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MRT Year 1 Semester 2 > Anatomy and Pathology 2: Quiz 2 > Flashcards

Anatomy and Pathology 2: Quiz 2 Flashcards

1
Q

Retroperitoneal structures? (Urinary system)

A
  • kidneys

- ureters

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2
Q

Infraperitoneal structures (urinary system)

A
  • distal ureters
  • urinary bladder
  • urethra
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3
Q

Which part of the kidneys is closer to the MSP?

A

Superior portion

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4
Q

2 kinds of nephrons

A
  • cortical

- juxtamedullary

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5
Q

The glomerulus and bowman’s capsule together are called?

A

Renal corpuscle

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6
Q

The kidneys maintain homeostatic blood chemistry by?

A
  • removing waste products of cell metabolism
  • regulating water and electrolyte levels
  • regulating blood pressure and volume to stimulate RBC production
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7
Q

How many liters do our kidneys filter a day vs. how many liters are excreted?

A

Filtered: 180L/day
Excreted: 2L/day

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8
Q

Where on the bladder do the ureters enter?

A

The posterolateral aspect

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9
Q

3 ureter constriction points?

A
  • Ureteropelvic junctions
  • Brim of pelvis
  • Ureterovesical junctions
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10
Q

What is a urinary tract obstruction? Signs/symptoms? Radiographic indications?

A

An occlusion that has the potential to cause structural and functional damage to the urinary structures

  • severity depends on speed of onset, degree of occlusion, and distance between kidney and blockage
  • common causes: kidney stones, tumours, urethral strictures, congenital malformations
  • calyceal clubbing, parenchymal necrosis, hydronephrosis, hydroureter
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11
Q

Most common sites for urinary tract obstructions?

A
  • urteropelvic junction
  • ureterovesical junction
  • neck of bladder
  • urethral meatus
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12
Q

Blockages superior to the bladder cause unilateral dilation of the ureter, blockages inferior to the bladder will cause bilateral dilations*

A

.

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13
Q

What is an ectopic kidney? Signs/symptoms? Radiographic indications?

A

A kidney that is out of its normal location

-usually functional, but its anatomical location may make it difficult to image

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14
Q

What is a crossed ectopy?

A

A kidney that is located on the same side and often fused with a normal kidney

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15
Q

What is renal duplication? Signs/symptoms? Radiographic indications?

A

One kidney has double ureter and/or a double renal pelvis and vesicouretal junction

  • commonly causes a ureterocele, vesicoureteral reflux
  • more prone to infection or obstruction
  • no treatment is required unless obstructions or infections arise, can be treated with stents or antibiotics respectively
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16
Q

What is a ureterocele? Signs/symptoms? Radiographic indications?

A

A dilation of the distal ureter
-commonly causes stenosis or ureteral orifice or prolapse into the bladder
-vesicoureteral reflux, hydronephrosis, renal-mass effect, infection, obstruction
-cobra head sign or filling defect in bade of bladder seen on IVU
-must be treated to maintain kidney function
-incision or surgical resection
-

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17
Q

What are posterior urethral valves? Signs/symptoms? Radiographic indications?

A

Thin transverse membranes that obstruct the outlet from the bladder

  • reverse valves, so catheterization is normal, but flow of urine is not
  • rarely found in females
  • compromised urine flow, hydronephrosis, hydroureter, renal damage
  • diagnosed with a voiding cystogram and corrected by surgery to prevent kidney damage
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18
Q

What are urinary calculi? Signs/symptoms? Radiographic indications?

A

Stones formed by crystallized urine

  • usually form in kidney
  • caused by metabolic imbalance (hypercalcemia caused by hyperparathyroidism)
  • caused by urinary stasis or infection
  • lodge at ureterovesical junction if too large to pass (+3mm)
  • pain in kidney and groin, alternating acute and chronic pain (renal colic)
  • symptoms: hematuria, fever, chills, polyuria, infection
  • increased intake of fluids, decreased intake of stone forming substances, lithotripsy, chemolysis, surgical removal
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19
Q

What is a staghorn calculus?

A

A stone formed by crystallized urine that fills the entire renal pelvis

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20
Q

What is a simple renal cyst? Signs/symptoms? Radiographic indications?

A

The most common type of benign kidney mass

  • usually fluid filled and unilocular
  • as it grows it elevates edges of renal cortex and displaces pelvicalyceal system
  • if patient had hematuria or hypertension=fluid aspiration
  • obliterated by injection of alcohol or iodine
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21
Q

Define the following words: hematuria, pyuria, anuria, dysuria, and polyuria

A 
Hematuria: blood in urine
Pyuria: pus in urine
Anuria: no urine
Dysuria: painful urination
Polyuria: constant, frequent urination
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22
Q

What is hydronephrosis?

A

Water in the kidney

  • swelling of renal pelvis and calyces from stasis
  • a symptom of any condition that blocks the outflow of urine
  • left untreated it can cause ischemia, infection, and permanent kidney damage or failure
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23
Q

What is uremia?

A

Urine in the blood

  • urea a creatinin are waste products of cell metabolism
  • high blood concentrations of these products indicated acute or chronic kidney failure
  • BUN and blood creatinin are lab tests that must be done before administering radiographic contrast to a patient
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24
Q

What is polycystic kidney disease? Signs/symptoms? Radiographic indications?

A

An inherited disorder characterized by multiple cysts throughout the kidneys

  • causes lobulated enlargement, compression of the nephrons, and intrarenal obstructions
  • usually asymptomatic until age 30-40
  • “moth-eaten” appearance, swiss cheese appearance
  • 1/3 of patients have cysts in liver
  • medications to control pain, high blood pressure, and infection
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25
Q

What is acute renal failure? Signs/Symptoms? Radiographic indications?

A

Sudden deterioration of kidney function

  • causes waste products to build up in the blood
  • blood flow to the kidneys is decreased (pre-renal failure) because of hemorrhage, dehydration, surgical shock, cardiac failures, obstruction of renal arteries
  • other causes: toxins, meds, anesthetics, heavy metals, organic solvents, muscle proteins in blood after trauma
  • urine like “fishy” breath
  • kidneys enlarged, but smooth
  • diuretics, vasodilators, dietary changes, antibiotics, dialysis
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26
Q

What is chronic renal failure? Signs/symptoms? Radiographic indications?

A

Kidney failure caused by chronic conditions such as renal artery stenosis, ureteral obstructions, cystic disease, and other intrinsic renal disorders

  • can arise from acute renal failure that has not been well managed
  • blood chemistry and fluid levels compromised, causes RBC, electrolyte, H20, and acid/base imbalances
  • uremia, nausea, vomiting, diarrhea, dim vision, sleepiness, loss of mental acuity, convulsions, and eventually coma
  • balance intake and output of water and electrolytes and control hypertension, dialysis, or transplant
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27
Q

What is contraindicated for chronic renal failure?

A

The used of radiographic contrast

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28
Q

What is renal adenocarcinoma (hypernephroma)? Signs/symptoms? Radiographic indications?

A

Most common malignant tumour of the kidney

  • usually +40yrs
  • contributing factors: chronic inflammation from obstruction, smoking, other carcinogens
  • painless hematuria, flank pain, palpable mass
  • commonly metastasizes to lungs, liver, brain, and bone
  • tumor can stretch, distort, or displace the kidney’s collecting system
  • nephrectomy = 40% survival rate
  • radiation and chemo are ineffective
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29
Q

What is pyelonephritis? Signs/symptoms? Radiographic indications?

A

Kidney infection, bacterial infection of calyces and renal pelvis

  • greater chance if urine flow is slowed or stopped
  • usually originated with bladder infection, but can travel to kidney via blood
  • high fever, chills, sudden back pain, dysuria leading to pyuria renal abscesses
  • IVU appears normal, in chronic cases, calyces will appear blunted and edematous as renal pyramids atrophy
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30
Q

What is common in women with recurrent UTIs?

A

Chronic pyelonephritis

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31
Q

What is cystitis? Signs/symptoms? Radiographic indications?

A

Inflammation of the bladder

  • caused by fecal bacteria that has com in contact with the urinary opening, poor hygiene, medical instrumentation or catheterization
  • most common HAI
  • burning pain on urination, polyuria
  • may spread to kidneys
  • bladder walls appear rough
  • antibiotics
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32
Q

What is bladder carcinoma? Signs/symptoms? Radiographic indications?

A

A carcinoma that originates int he epithelium of the bladder, more common in men

  • risk factors: smoking*, exposure to industrial chemicals
  • painless hematuria
  • tumors usually located in trigone area = hard to see
  • low grade malignancies, but often recur
  • filling defects in bladder, cystoscopy, cystectomy
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33
Q

What is pelvic inflammatory disease? Symptoms/complications? Radiographic indications?

A

Bacterial infection of the female genital system, especially the fallopian tubes

  • caused by unsterile abortion or other outside sources of pathogens, venereal disease (especially in women 20-24yrs)
  • untreated infection can spread to the fallopian tubes, peritoneum, and/or blood
  • fallopian tubes may become blocked by fibrous tissues or may rupture and cause septic shock (life threatening)
  • antibiotics or surgery
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34
Q

What is female infertility? Radiographic indications?

A

Infertility

  • caused by developmental anomalies of the reproductive organs, blockages in the fallopian tubes, or inability to produce healthy ova
  • hysterosalpingography to demonstrate blockage
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35
Q

What are uterine fibroids? Signs/symptoms? Radiographic indications?

A

Very common smooth benign muscle tumors of the uterus

  • may grow during pregnancy and stop in menopause
  • asymptomatic until they interfere with the anatomy and physiology of the body
  • ultrasound, CT, MRI used to locate
  • medications, surgery
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36
Q

What is benign breast disease fibrocystic/fibroadenoma? Signs/symptoms? Radiographic indications?

A

Overgrowth of fibrous tissue in the breast

  • tenderness fluctuates with monthly hormone levels
  • caffeine increases pain
  • appears as smooth mass with no invasion of surrounding tissue
  • dietary modifications, drainage, surgery is not realistic as most patients have multiple cysts
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37
Q

What is breast cancer adenocarcinoma? Signs/symptoms? Radiographic indications?

A

Most common malignancy in women between 44 and 50yrs

  • most lesions are infiltrating duct carcinomas in the upper lateral quadrant
  • can also occur in men-gynecomastia
  • 98% survival rate it detected early
  • appear as tumor masses or clustered calcifications
  • biopsies done to determine if cancerous
  • radiation, chemotherapy, surgery
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38
Q

What is prostatic hyperplasia? Signs/symptoms? Radiographic indications?

A

Benign enlargement of the prostate gland

  • common in men over 60yrs
  • difficulty in starting, stopping, and maintaining urine flow, inability to completely empty bladder
  • can lead to kidney infection
  • smooth filling defect at base of bladder
  • “j shaped” “fishhook” appearance of insertion of ureters
  • surgical resection
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39
Q

What is prostate cancer (adenocarcinoma)? Signs/symptoms? Radiographic indications?

A
  • 2nd most common malignancy in men
  • +50yrs usually
  • diagnosed with DRE and PSA test
  • increased levels of PSA, hard enlarged prostate, low back pain, dysuria, bone pain
  • can be slow growing or aggressive
  • can spread to bone, blood, lymphatic system, or rectum
  • may block bladder neck or infiltrate the trigone
  • irregular filling defect depressing on the floor of the bladder
  • surgery, radioactive seeds, or chemical castration
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40
Q

Purpose of the respiratory system?

A
  • supplies body tissues with oxygen
  • disposes of carbon dioxide
  • filters, warms, and humidifies air
  • makes it possible to speak and smell
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41
Q

Major organs of the respiratory system?

A
  • nose, nasal cavity, and paranasal sinuses
  • pharynx
  • larynx
  • trachea
  • bronchi and their branches
  • lungs and alveoli
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42
Q

Another word for nostrils?

A

External nares

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43
Q

3 nasal conchaes and their purpose?

A
  • superior, middle, and inferior
  • increase mucosal area
  • enhance air turbulence
  • filter, heat, and moisten air during inspiration
  • reclaim heat and moisture during expiration
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44
Q

Purpose of paranasal sinuses

A
  • lighten skull
  • secrete mucous
  • help to warm and moisten air
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45
Q

What vertebral level does the pharynx extend to? What is it composed of?

A

C6

-skeletal muscle

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46
Q

Purpose of the larynx?

A
  • provide patent airway
  • directs air and food into proper channels
  • allows for voice production
47
Q

The point where the trachea branches into 2 main bronchi is called?

A

Carina

48
Q

Which bronchi is more straight than the other?

A

The right bronchi is more straight

49
Q

Branches of the bronchial tree

A
  1. Right and left (primary) bronchi
  2. Lobar (secondary) bronchi
  3. Tertiary (segmental bronchi)
  4. Bronchioles (little bronchi <1mm)
  5. Terminal bronchioles. (<0.5mm)
  6. Respiratory bronchioles
  7. Alveolar ducts
  8. Alveolar sacs with alveoli
50
Q

Alveolar cells secrete ________ and ________

A

Surfactant and antimicrobial proteins

51
Q

What keep alveolar surfaces sterile?

A

Alveolar macrophages

52
Q

Which lung is smaller? Why?

A

Left lung because of the cardiac notch

53
Q

How many lobes does each lung have?

A

Right: 3, oblique and horizontal fissure
Left: 2, oblique fissure

54
Q

Blood supply in the respiratory system

A
  • Pulmonary arteries
  • Pulmonary veins
  • Bronchial arteries
55
Q

Is inspiration a passive or active process?

A

Active: diaphragm and external costal muscles contract

56
Q

What is pulmonary edema? Complications? Radiographic appearances?

A

Build up of fluid in the interstitial spaces of the lung parenchyma due to increased venous pressure

  • compromised lung function “drowning from the inside out”
  • avoid physical stress, decreases salt intake, wear compressive stockings, and fluid retention reducing meds
  • increased lung marking (loss of defined lung markings), “butterfly sign” or “bats wings”
57
Q

What is a pleural effusion? Complications? Radiographic appearances?

A

A build up of fluid in the pleural space

  • caused by CHF, pulmonary embolism, infection, pleurisy, CA, ascites, abdominal disease, and pancreatitis
  • massive effusions may compress of displace the other lung or mediastinum
  • blunting of the costophrenic angles, concave border of fluid
  • small effusions best demonstrated with a decubitus
58
Q

What is a pneumothorax? Complications? Radiographic appearances?

A

Free air or gas in the pleural cavity

  • compresses the lung and causes partial/complete lung collapse
  • can occur spontaneously
  • sudden severe chest pain and dyspnea
  • small ones reabsorb on their own, large ones require a chest tube
  • no lung markings, upright images important, 2 images: 1 inspiration, 1 expiration (1/3rd the technique)
  • small ones best seen on lateral decubitus
59
Q

What is a Tension Pneumothorax? Complications? Radiographic appearances?

A

Medical emergency where air is continually entering the pleural space, but can;t escape due to a “one way valve”

  • leads to complete collapse of ipsilateral lung, depression of hemi-diaphragm, and displacement of mediastinum
  • decreases venous return to the heart and can result in death
  • needle may be inserted into chest wall to equalize air pressure
  • looks like collapsed lung and displacement of mediastinum
60
Q

What is Empyema? Complications? Radiographic appearances?

A

Infected liquid or pus in the pleural space that has spread from adjacent infection

  • if the empyema is near the chest wall it can be drained under fluoroscopic guidance
  • initially looks like a pleural effusion, but over time will become loculated
61
Q

What is Atelectasis? Complications? Radiographic appearances?

A

Reduction or absence of air in some portion of the lung that reduces lung volume

  • most commonly caused y brachial obstruction from neoplasm, foreign body, or mucous plug (abdominal surgery/bronchitis)
  • can also be caused by pneumothorax, tumors, abscess, or endotracheal tube placement below carina
  • removal of secretions, re-inflation of the lungs by gravitational positioning or positive pressure
  • appears as area of increased density, “plate-like” or streak to a collapsed lobe
62
Q

What is a lung abscess? Complications? Radiographic appearances?

A

Necrotic lung parenchyma encased by a fibrous wall containing pus-like fluid and debris

  • most commonly caused by aspiration
  • can be secondary to bacterial pneumonia, neoplasms, periodontal disease, or other invading organism of the lung
  • may spread hematogenically, brain abscess is common complication
  • spherical density with hazy border
63
Q

What is Adult Respiratory Distress Syndrome? Complications? Radiographic appearances?

A

Sever, unexpected, and life-threatening scute respiratory distress thats caused by a number of medical and surgical issues, but unrelated to actual lung disease

  • “shock lung” because no thoracic trauma
  • some causes include infection, aspiration, inhalation of toxins or drug overdose
  • complete breakdown in lung structure, sever hypoxemia, pulmonary edema, and leakage of fluid into the alveolar sacs
  • treated with diuretics, oxygen therapy, and ventillation
64
Q

What is a foreign body? Complications? Radiographic appearance?

A

Something that shouldn’t be there

  • most common in children
  • obstruction of major bronchus will caused reabsorption of trapped air, alveolar collapse, and atelectasis of affected portion of lung
  • partial obstruction may cause air to become trapped to “one-way valve” effect
  • expectoration, bronchoscopy, and surgery
65
Q

What is mediastinal emphysema (pneumo-mediastinum)? Complications? Radiographic appearances?

A

Air in the mediastinal space because of chest trauma, or perforation of the esophagus or tracheobronchial tree

  • spontaneous pneumomediastinum can be caused by severe coughing, vomiting or straining
  • may cause pneumothorax secondary
  • may resolve on its own or may require surgery to block off source of air
  • lateral displacement of mediastinal pleura
  • air will be posterior to sternum on lateral chest
66
Q

What is subcutaneous emphysema? Complications? Radiographic appearances?

A

Air forced into the tissues surrounding the chest wall because of chest trauma that has compromised the lung and parietal pleura

  • causes a crackling sound or sensation when palpated
  • may resolve on its own or may require surgery to block off the source of air
  • appears as streaking of air outlining muscle bundles of soft tissues surrounding the chest cavity
67
Q

What is bronchiectasis? Complications? Radiographic appearances?

A

Permanent dilation of one of more large bronchi because of destruction of the muscular wall

  • caused by acute or chronic infection arising from metabolic abnormalities
  • most commonly affects lower lobes
  • bronchitis with a chronic productive cough, SOB, hemoptysis
  • modern antibiotics and vaccines control many bacterias and viruses that cause it (not as common anymore)
  • loss of lung marking caused by fibrosis and mucosal secretions
68
Q

What is cystic fibrosis? Complications? Radiographic appearances?

A

Metabolic imbalance surrounding the production and reabsorption of sodium and chloride. Patients produce profuse amounts of viscous mucus which clogs may organs including small bowel, pancreas, biliary tracts, trachea, and bronchi

  • mucus plugs lead to localized areas of lung collapse
  • repeat lung infections result when bacteria are trapped by mucus
  • bronchiectasis, cysts, and abscesses are common, weight gain, bowel perforations w/ peritonitis cause death
  • profuse sweating
  • chronic-irregular thickening of lung markings and hyperinflation of lungs
  • antibiotics reduce lung infections, bronchodilators and chest tapping can be used to control infection and keep mucous moving
69
Q

What is croup? Complications? Radiographic appearances?

A

Subglottic viral infection common in infants and children

  • barking cough, respiratory stridor (high pitched and noisy sound)
  • trachea appears as smooth/hourglass/fusiform shape
  • cools mist helps to alleviate symptoms
  • corticosteroid treatment will help in extreme cases
70
Q

What is epiglottitis? Complications/symptoms? Radiographic appearances?

A

Acute infection of the epiglottis caused by influenza virus

  • causes thickening of epiglottis and surrounding pharyngeal structures
  • incidence has been reduced due to vaccines
  • may cause complete airway obstruction and required hospitalization
  • intubation, antibiotics, and corticosteroids may be required
  • NEVER PLACE PATIENT IN RECUMBENT POSITION
  • appears as “thumbs up” sign on lateral soft tissue neck
71
Q

What is another name for hyaline membrane disease?

A

Idiopathic respiratory distress syndrome

72
Q

What is the most common fatal genetic disorder of amongst white children?

A

Cystic fibrosis

73
Q

What is SARS? Signs/complications? Radiographic Indications?

A

A virus that causes upper and lower respiratory infections, spread by contact or droplet

  • severe cases require intubation and mechanical ventilation
  • symptoms similar to pneumonia: productive cough, fever, sever chills, headache, chest pain
  • follow up chest x-rays are used to monitor the status of the disease and to determine appropriate level of treatment
74
Q

Types of pneumonia?

A
  1. Alveolar (pneumococcal)
  2. Bronchopneumonia
  3. Interstitial pneumonia
  4. Aspiration pneumonia
75
Q

What is pneumonia in general? Signs, symptoms, and treatment?

A

Inflammation of the lungs caused by numerous bacterial and viral pathogens

  • productive cough, fever, severe chills, headache, chest pain
  • antibiotics, rest, hydration, corticosteroids, and deep breathing instructions
76
Q

What is alveolar pneumonia? Radiographic indications?

A

Alveolar air is replaced with an inflammatory exudate that spreads from one alveoli to the next

  • “air bronchogram” sign
  • exudate filled alveoli (white)
77
Q

What is bronchopneumonia? Radiographic indications?

A

A bacterial infection that originates in the bronchiolar mucosa and spreads to adjacent alveoli, doesn’t tend to spread from one alveoli to the next

  • white coming from around bronchioles, follows the path of bronchial tubes
  • no “air-bronchogram” sign
78
Q

What is interstitial pneumonia? Radiographic indications?

A

A viral infection of the walls, linings, and alveolar septa

  • a linear pattern appears throughout the ling fields
  • “air-bronchogram” sign
79
Q

What is aspiration pneumonia? Radiographic indications?

A

Inflammation caused by aspiration of esophageal or gastric contents

  • multiple alveolar densities are distributed throughout lungs
  • posterior upper and lower lobes most affected
80
Q

What is tuberculosis? Symptoms/complications? Radiographic indications?

A

Infection caused by mycobacterium tuberculosis

  • spread by air droplets from coughing patients or the dust created from dried sputum, or from drinking milk from infected cows
  • diseases usually affects the lungs, but can affect the GI, GU, or skeletal systems
  • lesions composed of inflammatory cells surrounding bacteria, body encapsulates bacteria with fibrous tissue
  • if immune system compromised, bacteria eats away at tissue and creates a hole in lung (cavitation) and spreads
  • hemoptysis
  • mantoux test (2-10 week incubation period)
  • 6-12 months of antibiotics
  • secondary TB can occur years after initial exposure if immune system becomes weakened
81
Q

What is COPD?What components does chronic obstructive pulmonary disease consist of? Risk factors?

A

A group is disorders that involve chronic airway obstruction and distention of the alveoli?

  • chronic bronchitis
  • emphysema
  • smoking, air pollution, occupational exposure to hazards such as asbestos
82
Q

What is chronic bronchitis? Symptoms/complications? Radiographic indications?

A

Inflammation of the bronchi with increased production of sputum, and hyperplasia of mucous glands (narrows airways)

  • caused by infection, smoking, or long term exposure to air-pollution
  • chronic productive cough
  • thickening of bronchial walls and widespread inflammation
  • increased lung markings, “train tracks”, maybe normal chest x-ray, hyperinflation of the lungs
83
Q

What is emphysema? Symptoms/complications? Radiographic indications?

A

Obstruction and destruction of small airways and alveolar sacs

  • pollutants damage respiratory cilia and debris irritates the mucosa causing inflammation and increased mucous production, airways become plugged, lungs become hyperinflated, and alveolar structures are destroyed caused
  • cardiomegaly because heart tries to compensate for failing lungs
  • bullae may rupture: spontaneous pneumothorax, atelectasis
  • blunted lung bases*, radiolucent lungs, retrosternal air space, large bullae
84
Q

What is asthma? Symptoms/complications? Radiographic signs?

A

Reactive airway disease characterized by inflammation of respiratory mucosa, increased production of mucous, bronchospasm, and narrowing of airways

  • response to extrinsic factors (mold, dust, dander, food) and intrinsic factors (exercise, emotional upset, cold)
  • laboured wheezy breathing, compromised expiration
  • uncontrolled asthma = scarring of bronchial tubes
  • chest x-ray during episode = hyperinflation of lungs
  • can progress to pneumonia
85
Q

What is sinusitis? Symptoms/complications? Radiographic indications?

A

Inflammation and obstruction of normal sinus drainage

  • pain, tenderness, fever
  • destruction of bony sinus wall is an unfavourable indication of secondary osteomyelitis
  • inflammation appears as soft tissue density lining the walls of sinuses
  • air-fluid levels indicate acute inflammatory disease
  • maxillary sinuses most commonly affected
86
Q

What is bronchogenic carcinoma? Symptoms/complications? Radiographic indications?

A

A malignancy originating in the bronchial mucosa

  • smoking, inhalation of caricinogens
  • squamous, adenocarcinoma, bronchiolar (alveolar) make up 80% of lung cancers
  • gradual narrowing of bronchial tree
  • cancer cells may be detected in sputum, but biopsy is more conclusive
  • usually appears as a singular lesion, unilateral enlargement of the hilum
87
Q

What is pulmonary metastasis? Symptoms/complications? Radiographic indications?

A

Malignancy of the lungs that has spread from hematogenic or lymphatic system from musculoskeletal, breast, urogenital tract, thyroid or colon

  • usually asymptomatic
  • may have hypoxemia, dyspnea, cough, hemoptysis
  • distinct round nodules throughout the lungs “snowstorm” “cannonball appearance”
  • more common cancer
88
Q

What is spina bifida? Symptoms/complications? Radiographic indications?

A

Defective fusion of the posterior vertebral canal

  • occulta: insignificant, no neural defects, just a slight opening
  • menigocele: meninges protruding
  • mylecele: spinal cord protruding
  • myelomenigocele: spinal cord and meninges severe
  • large bony defects, absence of laminae, distance between pedicles, soft tissue mass
  • surgery
  • daily intake of folic acid during pregnancy can prevent this condition
89
Q

What is osteogenesis imperfecta? Symptoms/complications? Radiographic indications?

A

“Brittle bone disease” an inherited disorder of connective tissue causing multiple fractures

  • ol congenita: fractures beginning at birth throughout life causing deformities and death
  • ol tarda: begins later in childhood and ends in adulthood
  • whites of eyes have blue tinge, bizarre deformities from healing bone, juxtasutural accessory bones (wormian bones)
  • decreased bone density
  • surgically placed rods, drug therapy, stem cell transplants
90
Q

What is osteoporosis? Symptoms/complications? Radiographic considerations?

A

Generalized loss of bone density caused by an imbalance between metabolic bone formation and reabsorption

  • caused by cushing’s or immobilization with cast
  • caused by aging and post-menopausal changes
  • bone fracture more easily, increased risk of compression fractures in the T and L spine
  • weight bearing exercises, hormone replacement, vitamin C and D may slow disease
  • cortical thinning, decreased density, “picture frame” appearance, inferior and superior vertebral bodies look concave
  • use low kVp
91
Q

What is congenital/developmental hip dysplasia? Symptoms/complications? Radiographic indications?

A

Incomplete formation of the acetabulum

  • hip may pop out of joint frequently
  • if not treated, child will waddle like a duck
  • pelvic cast or harness used to immobilize femoral head until infant begins to walk
  • ultrasound, AP pelvis and modified cleaves views
  • hip usually demonstrated superiorly and posteriorly
  • gonadal shielding is imperative because of multiple follow up images
92
Q

What is scoliosis? Symptoms/complications? Radiographic indications?

A

Twisting, lateral “S” shaped curvature of the spine

  • idiopathic: no known cause
  • functional: caused by a problem external to the spine such as one leg shorter than the other
  • neuromuscular: caused by incomplete formation of the vertebrae
  • degenerative: adult type commonly associated with arthritis
  • bracing using for curves exceeding 25-40 deg
  • surgery for rod or spinal fusion in severe cases
  • full spine images of the patient, normal stance
  • gonad and breast shielding imperative because of follow up images
93
Q

What is osteomyelitis? Symptoms/complications? Radiographic indications?

A

A bacteria infection that spreads to bone and bone marrow via the blood stream

  • common in metaphyses of long bones, and spine in adults
  • can be a complication of IV drug use or conditions involving vascular insufficiency such as diabetes where bacteria from soft tissue abscesses can spread to bones
  • fever, heat in affected area, swelling, tenderness, eventually necrosis
  • inflammation appears on x-ray 10 days after
  • displacement of normal fat planes adjacent to and between deep muscle bundles
  • bone appears ragged and moth eaten
  • antibiotics, drainage, and debridement (scraping)
94
Q

What is rheumatoid arthritis? Symptoms/complications? Radiographic indications?

A

Chronic crippling disease of no known cause characterized by inflammation and overgrowth of synovial membranes leading to erosion of joint spaces

  • initially in hand and fee
  • 3x more common in women
  • pain, swelling, stiffness, deformity, subluxation, dislocation in extreme cases, ulnar deviation of hands
  • joint effusions and hyperplasia of synovial joints
  • disuse, increased blood flow to affected joints cause distinctive periarticular osteoporosis
  • EVENLY narrow joint spaces
95
Q

What is ankylosing spondylitis? Symptoms/complications? Radiographic indications?

A

Rheumatoid arthritis that begins in the SI joints and progresses superiorly (inflammatory process)

  • more common in men 20-40
  • ossification of soft tissues and formation of bony bridges in between vertebrae “bamboo spine”
  • decreased activity increases risk for osteoporosis and fracture
  • spine is fused into a solid block of bone, SI joints fused
96
Q

What is another name for ankylosing spondylitis?

A

Marie Strumpell’s disease or bamboo spine

97
Q

What is osteoarthritis? Symptoms/complications? Radiographic indications?

A

Generalized loss of joint cartilage and reactive new bone formation due to wear and tear of gravity and age

  • affects large weight bearing joint primarily
  • can also develop secondary to physical, septic, or inflammatory joint pathologies
  • loss of articular cartilage and development of bone spurs (osteophytes)
  • protecting joints, maintaining mobility, strengthening muscles through rest and exercise, support devices and/or surgery
  • joint spaced are narrow (unevenly), bone spurs
98
Q

What is Giantism (hyperpituitarism)? Symptoms/complications? Radiographic indications?

A

Over production of growth hormone before fusion of epiphyseal plates

  • most common cause is pituitary tumour
  • large skeleton
  • if condition persists and growth plates fuse, acromegaly will result-
  • prominent frontal bone, mandible, widened teeth, large hands, coarse facial features, erosion of sella turcica
  • radiation or surgery of pituitary gland
99
Q

What is acromegaly (hyperpituitarism)? Symptoms/complications? Radiographic appearance?

A

An overproduction of growth hormone after the fusion of the epiphyseal plates

  • most commonly caused by pituitary gland tumour
  • bones of hands, feet, face get thicker and there is an increase in the growth of the body’s soft tissue, especially heel pads and tongue
  • prominent forehead and jaw, widened teeth, spade shaped hands, coarse facial features, expansion and erosion of sella turcica
  • radiation or surgery of pituitary gland
100
Q

What is hypopituitarism? Symptoms/complications? Radiographic indications?

A

Insufficient levels of growth hormone in the body

  • can cause dwarfism in children
  • no significant effects in adults
  • limbs are just short, body well proportioned
  • patients sexually immature, but neurologically normal
  • growth hormone injections, and/or surgery to remove tumour
101
Q

What is achondroplasia? Symptoms/complications? Radiographic appearance?

A
  • most common cause of dwarfism
  • congenital condition characterized by an inability to convert epiphyseal cartilage to bone
  • limbs are short, head is large, pronounced jaw, prominent buttocks, saddle nose
  • long bones short and thick with widened metaphyses
  • no known cure, bones can be surgically lengthened, patients live normal life
102
Q

What is gout? Symptoms/complications? Radiographic indications?

A

Build up of uric acid in the blood that causes uric acid crystals to precipitate into the joints, cartilage, and kidneys

  • more common in men, “disease of kings” due to diet high in meat, carbs
  • usually begins in the 1st MTP
  • painful arthritic attack of joints, inflammation, periarticular swelling, some renal dysfunction
  • antihyperuricemic drugs
  • untreated can lead to kidney failure
  • joint effusions with deposits of uric acid crystals, joint space narrowing, “rat bite” erosions
103
Q

What is spondylolysis? Symptoms/complications? Radiographic indications?

A

Un-displaced break in the pars interarticularis

  • pre-disposes person for eventual forward displacement of the vertebrae (spondylolisthesis)
  • usually involved L5
  • lower back pain
  • bracing, physical therapy, restricted activity, NSAIDS, surgical laminectomy and/or spinal fusion
  • oblique spine to demonstrate break without subluxation, lateral to demonstrate break with forward displacement
  • scottie dog will have fracture neck “collar”
104
Q

What is a cystic bone lesion (unicameral bone cyst)? Symptoms/complications? Radiographic indications?

A

Fluid filled benign bone cyst

  • most commonly found in humerus and femur
  • most common in children
  • asymptomatic until tumour is large enough to cause a pathological fracture
  • appears as radiolucent oval with its long axis along the length of the bone
105
Q

What is osteogenic carcinoma? Symptoms/complications? Radiographic indications?

A

A malignant bone tumour that occurs in the metaphysis of a long bone

  • usually knee
  • most common in 10-25yr olds
  • local pain, swelling, fever, weight loss, secondary anemia, lung metastasis
  • chemo, radiation therapy, prognosis is poor, usually fatal
  • sunray or sunburst sign, tumour grows and lays down spicules of bone radiating from the center, “codman’s triangle”- elevation of periosteum
106
Q

What is a metastatic bone lesion? Symptoms/complications? Radiographic indications?

A

Most common form of malignant bone tumour, spreads via blood stream from primary sites (prostate, breasts, lung, kidney, or thyroid)

  • early detection is crucial, this cancer rules out the use of radical “curative” therapies
  • nuclear med bone scan, x-rays use to further evaluate lesions, if found
107
Q

What is multiple myeloma? Symptoms/complications? Radiographic indications?

A

A primary bone tumour arising from a proliferation of plasma cells

  • attacks intramedullary cavities of bones
  • causes bone destruction, bone marrow failure, hypercalcemia, recurring infections, and renal failure
  • prognosis is poor (3-4 years)
  • uniform sized punched-out lytic lesion scattered throughout the skeletal system, best seen on lateral skull
108
Q

What is aseptic necrosis (ischemic necrosis of bone)? Symptoms/complications? Radiographic indications?

A

Decreased blood flow leading to bone necrosis

  • caused by trauma, steroid therapy, cushing’s, anemia, alcoholism, chronic pancreatitis, radiation, and “the bends”
  • most common in femoral heads
  • uneven weight-bearing in hips causes premature osteoarthritis
  • radiolucent subcortical band (crescent sign) on the head of the femur, fragmentation, lytic lesions, and flattening of femoral head,
  • take 1 x-ray with normal kVp and one with a kVp that will penetrate sclerotic lesions
  • dense calcification of medullary canal
109
Q

What is Legge-Calve-Perthe’s? Symptoms/complications? Radiographic Indications?

A

Common form of aseptic necrosis affecting the femoral head

  • common in boys 5-10yrs
  • clinically affected patients will have a limp with little or no pain
  • bone in the center of the epiphysis is fragmented
110
Q

What is Paget’s disease (osteitis deformans)? Symptoms/complications? Radiographic indications?

A

Metabolic cycles of bone destruction and bone repair weaken, deform, and soften bone

  • most common skeletal disease, 2x more common in men 40+
  • usually affects pelvis, femurs, skull, tibias, vertebrae, calvicles, and ribs
  • compromised cranial nerves, compression of brain stem, compression in spine, spinal cord, and nerve roots, atriovenous lesions in affected bone can lead to cardiac failure
  • “cotton-wool” appearance
111
Q

What is Osgood Schlatter’s? Symptoms/complications? Radiographic indications?

A

The epiphysis of the tibia tubercle separates or partially separates from the tibial shaft

  • most often in active, adolescent boys
  • pain just below the knee joint worsening with activity, bony bump that is painful when pressed
  • x-ray may show avulsion injury
112
Q

Types of fractures

A
  • Boxer’s: fracture of head of 5th metacarpal
  • Jone’s: fracture of base of 5th metatarsal
  • Pott’s: fracture of malleoli of ankle
  • Monteggia: fracture of ulna with anterior displacement of radius
  • Blowout
  • LeFort: fracture of maxilla
  • Tripod: fracture of zygoma
  • Dislocation
  • Subluxation: small dislocation
113
Q

Types of fractures continued

A
  • Pathological fracture: due to a pathological process
  • Open (compound): break through the skin of a person
  • Closed (simple): contained by soft tissue
  • Complete: fracture right through the shaft of the bone
  • Incomplete: only affects part of the bone
  • Greenstick: cracks on one side, but not the other
  • Comminuted: community of fracture fragments
  • Non-comminuted: “complete” fracture
  • Transverse: perpendicular to the length of the bone
  • Oblique: runs obliquely through the long axis of the bone
  • Spiral: fracture goes around the bone
  • Compression: bones forced against each other and wedged
  • Impacted: two edges of fracture crushed together
  • Avulsion: little piece of bone that got ripped off by tendon
  • Stress: occurs in a bone that has wear and tear over time
  • Growth plate (salter harris): fracture of growth plate between epiphysis and metaphysis
  • Colle’s: transverse fracture of the distal radius with posterior displacement
  • Smiths: transverse fracture of the distal radius with anterior displacement
  • Supracondylar: fracture superior to condyles
  • Bennett’s: fracture of base of thumb

MRT Year 1 Semester 2 (11 decks)

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