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Pathology > CH.2 Skeletal System > Flashcards

CH.2 Skeletal System Flashcards

0
Q

What are the two types of bone in the skeletal system?

A

compact and cancellous

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1
Q

What are the 2 types of tissues in the skeletal system?

A

bone and cartilage

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2
Q

Describe compact and cancellous bone.

A

compact is the dense outer layer where cancellous is the spongy inner layer located within the medullary canal

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3
Q

What are the two types of bone cells?

A

Osteoclasts and Osteoblasts

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4
Q

This is an inherited generalized disorder of the bone and connective tissue. It is characterized by multiple fractures and an unusual blue color of the normally white sclera of the eye.

A

Osteogenesis Imperfecta (OI)

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5
Q

Describe osteoblasts and Osteoclasts

A

Osteoblasts - are bone forming cells that lineage medullary canal.
Osteoclasts - cells that break down bone to enlarge medullary canal for bone growth

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6
Q

What is another term for Osteogenesis Imperfecta?

A

Brittle bone disease

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7
Q

What are the two types of OI?

A

Rare- present at birth with mutliple fractures-generally fatal
OI Tarda- occurs later in life when one can walk and bear weight

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8
Q

This is the most common form of dwarfism caused by diminished proliferation of cartilage in the growth plate. Patient will have a normal axial skeleton with shortened limbs. It is a genetic condition.

A

Achondroplasia

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9
Q

This is a rare hereditary bone dysplasia causing bone to be abnormally heavy and compact yet also brittle. Reabsorptive mechanisms of calcified cartilage interferes with normal replacement of the mature bone.

A

Osteopetrosis

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10
Q

What is another name for Osteopetrosis?

A

Marble Bones as apparent on a radiographic image with an overall whiteness of bone. Technologists must increase their technical factors for greater penetration of this bone disease.

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11
Q

What are the two forms of Osteopetrosis?

A

Albers-Schonberg Disease- which is typically asymptomatic

Craniotubular Dysplasia- Cranial and long bone malformation

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12
Q

This is the failure of fingers and toes to seperate. Occurs in the 16th week of gestation and caused webbed digits via the fusion of skin.

A

Syndactyly

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13
Q

This is the formation of extra digits and is genetically passed down via family.

A

Polydactyly

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14
Q

This is a congenital malformation of the foot preventing normal weight bearing. The foot is turned inward at the ankle and is the most common congenital disorder of the leg.

A

Clubfoot (talipes)

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15
Q

How can clubfoot be corrected?

A

with splints and casts and surgical intervention

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16
Q

This is the most common disorder affecting the hips in children under 3-When the acetabulum does not completely form and the head of the femur is displaced superiorly and posteriorly is known as?

A

Congenital Dislocation of the Hip (CHD) -Duck Waddle

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17
Q

What are the two diagnosis of CHD?

A

Ortolani Sign- in infants

Trendelenburgs Sign- in older weight bearing children

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18
Q

This is known as the abnormal lateral curvature of the spine with twisting in advanced cases.

A

Scoliosis

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19
Q

What are the 4 types of scoliosis?

A
  • Idiopathic
  • Functional
  • Neurotransmitter
  • Degenerative
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20
Q

No known cause of scoliosis is known as what type?

A

Idiopathic

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21
Q

Leg length discrepancies causing scoliosis is known as which type?

A

Functional

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22
Q

When the muscles of the vertebral column lax on one side this can cause which type of scoliosis?

A

neurotransmitter

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23
Q

This type of scoliosis is secondary to osteoarthritis and osteoporosis.

A

degenerative

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24
Q

A curve with convexivity to the right at the thoracic curve is known as?

A

Dextroscoliosis

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25
Q

A curvature with a convexity to the left more common in the lumbar spine is known as?

A

Levoscoliosis

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26
Q

This consists of both dextroscoliosis and levoscoliosis causing right thoracic curvature and left lumbar curvature of the spine. Often a double major curve of 70 degrees.

A

Thoracolumbar Scoliosis

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27
Q

Thoracolumbar Scoliosis can be classified into what 4 groups?

A
  • Osteopathic
  • Neuropathic
  • Myopathic
  • Idiopathic
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28
Q

This form of thoracolumbar scoliosis includes congenital anomalies and deformities that are the result of trauma or disease.

A

Osteopathic

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29
Q

This form of thoracolumbar scoliosis is caused by deformities that are the result of muscle imbalance caused by neurological lesions.

A

Neuropathic

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30
Q

This form of thoracolumbar scoliosis results from muscular disorders.

A

Myopathic

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31
Q

This form of thoracolumbar scoliosis is the most common form which is congenital with no clear inheritance pattern. It forms and appears most commonly with straight spine and active during growth years.

A

Idiopathic

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32
Q

What are the 3 types of idiopathic scoliosis?

A
  • Infantile Idiopathic Scoliosis- evident within 3 years of life
  • Juvenile Idiopathic Scoliosis- age group 4-9yrs
  • Adolescents Idiopathic Scoliosis- after age 10 but before skeletal maturity occurs.
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33
Q

How is scoliosis treated?

A

It depends on the severity of the curvature.

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34
Q

How are spinal curvatures of 25 degrees or less treated?

A
  • monitored by x-ray

- helped by exercises

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35
Q

How are spinal curvatures of 25-30 degrees treated?

A

Requires spinal exercise and a brace to be worn until bone growth is complete. The brace usually halts progression 90% of the time.

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36
Q

How are spinal curvatures of 45 degree and greater treated?

A

This requires surgery due to lateral curvature continuing to progress at 1 degree/yr after maturity occurs.

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37
Q

This spinal canal defect is caused from failure of the posterior elements of the lumbosacral area to fuse properly. The lamina do not fuse into the spinous processes.

A

Spina Bifida

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38
Q

This is a mild insignificant form of spina bifida that has a splitting of the bony neural canal at L5-S1.

A

Spina Bifida Occulta

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39
Q

Large Spina Bifida defects have complications of herniations known as? (there are 2)

A
  • Meningocele

- Myelomeningocele

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40
Q

This is the premature closure of sutures of the skull. There is a questionable genetic link with no known family link.

A

Craniosynostoses

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41
Q

This is an abnormality causing failure of development of the brain and cranial vault to form. It is linked to mothers diet and vitamin intake during gestation.

A

Anencephaly

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42
Q

This is a disease caused by infection of the bone and bone marrow.

A

Osteomyelitis

43
Q

How is Osteomyelitis caused? 3 ways discussed.

A
  • By bacterial spread into the bloodstream
  • Extension from adjacent site of infection
  • Direct introduction of organisms (via surgery)
44
Q

What are 3 known culprits of Osteomyelitis?

A
  • E. Coli
  • Staphylococcus Aureas
  • Group B Strep
46
Q

This is rheumatoid like involving asymmetrical rather than symmetrical destructions of the DIP joints of the hands and feet.

A

Psoriatic

47
Q

How does Psoriatic Arthritis develop?

A

In patients with skin changes associated with Psoriasis

48
Q

What does a radiographic image of Psoriatic Arthritis show?

A
  • alkalosis of the DIP joints

- reabsorption of the terminal ends of the distal phalanx

49
Q

This is a chronic systemic disease appearing primarily as a non infectious inflammatory arthritis of the hands and feet primarily attacking the peripheral joints, surrounding muscles, tendons, ligaments and blood vessels.

A

Rheumatoid Arthritis

50
Q

With rheumatoid arthritis which direction are the hands typically deviated?

A

Ulnar

51
Q

What does the rheumatoid factor activate?

A

Polymorpholeukocytes

52
Q

What do Polymorpholeukocytes do?

A

Attack the RA factor and release a digestive enzyme into the joint space causing irritation in the synovial lining causing wear and tear on the joint space

53
Q

RA frequently follows what types of events?

A

stress, trauma, menopause, childbirth

54
Q

What are the 4 stages of RA?

A
  1. Synovitis
  2. Pannus
  3. Fibrous Anklyosis
  4. Anklyosis
55
Q

What occurs in first stage Synovitis?

A

Congestion and edema of the synovial membrane and joint capsule.

56
Q

What occurs in the second stage Pannus?

A

Thickened layers of granulation tissue, involves cartilage and eventually destroys the joint capsule and bone.

57
Q

What happens in third stage Fibrous Anklyosis?

A

Scar formation occludes the joint space, bone strophes and the joint becomes misaligned and deformed.

58
Q

What occurs in fourth stage Anklyosis?

A

Calcification and a bent, deformed, and fused joint.

59
Q

What are some general signs and symptoms of RA?

A
  • Stiffness inf the PIP and MCP joints
  • pain and stiffness in the wrists knees elbows and ankles later on in the disease
  • diminished joint function.
60
Q

What does a radiograph appear like with a pt who has RA?

A
  • May show fusiform periarticular soft tissue swelling

- Later films show decrease in joint space, eroded bone ends, subluxation

61
Q

What are the 2 types of ulnar deviation deformities associated with RA?

A
  1. Boutonniere Deformity (Flexion)

2. Swan Neck Deformity ( Hyper-extension) of the PIP joint

62
Q

What is another term for Anklyosing Spondylitis?

A

Bamboo spine

63
Q

This is a variant of RA beginning in the SI joints. It has a gradual development where the patient will rely on everything from the hips for flexion and extension.

A

Anklyosing Spondylitis

64
Q

This is the most common form of arthritis. It is a degenerative joint disease, hypertrophic arthritis usually affects persons over age 40.

A

Osteoarthritis

65
Q

Osteoarthritis is essentially a degenerative condition of what?

A

Articular cartilage with reactive and hypertrophic changes in underlying bone.

66
Q

Osteoarthritis is most often seen where?

A

In the large weight bearing joints of the body.

67
Q

What is the initial step in osteoarthritis?

A

Joint stress breaks down the synovial lining=mechanical

68
Q

What occurs after the initial joint stress of osteoarthritis?

A

It follows steps similar to RA.

69
Q

What are the 2 types of osteoarthritis?

A

Primary- due to age

Secondary- due to trauma, joint infection, or stress

70
Q

Osteoarthritis is predisposed to whom?

A

Females due to menopause- the metabolic changes in the body

71
Q

What are some signs and symptoms of osteoarthritis?

A

joint pain following exercise or long periods of weight bearing, after rising in the morning, changes in weather, grating of the joint during motion, limited range of motion

72
Q

Grating of the joints during motion is known as?

A

Crepitus

73
Q

The DIP joints form what types of pea shaped nodules in Osteoarthritis.

A

Heberdens Nodes

74
Q

The PIP joints form small pea-shaped nodules called what in osteoarthritis.

A

Bouchard’s Nodes

75
Q

What does a radiographic image look like of a patient with Osteoarthritis?

A

Narrowing of the joint space or margins with cyst like bony deposits in the joint space/margins. There is also joint deformity and bone growths on weight bearing joints.

76
Q

Periosteal growths form on the joint margins and are specifically evident on the vertebrae, these are known as? And can cause what in the vertebral column?

A

“lipping” or “spondylitis deformans” This can lead to kyphosis, scoliosis, and osteophytic outgrowth of nerve roots.

77
Q

Tenosynovitis, Bursitis, Ganglion, Gouty Arthritis, Excess Uric Acid and Tophi are all types of what?

A

Inflammatory Diseases

78
Q

This is a disorder in the metabolism of purine ( a component of nucleic acids) It creates increases in uric acid in the blood leading to deposition of uric acid in the joints, cartilage, and kidneys.

A

Gout

79
Q

Gout manifests as very painful arthritis that initially attacks a single joint? Which joint is most commonly attacked?

A

First metatarsophalangeal joint of the great toe

80
Q

This is an inflammation of the small fluid filled sacs (bursa) located near the joints that reduce friction caused by movement.

A

Bursitis

81
Q

What are the causes of Bursitis?

A
  • Repeated physical activity
  • Trauma
  • Rheumatoid Arthritis
  • Gout
  • Infections
82
Q

Describe the appearance of Benign tumors.

A

defined edges surrounded by a thin rim of sclerotic bone… most are osteoblastic, some are cartilaginous

83
Q

Describe the appearance of Malignant tumors.

A

branching out of edges.

84
Q

This type of tumor comes from the dense cortex of bone and becomes static after maturity. It is a common benign tumor occuring in childhood. The tumor usually points away from the adjacent joint and is capped by radiolucent cartilage.

A

Osteochondroma

85
Q

What does Osteochondroma look like?

A

a mushroom which cap can contain flake like calcifications.

86
Q

What are other characteristics of Osteochondroma?

A
  • Long axis of the tumor runs // to the bone shaft

- Points away from nearest joint

87
Q

This is a rare tumor most often arising in the outer table of the skull, paranasal sinuses, and the mandible.

A

Osteomas

88
Q

How to osteomas appear radiographically?

A

well circumscribed dense lesions.

89
Q

This type of tumor can develop anywhere in the skeleton where cartilage is present. Usually in the small bones of the hand and feet.

A

Enchondroma

90
Q

How are enchondromas typically found?

A

Due to the swelling or pain from a fracture through the lesion.

91
Q

How can enchondromas be treated?

A

usually by scrapping and cleaning out the area and packing with bone or using bone cement. It depends on the age and growth of the individual.

92
Q

How do enchondroma’s appear radiographically?

A

Radiolucent lesions containing small stripped calcification. Well circumscribed and appear “bubbly”

93
Q

This is a true fluid filled cyst with a wall of fibrous tissue most often occuring in the proximal humerus or femur at the metaphysis.

A

Simple Bone Cyst.

94
Q

How are simple bone cysts typically diagnosed?

A

Incidentally or after a fracture.

95
Q

This consists of numerous blood filled arteriovenous communications thought to be caused by trauma. The capillaries are shortchanged

A

Aneurysmal Bone Cyst.

96
Q

These types of tumors are mostly found in the femur or tibia of males under 30. They arise within the cortical bone and errode the underlying bone tissue resulting in a lytic lesion called a nidus.

A

Osteoid Osteoma

97
Q

This tumor consists of numerous multinucleated osteoclastic giant cells, the tumors may be either benign or malignant. Found at the distal ends of long bones arising from the epiphysis.

A

Osteoclastoma/ Giant cell tumors

98
Q

_____ is a malignant tumor of osteoblasts which produce osteoid and spicules of calcified bone. Generally occurs at the ends of long bones. Is most common in persons 10-25

A

Osteogenic Sarcoma

99
Q

What does Osteogenic Sarcoma look like radiographically?

A

Dense areas, radiolucent areas, or mixed areas that give the characteristic sunray, or sunburst pattern

100
Q

This type of sarcoma is a primary malignant tumor arising in the bone marrow of long bones. Involves extensive lesions often involving entire shafts of long bones.

A

Ewings Sarcoma

101
Q

This malignant tumor of the cartilage may originate anew or within a preexisting cartilaginous lesion. It is the 2nd most common malignant bone tumor commonly occuring in long bones as well as ribs, pelvis, vertebra, adn scapula.

A

Chondrosarcoma

102
Q

What is the age range and growth of Chondrosarcomas?

A

Develops at a later age 35-60. Grows more slowly and metastasizes later.

103
Q

What do Chondrosarcomas look like radiographically?

A

Arise from points of muscle attachment, shows soft tissue lesions which contain flecks of calcification.

104
Q

Metastatic disease from carcinomas is the most common malignant tumor of the skeleton. Which bones does this disease affect?

A

Bones containing red marrow with spine being most common. Can also affect flat bones such as ribs, sternum, pelvis and skull.

105
Q

What are the primary sites for metastatic bone disease?

A

Cancers of the breast, lung, prostate, and kidneys

106
Q

How do the primary tumors spread into metastatic bone disease?

A

By means of the bloodstream or lymphatic vessels, or by direct extension.

107
Q

What does metastatic bone disease typically look like radiographically?

A

Lucent lesions are often irregular and poorly defined. In the spine it causes sclerosis and the vertebral bodies will have an “ivory appearance”

Pathology (10 decks)

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