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Pathology Final > Chapter 2 Skeletal System > Flashcards

Chapter 2 Skeletal System Flashcards

1
Q

What is anchondroplasia?

A

It is the failure of the cartilage that becomes bone to form properly, thus not allowing ossification to proceed as it should

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2
Q

What is anchondroplasia caused by?

A

An abnormal gene located on one of the chromosomes

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3
Q

What is the most common cause of disproportionate short stature?

A

Anchondroplasia

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4
Q

What do individuals affected with anchondroplasia display?

A

They have short extremities while the trunk and skull are of normal size. Often the arms are shorter than the lower extremities. There is lordosis of the lumbar spine, bowed legs, and a bulky forehead with a saddle shaped nose

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5
Q

What happens to the technique with anchondroplasia?

A

Because the cartilage is not ossified as it should, radiographs taken of infants will not require the higher kVp

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6
Q

What is ankylosing spondylitis?

A

A chronic inflammatory disorder that predominantly affects the sacral iliac joints and lumbar spine

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7
Q

What is another name for ankylosing spondylitis?

A

Rheumatoid spondylitis

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8
Q

Who is more affected by ankylosing spondylitis

A

Males between 15 and 35 years with an average age of 26

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9
Q

Where does ankylosing spondylitis start?

A

It stars in the lumbar spine and progresses upward causing kyphosis and difficulty breathing as it reaches the thoracic area

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10
Q

What does ankylosing spondylitis cause?

A

Extensive calcifications of the anterior longitudinal ligament

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11
Q

What is bursitis?

A

It is an inflammation of the synovial bursa caused by excess stress on the joint. It is the most common non arthritic ailment of joints

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12
Q

Where is bursitis generally found?

A

In the shoulder, and radiographs may show calcified deposits in the tendon above the greater tuberosity of the humerus

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13
Q

What is spondylolisthesis?

A

The forward displacement of the vertebrae on top of another, usually occurring at the L5/S1 junction

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14
Q

Where can spondylolisthesis occur?

A

Usually L5/S1 junction but will occur anywhere that a vertebral body will slide forward over the vertebrae below it

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15
Q

What is the less common type of spondylolisthesis?

A

Seen between L4 and L5

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16
Q

What is spondylolithesis usually caused by?

A

Some kind of defect of the pedicle

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17
Q

What is spondylolysis?

A

A condition of the spine characterized by fixation and stiffness

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18
Q

What is spina bifida?

A

The failure of fusion of one or more vertebral arches

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19
Q

What are the different types of spina bifida?

A

Spina bifida occulta, and spina bifida aperta

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20
Q

What is spina bifida occulta?

A

It occurs when the two halves of the posterior arch fail to unite

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21
Q

Where does spina bifida occulta most often occur?

A

The first sacral vertebra

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22
Q

With SBO, there is no protrusion of what?

A

The spinal cord or its membrane, however if neural elements project through the defect without any meninge covering a myelocele is present

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23
Q

What is a meningocele?

A

A cerebrospinal fluid filled sac covered with the meninges of the cord

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24
Q

What is spina bifida aperta?

A

There is a wide bony defect in the posterior arch of the lumbar vertebrae

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25
Q

What does spina bifida aperta leave room for?

A

A protrusion of the spinal cord contents beyond the spinal canal

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26
Q

What is a myelomeningocele?

A

A sac containing CSF and some of the neural elements of the cord protruding

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27
Q

What will plain radiographs show with spina bifida?

A

The absence of the lamina and spinous processes, along with the widening of the space between the thinning pedicles

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28
Q

What is scoliosis?

A

The lateral deviation and rotation of the spine

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29
Q

What are the different types of scoliosis?

A

Idiopathic, congenital, or acquired

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30
Q

What is congenital scoliosis commonly the result of?

A

Vertebral abnormalities such as hemivertebrae, wedge vertebrae, or neuromuscular development

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31
Q

What other anomalies are associated with congenital scoliosis?

A

Urinary anomalies

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32
Q

What is wedge vertebrae or hemi vertebrae?

A

Failure of formation of the vertebrae

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33
Q

What is Congenital dislocated hip?

A

It occurs when the capsule of the hip joint relaxes and allows dislocation of the hip

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34
Q

What is another name for congenital dislocated hip?

A

Developmental dysplasia of the hip

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35
Q

Who is more often affected by CDH?

A

Caucasian females

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36
Q

What are predisposing factors of CDH?

A

Breech deliveries and oligohydraminos

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37
Q

What complications may occur if CDH has not been diagnosed and treatment is not put into place?

A

Avascular necrosis, pseudoacetabulae may develop from pressure of a displaced femoral head in the iliac wing,and secondary arthritis

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38
Q

What is a bone cyst?

A

A wall of fibrous tissue filled with clear fluid, occurring in the proximal humerus and knee of adolescents and young adults

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39
Q

Who is most often affected by bone cysts?

A

Males

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40
Q

Where does a bone cyst develop?

A

Beneath the epiphyseal plate but migrates down the shaft with growth

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41
Q

True or False
Bone cysts are not usually noted on a radiograph but are detected only when pain due to cyst growth or a pathologic fracture occurs

A

True

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42
Q

When bone cysts do appear on radiographs, what do they show?

A

A lucent focus with a thin cortex and sharp boundary. There may be septae to cause a loculated appearance

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43
Q

What do CT scans show with bone cysts?

A

A fluid density within a well-defined lesion with bony spetations within it. This will help differentiate it from fibrous dysplasia

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44
Q

Where are disk herniations common?

A

The lumbar spine area

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45
Q

What are disk herniations?

A

The fibrous ring of the disk degenerates to the point that the pulpy nucleus is forced out of the disk

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46
Q

What do posterior herniations result in?

A

Pressure on the spinal cord and nerve roots which can cause neurologic symptoms

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47
Q

What do radiographs show with disk herniations?

A

narrowing of the disk

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48
Q

What is the most common types of arthritis?

A

Osteoarthritis and occurs in patients who have put a lot of “wear and tear” in the large weight-bearing joints such as the knee

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49
Q

What is another name for osteoarthritis?

A

Degenerative joint disease

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50
Q

What is osteoarthritis?

A

A noninflammatory deterioration of the articular cartilage with new bone forming at the surface of the joint

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51
Q

What may occur with osteoarthritis?

A

Narrowing joint spaces and some erosion

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52
Q

What happens when the smaller joints are affected with osteoarthritis?

A

They will show nodules and increased size at the interphalangeal joint spaces

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53
Q

What is rheumatoid arthritis?

A

It is an autoimmune disease characterized by chronic and progressive inflammatory involvement of the joints and atrophy of the muscles

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54
Q

What does rheumatoid arthritis affect?

A

The small joints of the hands and feet

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55
Q

Who is more often affected by rheumatoid arthritis?

A

Women in their 30s and 40s

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56
Q

What is the cause of RA?

A

The cause is unknown

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57
Q

Where does widespread inflammation occur with RA?

A

In the synovial membrane causing pain, stiffness, and thickening of the tissue. This thickened tissue grows inward and damages the cartilage. Later, the tissue becomes fibrous, which prevents motion of the joint (fibrous ankylosis). As the disease progresses, the fibrous tissue becomes calcified and becomes osseous tissue (bony ankylosis)

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58
Q

What do radiographs show in the early stages of RA?

A

Soft-tissue swelling around the joints

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59
Q

What do radiographs show in the later stages of RA?

A

A decrease in the joint space, with eroded bone ends and subluxation which leads to the gross deformities

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60
Q

What happens to the wrist with RA?

A

Ulnar deviation of the wrist with either boutonniere deformity (flexion) or swan neck deformity (hyperextension) of the proximal interphalangeal joint

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61
Q

What is osteogenic sarcoma?

A

A highly malignant primary tumor occurring at 10 to 30 years of age with the peak incidence rate at 20 years of age

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62
Q

Where does osteogenic sarcoma most often occur?

A

In the long bones, particularly at the lower ends of the femurs and upper ends of the humerus or radius

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63
Q

What is lifted from the bone with osteogenic sarcoma?

A

The periosteum

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64
Q

What is another term used for osteogenic sarcoma?

A

Osteosarcoma

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65
Q

What radiate outward from the central mass with osteogenic sarcoma?

A

Spicules of new bone

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66
Q

How is osteogenic sarcoma often found?

A

It is usually found as an incidental finding while investigation recent trauma to the bone. Known as traumatic determinism

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67
Q

What is multiple myeloma?

A

It is the most common primary tumor of the bone

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68
Q

What bones does multiple myeloma most often affect?

A

The flat bones

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69
Q

Who is most often affected by multiple myeloma?

A

Persons over the age of 50 years

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70
Q

Where does multiple myeloma often arise from?

A

The bone marrow plasma cells and occurs in bone marrow that is actively hemopoietic. Therefore, it is not a true osseous tumor

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71
Q

What increases with multiple myeloma?

A

The chance of pathologic fractures as the destruction of the bone continues

72
Q

What is Ewing Sarcoma?

A

The most common primary malignant bone tumor seen in a child of 5 to 15 years of age

73
Q

Where does Ewing Sarcoma occur?

A

In the diaphysis of long bones

74
Q

What is Ewing Sarcoma often misdiagnosed with?

A

Osteomyelitis because of the constant low-grade pain, fever, and leukocytosis that are present. This unique feature appears to be due to the tumor outgrowing its blood supply. This will cause extensive degeneration and necrosis

75
Q

What is the best imaging modality for Ewing sarcoma?

A

Nuclear medicine

76
Q

What are osteoclastomas?

A

They are benign tumors seen in young people in their early 20s

77
Q

What will determine the tendency of osteoclastomas being benign or malignant?

A

The proportion of stromal cells to giant cells in the lesion

78
Q

What is the most common location of osteoclastomas?

A

In the long bone arising from the epiphysis after closure. The tumor does extensive damage but does not metastasize

79
Q

What is another name for osteoclastomas?

A

Giant cell tumors

80
Q

What is osteochondroma?

A

It is the most benign skeletal growth or tumor

81
Q

What is another term used for osteochondroma?

A

Exostosis

82
Q

Where does osteochondroma arise from?

A

The cortex and grows parallel to the bone.

83
Q

In which direction does osteochondroma point?

A

The tumor points away from the adjacent joint and is capped by radiolucent cartilage. This cap may contain flake-like calcifications

84
Q

What often occurs with osteochondroma?

A

Exostosis is caused by localized bone overgrowth at a joint, seen often at the knee. It enlarges during bone growth and them becomes static

85
Q

What is osteitis deformans?

A

It is overproduction of bone

86
Q

What is another term for osteitis deformans?

A

Pagets disease

87
Q

What is the cause of osteitis deformans?

A

It is an idiopathic disease but appears to be associated with an increased blood flow to the affected bones

88
Q

Who is most often affected by osteitis deformans?

A

Men over 55 years of age

89
Q

Where does osteitis deformans most often occur?

A

At the skull, tibias, and vertebrae

90
Q

What happens to the bones with osteitis deformans?

A

The bones become softened because of the over action of osteoclasts removing calcium. As the bones become sufficiently soft, they bow.

91
Q

What happens as the bone tries to repair itself with osteitis deformans?

A

Ossification takes place at the outside of the bone. This constant destruction of the inside of the bone with simultaneous production at the outside of the bone, leading to enlargement is known as acromegaly

92
Q

What is osteoporosis?

A

When osteoblasts fail to lay down sufficient amount of bone matrix, an abnormal decrease in bone density occurs

93
Q

What is there a lack of with osteoporosis?

A

There is a lack of bone formation (osteoid) but calcium production is NORMAL

94
Q

What may be associated with osteoporosis?

A

Kidney or bladder stones because the calcium that would normally go to the bone is drained from it and excreted through urine

95
Q

What are the prime factors associated with osteoporosis?

A

Age, gender, and race

96
Q

What are the different variety of clinical conditions osteoporosis may occur in?

A

Primary and secondary

97
Q

Is secondary or primary osteoporosis more common?

A

Primary

98
Q

What is primary osteoporosis associated with?

A

An underlying illness

99
Q

What is secondary osteoporosis caused by?

A

Some other problem such as disease atrophy, people who are under prolonged administration of steroids or suffer from adrenocortical hormone hyperactivity,

100
Q

Who are more to osteoporosis?

A

Postmenopausal women because of a deficiency in the gonadal hormone level that leads to decreased bone formation

101
Q

What are common locations for osteoporosis?

A

Spine, pelvis, hips, femurs, distal radius/hand, and proximal humerus/shoulder

102
Q

What are common in those who suffer from osteoporosis?

A

Pathologic fractures

103
Q

What do radiographs show with osteoporosis?

A

lack of density in the bones due to loss of calcium and thin cortices with fewer trabeculae

104
Q

What happens to the technical factors with osteoporosis?

A

The technical factors (particularly kVp) should be decreased so as not to overexpose the image

105
Q

What is osteomalacia?

A

An abnormal decrease in bone density caused by a lack of calcium and phosphorus

106
Q

What does osteomalacia lead to?

A

The defect of mineralization leads to softening of the bone in an adult, even though a normal amount of osteoid is present

107
Q

What is a cause of osteomalacia?

A

Vitamin D deficiency and pregnancy

108
Q

What happens if osteomalacia occurs before the growth plate at the epiphysis closes in children?

A

Rickets

109
Q

What is another name for rickets?

A

Infantile osteomalacia, since the bones lack hardening

110
Q

What happens with rickets?

A

The osteoid tissue in growing bones is not calcified or hardened, and deformities of the skeleton result

111
Q

What is a common manifestation with rickets?

A

bowing of the lower legs

112
Q

What is osteogenesis imperfecta?

A

It is an inherited connective tissue disorder that affects multiple organs and not just the skeletal system

113
Q

What is osteogenesis imperfecta called?

A

Brittle bone disease because of the extreme vulnerability of bones to fracture

114
Q

What are the most common abnormalities associated with osteogenesis imperfecta?

A

Blue sclera, osteoporosis, wormian bones in the skull, and multiple fractures

115
Q

What is there a lack of with osteogenic imperfecta?

A

Osteoblastic activity and abnormal collagen formation so that the skeleton does not ossify properly

116
Q

What are the two different forms of osteogenic imperfecta?

A

Congenital and tarda

117
Q

What is more severe, congenital or tarda osteogenic imperfecta?

A

congenital with multiple fractures at birth

118
Q

When does the tarda form of osteogenic imperfecta occur?

A

After puberty with multiple fractures and milder deformities of the long bones at varying times following birth

119
Q

What is used for the initial diagnosis of OI?

A

Dual-energy X-ray absorptiometry

120
Q

What process is exactly opposite of OI?

A

Osteopetrosis

121
Q

What happens with osteopetrosis?

A

There is a deficiency of osteoclasts and therefore, faulty bone absorption

122
Q

What does faulty bone absorption lead to with osteopetrosis?

A

A generalized increase in bone density which leads the disease to be called “marble bone” disease

123
Q

What happens to the long bones with osteopetrosis?

A

They are sclerotic and fragile with frequent transverse fractures

124
Q

What are the different forms of osteopetrosis?

A

Osteopetrosis infantile, osteopetrosis tarda, and osteopetrosis intermediate

125
Q

What happens with osteopetrosis infantile?

A

It frequently ends in blindness and deafness and then death by the age of 2 years

126
Q

What happens with osteopetrosis tarda?

A

It remains asymptomatic with detection being made with anemia or pathologic fractures

127
Q

What happens with osteopetrosis intermediate?

A

It falls somewhere in between the other two forms and in severe forms, there is obliteration of the marrow cavity and a deformed skull

128
Q

What are patients who suffer from osteopetrosis prone to?

A

Osteomyelitis

129
Q

What is the best modality used to diagnose osteopetrosis?

A

Radiography

130
Q

What is osteomyelitis?

A

Infection of the bone and bone marrow

131
Q

What is osteomyelitis commonly caused by?

A

Staphylococci bacteria carried through the blood, but I can be caused directly if bacteria enters the bone from outside

132
Q

What is the usual site for development of osteomyelitis?

A

The long bones of the lower limbs

133
Q

What is a complete fracture?

A

One that occurs through the entire cross section of the bone

134
Q

What is an incomplete or fissure fracture?

A

A fracture that breaks only one cortex

135
Q

What do terms such as transverse, spiral, oblique, and longitudinal describe?

A

The direction of the fracture in relation to the long axis of the bone

136
Q

What is an avulsion fracture?

A

When a small chip of bone breaks away when a joint has dislocated

137
Q

What is a comminuted fracture?

A

It may be shattered, but there must only be three or more fragments for the fracture to be termed comminuted

138
Q

What is a compression fracture?

A

When compressing forces applied to both sides of the bone ends

139
Q

What is a stress fracture?

A

It occurs at sites of maximum stress, usually the metatarsal bones. The fracture is the result of repeated, relatively trivial trauma to an otherwise normal bone

140
Q

What are other names used for stress fracture?

A

fatigue or march fracture

141
Q

What is a pathologic fracture?

A

A fracture that occurs when normal stress is placed on diseased areas of bone

142
Q

What is a greenstick fracture?

A

A break in the cortex but on only one side of the shaft. This is a type of fissure fracture

143
Q

What is a plastic fracture?

A

A fracture that occurs when the soft young bone bends, but the cortex does not actually break

144
Q

What is displacement?

A

refers to the lateral positioning of the fragments

145
Q

What is dislocation?

A

The bones that form a joint no longer articulate

146
Q

What is subluxation?

A

Partial dislocation

147
Q

What is a Colles fracture?

A

Occurs when the distal radius fractures with the fragment being displaced posteriorly

148
Q

What is a boxers fracture?

A

Occurs at the neck of the fifth metacarpal

149
Q

What is a Bennett fracture

A

A fracture at the base of the first metacarpal (thumb) with proximal displacement

150
Q

What is a Pott fracture?

A

A bimalleolar fracture with an avulsion fracture of the medial malleolus caused by abductions and external rotation of the ankle

151
Q

What is a bimalleolar fracture?

A

Fracture of the lateral and medial malleoli

152
Q

What is a trimalleolar fracture?

A

A fracture of the lateral, medial, and posterior malleoli of the ankle

153
Q

How many bones is the skeletal system composed of?

A

206 bones

154
Q

How many bones is the axial skeleton composed of?

A

80 bones of the skull, spine, ribs & sternum

155
Q

How many bones is the appendicular skeleton composed of?

A

126 bones of the extremities, pectoral, and pelvic girdles

156
Q

What are the five types of bones?

A

Long, short, irregular, flat, sesamoid

157
Q

What type of tissue is bone?

A

connective

158
Q

What are bones covered with (outer layer)?

A

Periosteum

159
Q

What is the inner layer of bones made up of?

A

Osteoblasts

160
Q

What are osteoblasts associated with?

A

The production of bone

161
Q

What is beneath the inner layer of periosteum?

A

Cortical or compact bone

162
Q

What is below the cortical layer of bone?

A

The cancellous or spongy bone (honeycomb appearance)

163
Q

What is the name of the open canal that runs down the center of the diaphysis (shaft) of long bones and contains the bone marrow?

A

Medullary or marrow cavity

164
Q

What lines the marrow cavity?

A

Endosteum

165
Q

What are the two types of tissue found in the cavities of bones?

A

Red bone marrow and yellow bone marrow?

166
Q

Where is the red bone marrow found and what is its function?

A

It is found in the open areas of spongy bone and forms red blood cells

167
Q

Where is the yellow bone marrow found and what is its function?

A

Yellow bone marrow contains predominantly fat and is found in the marrow cavity of long bones

168
Q

What are the three types of joints?

A

Synarthrodial, amphiarthrodial, and diarthrodial

169
Q

Synarthrodial joinst are

A

immovable

170
Q

Amphiarthrodial joints are

A

slightly movable

171
Q

Diarthrodial joints are

A

freely movable

172
Q

What is ossification?

A

The process of bone replacing fibrous membranes and begins with the appearance of osteoblasts

173
Q

What are osteoblasts?

A

Bone-forming cells

174
Q

What do osteoblasts form?

A

Bone matrix

175
Q

What are osteoclasts?

A

Cells associated with the absorption and removal of bone. They “eat away” the inside of the marrow cavity white the osteoblasts build up the outside of the bone

176
Q

What are the main functions of the skeletal system?

A

Support, protection, movement, production of blood cells, & storage

Pathology Final (5 decks)

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