Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bone Path 3 > Bone Path 3 Final > Flashcards

Bone Path 3 Final Flashcards

1
Q

What provides a general direction for clinicians when deciding to take images or not?

A

Mercy guidelines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 2 questions should be asked before ordering imaging?

A
  1. Will it affect diagnositic certainty about a DDX (if so how much). 2. will it change my diagnostic thinking enough so that it will significantly affect my choice of treatment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the things people can have that might be a high risk group for low back pain when radiographs have a high probability for positive findings?

A

Patients over 50, significant tauma, neuromotor deficits, unexplained weight loss, suspicion of ankylosing spondylitis, drug or alcohol abuse, history of cancer, corticosteroid use, fever over 100, DM/and or hypertension, lack of improvement, patients seeking compensation for back pain, dermopathy, cachexia, deformity and immobility, lymphadenopathy, elevated ESR, elevated acid or akaline phasphatase, positive Rheumatoid factor, positive HLA-B27, serum gammopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CT scans are highly sensitive and specific for what?

A

degenerative spinal stenosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why do we not take radiographs to screen for the clinically silent conditions?

A

A good history and physical should reveal red flags that place the person in the high risk groups so radiographs will then be taken.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 4 nonclinical reasons people take radiographs?

A

financial gain, force of habit, medicolegally advantageous, patient education.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

low back pain that persists for how long should then be x-rayed?

A

7 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How much bone destruction is needed to be visualized on x-ray and bone scan?

A

x-ray- 30-50%, bone scan- 3-5%. So radiographs are very specific and less sensitive and bone scans are very sensitive and not specific.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 3 areas radiographs are used for biomechanica and posture?

A

scoliosis, spinogrpahic analysis, functional radiography.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Are full spine radiographs for scoliosis diagnosticly effective and have an acceptable risk/benefit ratio?

A

Yes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is spinographic analysis clinically justifiable?

A

No.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How clinically significant are functional radiographs (flexion/extension, lateral bending)?

A

New research shows they are probably not that good.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Should degenerative processes be monitored with radiographs?

A

No since it will not alter the treatment, besides with stenosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CT is particularly useful in evaluating what?

A

apophyseal joint degeneration, bone hypertorphy, spine fx/dislocations, infections, bone neoplasms, complex congenital anomalies, spinal stenosis, metabolic disease, post operative spines, HNP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is CT superior to MRI and when is MRI superior to CT?

A

CT is superior in evaluating bone changes and MRI is superior in evaluating soft tissue changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the indications for CT?

A

spinal stenosis, bone/joint/disc disease, complex anomalies, spinal trauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the indications for CT with myelography?

A

thecal sac, nerve root (if MRI is not available) MRI IS BETTER.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the indications for MRI?

A

direct visulaization of soft tissues, joint and disc diseases, sensitive to bone marrow pathologies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the indications for MRI with gadolinium?

A

postoperative fibrosis (since scars will have increase in vascularization), recurrent HNP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the indications for radionuclide studies?

A

to identify metabolic activity benign vs. aggressive, acute vs chronic, mets and infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the indications for diagnostic ultrasound?

A

indirect causes of back pain like: AAA, pelvic neoplasms, neonatal spinal evaluations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the best test for herniated nucleus pulposus?

A

MRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the best test for spinal stenosis?

A

CT or CT with myelography.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the best test for spondylolisthesis?

A

plain film.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the best test for inflammatory arthropathies?

A

Plain film.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the best test for trauma?

A

CT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the best test for infections?

A

MRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the best test for instability?

A

plain film.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What has replaced myelography?

A

MRI and CT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What 2 things will MRI be really good at imaging?

A

Infection and neoplasms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How can you distinguish between post operative fibrosis pain or pain from a recurrent disc herniation?

A

Use Gadolinium with the MRI. Fibrosis will take in the contrast within 15 minutes and disc herniations will only take in a little contrast after 30 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the main reason now days for using discography?

A

used as a provocative test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What will hot spots on a bone scan mean?

A

Areas of increased blood flow due to increased metabolism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are SPECT bone scans used for?

A

Exact location of a lesion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When should bone scans be used?

A

after less expensive imaging and with red flags.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When would you use ultrasound to image the spine?

A

Only with neonates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why would you take a Ct or an MRI of the brain?

A

CT- SAH, acute subdural. MRI- MS, recent infarct, tumors, aVM’s, cerebral aneurysms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Why would you take a CT or an MRI of the orbits?

A

CT- graves, pseudotumors, foreign bodies, Fx. MRI- secondary evaluation of masses, tumors of optic nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why would you take a CT or an MRI of the head and neck?

A

CT- tumors and adenopathy. MRI- parathyroid tumors, problem solving after CT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why would you take a CT or an MRI of the chest?

A

CT- CXR abnormalities, CA, fibrosis, PE. MRI- problem solving after CT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why would you take a CT or an MRI of the abdomen?

A

CT- liver diseases/tumor, lymphoma, pancreatic CA, renal colic. MRI- problem solving after CT.

42
Q

Why would you take a CT or an MRI of the pelvis?

A

CT- appendicitis and diverticulitis. MRI- uterine problem solving after US and prostate cancer staging.

43
Q

Why would you take a CT or an MRI of the bones?

A

CT- Fx. MRI- tumors, osteomyelitis, AVN, stress Fx, Marrow changes.

44
Q

Why would you take a CT or an MRI of the joints?

A

CT- loose bodies, post-arthrogram studies. MRI- most problems of the shoulder, hip, knee ankle and wrist.

45
Q

Why would you take a CT or an MRI of the spine?

A

CT- degenerative stenosis. MRI- disc disease, bony metastasis, any cord pathology.

46
Q

What are the 3 advantages of plain film radiography?

A

cost effective, minimal radiation, widely available.

47
Q

Contrast resolution of CT is how much better than plain film radiopgraphy?

A

100 times better.

48
Q

Will CT have a film based receptor?

A

No. Only numerical data is collected by a photon detector cell that is placed around the patient has the x-ray part rotates around the patient.

49
Q

CT slices can be what sizes?

A

0.5m-10mm thick.

50
Q

How much can the CT machine be angled?

A

15-30 degrees.

51
Q

Typically what type of images are produced with CT?

A

axial images. Other types will have a decreased detail.

52
Q

CT image is made up of a _____ and each part of this is known as ______.

A

matrix , voxel.

53
Q

What are the 3 dimesions of a voxel?

A

length, width, depth.

54
Q

what is a pixel?

A

a two dimensional representation of a voxel which is length and width.

55
Q

What are the different types of units assigned to each voxel?

A

Hounsfield units from -1000 to 1000.

56
Q

What will bone and air be in hounsfield units?

A

bone- 1000. Air- -1,000

57
Q

What are the 2 types of contast or windows used with CT?

A
  1. Bone window- better to see fine detail of bone (cortex and medullary bone are distinctly different). 2. soft tissue window- better for soft tissue (cortex and medullary bone have similar densities.
58
Q

What are the contraindications of CT?

A

metallic objects near by can create artifacts. Radiation, claustrophobia and sensitivity to iodine contrast.

59
Q

When would CT be better than MRI for infections?

A

with cortical involvment, but MRI is better with medullary and soft tissue invovlement.

60
Q

Why is CT better for chest and abdomen than MRI?

A

faster and less motion artifacts.

61
Q

Would you use MRI or CT for sinuses?

A

CT.

62
Q

What will a CT myelogram look like?

A

like a soft tissue density with white contrast around the cord.

63
Q

What has better soft tissue contrast CT or plain film radiography?

A

CT.

64
Q

How do you control contrast with CT?

A

electronic manipulation of the digital info like using different windows.

65
Q

What are the disadvantages of CT?

A

relatively high radiation dosage, high cost, reformatted images not as good as original.

66
Q

What is the cage used to sheild extraneous radiofrequencies from MRI machines?

A

Faraday cage.

67
Q

The greater the ____ the better the image with MRI?

A

magnetic strength.

68
Q

What do you need to do with an MRI magnet to maintain its magnetism and create a homogenous field?

A

Keep it cooled.

69
Q

What will the radiofrequency do for MRI?

A

knock the neclei out of alignment so they can re-align.

70
Q

What is the spin density?

A

The number of hydrogen protons in tissues being imaged.

71
Q

How can you tell the difference between T1 and T2 MRI’s?

A

T1- fat will be white. T2- water will appear bright.

72
Q

What will ligaments and tendons look like on T1 and T2 images?

A

both will be dark gray or black.

73
Q

What will cortical bone look like with T1 and T2 MRI images?

A

black.

74
Q

What is a high signal with MRI and what is a low signal?

A

White is high black is low.

75
Q

T1 is used to better visualize what?

A

fat, precise anatomy, medullary bone, spinal cord, low signal bone, CSF intermediate.

76
Q

T2 is used to better visualize what?

A

water, discs,

77
Q

What has better detail T1 or T2?

A

T1.

78
Q

What will the CSF look like with a proton density MRI?

A

Same as cord.

79
Q

Gadolinium is only used with what type of MRI?

A

T1 images before and after.

80
Q

What are the contraindications for MRI?

A

during first trimester of pregnancy, over 300 lbs, ferromagnetic artifacts, surgical clips, pacemakers, cochlear implants.

81
Q

What are the limitations of MRI?

A

claustrophobia, have to hold still for 30 min to 1 hour, loud tapping noises.

82
Q

Myelography is not used as much with plain film radiography anymore, but when is it used?

A

With CT to visualize indirectly a lesion in the spinal canal.

83
Q

Myelography has been largely replaced by what?

A

MRI.

84
Q

What are the indications for myelography?

A

When CT or MRI is not available and can be used with CT presurgically.

85
Q

When is CT-myelography the gold standard?

A

pre-surgically for spinal stenosis.

86
Q

what are the disadvantages of Myelography?

A

Pt needs to be monitored for 3 hours after, infection risk, invasive.

87
Q

What do radionuclides do with nuclear medicine?

A

They emit gamma radiation as they undergo radioactive decay.

88
Q

What is the most commonly used radionuclide used with nuclear medicine?

A

technetium-99.

89
Q

What is scintigraphy?

A

a three phase scan commonly employed.

90
Q

What are the 3 phases of scintigraphy?

A

first- flow phase, second- blood pool, third- delayed or bone scan phase.

91
Q

What type of sensitivity and specificity will bone scans have?

A

high sensitivity and low specificity.

92
Q

Bone scan will uptake radionuclides when?

A

tumors, infections, acute Fx, stress Fx.

93
Q

What are the advantages of bone scans?

A

evaluate entire body, very sensitive, only need 3-5% bone destruction to been seen.

94
Q

What is discography?

A

injection of radiopaque contrast agent into the IVD as a provocative test and may demostrate dessicated discs and herniated discs.

95
Q

What is SPECT?

A

Like a bone scan, but offers multiple imaging planes like CT.

96
Q

What are the benefits of SPECT?

A

better localization of a lesion.

97
Q

What is PET?

A

positron emission tomography.

98
Q

What is PET used for?

A

to find soft tissue tumors like in lymph nodes, good for tumor grading, and used to monitor treatment success.

99
Q

PET has a greater resolution than what?

A

SPECT or scintigraphy.

100
Q

What is the major disadvanatge of PET?

A

high cost and low availability.

Bone Path 3 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions