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SEM IV - Rad Pathology > Skeletal Anatomy/Pathology > Flashcards

Skeletal Anatomy/Pathology Flashcards

0
Q

Osteoblasts

A

Bone building cells

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1
Q

Bone remodeling

A

Continuous build up and breakdown process of bone

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2
Q

Osteoclasts

A

Bone breakdown cells

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3
Q

Ossification

A

Bone formation

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4
Q

Resorption

A

Bone destruction

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5
Q

Periosteum

A

Fibrous membrane that lines the outside of bones except articular surfaces

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6
Q

Diaphysis

A

Main shaft like portion of bone

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7
Q

Epiphysis

A

End of bones

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8
Q

Epiphyseal plate

A

Cartilage area for long bone growth (growth plate)

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9
Q

Medullary cavity

A

Hollow cylinder center of bone lined by the endosteum

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10
Q

The medullary cavity is filled with ?

A

Yellow bone marrow (fat storage)

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11
Q

Enchondial ossification

A

Bone formation by expansion formed by hyaline cartilage

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12
Q

A majority of bones form by

A

Enchondial ossification

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13
Q

Cortical bone

A

Aka compact bone (20% of skeleton)

Dense outer layer shell of bone, strong/tightly packed

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14
Q

Cancellous bone

A

Aka spongy bone (80% of skeleton)

Semi hollow inner portion of bone; trabecular

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15
Q

Trabecular

A

“Struts and braces”, scaffold like

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16
Q

Spaces between “struts and braces”

A

Red bone marrow; blood cell production

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17
Q

Basic function of bones

A 
PMS:
Production
Protection
Movement
Storage
Support
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18
Q

Production (of bone)

A

Red bone marrow

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19
Q

Protection (of bone)

A

Vital organs of body

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20
Q

Movement (of bone)

A

Levers for muscle action

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21
Q

Support (of bone)

A

Framework of the body

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22
Q

Storage (of bone)

A

Minerals and fat

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23
Q

Types of fractures

A

Displaced or undisplaced, complete or incomplete, open or closed, simple or comminuted

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24
Q

Fracture

A

Disruption of bone caused by mechanical forces applied directly to the bone or transmitted along the shaft of a bone

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25
Q

Fractures are the most

A

Common skeletal abnormality demonstrated by general radiography and typically appears as a Radiolucent line crossing a bone that disrupts the bones margin

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26
Q

Displaced fracture

A

Occurs when the fragments of bone are out of their normal alignment

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27
Q

Undisplaced fractures

A

Occur when the bone is broken but alignment remains unchanged

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28
Q

Fractures are classified by their…

A

Extent, direction, position, number of fracture lines, integrity of overlying skin, displacement of bone

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29
Q

Complete versus incomplete fractures

A

Refer to the fracture line

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30
Q

Complete fractures

A

Describe a fracture that has a discontinuity between two or more fragments

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31
Q

Incomplete fragments

A

Describes a fracture that has only partial discontinuity of a bone

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32
Q

Open fractures

A

Aka compound fractures; when bone(s) pierce through and disrupt overlying skin, resultant infections

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33
Q

Closed fractures

A

Occur when the fractured bone(s) do not disrupt the overlying skin

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34
Q

Simple fractures

A

Occur when the fracture results in no more than two bony fragments

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35
Q

Comminuted fractures

A

Occur when the fracture results in more than two bony fragments, often multiple fragments

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36
Q

Butterfly fragment

A

Type of comminuted fracture resulting in elongated triangular fragment isolated by proximal and distal lines of fracture

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37
Q

Direction of fractures

A

The relation of fracture to the long axis of the bone affected, can be transverse, oblique, or spiral

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38
Q

Transverse fracture

A

Fracture with a 90 degree angle to the long axis of the bone

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39
Q

Oblique fracture

A

Fracture with a 45 degree angle to the long axis of bone

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40
Q

Spiral fracture

A

Encircles the shaft of the long axis, caused by rotational/torsional forces

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41
Q

Avulsion fractures

A

Small fragments of bone torn from prominences as a result of indirectly applied tension from tendons and ligaments

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42
Q

Segmental fracture

A

A segment of the shaft isolated from the proximal and distal shaft by fracture lines

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43
Q

Compression fracture

A

Results from compression and compaction of the bone resulting in decreased length or width of the bone

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44
Q

Stress fracture

A

A segment of the shaft isolated from the proximal and distal shafts by fracture lines

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45
Q

Greenstick fracture

A

Incomplete fracture with the opposite cortex intact. Normally occurs in infants and small children.

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46
Q

Torus fracture

A

Buckling or impaction of one cortex while the opposite cortex remains intact. Normally seen in children.

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47
Q

Metaphysis

A

The wider part at the end of the shaft of a long bone, adjacent to the epiphyseal plate; located between the epiphysis and diaphysis

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48
Q

Scoliosis

A

A twisting and curvature in the lateral perspective of the spine, somewhat like an “s” curve

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49
Q

Lordosis

A

Anterior concavity in the curvature of the lumbar and cervical spine, as viewed from the side

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50
Q

Kyphosis

A

Anterior convexity in the curvature of the thoracic spine, sacrum, and coccyx, as viewed from the side

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51
Q

Bursitis

A

Inflammation of the bursae (small fluid filled sacs located near the joints that reduce the friction caused by movement). Not well visualized on X-ray, ultrasound is used.

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52
Q

Spondylolisthesis

A

Spondylolysis with displacement of vertebral alignment

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53
Q

Pathological fracture

A

Occurs when the bone weakens due to another process such as a tumor, infection, or metabolic disease

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54
Q

Transitional vertebra

A

Vertebra with characteristics of another spinal region, occurring most frequently at the limbo sacral junction

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55
Q

Spina bifida

A

A posterior defect of the spinal canal, resulting from failure of the posterior elements to fuse properly

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56
Q

Osteopetrosis/marble bones

A

Rare hereditary bone dysplasia results in osteoclasts dysfunction; prevents bone marrow formation, bones become brittle causing stress fractures

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57
Q

Osteogenesis inperfecta / brittle bones

A

Inherited generalized disorder of connective tissue characterized by multiple fractures, unusual blue color of the whites of eyes, and early hearing loss. Adults with this are usually wheelchair bound.

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58
Q

Achondroplasia

A

Most common form of dwarfism results from diminished proliferation of cartilage in the growth plate (decreased Enchondral bone formation).

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59
Q

Congenital hip dysplasia

A

Dislocation of hip which results from incomplete acetabulum formation caused by physiological and mechanical factors

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60
Q

Osteoarthritis

A

Degenerative joint disease characterized pathologically by the loss of joint cartilage and reactive new bone formation. Primarily affects weight baring joints (knees/spine/hip/ankle) also hands and feet

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61
Q

Rheumatoid arthritis

A

Autoimmune disease, a Chronic systemic disease of unknown cause that appears primarily as a nonsupperative inflammatory arthritis of the small joints of the hands/feet

62
Q

Ankylosing spondylitis

A

Chronic inflammation affecting the spine, starts inferior and works its way superior up the spine

63
Q

Osteomyelitis

A

Inflammation of the bone and bone marrow

64
Q

Osteoporosis

A

Generalized or localized deficiency of bone matrix in which the mass of bone per unit volume is decreased in amount but normal in composition

65
Q

Osteomalacia

A

Insufficient mineralization of the adult skeleton after closure of the epiphyseal plates; failure of calcium and phosphorus deposits in formation of the bone matrix

66
Q

Rickets

A

Systemic disease of infancy and childhood that is the equivalent of osteomalacia in the mature skeleton

67
Q

Gout

A

A disorder in the metabolism of purine in which an increase in the blood level of uric acid leads to deposition of uric acid crystals in the joints, cartilage, and kidney

68
Q

Paget’s disease

A

One of the most common chronic metabolic diseases of the skeleton. Destruction of bone, followed by a reparative process results in weakened, deformed and thickened bony structures that tend to break easily.

69
Q

Club foot/talipes

A

Congenital deformity of foot in which the foot is twisted and relatively fixed in an abnormal position; occurs in 1 in 1000 births

70
Q

Syndactyly

A

Congenital anomaly characterized by the fusion of fingers or toes

71
Q

Polydactyly

A

Congenital anomaly characterized by the presence of more than the normal number of fingers or toes

72
Q

Tendonitis

A

Inflammation of the tendon, usually from strain. Common examples are tennis elbow, golf elbow, Achilles tendinitis, DeQuervains tenosynovitis (gamers thumb)

73
Q

Tenosynovitis

A

Inflammation of a tendon sheath caused by calcium deposits, repeated strain or trauma, high blood cholesterol levels, rheumatoid, gout, or gonorrhea

74
Q

Osteophyte

A

A bony outgrowth, usually found around the joint area

75
Q

Articular cartilage

A

Type of hyaline connective tissue that covers the articulating surfaces of bone within synovial joints

76
Q

Osteopenia

A

Condition of sub normally mineralized bone

77
Q

Typhos/tophi

A

A calculus containing sodium rate deposits that develops in particular fibrous tissue, typically in patients with gout.

78
Q

Transitional vertebra also occur at the cervicothoracic and thoracolumbar junctions forming a

A

Floating rib

79
Q

Spina bifida occulta

A

Mild form of Spina bifida where the bone is split at L5 or S1
Occulta- hidden / asymptomatic

80
Q

Meningomyelocele

A

Herniated meninges and spinal cord

81
Q

False joints formed between the transverse processes of L5 and the Iliac Crest are known as

A

Psuedoarthroses

82
Q

Cervical spine

A

Normally 7 vertebra, transverse process foramina

83
Q

Thoracic spine

A

Normally 12 vertebra with ribs bilaterally

84
Q

Lumbar spine

A

Normally 5 LARGE vertebra that are not fused to adjacent bodies

85
Q

Radiographically, osteopetrosis appears as

A

A generalized increase in bone density (considered an additive pathology)

86
Q

Severe cases of osteogenesis imperfecta include

A

Bowed legs/arms, scoliosis, and kyphosis

87
Q

Osteogenesis imperfecta patients will suffer from multiple fractures due to

A

Severe osteoporosis and thin, defective bone cortex

88
Q

Fracture sites for osteogenesis imperfecta patients may appear as

A

Bone tumors due to extensive callus formation at fracture sites (destructive pathology)

89
Q

Achondroplasia results in

A

Short limbs and an average size trunk

90
Q

Achondroplasia is characterized radiographically by

A

Abnormally short/wide long bones

91
Q

Congenital hip dysplasia is more common in

A

Females

92
Q

Assessment of congenital hip dysplasia, the hip

A

“Pops out of place” upon flexion and abduction of hip

93
Q

Congenital hip dysplasia is radiographically demonstrated by

A

AP pelvis and cleaves method of the hip(s)

94
Q

Club foot/talipes results in various anomalies but most commonly

A

Talipes Equinovarus

95
Q

Treatment for club foot/talipes

A

Progressive casting, braces, surgery.

Frequent X-ray follow up

96
Q

Osteoarthritis radiographic appearance

A

Narrowing of joint spaces, osteophyte (bone spur) formation along articular edges (hyper dense bone)

97
Q

With advanced osteoarthritis disease

A

Subluxation may occur

98
Q

Osteoarthritis is the ? arthritis

A

“Wear and tear”

99
Q

Infectious arthritis

A

Caused by pyogenic organisms gaining access to a joint space by the Hematogenous route from surgery or trauma to the joint space

100
Q

The most common infectious arthritis is a migrating form

A

Lyme disease with a classic bullseye appearance

101
Q

Symptoms of infectious arthritis include

A

Severely tender joint space, high fever, shaking and chills

102
Q

Vector

A

Insect that spreads disease

103
Q

Radiographic appearance of infectious arthritis

A

Soft tissue swelling causing fluid distention if the joint space and destruction of the joint cartilage erosion of the cortical bone

104
Q

Rheumatoid arthritis affects women

A

3 times more often than men

105
Q

The average onset age for rheumatoid arthritis is

A

About age 40

106
Q

Rheumatoid arthritis can be protracted or progressive leading to a

A

Crippling deformity of the affected joints

107
Q

Rheumatoid arthritis begins as inflammation of synovial membrane causing

A

Excess exudate to be produced which erodes the bone/joint surfaces

108
Q

Rheumatoid arthritis often works its way

A

Proximally toward the trunk until every joint in the body is affected

109
Q

Rheumatoid arthritis results in severe deformity of the joints with occurrence

A

Of bones fusing the joint spaces

110
Q

Rheumatoid arthritis variants

A

Ankylosing spondylitis
Reiters syndrome
Psoriatic arthritis

111
Q

Ankylosing spondylitis most frequently begins in the

A

SI joints bilaterally and can result in fusion (Ankylosing) of joints

112
Q

Ankylosing spondylitis AKA

A

Bamboo spine

113
Q

Ankylosing spondylitis causes blurring of

A

The articular lines of the sacrum and ilium

114
Q

Reiter’s syndrome

A

Reactive arthritis characterized by arthritis, urethritis, and conjunctivitis; primarily affects young males after a GI or vanereal disease; affects heels, toes, and SI joints

115
Q

Reiter’s syndrome affects bilaterally but not

A

Symmetrically, only minimal affects to spine

116
Q

Psoriatic arthritis

A

A rheumatoid like destruction involving peripheral joints in patients with psoriasis, primarily effects the DIP joints of the feet and hands, primarily the distal hands

117
Q

Stress, rheumatoid, gout, arthritis, and infections are the most common causes of

A

Bursitis.

118
Q

Rotator cuff tears

A

A tear of one of the four shoulder muscles allowing a passageway between the shoulder joint and subacromial bursae

119
Q

Rotator cuff tears are best demonstrated by

A

Arthrogram, CT and MRI. ultrasound may be used due to cost/less invasive.

120
Q

Meniscal tears

A

Often occur in correlation with ACL and PCL tears. Can be acute or degenerative in nature.

121
Q

Meniscal tears are best demonstrated by

A

MRI (more accurate and less invasive than arthrography)

122
Q

Bacterial osteomyelitis

A

Inflammation of bone and bone marrow caused by infectious pathogen from hematogenous spread

123
Q

Acute osteomyelitis

A

Affects red bone marrow rich long bones (commonly tib/fib and femur)

124
Q

Bacterial osteomyelitis is commonly found in

A

Drug abusers and diabetics; spread from soft tissue infections and vascular deficiencies.

125
Q

Bacterial osteomyelitis begins as

A

an abscess of bone and can spread along the periosteum very rapidly if not treated.

126
Q

Bacterial osteomyelitis is best detected by

A

Bone scan, a nuclear medicine procedure looking for “hot spots” (fractures/infections)

127
Q

Osteoporosis is usually caused by

A

An accelerated absorption of bone due to osteoclast activity surpassing osteoblasts activity

128
Q

Osteoporosis may also occur as a result of

A

Decreased bone formation (osteoblasts) with prolonged steroidal use and prolonged immobilization of extremities

129
Q

A 50-70% loss of bone mineralization is required to

A

Demonstrate osteoporosis on plain film

130
Q

It is recommended that KVP be decreased in order to increase the absorption of the beam and produce a

A

Shorter scale of contrast for osteoporosis patients

131
Q

Osteoporosis is considered to be a ? Pathology

A

Destructive

132
Q

Osteoporosis is commonly diagnosed by

A

Bone densitometry (DEXA)

133
Q

Causes of bone loss include

A

Aging, post menopausal hormone changes, poor diet, inactivity, and long term medications (steroids, anti-convulsants)

134
Q

Radiographic appearance of bone loss

A

Thinning cortical bone best demonstrated in spine/pelvis, kyphosis, compression fractures, or anterior displacement of vertebral bodies over one another

135
Q

In the skull, bone loss appears as

A

A spotty loss of density and loss in sella turcica and dorsum sallae

136
Q

Fragility fractures

A

Broken bones resulting from minimal trauma usually caused by bone loss

137
Q

Treatment of bone loss

A

Prevention is the best cure!
Weight baring exercise, hormone replacement therapy, adequate vitamin and mineral intake, supplements (vitamin d/calcium), medications.

138
Q

In severe cases verteboplasty is done to

A

Prevent further collapse of vertebral bodies

139
Q

Osteomalacia is caused by

A

Inadequate intake of calcium, vitamin d, phosphorus, kidney failure, renal diseases where calcium is lost in the urine; failure of the body to absorb necessary nutrients

140
Q

Osteomalacia appears radiographically

A

As a loss of bone density, thinning of the cortical bone, deossification of medullary cavity, bones may be bent due to stress/loss of minerals

141
Q

Rickets is caused by

A

Deficiency of vitamin d and calcium, lack of sunlight, lack of physical activity

142
Q

Rickets appears radiographically as

A

Bowing of bones, lack of calcification, increase in growth of non calcified tissue, most often seen in fast growing bones (sternal ends of ribs, proximal humerus/tibia, distal radius/ulna)

143
Q

Rickets treatment

A

Doses of vitamin D and calcium supplements

144
Q

Primary gout

A

Caused by inherited enzymatic defects that cause over production of uric acid

145
Q

Secondary gout

A

Hyperuricemia caused by an overproduction of uric acid due to metastatic carcinoma, myeloma, drugs, or a decrease in excretion due to kidney failure

146
Q

Gout appears radiographically as

A

Early detection cannot be determined due to the changes manifesting late in the disease process, earliest signs include joint effusion

147
Q

Advanced gout presents as

A

Severe destructive lesions with joint space narrowing, characteristic large soft tissue masses

148
Q

Padget’s disease presents most commonly in

A

Mid life and affects men twice as much as women, it affects 3% of people over age 40

149
Q

The pelvis is the most common and often the initial site of manifestation of

A

Padget’s disease

150
Q

Padget’s disease in long bones

A

The destructive phase starts at one end and extends along the shaft for varying distances and usually ends in a v shaped pattern. Upon repair, the bone is enlarged with widened cortex.

151
Q

Padget’s disease in the skull

A

A well defined area of radiolucency is seen in the destructive phase of the disease.

152
Q

Padget’s disease in the spine

A

Enlargement of the vertebral body occurs with an increase in cortical bones.

153
Q

There is no known cure for Padget’s disease, the progression can be slowed by

A

Administering biophosphonates or administering calcitonin (these minimize the resorption of bones and inhibit osteoclastic activity).

SEM IV - Rad Pathology (6 decks)

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