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Diagnostic Imaging I Exam One > Congenital Anomalies 1 > Flashcards

Congenital Anomalies 1 Flashcards

1
Q

What term is used for the underdevelopment of anatomy?

A

Hypoplasia

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2
Q

What term is used for the overdevelopment of anatomy?

A

Hyperplasia

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3
Q

What term is used for the absence of development of anatomy?

A

Aplasia

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4
Q

What term is used for the increased size of anatomy due to pathology?

A

Hypertrophy

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5
Q

What term is used for the increased size of anatomy from development?

A

Hyperplasia

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6
Q

What type of ossification occurs from a cartilage model formed from mesenchyme? Examples?

A

Enchondral ossification (extremities, spine, base of skull)

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7
Q

What type of ossification occurs when bone tissue replaces membranous fibrous tissue? Example?

A

Intramembranous ossification (skull)

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8
Q

What are the primary ossification centers of a vertebra?

A

One for centrum, two for each neural arch (3 total)

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9
Q

When are primary ossification centers present? Secondary?

A 
Primary = before birth
Secondary = after birth
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10
Q

What is the difference between an epiphysis and apophysis?

A 
Epiphysis = forms articular cartilage and gives length to bone
Apophysis = attachment for ligaments and tendons
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11
Q

Is a trochanter is an example of an apophysis or epiphysis?

A

Apophysis

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12
Q

What is the condition of the failure of separation of the most cranial somites?

A

Occipitalization (assimilation of atlas)

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13
Q

50% of those with occipitalization of atlas also have vertebral fusion at what level?

A

C2/C3

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14
Q

Since the odontoid process is high with occipitalization, is basically impression common?

A

No

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15
Q

What other films must be done when occipitalization is seen on the lateral X-ray?

A

Flexion/extension (assess ADI)

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16
Q

What are the areas of compensation for agenesis of the posterior arch of C1?

A

1 enlarged spinous of C2

2 hypertrophy of anterior tubercle

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17
Q

What is the condition where the posterior arch of C1 never developed due to a defect in the cartilage template?

A

Agenesis posterior arch

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18
Q

What must be done next when agenesis posterior arch is seen?

A

Flexion/extension views to check transverse atlantal ligament and to see if C1 and C2 are fused

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19
Q

Why does the anterior tubercle become larger with agenesis posterior arch?

A

Stress is shifted anteriorly from behind

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20
Q

What is the condition of spina bifida at C1?

A

Non union of the posterior arch of C1

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21
Q

Why can we still adjust on the posterior arch of C1 if there is a non union?

A

“hole” is mostly likely made out of cartilage and sturdy

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22
Q

What normal finding would be absent on the lateral cervical film with a non union of the posterior arch of C1?

A

Spinolaminar line

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23
Q

What area will compensate by increasing in size following a non union of the posterior arch of C1?

A

Anterior tubercle

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24
Q

What is the most common reason for a terribly large ADI?

A

Rheumatoid arthritis

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25
Q

What is the term for a small piece of bone that grows separately but near the anterior tubercle of C1 that is well corticated?

A

Accessory ossicle

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26
Q

Chiari malformations tend to lead to anomalies specific to what organ system?

A

Renal

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27
Q

What is a Chiari malformation?

A

Herniation of the cerebellar tonsils

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28
Q

Herniation of the cerebellar tonsils less than how many millimeters is considered within normal limits?

A

3mm

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29
Q

Chiari malformation is associated with what kind of spinal curvature?

A

“wrong way” scoliosis (different from the right thoracic norm)

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30
Q

Which is more clinically significant of a serious pathology: right or left scoliotic curve?

A

Left curve

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31
Q

What is the term for a cystic cavity in the spinal cord that tends to develop following an Chiari malformation?

A

Syrinx/syringomyelia

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32
Q

If a left curvature is seen upon X-ray, what should be the next move?

A 
Adults = MRI if neurological symptoms are present
Children = always do MRI
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33
Q

What would the treatment be for syringomyelia?

A

Laminectomy to relieve cord pressure

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34
Q

What is the eponym for a posterior ponticle?

A

Kimmerly anomaly

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35
Q

What ligament is ossified to form the ponticulus posticus?

A

Atlanta-occipital ligament between posterior aspect of lateral mass and posterior arch

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36
Q

What structures are contained in the arcuate foramen?

A

Vertebral artery and first cervical nerve

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37
Q

What is a bony extension originating from the transverse process of C1 to the skull base?

A

Epitransverse process

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38
Q

What is a bony extension originating from the skull base to the transverse process area of C1?

A

Paracondylar process

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39
Q

What is the significance of an epitransverse or paracondylar process?

A

1 possible lateral head tilt

2 may affect adjusting technique

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40
Q

What is os terminale?

A

Failure of the UNION of the secondary center of ossification found at the TIP of the dens

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41
Q

What is os odontoideum?

A

Failure of FUSION of the odontoid with the body of C2

42
Q

When in age is os terminale usually seen?

A

After the age of 12

43
Q

How can you differentiate between os terminale and a fracture?

A

Smooth, white margins = os terminale

44
Q

Which is associated with hypermobility: os terminale or os odontoideum?

A

Os odontoideum

45
Q

Why is hypermobility associated with os odontoideum?

A

Dens isn’t there to restrict the transverse atlantal ligament

46
Q

What other conditions are associated with os odontoideum?

A

1 Down’s syndrome

2 Klippel-Feil syndrome

47
Q

How can we assess for atlanto-axial stability especially in cases like an os odontoideum?

A

Flexion/extension views

48
Q

Most os odontoideum are a result of what prior condition?

A

Old un-united odontoid fracture

49
Q

Are most old un-united odontoid fractures an os odontoideum?

A

No

50
Q

What kinds of neurological symptoms can be present with an os odontoideum?

A

Cerebellar/gait issues, upper motor neuron findings like hyperreflexia

51
Q

What are the most common areas for block vertebrae?

A

C5/C6
C2/C3
L4/L5

52
Q

How can you tell a block vertebra from a fusion derived from infection?

A

Maintenance of vertebral body height with block vertebra

53
Q

What is the term for the smooth, concave anterior vertebral body margins seen with block vertebra?

A

Wasp waist vertebra

54
Q

How is the IVD affected by block vertebra?

A

Hypoplastic

55
Q

What structures become visible on a lateral X-ray with block vertebra that are usually only seen on cervical obliques?

A

IVFs

56
Q

What are the four diagnostic criteria for block vertebra?

A

1 wasp waist configuration
2 hypoplastic IVD
3 IVFs visible on lateral X-ray
4 posterior elements also fused

57
Q

How can block vertebra change mobility?

A

Hypo at area of blocking, therefore hyper above and below the area

58
Q

What is the term for congenital fusion? Fusion from pathology? Fusion from surgery?

A 
Congenital = synostosis
Pathology = ankylosis
Surgery = arthrodesis
59
Q

What condition involves multiple block anomalies in the cervical spine?

A

Klippel-Feil syndrome

60
Q

Klippel-Feil syndrome is associated with anomalies of what organ system in 50% of cases?

A

Renal

61
Q

What is the unique appearance of the neck associated with Klippel-Feil syndrome?

A

Short, webbed neck (pterygium colli)

62
Q

How is the appearance of the hair different in those with Klippel-Feil syndrome?

A

Low hairline

63
Q

What other conditions or abnormalities are associated with Klippel-Feil syndrome?

A

1 renal anomalies
2 deafness
3 spinal cord issues like chiari
4 Sprengel’s deformity

64
Q

What is Sprengel’s deformity?

A

Failure of a scapula to descend (appears elevated)

65
Q

Horseshoe kidney is seen in patients with what cervical spine anomaly?

A

Klippel-Feil syndrome

66
Q

What structures appear massive in the cervical spine due to Klippel-Feil syndrome along with anterior body scalloping?

A

IVFs

67
Q

What gender is more likely to have Sprengel’s deformity?

A

Females (usually unilateral)

68
Q

What is the piece of bone that can run from the superomedial border of the scapula to the spinous processes, transverses, or laminae of C4-C7?

A

Omovertebral bone

69
Q

Omovertebral bones are found in 35% of cases of what other underlying condition?

A

Sprengel’s deformity

70
Q

A finding of an elongated transverse of C7 occurs when it extends beyond what structure?

A

Transverse of T1

71
Q

What forms when elongated transverses of C7 join?

A

Cervical rib

72
Q

Which gender is more likely to have cervical ribs?

A

Females

73
Q

What is the significance of cervical ribs (although normally asymptomatic)?

A

Thoracic outlet syndrome (especially in older patients)

74
Q

Cervical ribs can be palpated and confused with what other structure?

A

Enlarged lymph nodes

75
Q

Why do cervical ribs have symptomatology more in older patients?

A

Drooped posture of shoulders

76
Q

How do pedicles change in a segment exhibiting butterfly vertebra?

A

Become wider

77
Q

How do the vertebrae above and below a segment exhibiting butterfly vertebra change to compensate?

A

Round into the curved space

78
Q

What causes a butterfly vertebra?

A

Failure of fusion of lateral halves secondary to persistence of notochord tissue

79
Q

In what areas of the spine are butterfly vertebrae most common?

A

Thoracics and lumbars

80
Q

Can we adjust butterfly vertebrae?

A

YES (if no hypermobility persists)

81
Q

How do pedicles differ in the lumbar spine?

A

Become wider as you descend

82
Q

What are the only two conditions that can cause pedicle shadows of a segment above to be wider than the segment below?

A

1 burst fracture

2 butterfly vertebra

83
Q

What type of segment forms when there is a lack of formation of one half of a vertebral body?

A

Hemivertebra

84
Q

What type of curvature can be caused by hemivertebra?

A

Structural scoliosis (usually 2 or more on the same side)

85
Q

Hemivertebrae are associated with what other congenital anomaly?

A

Block vertebra

86
Q

Which progress more: segmented or nonsegmented hemivertebra?

A

Segmented

87
Q

Why are extra ribs a potential complication from hemivertebrae?

A

Possible aberrant respiration

88
Q

In what region of the spine are Schmorl nodes more common?

A

Thoracics and lumbars

89
Q

What causes Schmorl nodes?

A

Nucleus pulposus herniates through vertebral end plates

90
Q

Giant Schmorl nodes are associated with what conditions?

A

1 degenerative disc disease
2 vacuum phenomenon
3 elongation of vertebral bodies

91
Q

What is the other term for juvenile discogenic disease involving multiple Schmorl nodes?

A

Scheuermann’s disease

92
Q

What causes a limbus vertebra?

A

Herniation of the nucleus pulpous through secondary growth centers (appear as free fragment at margin of body)

93
Q

Where in the spine are limbus vertebrae most common?

A

Lumbars

94
Q

Why is it easy to differentiate a limbus vertebra in the lumbars from a vertebral body avulsion fracture?

A

Avulsion = less common (also history)

95
Q

Limbus vertebrae are associated with what condition?

A

Scheuermann’s disease

96
Q

Cupid’s bow contour is seen with what condition?

A

Nuclear impression (notochordal persistance)

97
Q

On what X-ray film can Cupid’s bow contour be seen?

A

A-P

98
Q

What serious compilation can arise from significant spina bifida?

A

Meningocele (protrusion of meninges)

99
Q

What is the most common location for spina bifida occulta?

A

L5/S1

100
Q

Should spina bifida occult be considered in radiographic pre-employment screening?

A

NO

Diagnostic Imaging I Exam One (5 decks)

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