Quiz 1

Question 1

What does alignment include?

Answer 1

General Skeletal Architecture
General Contour of Bone
Alignment of Bones Relative to Adjacent Bones

Question 2

What is aberrant size of bones?

Answer 2

Gross enlargement of bone seen in conditions such as gigantism, acromegaly, or Paget’s disease
Grossly undersized bone may be related to congenital, metabolic, or endocrine abnormalities

Question 3

What does general skeletal architecture include?

Answer 3

• aberrant size of bones
• supernumerary bones
• congential anomalies
• absence of any bones
• development deformities

Question 4

What can a cervical rib cause?

Answer 4

transverse process of C7 because elongated: can cause neurological or vascular issues

Question 5

What is included with general contour of bone?

Answer 5

• internal or external irregularities
• cortical outline of each bone
• any bony outgrowth of spurs at joint margin
• breaks in continuity of cortex, signifying fracture
• past surgical site marking

Question 6

The cortical outline of bone should be:

Answer 6

smooth and continuous

Question 7

Bony outgrowth of spurs at joint margins may be indicative of:

Answer 7

degenerative joint changes or may result from tension at areas of tissue attachment

Question 8

What can sharp angles in the cortex be a sign of?

Answer 8

impaction fracture

Question 9

What is included in alignment of bones relative to adjacent bones

Answer 9

fracture
dislocation
subluxation

Question 10

What is evaluated with bone density?

Answer 10

general bone density
textural abnormalities
local density changes

Question 11

Healthy cortex shows up with ____ density than cancellous bone and appears as ____ mrgin along bone shafts

Answer 11

greater, white

Question 12

When is trabeculae altered?

Answer 12

when mineralization of bone is altered

Question 13

How is image of trabeculae described?

Answer 13

thin, delicate, coarsened, smudged or fluffy

Question 14

What is fluffly trabecular?

Answer 14

represent random proliferation of both osteoblastic and osteoclastic activity, as seen in skull of patient with Paget’s disease and in hyperparathyroidism

Question 15

What is smudged trabecular characeristic of?

Answer 15

osteomalacia

Question 16

When is coarsening of trabeculae seen?

Answer 16

seen in patients with chronic renal failure and osteoporosis
Accentuation of these trabeculae do not signify strength rather, loss of surrounding trabeculae cause remaining trabeculae to appear prominent

Question 17

Lacy, delicate trabeculae:

Answer 17

secondary to thalassemia (Cooley’s anemia)

Question 18

When is sclerosis seen?

Answer 18

normal local increases in bone density seen in areas subjected to increased physical stress, such as weight-bearing areas of joints

Question 19

Localized sclerosis is a sign of what?

Answer 19

repair- extra bone deposited to fortify bony architecture to withstand forces of weight-bearing

Question 20

When is excessive sclerosis normal?

Answer 20

site of healing fracture as callus is formed and new bone remodeled

Question 21

When is reactive sclerosis seen?

Answer 21

when body acts to surround and contain a diseased area, such as a tumor or infection

Question 22

Why is articular cartilage of joints and cartilaginous IVDs of spine not well demonstrated?

Answer 22

water-like density

Question 23

Cartilage space analysis includes evaluation of items on following lists

Answer 23

1. Joint Space Width
2. Subchondral Bone
3. Epiphyseal Plates

Question 24

What does well preserved joint space imply?

Answer 24

cartilage or disk of normal thickness

Question 25

What does decreased joint space imply?

Answer 25

cartilage or disk thinned down as result of degenerative processes

Question 26

What is subchondral bone assessed for?

Answer 26

density changes or irregularities

Question 27

What is looked for in subchondral bone?

Answer 27

- increased sclerosis | - erosion

Question 28

What is looked for in epiphseal plates?

Answer 28

position size smooth margin disruptions

Question 29

What is soft tissue of muscles evaluated for?

Answer 29

gross muscle wasting | gross swelling

Question 30

What does gross muscle wasting suggest?

Answer 30

primary muscle disease, paralysis, inanition associated with severe illnesses, or disuse atrophy secondary to trauma

Question 31

What is gross swelling of muscle and soft tissue indicative of:

Answer 31

inflammation, edema, hemorrhage, or tumor

Question 32

What is the loss or displacement of fat due to?

Answer 32

swelling and provide clue to adjacent abnormality

Question 33

Displacement of pronator quadratus fat line at wrist indicates:

Answer 33

wrist fracture

Question 34

Displacement of fat pads at elbow (from olecranon fossa posteriorly and from coronoid and radial fossae anteriorly) indicates:

Answer 34

gross effusion associated with fracture

Question 35

When is effusion seen?

Answer 35

Seen in exacerbations of arthritic conditions, infection, hemophilia, and in acute joint trauma

Question 36

What are the four types of periosteal reactions?

Answer 36

solid laminated or onion skin spiculated or sunburst condman's triangle

Question 37

Solid periosteal reaction:

Answer 37

benign process | Seen in fracture healing and osteomyelitis

Question 38

Laminated or onion skin reaction:

Answer 38

indicates repetitive injury, as in battered child syndrome | Also associated with sarcomas such as Ewing’s sarcoma

Question 39

Spiculated or sunburst reaction:

Answer 39

associated with malignant bone lesions, such as osteogenic sarcomas, and less frequently seen in metastatic squamous cell tumor - Distinct appearance of periosteum due to repeated breakthrough of neoplastic process followed by new periosteal response

Question 40

Condman's triangle reaction:

Answer 40

Piece of periosteum elevated by abnormal conditions ossifies in triangular shape

Question 41

Gas in soft tissue:

Answer 41

gas gangrene or trauma

Question 42

Calcifications in soft tissue:

Answer 42

may be result of old trauma whereby bloody hemorrhage has coagulated and calcified

Question 43

How is the broad index of skeletal diseases can be organized for diagnosis by identifying:

Answer 43

category of pathology, distribution of lesion, and predictor variables that characterize disease features

Question 44

Six categories of pathology in classification of skeletal diseases:

Answer 44

``` Congenital Inflammatory Metabolic Neoplastic Traumatic Vascular ```

Question 45

Lesion may be:

Answer 45

monostotic or monoarticular polyostotic or polyarticular diffuse

Question 46

Monostotic or monoarticular

Answer 46

affecting only one bone or one joint

Question 47

Polyostotic or polyarticular

Answer 47

affecting multiple bones or multiple joints

Question 48

Diffuse

Answer 48

affecting all or nearly all bones or joints

Question 49

What two disease categories occur diffusely:

Answer 49

Neoplastic | Metabolic

Question 50

Bone lesions are described as:

Answer 50

osteolytic | osteblastic

Question 51

Osteolytic

Answer 51

bone destroyed by osteoclastic activity

Question 52

Osteoblastic

Answer 52

new reparative or reactive bone present

Question 53

Three forms of osteolytic lesions:

Answer 53

geographic destruction moth-eaten appearance permeative destruction

Question 54

Geographic destruction:

Answer 54

Large areas of bone destroyed and appear as radiolucent lesions Sharply defined borders suggest benign lesion

Question 55

Moth-eaten appearance:

Answer 55

Several small holes throughout bone appear similar to moth-eaten cloth Ragged borders here suggest malignant lesion

Question 56

Permeative destruction

Answer 56

Very fine destruction of bone through haversian system, sometimes requiring magnifying lens to recognize on film Poorly defined borders suggest malignant lesion

Question 57

Where does osteoarthritis affet?

Answer 57

weight bearing areas

Question 58

RA affects:

Answer 58

entire joint surface

Question 59

What is a significant factor in predicting type of malignant and benign bone tumors?

Answer 59

age | gender predominance

Question 60

Margins of a lesion are:

Answer 60

sharp and clearly defines or wide and poorly defined

Question 61

Benign lesion borders:

Answer 61

Sharp, clearly defined, sclerotic borders

Question 62

Fast growing or malignant lesion:

Answer 62

Wide, poorly defined borders with minimal or absent reactive sclerosis

Question 63

Immature bone, lesions that are ___ than ____ are likely to be benign because:

Answer 63

longer than wide | lesion has grown slowly along with bone

Question 64

Tumors do not cross:

Answer 64

joint spaces or epiphyseal growth plates

Question 65

Infections do not cross:

Answer 65

joint space

Question 66

Inflammatory processes cause:

Answer 66

destruction of bone on both sides of joint

Question 67

Responses of bone to lesion, trauma, or degenerative processes can include

Answer 67

periosteal reaction, sclerosis, and buttressing

Question 68

Sclerosis is:

Answer 68

new bone growth established to fortify an area subjected to increased stress,

Question 69

What is reactive sclerosis:

Answer 69

body’s attempt to contain an area of abnormal bone

Question 70

Buttressing:

Answer 70

formation of bony exostoses or osteophytes at joint margins, which serve to strengthen architecture of joint

Question 71

How are periosteal reaction to neoplasm characterized:

Answer 71

interrupted or uninterrupted

Question 72

Interrupted periosteal response suggests

Answer 72

malignant or non-malignant but highly aggressive lesions

Question 73

Uninterrupted periosteal response suggests

Answer 73

benign processes and presents as solid density, either longitudinal, undulated, or buttressing in pattern

Question 74

What is matrix?

Answer 74

intercellular tissue produced by some bone tumors

Question 75

How is a tumor matrix indentified?

Answer 75

chondroid (cartilaginous) osteiod (bony) mixed

Question 76

Chondroid matrix appears:

Answer 76

stippled, popcorn-like, or comma-shaped calcifications seen in tumors invading soft tissues

Question 77

Osteiod matrix appears:

Answer 77

white, cloud-like, fluffy density within medullary cavity and in adjacent soft tissue, most often in osteosarcomas