Lecture 1- Dr. Sernda

Question 1

What is radiography?
What is based on?

Answer 1

• X-rays
• Based on selective absorption of the x-ray beam

Question 2

What does the radiopaque appear as? Radiolucent?

Answer 2

• Radiopaque (radiodense) structures appear white-> bone and it is denser
• Radiolucent structures appear black-> Air and it is lighter

Question 3

Other structures appear as different shades of gray based on what?

Answer 3

Other structures appear as different shades of gray based on their ability to absorb radiation

Question 4

Answer 4

Question 5

How would lungs look in x-ray?

Answer 5

Question 6

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Question 7

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Question 8

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Question 9

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Question 10

Answer 10

Question 11

Point out all the organs, major muscle and strucutes

Answer 11

Question 12

Arteriogram/venograms are what?

Answer 12

Intra-arterial or intravenous contrast material used

* Ingested contrast can also work

Question 13

What is tomography? How does it work?

Answer 13

• Image is made with both the x-ray tube and the film moving at the same time
• The effect is the ability to image different slices of the body, aka Body Section Radiography
• X-ray source moves in one direction as the film is moved in the opposite direction, thus showing detail in a predetermined plane of tissue while blurring or eliminating detail
  in other planes

Question 14

Answer 14

Question 15

How is this viewed?

Answer 15

Viewed from below as looking towards head

Question 16

What plane are we looking at?

Answer 16

Sagittal plane->Looking at patient from the left side

Question 17

Answer 17

Question 18

Magnetic Resonance Imaging:
* What is it? How does it work?

Answer 18

Question 19

What the ultrasound based on?

Answer 19

Based on directing high frequency sound waves into the patient, and recording the manner in which sound is absorbed or reflected from organs and structures

Question 20

In ultrasound, what is the echogenicity?

Answer 20

• Solid structures appear white (echogenic, or hyperechoic)
• Cystic structures appear black (echolucent, hypoechoic or anechoic)

Question 21

What is used for blood flow?

Answer 21

Question 22

• What is nuclear medicine based on?
• How does it work?

Answer 22

Question 23

Scoliosis:
* What is it?
* How do you visualize it?
* What is most common?

Answer 23

• Abnormal curvature of spine
• Typically visualized in frontal plane
• Adolescent idiopathic type is most common

Question 24

What are the four natural curves in the vertebral column?

Answer 24

Question 25

Scoliosis: * Clinical presentations? * How do you diagnosis? * Treatment?

Answer 25

* Clinical Presentation – Uneven shoulders/waist – Back pain * Diagnosis – Cobb angle or Adams forward bend * Treatment – Observation, bracing or surgery

Question 26

What is the spondylosis?

Answer 26

Spondylosis: Osteoarthritis of the spine

Question 27

What is spondylolysis ? What it is usual?

Answer 27

– Stress fracture at the pars interarticularis with maintained spinal column * Usually unilateral – L5 is most common

Question 28

What is spondylolistesis? When is it more common?

Answer 28

* Involves shifting of the superior vertebrae anteriorly if bilateral fracture occurred * More common in kids with a lot of bending-> gymnastics and swimming ## Footnote Fractured and shifted forward

Question 29

What is this?

Answer 29

Question 30

* What is ankylosising spondylitis? * How it caused? * When does it happen? * What is the clinical presentation?

Answer 30

Question 31

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Question 33

Disc herniation: * What it is? * What may it cause? * How do we diagnosis it ? * How it treated?

Answer 33

* Fragment of nucleus pulposus herniates * May or may not cause irritation locally leading to pain – Sciatica-> unilateral – Paresthesia-> pins and needles * Bilateral symptoms are a red flag * Diagnosis – Imaging OR clinical exam – Straight leg raise -tenderness of sciatic nerve by pushing between ESIC and greater trochanter. * Treatment – Physical therapy or Surgery

Question 34

What is the straight leg raise?

Answer 34

Question 35

What are the three main spinal cord pathways and what fibers are carried?

Answer 35

* Dorsal Column Pathway : ipsilateral position and vibration * Spinothalamic pathway: contralateral pain and temperature * Corticospinal pathway: movement/ipsilateral mostly, minimally contralateral

Question 36

What is central cord and anterior cord syndromes?

Answer 36

* Central cord: –Quadriparesis greater in the upper extremities than in lower; Greater loss of pain and temperature in upper ext. * Anterior cord: – paralysis below the lesion, loss of pain and temperature, preservation of proprioception and vibratory function

Question 37

What is the posterior cord and brown sequard spinal cord syndromes?

Answer 37

* Posterior cord: –Injury to dorsal columns leading to ipsilateral position and vibration sensation loss * Brown Sequard: –ipsilateral weakness, loss of proprioception and vibratory; Contra-lateral loss of pain and temperature

Question 38

What is Cauda Equina spinal cord syndrome?

Answer 38

* Cauda Equina (not a true spinal cord syndrome): –motor and sensory loss in legs, sciatica, bowel/bladder dysfunction and “saddle” anesthesia –Retention is more common than loss of bladder

Question 39

What is spina bidida? What are the three types? tx?

Answer 39

Question 40

* What is the Risk factorts, diagnosis, and treatment of both TMJ syndrome an dislocation?

Answer 40

Question 41

What is a clavicle fracture and when do we need surgery and why?

Answer 41

* Trauma to upper girdle * need surgery when skin is tinting because it can ulcerate

Question 42

What is DEXA Scan?

Answer 42

Dual-energyX-rayabsorptiometry * Uses low dose xray to assess density of bone material * Helpful in diagnosis of osteopenia and osteoporosis

Question 43

How do we measure bone mineral density?

Answer 43

Question 44

Osteoporosis: * What are the risk factors? * Clinical presentation? * Treatment?

Answer 44