Lecture Midterm Flashcards by B Burr

What does CATBITES stand for?

-Categories of bone disease
Congenital
Arthritis
Trauma
Blood
Infection
Tumor
Endocrine, Nutritional, Metabolic
Soft Tissue

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What are some clinical data to consider during your preliminary analysis of a film?

Age
Sex
Race
History
Symmetry of lesions
Systems Involved

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An osteolytic lesion will appear more __ on the film

black

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What are the 3 types of Osteolytic lesions?

Geographic
Moth-eaten
Permeative

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A Geographic lesion has ___ borders and is the ___ aggressive. It is ___ growing and >__mm in diameter

sharp
least
slow
5

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Geographic lesions have a __ zone of transition

narrow

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T/F Geographic lesions are benign

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Moth-eaten lesions have ___ borders and may be ___. These are from __-__mm in diameter

jagged
malignant
2-5

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Permeaive (pinhole) lesions have a __ zone of transition and implies aggressive ___. These lesions are <__mm in diameter.

wide
malignancy
1

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Motheaten lesions predispose patients to a high risk of pathological ___

fracture

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Osteoblastic lesion AKA

Osteogenic

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Osteoblastic lesions appear ___ on film

white

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2 pathologies that may cause an osteoblastic lesion

Paget’s

Osteosarcoma

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Mixed lesions are __ and __, and are fairly uncommon

blastic

lucent

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What are 7 things to consider when analyzing a lesion?

Skeletal Location
Metaphysis
Site of origin
Shape
Size
Length
Margination

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A sharp or short zone of transition means that the lesion is ___

benign

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Poorly-defined or long zone of transition means __ or __

infection

malignancy

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Sclerotic margin is typical of ___

infection

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A destroyed cortex indicates __ or ___ ___

infection

malignant tumor

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e lesion with an expanded cortex may be __ or __

benign

malignant

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5 categories of the matrix of a lesion

Fat
Cartilage
Osseous
Hematogenous
Fibrous

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What are the 3 types of Cartilage appearances in the matrix of a lesion?

Stippled
Flocculent (cloud-like)
Arc/Ring

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The periosteum is the __ covering the bone and shares __ supply with the bone

membrane

blood

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What 4 things may stimulate the psriosteal response?

Inflammation
Break
tear 
stretching
.... of the periosteum

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With slow-growing processes, there is an ___ pattern of the periosteal new bone along the __ of affected bone.

uninterrupted | cortex

AKA for slow growing processes

Solid Periosteal reaction

With rapidly-growing processes, the perisoteum cannot produce new bone as fast as the lesion is growing. What appearances of lesion are associated with rapid growing processes?

Lamellated | Spiculated

If a lesion grows unevenly, (stops and stops) the periosteum may lay down a thin shell of calcified new bone, leading to a ___ appearance that creates ___.

lamellated/ Onion Skin/ Laminated

If a lesion grows fast and evenly, Periosteum will not have enough time to lay down even a thin shell of bone. __ fibers become stretched out ___ to the bone and ossified fibers produced a ___ pattern periosteal reaction. This is the ___ aggressive of the 3 (solid, onion, sunburst)

Sharpey's perpendicular Sunburst/ Spiculated Most

Codman's triangle appears on a process growing too fast for the periosteum to respond with even thin shells of new bone. Only the __ of the __ periosteum will ossify. It forms a small ___ with the surface of the bone, but not a complete triangle.

edges raised triangle

What are 3 causes of solid periosteal reaction?

Infecton Benign neoplasm Osteoid Osteoma

What are some possible causes of aggressive periosteal reactions?

Osteomyelitis Malignant Neoplasm Lymphoma Leukemia

What is used to quantitatively evaluate bone density?

Dexa Scan

How many bones are in the body? How many are Appendicular? Axial?

206 126 80

4 Functions of bone

Support mechanical loads Protect vital organs Contributes to mineral homeostasis Serves as a site for hematopoiesis

First bone (and last) to ossify?

Clavicle

From which germ layer is bone formed?

Mesodermal tissue (Mesenchymal cells)

Long bone begins as __ cartilage in fetus

hyaline

Primary center ossification

Diaphysis

Secondary center of ossification

Epiphysis

Intramembranous ossification is the __ stage of the ossification process. In this process, embryonic __ transforms into bone. This increases the __ of the bone

first CT diameter

Endochondral ossification is the __ stage of ossification process. Primary endochondral ossification is when ___ tissue from ___ cells transforms into bones. This __ the bone.

2nd cartilaginous mesenchymal lengthens

Seocondary endochondral ossification occurs within the __ and __. Associated with which bones?

``` Epiphysis Apophyses Tubular bones Vertebrae Ethmoids Inf. Conchae ```

Zone of proliferation is the most ___ zone

active

ZOne of hypertrophy is where ___ fractures may occur

salter-harris

Bone is __% mineral and __% collagen

70 | 30

Compact bone makes up __% of total bone

Flat Flat bones have an inner and outer layer of ___ tissue and there is __ between the 2 layers of cancellous bone

dense bony tissue | red marrow

Bone marrow lies in spaces between the ___ of the __ bone

trabeculae | cancellous

Calcium to phosphorus ratio

2:1

What is the main calcium-phosphorus complex?

Crystalline Hydroxyapatite | Ca10(PO4)6(OH)2

Phosphorus levels are __ related to calcium. Phosphorus allows __ of calcium at the bone crystal surface

inversely | Precipitation

Gigantism is increased somatropin ___ physeal closure

before

Acromegaly is increased somatropin ___ physeal closure

after

Parathyroid Hormone is an important regulator of skeletal ___. What are it's 2 main functions?

Metabolism - Stimulate and control rate of bone remodeling - Influence mechanisms governing control of the plasma level of calcium

PTH direct effect is in the __ and it stimulates __ absorption from __ fluid

Kidney Ca++ Glomerular

PTH indirect effect is in the ___ and it promotes osteoclastic ___.

bone | resorption

Vitamin D regulates intestinal __ absorption. Also maintains ___ growth and mineralization

mineral | skeletal

What produces estrogen?

Ovarian Follicle

Estrogen ___ bone production by inducing ___ anabolic activity

stimulates | protein

Androgen is produced in ___ and ___

testicles | adrenal cortex

Growth Hormone comes from ___ cells of ___ ___

acidophilic | anterior pituitary

Growth hormone controls ___ proliferation and __ at the growth plate

chondrocyte | proliferation

What is the most common glucocorticoid to affect bone?

hydrocortisone

Glucocorticoids induce protein ___ and ___ excretion , therefore encourages ___

catabolism phosphorus osteoclasts

A person with acromegalywill have an enlarged __ __ after growth plate closes

sella turcica

Is dexa scan quantitative or qualitative?

Quantitative

What is the most metabolically active part of the long bone?

Metaphysis

What is the most active layer of the physeal plate?

Proliferative zone

Do newborns have more red or yellow marrow?

red