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Skeletal Rad > Test #1 > Flashcards

Test #1 Flashcards

1
Q

Areas of normal uptake in bone scintigraphy?

A

Long bone metaphyses, thyroid, kidneys, sternum, spine, S.I., bladder

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2
Q

Type of forces that produce fxs?

A

Torsion, compression, shearing, rotation, angulation(bending)

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3
Q

Types of incomplete fxs?

A

Green stick, torus, bowing, stress

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4
Q

What to look for to detect a fx?

A

Abnormal line of lucency, offset of the cortex, increased bone density, soft tissue swelling, obliteration or displacement of myofascial planes, periosteal & endosteal responses, joint effusion, intracapsular fat (FBI sign), double cortical line, irregular metaphyseal corners, zone of impaction

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5
Q

Factors which influence fx healing?

A

Pt’s age, site & type of fx, position of the fragments, status of blood supply, quality of immobilization or fixation, complications

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6
Q

What are the phases of the circulatory/inflammatory phase?

A

Cellular phase, vascular phase, primary callus phase

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7
Q

Steps during cellular phase

A

Hematoma, Inflammatory response, granulation tissue replaces the hematoma

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8
Q

Steps during the vascular phase

A

Ingrowth of new blood vessels leading to hyperemia, increased osteoclastic activity, hair growth, tan skin

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9
Q

Circulatory phase occurs when?

A

First 5-30 days

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10
Q

What happens during the Reparative/metabolic phase?

A

Callus formation becomes more orderly & woven bone is replaced by more mature bone

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11
Q

How long does the Reparative/Metabolic phase last?

A

4-6 weeks in the young & 6-15 weeks in adults

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12
Q

What happens during the remodeling/mechanical phase?

A

Bone is deposited & removed according to Wolff’s law, restoration of the medullary cavity & bone marrow

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13
Q

How long does the Remodeling/Mechanical phase last?

A

May take months or years to complete

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14
Q

What happens in first 5-10 days following a fx?

A

Resorption of the fx line occurs creating an increase in width of the actual fx line

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15
Q

What happens 10-30 days following a fx?

A

“Veil” of new bone formation adjacent to fx site (callus)

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16
Q

Immediate complications of delayed union/nonunion?

A

Articular injury, compartment syndrome, fat emboli

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17
Q

Intermediate complications of delayed union/nonunion?

A

Osteomyelitis, hardware failure, RSDJ, myositis, delayed union

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18
Q

Delayed complications of delayed union/nonunion?

A

Osteonecrosis, DJD, osteoporosis, nonunion, malunion

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19
Q

Contributing factors to nonunion?

A
  • Distraction
  • Inadequate immobilization (99% of problems)
  • Infection
  • Impaired circulation (avascular necrosis)
  • Soft tissue b/w fragments
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20
Q

M/C site for non-union?

A

Mid-clavicle, ulna, tibia

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21
Q

5 P’s assoc. w/ Volkmanns Ischemic Contracture?

A
  • Pulselessness
  • Pain
  • Pallor
  • Paresthesia
  • Paralysis
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22
Q

Premature DJD is M/C where?

A

Weight bearing joints (hip, knee, ankle)

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23
Q

What views are in a head series?

A

AP Caldwell, AP Towns, L & R Lateral, Base view, Waters view (shows sinuses)

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24
Q

Most spinal trauma is secondary to?

A

MVAs & falls

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25
Q

Most common sites for spinal fxs?

A

C1-C2 - cord injury less common b/c canal is large
C5-C7 - canal is smaller so cord injuries more common
T12-L1

26
Q

What type of forces disrupt ligaments?

A

Rotational & shearing forces

27
Q

What is located in the anterior column of the spine?

A

ALL, ant. annulus fibrosis, anterior body

28
Q

What is located in the middle column of the spine?

A

PLL, pos. annulus fibrosis, pos. body

29
Q

What is located in the pos. column of the spine?

A

Neural arch & intervening soft tissues

30
Q

For an injury to be considered stable what column has to be intact?

A

Middle column

31
Q

If an injury disrupts 2 of 3 columns is it considered stable or unstable?

A

Unstable

32
Q

What is the M/C mechanism of spinal injury?

A

Flexion

33
Q

Types of hyperflexion injuries

A

Bilateral facet dislocation, Clay-Shovelers, Hyperflexion sprain/strain, Odontoid process fx, Simple wedge fx, Flexion teardrop fx

34
Q

What is the most unstable fx in the C-spine compatible w/ life?

A

Flexion teardrop fx

35
Q

Types of hyperextension injuries

A

Extension teardrop fx, fx of pos. arch of C1, Hangman’s fx, Articular pillar/facet fx, spinous process fx, Hyperextension sprain/strain

36
Q

Types of rotation injuries

A

Laminar/facet fx (extension), Transverse process fx (C-7), Unilateral facet dislocation (flexion), Rotary atlantoaxial fixation

37
Q

Types of lateral flexion injuries

A

Uncinate process fx, Transverse process fx (M/C)

38
Q

Lateral flexion injuries are usually located where?

A

Junction of TVP & pedicle

39
Q

Types of shearing injuries

A

Fx/dislocation in thoracic & lumbar spine, Atlanto-occipital dislocation

40
Q

Types of dislocation injuries

A

Chance fx (seat belt fx), Atlanto-occipital dislocation

41
Q

List findings that suggest instability

A

Increased angulation b/w vert. bodies that is at least 11degs greater than adjacent segments, ant. or pos. translation greater than 3.5mm, segmental spinous process widening, facet joint widening, lateral tilting of vertebral bodies

42
Q

A majority of signs of cervical trauma can be visualized on what view?

A

Neutral lateral view

43
Q

What segments need to be shown on a neutral lat. view of the C-spine?

A

C7 & T1

44
Q

The retropharyngeal space should be no more than?

A

7mm

45
Q

The retrotracheal space should be no more than?

A

21mm

46
Q

Minimum views of a 3-view cervical series?

A

APOM, APLC, neutral lateral

47
Q

Most common fx of C1?

A

Pos. arch fx of atlas

48
Q

M/C location of extension teardrop fx is C-spine?

A

C2/C3

49
Q

Important clue indicating an articular pillar/facet fx?

A

Acute cervical radiculopathy

50
Q

M/C location for articular/pillar fx of C-spine?

A

C4-C6 (C6)

51
Q

This fx usually has a “horizontal facet sign”?

A

Articular pillar/facet fx

52
Q

2 types of fxs that result from compression injuries?

A

Jefferson’s fx & burst fx

53
Q

This fx will show bilateral offset or spreading of the lat. masses known as the “Overlap sign”?

A

Jefferson’s fx

54
Q

Posteriorly displaced fragments may produce spinal cord injury in this type of fx?

A

Burst fx

55
Q

This fx is assoc. w/ MVAs, wrestling, diving; caused by abrupt flexion, direct blow extension?

A

Clay-Shoveler’s fx

56
Q

This fx is assoc. w/ the “double spinous process” sign?

A

Clay-Shovelers

57
Q

3 types of fusion

A

Synostosis (congenital), Ankylosis (pathological), Arthrodesis (surgical)

58
Q

This is seen in Down’s syndrome, inflammatory arthritides, & Jefferson’s fx?

A

Transverse ligament disruption

59
Q

3 things that suggest injuries?

A

Soft tissue changes, zone of impaction, step defect

60
Q

Types of stable Fxs

A

Pos. arch fx of atlas, extension teardrop fx, Jefferson’s fx, Simple wedge fx, Clay-Shovelers fx, Type I odontoid process fx, Type III odontoid process fx, Unilateral facet dislocation

61
Q

Types of unstable fxs

A

Hangman’s fx, Articular pillar/facet fx, Burst fx, Flexion teardrop fx, Hyperflexion strain/sprain, Bilateral facet dislocation, Transverse ligament disruption, Type II odontoid process fx

Skeletal Rad (5 decks)

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