the ischium located? *

Posterior and inferior on the hip bone

The angle below the pubic symphysis:

Is larger in females

Which pathologic condition of the pelvis and upper femora is characterized by flattening of the femoral head and is caused by vascular interruption?

Legg-Calvé-Perthes disease

The medial aspects of each ilium articulate with:

The sacrum

The first step in localizing the femoral head is to draw an imaginary line connecting the:

ASIS and superior margin of the pubic symphysis

What anatomic structure is located at the center of the first imaginary line drawn in the hip localization method?

Top of the acetabular dome

What is the shape of the pelvic inlet (superior aperture) in a female?

Oval - The female pelvic inlet, or superior aperture, is described as oval; it is more rounded in a male.-

How are the lower limbs positioned for the AP projection of the pelvis?

Medially rotated 15 to 20 degrees

Which projection is used to demonstrate the hip joint and the relationship of the femoral head to the acetabulum?

Lateral projection of the hip (Lauenstein and Hickey methods)

How is the central ray directed for the axiolateral projection of the hip (Danelius-Miller method)?

Horizontally and perpendicular to the femoral neck

All of the following directions apply to the AP projection of the hip except a. The central ray is directed vertically and perpendicular to the image receptor b. The central ray is directed approximately 2½ inches (6.4 cm) distal on a line drawn perpendicular to the midpoint of a line between the anterior superior iliac spine and the pubic symphysis c. The lower limb is flexed at the knee and the thigh abducted as much as possible d. The lower limb is medially rotated 15 to 20 degrees

The lower limb is flexed at the knee and the thigh abducted as much as possible

All of the following projections require the central ray to be directed perpendicular to the image receptor, except: a. Axiolateral of the hip (Danelius-Miller method) b. Lateral of the hip (Hickey method) c. AP oblique of the acetabulum (Judet method) d. AP pelvis

Lateral of the hip (Hickey method)

Which of the following projections is used to demonstrate bilateral projections of the femoral necks? a. Axiolateral (Danelius-Miller method) b. AP oblique (modified Cleaves method) c. AP oblique (Judet method) d. Lateral (Hickey method)

AP oblique (modified Cleaves method)

What is the purpose of the lower limb position in the AP projections of the pelvis and hip?

To place the femoral neck(s) parallel with the image receptor

How much abduction of the thigh is required in the AP oblique projection (modified Cleaves method)?

45 degrees from the vertical

A radiograph of an axiolateral projection (Danelius-Miller method) demonstrates that the acetabulum is not included on the image. What is the next step the technologist should take for this procedure?

Repeat the projection, ensuring the top of the image receptor is above the crest of the ilium

Which of the following statements is part of the proper localization technique for the femoral head? a. The femoral head is located 1 inch above a line that connects the ASIS and pubic symphysis. b. The femoral head is located 1 inch below a line that connects the ASIS and the pubic symphysis. c. The femoral head is located 1.5 inches proximally on a line that is perpendicular to and bisects a line that connects the ASIS and pubic symphysis. d. The femoral head is located 1.5 inches distally on a line that is perpendicular to and bisects a line that connects the ASIS and pubic symphysis.

The femoral head is located 1.5 inches distally on a line that is perpendicular to and bisects a line that connects the ASIS and pubic symphysis.

All of the following criteria apply to the axiolateral projection (Danelius-Miller method) except: a. Unaffected limb medially rotated 15 to 20 degrees b. Vertical image receptor c. Entry of horizontal central ray perpendicular to femoral neck d. May be used in trauma patients

Unaffected limb medially rotated 15 to 20 degrees

The right lower limb is medially rotated 15 to 20 degrees for the: a. AP projection of the right hip b. AP projection of the left hip c. Lateral projection of the right hip (Lauenstein method) d. Axiolateral projection of the right hip (Clements-Nakayama method)

AP projection of the right hip

Which of the following landmarks cannot be palpated directly? a. Anterior superior iliac spine b. Greater trochanter c. Lesser trochanter d. Iliac crest

Lesser trochanter

Which essential lateral projection of the hip demonstrates the femoral neck free of superimposition?

Lateral projection (Hickey method)

Which of the following structures are demonstrated in profile on a well-positioned AP pelvis projection? a. Obturator foramina b. Sacrum and coccyx c. Lesser trochanters d. Greater trochanters

Greater trochanters

The two flat, superior surfaces of the tibia are called the:

tibial plateaus

The tibial plateaus slope:

posteriorly 10 to 20 degrees

When the femur is vertical, the medial condyle is lower than the lateral condyle. How many degrees' difference is there between the two?

5 to 7 degrees

Posteriorly, the femoral condyles are separated by a deep depression called the:

intercondylar fossa

The proximal end of the tibia presents two prominent processes called the:

condyles

The lesser trochanter is located at the:

Medial proximal femur

Which of the following structures serves as a shock absorber within the knee joint? a. Cruciate ligament b. Collateral ligament c. Meniscus d. Hyaline cartilage

Meniscus

What bones comprise the knee joint? a. Tibia and Femur b. Tibia, Fibula and Femur c. Tibia, Femur and Patella d. Tibial, Fibula, Femur and Patella

Tibia and Femur

The knee joint can be topographically located where?

1/2" inferior to the patellar apex

How would the central ray be directed for an AP projection of the knee in a patient whose ASIS-to-tabletop measurement is 26 cm?

3 to 5 degrees cephalad

The PA axial projection (Holmblad method) of the intercondylar fossa requires the knee to be flexed:

70 degrees from full extension

All of the following are procedural steps for the AP distal femur except: a. Placing the bottom of the image receptor or collimated field 2 inches (5 cm) below the knee joint b. Internally rotating the lower limb to place the femoral neck parallel to the image receptor c. Directing the central ray perpendicular to the midfemur d. Collimating to 1 inch (2.5 cm) beyond the shadow of the thigh and 17 inches (43 cm) long

Internally rotating the lower limb to place the femoral neck parallel to the image receptor

Where is the central ray directed for an AP projection of the knee?

1/2 inch below the patellar apex

When the ASIS to tabletop measurement is between 19 and 24 cm, the central-ray angulation for an AP knee is:

0 degrees

How much should the leg be flexed for a lateral projection of the knee?

20 to 30 degrees

In order to place the patella parallel with the plane of the IR for a PA projection, the heel must be rotated:

5 to 10 degrees laterally

How many degrees should the limb be internally rotated for an AP projection of the femur?

10- 15 degrees

What is the degree of angulation for the tangential projection of the patella (Settegast method)?

variable—depending on the degree of knee flexion

How much is the knee flexed for a lateral projection of the patella?

5 to 10 degrees

Valgus and varus deformities of the knee can be evaluated with which of the following projections?

AP, bilateral weight-bearing

Which of the following will ensure that the knee is in proper position for a lateral projection?
(1) epicondyles are perpendicular to the IR
(2) patella is perpendicular to the IR
(3) leg is flexed 20 to 30 degrees

1, 2, and 3

What is the position of the femoral condyles when the leg is properly positioned for an AP projection?

parallel to the IR

Where does the central ray enter the knee for a lateral projection of the patella?

through the patellofemoral joint space

When the ASIS to tabletop measurement is greater than 24 cm, the central-ray angulation for an AP knee is:

5 degrees cephalad

Which of the following will ensure that the knee is in proper position for a lateral projection?
(1) epicondyles are perpendicular to the IR
(2) patella is perpendicular to the IR
(3) leg is flexed 20 to 30 degrees

1, 2, and 3

For an AP oblique projection of the knee, the limb is rotated:

45 degrees

How is the central ray directed for the PA axial projection (Holmblad method) of the intercondylar fossa?

perpendicular to the lower leg

How much is the knee joint flexed for the PA axial projection (Holmblad method) of the intercondylar fossa?

70 degrees

Which of the following projections of the knee best demonstrates the narrowing of a joint space?

AP of both knees with weight-bearing

How far should the patient be rolled posteriorly from the lateral position, for a lateral projection of the hip that will include the proximal femur?

10 to 15 degrees

When the knee is properly positioned for an AP projection, the patella will lie:

slightly to the medial side

The incomplete separation or avulsion of the tibial tuberosity is known as:

Osgood-Schlatter disease

If the knee is flexed 40 degrees for the PA axial intercondylar fossa (Camp-Coventry) projection, the central ray will be angled:

40 degrees

Which of the following bones does not bear body weight?

fibula

When the ASIS to tabletop measurement is between 19 and 24 cm, the central-ray angulation for an AP knee is

0 degrees

The preferred method of positioning the patient for the tangential projection (Settegast method) of the patella is:

prone

Which of the following landmarks cannot be palpated directly?

Lesser trochanter

Compared with the male pelvis, the female pelvis is:

Wider and shallower

Before localizing the femoral head or neck, the technologist must draw an imaginary line connecting the

ASIS and the superior margin of the pubic symphysis

Which of the following structures is not part of the ilium?

Fovea capitis

Which of the following actions are technical considerations for radiography of the pelvis and upper femora?
(1) Using the most comfortable position possible to reduce the risk of motion
(2) Noting contraindications before moving patient for the exam
(3) Immobilizing and supporting the area as needed

1, 2, and 3

All of the following criteria apply to the axiolateral projection (Danelius-Miller method) except:

Unaffected limb medially rotated 15 to 20 degrees

Which of the following structures are demonstrated in profile on a well-positioned AP pelvis projection?

Greater trochanters

Which of the following projections is contraindicated in patients with suspected fracture(s)?
(1) Modified axiolateral projection (Clements-Nakayama method)
(2) Lateral projection (Lauenstein method)
(3) AP oblique projection (modified Cleaves method)

2 and 3 only

How is the image receptor aligned to the femoral neck for an axiolateral projection (Danelius-Miller method)?

Parallel to the neck

Which of the following lateral hip projections can be performed in a patient with possible fractures of both proximal femurs?

Axiolateral projection (Clements-Nakayama method)

Which of the following projections might be used to evaluate the acetabulum for possible fractures?
(1) AP oblique projection (Judet method)
(2) PA axial projection (Teufel method)
(3) Axiolateral projection (Cleaves method)

1 and 2 only

A radiograph of an AP pelvis projection demonstrates foreshortening of the left ilium compared with the right. What specific positioning error has been committed?

Rotation of the right hip toward the image receptor

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