Brainscape's Knowledge GenomeTM

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


See full index

fall A 2024 > imaging final > Flashcards

imaging final Flashcards

1
Q

indications for imaging lumbar spine

A

trauma
pain radiating to legs
limitation in motion
planned or prior surgery
eval of primary/secondary malignancies
arthritis
osteoporosis
compression fractures
eval of kyphosis and scoliosis
suspected congenital anomalies and syndromes
eval of spinal abnormality seen on other imaging
follow-up of known abnormality
suspected spinal instability

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

lumbar spine projections

A

AP
lateral
right and left oblique
coned lateral view of lumbosacral articulation

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

right and left posterior oblique (Lspine)

A

right side structures on RPO
left side on LPO

posterior shows downside facet joints closest to image receptor

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

anterior oblique (Lspine)

A

shows upside facet joints farther from image receptor

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

R and L obliques need what to distinguish them

A

marker to determine left or right

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

scottie dog of oblique L-spine

A

nose - transverse process
eye - pedicle
ear - superior articular facet
foreleg - inferior articular facet
body - lamina and spinous process
tail - superior articular facet of opposite side
hind leg - inferior articular process of opposite side

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

what is best choice for imaging trauma at lumbar?

A

CT

TAP body scan

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

when is MRI indicated/not indicated in trauma at Lspine

A

in - if neural compromise
not - if CT is normal

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

predominate site for L spine vertebral fractures

A

thoracolumbar junction (T11-L2)

because they are transitional from fixed thoracic to mobile lumbar

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

spondylosis: definition and 3 causes

A

defect at pars interarticularis

congenial
traumatic
stress fracture by chronic strain (most common)

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

spondylolisthesis

A

forward displacement of vertebra on the one beneath it

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

retrolisthesis

A

posterior displacement on the one beneath it

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

incidence of spondylolisthesis

A

~5-10% of people
children and adolescents typically affected
lower lumbar levels most often involved - L4-L5 L5-S1

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

spondlylolisthesis can be the consequence of:

A

spondylolysis

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

spondlylolisthesis can result from:

A

congenital or developmental aberrations
pathological processes
degenerative changes

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

clinical presentation of spondlylolisthesis

A

pain after athletic activities
lumbar flexion reduces pain
palpation of SPs can reveal rotation of depression
SP sign correlated with radiologic findings to determine type

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

degenerative spondlylolisthesis

A

entire vertebra slips forward as a unit
~step off of Sp is below level of slip

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

fracture spondlylolisthesis

A

forward slip of vertebral body, pedicles, and superior articular processes

inferior processes, laminae and SPs remain in normal position
~step off is above level of slip

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

treatment of spondlylolisthesis

A

restriction of extension loads
flexion can be self-reducing and relieve pain
bracing
surgical fusion in cases of neurological compromise or persistent pain that does not respond to conservative

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

degenerative pathologies associated with lumbar spine

A

spinal stenosis
IVD herniations

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

DDD radiologic findings

A

decres disk space height
osteophytes at vertebral endplates
schmorl’s nodes
vacuum phenomenon

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

DJD radiologic findings

A

decres z joint space
sclerosis
osteophytosis at joint margins

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

spondylosis radiologic findings

A

osteophytes visible as readiodense irregularities at vertebral joint margins

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

spondylosis deformans radiologic findings

A

claw like spurs cupping towards IVD at more than one level

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

DISH radiologic findings

A

flowing ossification of at least four contiguous vertebrae
preservation of disk height and absence of DDD
absence of sacroiliitis or z joint DJD

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

lumbar stenosis

A

narrowing of spinal canal secondary to ST or bone enlargement

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

classification of lumbar stenosis

A

congenital
acquired
by anatomic region involved

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

congenital lumbar stenosis

A

achondroplasia
morquio’s syndrome
down’s
idiopathic stenosis

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

acquired lumbar stenosis

A

prior surgery
spondylolisthesis
infection
tumor
spinal deformity secondary to trauma
bulging og annulus
herniation of IVD posteriolaterally
PLL thickening
PLL ossification
hypertrophy of z joints
DJD of z joints
hypertrophy of ligamentum flavum
epidural fat deposition
spondylosis of vertebral joint margins
uncovertebral joint hypertrophy
metabolic/endocrine disorders

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

3 anatomical classifications of lumbar stenosis

A

central spinal canal
invertebral foramen
subarticular or lateral recesses

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

incidence of lumbar stenosis

A

1/4 of asymptomatic population under 40
most over 60 have some degree

symptomatic affects men > women 40-50 yo

central canal narrowing most prevalent at L4

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

etiology of degenerative stenosis

A

osteophytes at joint margins
bony hypertrophy of pedicles, laminae and z joints
IVD bulging
displacement of entire vertebra
thickening of ligamenta flava

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

normal AP diameter of spinal canal in adult men

A

cervical spine C3-C5: 17-18 mm
c-spine C5-C5: 12-14mm
T-spine: 12-14mm
L-spine: 15-27mm

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

clinical presentation of spinal stenosis

A

severe cases result in disability
most serious complication is central cord syndrome

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

central cord syndrome

A

incomplete spinal cord lesion associated with hyperextension injuries and results in proportionately greater loss of motor function to upper extremities than lower extremities with variable sensory sparing

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

cervical spine stenosis presents with

A

long tract and radicular signs
headaches
pain
radiating electric-like shock sensations elicited with cervical spine flexion

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

concurrent cervical and lumbar spinal stenosis can present with

A

gait disturbance
myelopathy
radiculopathy

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

lumbar spine stenosis presents with

A

diffuse unilateral or bilateral LBP and/or LE pain
numbness
weakness

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

simian stance

A

posture of trunk, hip and knee flexion

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

neurogenic claudication:

A

congestion of blood vessels at stenotic level
exacerbated by standing and spinal extension

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

vascular claudication

A

exacerbated by exercise and improved with standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

disk herniation differentiated clinically by aggravating factors:

A

pain by sitting, flexion, lifting, valsalva
relieved by walking
pain from spinal stenosis not affected by any of those maneuvers and aggravated with walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

diagnosis of pts with lumbar spinal stenosis

A

age 60-70 - 2
> 70 - 3
symptoms present > 6 months - 1
symptoms improve when bending forward - 2
symptoms improve when bending backward - -2
symptoms exacerbated while standing up - 2
intermittent claudication (+) - 1
urinary incontinence - 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

clinical bottom line for LSS

A

> 7 indicates a small meaningful shift in probability
< 2 indicated moderate shift that does not have LSS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what images significant for finding spinal stenosis?

A

conventional radiographs significant for exclusion or assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

advanced imaging in lumbar spine

A

CT - spinal stenosis
myelography - constriction of thecal sac
MRI - assessment of thecal sac and contents
SPECT - discriminating stenosis from medical disease, infections, tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

treatment of stenosis

A

analgesic medications
NSAIDs
epidural steroid injections
PT for strengthening and flexibility exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

IVD herniations

A

defined as extension of NP through AF and beyond adjacent vertebral margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

incidence of IVDH

A

most common in 25-45 yo
men > women
predominance in smokers, obsese, exposure to vehicular vibration

most common at lumbar spine - 90% at L4-L5
rare in thoracic spine
cervical IVDH occur at 90% frequency at C5-C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

clinical presentation of IVDH

A

cause LBP and referred or radicular pain
exacerbated with flexion, sitting and valsalva
nerve root pressure = loss of muscle strength
rarely cauda equina syndrome can develop - emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

history and physical examination data of cauda equina syndrome

A

urine retention
fecal incontinence
saddle anesthesia
sensory or motor deficits in the feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

radiologic findings of IVDH

A

unnecessary in first 4-6 weeks
20-30% are asymptomatic
many improve with conservative treatment in 4-6 weeks

imaging when conservative treatment fails
exceptions are CES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

advanced imaging for IVDH

A

myelography
CT myelography
diskography
CT
MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

treatment for IVDH

A

conservative measures
~PT
~analgesics
~short term bedrest
~restricted activities

only small percentage require surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

radiographic hallmarks at DJD at SI joint

A

decreased joint space
subchondral sclerosis
osteophyte formation at joint margins

only lower halves of joint space image represent synovial portion of joints

thus evaluation of DJD confined to lower half of joint space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

ankylosing spondylitis

A

inflammatory arthritis characterized by joint sclerosis and ligamentous ossification

manifests first in stiffness of SIJ and extends to L and T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

prevalence of ank spon

A

men affected seven times more than women
onset in 20s
early diag by blood work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

radiologic findings of ank spon

A

abnormal narrowing of upper half of SIJs
squaring-off of anterior borders of vertebral bodies

later, syndesmophytes form bridging vertebral bodies
known as bamboo spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

indications of hip radiologic examination

A

trauma
osseous changes secondary to metabolic disease
systemic disease or nutritional deficiencies
neoplasms
infections
arthropathies
preoperative, postoperative, follow up studies
congenital syndromes and developmental disorders
vascular lesions
evaluation of soft tissue
pain
correlation of abnormal skeletal findings on other imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

recommended projections of hip

A

AP and lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what is osseous pelvis evaluated with?

A

AP projection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

iliopectineal/iliopubic line

A

represents anterior column

line from sciatic notch to pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

ilioischial line

A

represents posterior column

line from iliac notch to inner surface of ischium representing posteromedial margin of quadrilateral surface of iliac bone

intersects teardrop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

anterior lip of ace

A

represents anterior wall of ace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

posterior lip of ace

A

represents posterior wall of ace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

acetabular roof

A

represents superior cortical aspect of ace cup
corresponds to major weight-bearing portion of ace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

anterior ace rim

A

represents anterior margins of ace cup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

posterior ace rim

A

represents posterior cortical rim of ace cup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

radiographic teardrop

A

seem on medial ace formed by cortical surfaces of pubic bone and ischium representing anteroinferior ace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

klein’s line

A

drawn along lateral femoral neck intersecting the femoral head bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

shenton’s hip line

A

should be possible to draw smooth curve along medial and superior surface of ob foramen to medial aspect of femoral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

iliofemoral line

A

smooth curve along outer surface of ilium that extends inferiorly along femoral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

femoral neck angle (angle of inclination)

A

intersection of line drawn through center of femoral shaft and line drawn through center of femoral neck

normal 130
coxa vara <130
coxa valga >130

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

DJD of hip

A

aka osteoarthritis

most common disease in the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

primary and secondary of DJD at hip

A

pri: developing without a clear precursor
sec: directly related to trauma or pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

secondary DJD caused by:

A

fracture
paget’s disease
epiphyseal disorders
congenital dislocation
AVN
other inflammatory arthritides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

clinical presentation of DJD in hip

A

progressive pain and loss of ROM
impaired ambulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

radiologic findings of DJD at hip

A

joint space narrowing
sclerotic subchondral bone
osteophyte formation at joint margins
cyst or pseudocyst formation
migration of femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what do cysts result from

A

degeneration of articular cartilage

loss of buffering effect results in microfractures
intrusion of synovial fluid into bone
show up as radiolucent lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what are cysts in acetabulum called?

A

egger’s cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

most common pattern of altered surface when femoral head migrates in DJD

A

superomedial to normal position

82
Q

treatment of DJD is designed with goals of:

A

decres pain
restoring flexibility and strength
reserving functional activities and amb with ADs to unload joint from full weight-bearing stresses

83
Q

surgical treatment of DJD

A

wedge osteotomy
femoral head and neck resection
hemiarthroplasty to replace fem head
total arthroplasty
hip resurfacing - young with goo bone density

84
Q

hip resurfacing

A

metal coating cemented over femoral head and metal liner impacted into ace
liner has coating to promote ingrowth of bone too further stabilize it

85
Q

rheumatoid arthritis of hip

A

progressive, systemic, autoimmune disease

3X more in women
onset most common in young adulthood

86
Q

clinical presentation of RA in hip

A

morning joint stiffness
bilateral and symmetrical swelling of joints
pain and functional disability
rheumatoid nodules
positive rheumatoid factor test
radiographic changes consistent with RA

87
Q

radiologic findings of RA in hip

A

osteoporosis of periarticular areas
symmetrical and concentric joint space narrowing
articular erosions
synovial cysts
periarticular swelling and joint effusions
axial migration of femoral head
acetabular protrusion

88
Q

where is osteoporosis first seen in hip?

A

femoral head

89
Q

what causes acetabular protrusion

A

concentric joint space narrowing promotes axial migration of femoral head into acetabulum

90
Q

best projection for synovial cysts

A

MRI

91
Q

distinct difference between DJD and RA in hip

A

RA has minimal or absent reparative process

sclerotic subcondral bone and osteophyte formation are not features of RA

92
Q

RA deformities

A

boutonniere deformity
swan neck deformity

93
Q

OA deformities

A

heberden’s node
bouchard’s node

94
Q

pharmacological treatments for RA

A

NSAIDs
coricosteroids
gold salts
immunosuppressive drugs

95
Q

conservative treatment for pain and disability for RA

A

rehab focuses on pain modalities, splinting, adaptive functional and amb devices, and exercise to promote strength/ROM to minimize deformity

96
Q

surgical treatment for RA

A

total arthroplasty

97
Q

AVN of femur

A

interruption of blood supply to femoral head causing bone tissue death

osteochondritis dissecans: local segment of bone
epiphyseal ischemic necrosis: affects entire epiphysis in growing child

98
Q

where is most common location for epiphyseal ischemic necrosis?

A

proximal femur

99
Q

three categories of AVN

A

compression or disruption
blood vessel occlusion
blood vessel blockage

100
Q

causes of epiphyseal ischemic necrosis at femoral head

A

called legg-calve-perthes disease
seen in young boys around 6 yo
idiopathic AVN

101
Q

clinical presentation of LCP

A

synovitis or inflammatory response of hip joint
non-specific dull pain in joint, thigh, leg
adults exhibit limited joint motion and progressive painful limp
children exhibit painless, slowly evolving limp
~waddling type gait

102
Q

radiologic findings of LCP

A

appear normal for several weeks
one of first signs: radiolucent crescent

crescent parallel to superior rim of femoral head subjacent to articular surface

103
Q

what are characteristic signs of initial necrotic processes?

A

sclerosis and cyst formation at femoral head

104
Q

radiographic findings of advanced AVN?

A

femoral head collapses or appears flattened
entire femoral head becomes more radio-dense
at advanced stage, joint is compromised

105
Q

what do radionuclide bone scans identify?

A

increased uptake at sit of lesion soon after injury

106
Q

what is the most appropriate study for early diagnosing AVN?

A

MRI

107
Q

when is conservative treatment of AVN most successful? (hip)

A

in younger pts.
they possess healthier, more adaptable blood supply

108
Q

how to revascularize AVN with conservative treatment? (hip)

A

prolonged avoidance of weight bearing
traction
bracing
casting
exercise

109
Q

surgical treatment of AVN at hip

A

drilling into femoral head to quicken revas
grafting healthy bone into drill hole to assist repair
varus derotation osetotomy
last resort - joint replacement

110
Q

ottawa knee rules

A

age greater than or equal to 55
isolated patella tenderness
tenderness at head of fibula
inability to bear weight immediately after

111
Q

pittsburgh knee rules

A

fall or blunt trauma
age <12 or >50 - immediate yes
not able to walk four weight bearing steps

112
Q

which knee rules more specific

A

pittsburgh

113
Q

images ordered at knee if

A

joint effusion after blow
inability to walk without limping
palpable tenderness over patella or fibular head
inability to flex to 90

114
Q

isolated meniscal tears present with

A

intermittent clicking and eventually blocking of motion
effusion
pain

115
Q

how are menisci seen on MRI?

A

low intensity
tears are high intensty

116
Q

most common meniscal tear

A

vertical

117
Q

bucket tear (meniscus)

A

longitudinal extension of vertical tear

118
Q

meniscal tears in older pop

A

usually horizontally oriented

119
Q

clinical presentation of tear of collateral ligs

A

pain
joint effusion
instability

120
Q

LCL MOI

A

varus force

121
Q

MCL MOI

A

valgus force
associated with medial meniscus tear

122
Q

O’Donoghue’s terrible triad

A

MCL
med meniscus
ACL

123
Q

most revealing image for knee ligaments

A

T2 MRI

124
Q

how do ligs look on T2 MRI

A

low intensity
abrupt discontinuity would show lig tear

125
Q

tears of cruciate ligs (women vs men)

A

women affected 8x more than men in same activities

126
Q

PCL MOI

A

external forces that strike anterior aspect of knee

127
Q

ACL MOI

A

non-contact forces that place great valgus and rotary stresses on knee
hears pop of rupture

128
Q

best image for cruciate ligs

A

sagittal MRI

129
Q

what is the most frequently injured joint?

A

ankle
only small percentage actually have a fracture

130
Q

ottawa ankle rules

A

unable to bear weight
point tenderness in malleolar zone, mid-foot, base of fifth MT, or navicular

100% sensitive

131
Q

adavanced imaging for ankle when:

A

plain insufficient to guide treatment
after radio findings are neg when further injury suspected

132
Q

what percentage of all ankle sprains are inversion?

A

85%

133
Q

larger mag inversion sprains associated with:

A

lig rupture or avulsion
ankle instability
functional impairment

134
Q

what ligs do inversion stresses sprain?

A

LCL
anterior tibfib
calcaneofib

without bony involvement

135
Q

spectrum of injuries from inversion stresses

A

LCL sprain
LCL rupture
transverse fracture of lateral malleolus
fracture of med mall with rupture of LCL

136
Q

eversion sprains

A

stress MCL

associated with bony damage

137
Q

spectrum of injuries from eversion stresses

A

MCL sprain
MCL rupture
med mall fracture
lat mal fracture with MCL rupture

138
Q

other structures that sever sprains can disrupt

A

avulsion fractures pull ligs at attachments
tearing of dis tibfib syndesmotic complex
instability- tearing ligs

139
Q

when is radio image needed in ankle

A

fracture is suspected

140
Q

maisonneuve fracture

A

insterosseous membrane involved and sprial fracture at prox fib

141
Q

treatment of ankle sprain

A

restore stability

142
Q

ankle fractures are in combo with:

A

lig rupture
avulsions
other fractures

143
Q

ankel fracture MOI

A

axial or rotational loading

144
Q

factors determining injury pattern in ankle fracture

A

instability
age
bone density
comorbidity to ST
position of foot at time of loading
mag, direction, rate of loading

145
Q

unimalleolar

A

indicating fracture of either lat or mad malleolus

146
Q

bimalleolar

A

fracture of both lat and med mall

147
Q

trimalleolar

A

both malleoli and post tib

148
Q

how to image stress fractures

A

MRI

149
Q

treatment of ankle fractures

A

stabilize
immobilize or surgery

150
Q

complications of ankle fractures

A

non-union or degen joint changes

151
Q

frequency of talar fractures

A

second to calcaneal

152
Q

MOI of talar fractures

A

dorsiflexed foot
ex. slam on breaks in collision

153
Q

interarticular fractures

A

almost all because 3/5 of talus covered art cart

154
Q

radio eval of talus fracture

A

plain films good most of the time
CT or MRI with plain neg or pre-op

154
Q

treatment of talus fracture

A

non-op - short leg cast for 8-12 weeks, NWB 6 weeks
op - often ORIF

155
Q

complications of talus fracture

A

post traumatic arthritis of ankle and subtalar
bad blood supply because no muscle attach to it
predisposed to AVN

156
Q

osteochondral defect

A

focal areas of articular damage and injury of adjacent subchondral bone

157
Q

osteochondritis dissecans

A

dur to repeated microtrauma
result of aseptic separation of osetochondral fragment

2:1 male to female ratio

158
Q

location of osteochondral defect

A

femoral condyle
humeral head
talus
capitulum of humerus

159
Q

clinical presentation osteochondritis dissecans

A

asymptomatic to sig pain and locking
joint effusion and synovitis present

160
Q

treatment of osteochondritis dissecans

A

spontaneous healing unless there is an unstable fragment

results are only fair

161
Q

accessory bones in foot

A

form due to failure of ossification centers
30% of adults
not always symmetrical
increased density

162
Q

describe protection and stability of shoulder

A

less mechanical protection and less bony stability than any other large joint

163
Q

MRI for acute shoulder pain when?

A

initial radiographs normal
RC pathology, instability or labral tears suspected

164
Q

when is shoulder CT recommended?

A

if MRI unavailable or contraindicated

165
Q

RC MOI

A

GH dislocation
FOOSH
forceful abduction of arm
impingement

166
Q

most common RC tear

A

involves hypovascular critical zone in supraspinatus 1 cm above insertion

167
Q

predictor variables for impingement syndrome

A

positive hawkins-kennedy impingement sign
positive painful arc sign
positive infraspinatus muscle strength test

168
Q

predictor variables for full thickness RC tear

A

positive painful arc sign
positive infraspinatus muscle strength test
positive drop arm test

169
Q

past radio eval of RC tears

A

arthrography

intact- contrast confined to joint capsule
complete tear- contrast travels up to bursa

170
Q

present radio eval of RC tears

A

MRI - more info and noninvasive
US

171
Q

changes secondary to RC tears

A

irregularity of greater tuberosity
narrowing of distance between acromion and hum head
erosion of inferior aspect of acromion

172
Q

conservative treatment if RC tears

A

rest
NSAIDs
cortison injections

most need surgery

173
Q

complications of RC tear

A

degen changes at GH and AC
failure to regain full ROM and strength following surgery

174
Q

SICK scapula

A

scapular malposition
inferior medial border
coracoid pain and malposition
dyskinesis of scapula

175
Q

SICK scapula symptoms

A

postero-superior scapular pain
anterior shoulder pain
proximal shoulder pain
c spine pain
TOS

176
Q

three types of dyskinesis

A

1: inferior medial scapular prominence
2: medial scapular border prominence
3: superomedial border prominence

177
Q

which types of dyskinesis associated with SLAP lesions

A

1 and 2

178
Q

which type of dyskinesis associated with impingement and RC lesions

A

3

179
Q

two basic functions of labrum

A

deepen glenoid fossa
attachment points for ligaments and biceps tendon

180
Q

symptoms of labral tear

A

pain with overhead movements
clicking or catching
instability

181
Q

MOI of labral tear

A

dislocation
forceful lifting
FOOSH
repetitive movements

182
Q

most appropriate procedure to assess instability and labral tears

A

MR arthrography
CT arthrogrphy is second choice

183
Q

treatment of labral tears

A

most heal conservatively because of rich oxygen supply

184
Q

what labral tears require surgery

A

avulsions to glenoid rim
debride minor tears
biceps tenodesis - changes insertion of biceps

185
Q

silhouette sign

A

loss of normal interference between air and ST
can localize lesion to a specific lobe of lung

186
Q

cardiothoracic ratio

A

estimate of heart size
in adults, width of heart should be less than half of width of chest at level of diaphragm

187
Q

mediastinum

A

space between lungs

188
Q

hilum (lung root)

A

where bronchi, arteries, veins, and nerves enter and exit lungs

189
Q

diaphragm

A

separates abdominal cavity from thoracic cavity
seen at 10th intercostal space

190
Q

costophrenic angles

A

sharply pointed downward indentations between each hemidiaphragm and adjacent chest wall

191
Q

routine chest exam

A

erect PA
erect left lateral during full inspiration

192
Q

PA chest

A

view from apices down to costophrenic angles

193
Q

lateral chest

A

from sternum anteriorly to posterior ribs

194
Q

diagnostic categories

A

lung field abnormally white
lung field abnormally black
mediastinum abnormally wide
heart abnormally shaped

195
Q

when is lung field abnormally white

A

pneumonia

water density consolidation
silhouette sign
air bronchogram signs

196
Q

when is lung field abnormally black

A

pneumothorax

common following penetrating chest wounds
affected lung field appear black
deep sulcus sign
mediastinal shift from radiolucent lung field

197
Q

when is mediastinum abnormally wide

A

aortic dissection - tear in inner layer of aorta
most common site in ascending aorta

198
Q

other signs of aortic dissection

A

obliteration of normal arch shape
downward slant of left main bronchus
tracheal deviation to right

199
Q

when is heart abnormally shaped

A

congestive heart failure

vascular redistribution
kerley b lines
peribronchial cuffing
pleural effusion
bat wing or butterfly pattern

fall A 2024 (10 decks)

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