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MSK 1 > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Purpose of Bone:

A

Storage of Ca+ + (In form of CaPO4).

Protection of vital organs.

Support for body and mechanical basis for movement.

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2
Q

what are the two forms of bone growth

A

intramembranous ossification or endochondral ossification (chondrification)

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3
Q

Intramembranous ossification

A

Direct ossification of the mesynchyme

Occurs during the embryonic period within the mesynchymal tissue, without prior cartilage formation

Formation of the periosteum

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4
Q

endochondral ossification

A

Mesenchyme is chondrified into a cartilaginous bone model

Bone forms later by replacing the membranous model with calcified cartilage

Occurs only in the presence of blood supply

Advances the ends of the cartilaginous model

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5
Q

when do Secondary centers of ossification form

A

Birth

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6
Q

where do long bone grow from

A

growth at the epiphysis

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7
Q

where do short bones grow from

A

growth plate for entire bone

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8
Q

The length of bone increases only by

A

Interstitial growth within the cartilage
Endochondral ossification

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9
Q

epiphysis and metaphysis movement

A

Interstitial growth of cartilage moves epiphysis further from metaphysis

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10
Q

Calcification

A

death and replacement of cartilage (endochondral ossification)

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11
Q

What is Appositional Growth:

A

growth in width

Activity of the osetoblasts

Located in the deep layer of the periosteum

Intramembranous ossification

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12
Q

what is Interstitial growth

A

increase in the length of bones

Endochondral ossification

Growth at the metaphysis and diaphysis of a long bone

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13
Q

Four Zones of the epiphyseal plate

A

Zone of resting cartilage

Zone of young proliferation

Zone of maturing cartilage

Zone of calcifying cartilage

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14
Q

Zone of resting cartilage

A

Anchors the epiphyseal plate to the epiphysis
Contains immature chondrocytes and delicate vessels

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15
Q

Zone of young proliferation

A

Site of the most active interstitial growth

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16
Q

Zone of maturing cartilage

A

Enlargement and maturation of the cartilage cells near the metaphysis

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17
Q

Zone of calcifying cartilage

A

Structurally the weakest zone

Active boney deposition on the metaphysis

Were the cells are ossifying – weakness

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18
Q

what are Chondrocytes

A

cells that produce the cellular matrix and eventually differentiate into osteoblasts (secrete osteoid which hardens to new bone)

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19
Q

why does Bone Growth and Remodeling occur

A

Occurs because of the growth of long bones

Occurs due to factors that demand removal of calcium from the bone
Occurs because the Haversian systems are continually being eroded

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20
Q

how is Bone Balance maintained

A

Bone balance is the result of osteoblastic vs. osteoclastic activity

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21
Q

Juvenile has a + or - bone balance

A

postive

Lay down more bone

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22
Q

Geriatric has a + or - bone balance

A

negative

Absorbing more bone

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23
Q

Wolff’s Law

A

(Law of Physical Stress)

Bone is deposited in sites subjected to increased stress

Bone is resorbed from sites of decreased stress

Alignment of trabecular systems is along the lines of stress

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24
Q

on a curved bone which side is more bone laid down on vex or cave

A

Marked cortical thickening is observed on the concave (compressive) side of a curved bone

Electrical properties of bone (-) on the concave side (deposition) (+) on the convex side (resorption)

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25
Long
Tubular (e.g. Humerus and Femur) have a body and 2 ends
26
Short
Cuboidal (e.g. Carpals and Tarsals) found only in the foot or wrist
27
Flat
Protective function (e.g. bones of cranial vault) help to form the walls of cavities
28
Irregular
Bones of the face
29
Sesamoid
Protect tendons from wearing (e.g. patella) (resembled sesame seeds)
30
where are RBC formed
bone marrow
31
Compact Bone
(Cortical) Very dense, little space Highly organized lamellar network of fibers, packaged in osteons. Fibers in each layer or osteon oriented in different directions
32
Trabecular Bone
Cancellous Less dense, more space than compact More metabolically active Contain blood vessels, nerve fibers and fat Hemopoietic tissue Flat bones, metaphyseal regions of long bones More flexible
33
Mechanical Properties of Bone
Must deal with various types of loading
34
types of loading that bones deal with
Compression, Tension, Torsion, Shear
35
where is compression felt
Compression is felt on every bone because of gravity (weight bearing)
36
what can take some of the tension force felt by bone away
muscles
37
Bending Mechanisms: Tension Failure
Transverse Fractures Greenstick Fractures Oblique Fractures
38
transverse, greenstick, oblique - which one heal the best
oblique - This heals because the is more SA and more area for blast and clast to lay down Greenstick - Will heal better because the periosteal sheath is still intact transverse: Hard to heal
39
Twisting Failure due to what kind of movement
torsion
40
Traction Failure leads to what kind of fracture
Avulsion fracture
41
Compression Failure leads to what kind of fracture
compressive fracture
42
what is Torus fractures
buckle fracture
43
What is the most common frx in lower forearm in young children
Torus (buckle) frxs of distal metaphysis of radius & ulna FOOSH
44
Salter-Harris fracture
fracture that can occur to a growth plate
45
Salter-Harris Classification type 1
Plane of separation along the epiphyseal plate through the zone of cartilage transformation
46
type 1 blood supply and future growth
Blood supply intact and future growth is normal
47
Type 1 is cause by
Usually produced by a shearing type force
48
type 1 periosteum
Periosteal attachments will sometimes remain intact
49
Salter-Harris Classification type 2
Most common (75%) Fracture extends across the corner of metaphysis
50
Type 2 healing and blood
Future growth is considered normal because blood supply remains intact
51
type 2 peri
Periosteal hinge remains intact
52
Salter-Harris Classification type 3
Rare This is an intra-articular fracture extending from the physis into the epiphysis Usually occurs at distal tibia
53
type 3 future growth
Future growth usually normal but displaced fractures produce an irregular articular surface
54
Salter-Harris Classification type 4
Intra-articular fracture that extends throught the epiphyseal plate and into the metaphysis
55
type 4 future growth
ORIF with “perfect” fixation needed to have any chance at union May lead to nonunion/malunion with progressive disturbance of growth
56
Salter-Harris Classification type 5
Crushing injuries, jumping from heights Diagnosis is difficult secondary to lack of displacement
57
type 5 blood supply and future growth
May lead to permanent damage with a complete or partial cessation of growth leading to limb length discrepancy and deformity
58
intraarticular fracture
a fracture that crosses a joint surface
59
agulated fracture
The two ends of the broken bone are at an angle to each other
60
Fracture translation
the movement of fractured bones away from each other
61
distracted fracture
A fracture resulting in increased overall bone length, is due to distraction (widening) of the bone components.
62
Overriding–
A displaced fracture where the bone fragments overlap
63
Callus
A soft callus (a type of soft bone) replaces the blood clot that formed in the inflammatory stage The callus holds the bone together, but isn't strong enough for the body part to be used
64
Application of weight bearing in remodeling stage of fracture healing is good or bad
good for healing will grow stringer in the direction of compressive loads
65
factors that effect fracture healing time
Age of the Patient Site and Configuration of the Fracture Initial Displacement of the Fracture Blood Supply to Fracture Fragments
66
age and fracture healing
Younger Patients Heal Faster Intact CV system More metabolic activity
67
Bones surrounded by muscle vs. bones that lie subcutaneously or within joints- which heal faster
Bones surrounded by muscle heal faster than bones that lie subcutaneously or within joints because of blood supply
68
Cancellous bone healing vs. compact bone
Cancellous bone heals faster than compact bone less structure
69
Epiphyseal separations vs. epiphyseal fractures healing
Epiphyseal separations heal faster than epiphyseal fractures
70
Non-displaced vs. displaced fractures healing rate
Non-displaced fractures with intact periosteal sleeve heal twice as fast as displaced fractures. The greater the displacement, the longer the healing time
71
Reduced vascularization and non-union.
Reduced vascularization increases risk of non-union.
72
what are Nonunion fracture
Fractures that still allow free movement of the bone ends at 3-4 months after injury demonstrate delayed union are classified as hypervascular (hypertrophic) or avascular (atrophic) based upon their capability of biologic reaction (vitality of the bone ends).
73
Reduced vascularization realtionship with avascular necrosis
Reduced vascularization increases risk of avascular necrosis
74
Avascular necrosis is most common where
more common with intra-articular fractures, especially of the femoral head/neck, femoral condyles, proximal and talar neck.
75
when do you use Protection Alone
Sling Undisplaced stable fractures of ribs, phalanges, metacarpals, clavicle (in children) Mild compression fractures of spine Impaction fracture of proximal humerus
76
when do you use Immobilization by External Splinting without Reduction
Undisplaced but unstable fracture
77
what is External Splinting without Reduction
Relative immobilization: can still move other aspects of the extremity. Casts, splints
78
Closed Reduction followed by immobilization
Displaced fracture where surgeon predicts reduction can be done accurately and maintained without need for surgery.
79
Closed Reduction with External Fixation
Severely comminuted unstable fractures Open fractures with extensive soft tissue damage including arteries and nerves
80
Closed Reduction with Internal Fixation
Can reduce fracture without surgery but cannot maintain it with immobilization Unstable fracture of femoral neck Place pins and screws after reduction is achieved.
81
Open Reduction Internal Fixation (ORIF)
Used when closed reduction is impossible Displace avulsion fractures, intra-articular fractures Soft tissue entrapment in fracture Displaced fracture crossing epiphyseal plate in children.
82
fever may be a sign of
infection
83
Persistent signs of inflammation around the joint of the fracture may be a sign of
infection
84
Radiodensity
Refers to the amount of radiation an object absorbs.
85
Radiopaque
Easily absorbs radiation therefore they are more radiant dense
86
Radiolucent
Easily penetrated by radiation, less dense and permit the x-ray beam to pass through them
87
Air in Xray
black
88
Fat in x ray
– Gray black
89
water in x ray
Gray
90
bone in x ray
White
91
contrast media in x ray
White outline
92
in x ray does the density of an object matter
yes, think of block of cheese
93
Arthrogram
inject the body with heavy metals Detailed view of what's happening inside your joints Improves visualization
94
Myelogram
Spine – Subarachnoid space where it mixes with CSF Look for problems in the spinal canal
95
Discogram
Nucleus:  contrast liquid is injected into the center of one or more spinal discs   Back pain
96
Arteriogram
X ray of Specific Vessels
97
CT Scans
radiography that gives slices of the body Provides greater visualization of soft tissue but can’t pick up histological changes.
98
MRI T1
Shorter time between pulses T1 images distinguish fat from CSF or those with high water content Soft tissue appears gray
99
MRI T2
Longer time between pulses Fat and CSF are both hyper-intense, but fat can be suppressed Muscle injury will appear bright with it’s increase in water content
100
what is T1 good at showing
the difference in fluid from fat
101
what is T2 good at showing
“fat surpressed” and shows clearer visualization of discs and the fluid muscle injury with show bright because of the swelling

MSK 1 (14 decks)

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