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Chapter 2 Pathology > The Skeletal System > Flashcards

The Skeletal System Flashcards

1
Q

How many bones is the skeletal system composed of?

A

206 bones

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2
Q

How many bones is the axial skeleton composed of?

A

80 bones of the skull, spine, ribs & sternum

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3
Q

How many bones is the appendicular skeleton composed of?

A

126 bones of the extremities, pectoral, and pelvic girdles

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4
Q

What are the five types of bones?

A

Long, short, irregular, flat, sesamoid

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5
Q

What type of tissue is bone?

A

connective

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6
Q

What are bones covered with (outer layer)?

A

Periosteum

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7
Q

What is the inner layer of bones made up of?

A

Osteoblasts

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8
Q

What are osteoblasts associated with?

A

The production of bone

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9
Q

What is beneath the inner layer of periosteum?

A

Cortial or compact bone

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10
Q

What is below the cortical layer of bone?

A

The cancellous or spongy bone (honeycomb appearance)

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11
Q

What is the name of the open canal that runs down the center of the diaphysis (shaft) of long bones and contains the bone marrow?

A

Medullary or marrow cavity

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12
Q

What lines the marrow cavity?

A

Endosteum

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13
Q

What are the two types of tissue found in the cavities of bones?

A

Red bone marrow and yellow bone marrow?

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14
Q

Where is the red bone marrow found and what is its function?

A

It is found in the open areas of spongy bone and forms red blood cells

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15
Q

Where is the yellow bone marrow found and what is its function?

A

Yellow bone marrow contains predominantly fat and is found in the marrow cavity of long bones

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16
Q

What are the three types of joints?

A

Synarthrodial, amphiarthrodial, and diarthrodial

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17
Q

Synarthrodial joinst are

A

immovable

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18
Q

Amphiarthrodial joints are

A

slight movable

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19
Q

Diarthrodial joints are

A

freely movable

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20
Q

What is ossification?

A

The process of bone replacing fibrous membranes and begins with the appearance of osteoblasts

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21
Q

What are osteoblasts?

A

Bone-forming cells

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22
Q

What do osteoblasts form?

A

Bone matrix

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23
Q

What are osteoclasts?

A

Cells associated with the absorption and removal of bone. They “eat away” the inside of the marrow cavity white the osteoblasts build up the outside of the bone

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24
Q

What are the main functions of the skeletal system?

A

Support, protection, movement, production of blood cells, & storage

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25
Q

What is scoliosis?

A

Lateral deviation and rotation of the spine

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26
Q

What are the various types of scoliosis?

A

Idiopathic, congenital, or acquired

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27
Q

What is congenital scoliosis commonly the result of?

A

hemivertebrae, wedge vertebrae, or neuromuscular development

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28
Q

What is wedge vertebrae or hemivertebrae?

A

A failure of formation of the vertebrae

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29
Q

What is the most definitive and important diagnostic tool for scoliosis?

A

Imaging

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30
Q

What are other modalities used to image scoliosis?

A

CT, MRI, ultrasound (prenatally), & nuclear medicine when patient presents with pain

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31
Q

What is a transitional vertebrae?

A

A vertebrae that takes on the characteristics of the vertebrae on either side of it

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32
Q

What is CDH?

A

Congenital dislocated hip also known as development dysplasia of the hip

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33
Q

What happens with CDH?

A

the capsule of the hip joint relaxes and allows dislocation of the hip

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34
Q

Who is affected the most by CDH?

A

Caucasian females

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35
Q

What percentage of newborns showing clinical signs of CDH will revert back to normal after 6 to 8 weeks of age?

A

75%-95%

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36
Q

What complications may take place if CDH is not diagnosed and treatment is not put into place?

A

Avascular necrosis, a possibility of pseudoacetabulae, and secondary osteoarthritis will occur later in life in the 50s or 60s

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37
Q

What is spina bifida?

A

The failure of fusion of one or more vertebral arches

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38
Q

What is spina bifida occulta (SBO)?

A

Occurs when the two halves of the posterior arch fail to unite

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39
Q

What is the most common location of SBO?

A

The first sacral vertebra

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40
Q

In SBO, what happens with the spinal cord?

A

There is no protrusion of the spinal cord or its membrane, however if neural elements project through the defect without any meninge covering, a myelocele is present

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41
Q

What is Meningocele?

A

When a cerebrospinal fluid (CSF) filled sac is covered with the meninges of the cord

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42
Q

What happens with spina bifida aperta?

A

There is a wide bony defect in the posterior arch of the lumbar vertebrae

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43
Q

What is myelomeningocele?

A

A sac containing CSF and some of the neural elements of the cord protruding

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44
Q

What modalities are used to diagnose myelocele, meningocele, and myelomeningocele

A

Sonography as early as 12 weeks, plain radiographs, and MRI

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45
Q

What is Osteogenesis imperfecta?

A

An inherited connective tissue disorder that affects multiple organs and not just the skeletal system

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46
Q

What is another name for osteogenesis imperfecta?

A

brittle bone disease because of the extreme vulnerability of bones to fracture

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47
Q

What are the two types of osteogenesis imperfecta?

A

Congenital and tarda

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48
Q

What is there a lack of with osteogenesis imperfecta?

A

There is a lack of osteoblastic activity and abnormal collagen formation so that the skeleton does not ossify properly

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49
Q

How many people does OI affect?

A

Between 20,000 and 50,000 people in the United States with 1 in every 20,000 births being afflicted

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50
Q

Is congenital or tarda more severe in regards to OI?

A

Congenital

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51
Q

What happens to infants with congenital OI?

A

They are stillborn or die very early

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52
Q

What happens to the long bones in individuals with OI?

A

The long bones are short, thick, and bowed, resembling dwarfism

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53
Q

When does the tarda form appear in regards to OI?

A

After puberty with multiple fractures and milder deformities of the long bones at varying times following birth

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54
Q

What is often associated with osteogensis imperfecta?

A

deafness since the small ossicles can easily fracture

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55
Q

What is the most common and mildest form of OI?

A

Type 1 (OI tarda 1)

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56
Q

What is the most severe form of OI?

A

Type IV

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57
Q

What is used to determine the initial diagnosis of OI?

A

Dual-energy X-ray absorptiometry

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58
Q

What appears on radiographs in individuals with OI?

A

diffuse osteoporosis with thin cortices, short and thick extremities, and a narrow pelvis

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59
Q

What happens to technique in patients with OI?

A

The kVp must be increased slightly because fractures heal by producing more bone

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60
Q

What process is exactly opposite of OI?

A

Osteopetrosis

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61
Q

What is osteopetrosis?

A

a deficiency of osteoclasts and therefore, faulty bone absorption

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62
Q

What is another name for osteopetrosis?

A

Marble bone disease

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63
Q

What are the different forms of osteopetrosis?

A

Osteopetrosis infantile, osteopetrosis tarda, and osteopetrosis intermediate

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64
Q

What happens with osteopetrosis infantile?

A

Frequently ends in blindness and deafness and then death by age of 2 years

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65
Q

What happens with osteopetrosis tarda?

A

It remains asymptomatic with detection being made with anemia or pathologic fractures

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66
Q

What happens with osteopetrosis intermediate?

A

It falls somewhere in between the other two forms

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67
Q

Patients who suffer from osteopetrosis are prone to what?

A

Osteomyelitis

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68
Q

What modalitiy is the best diagnostic procedure when diagnosing osteopetrosis?

A

Radiography and is supported by CT

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69
Q

What happens to your technique when imaging patients with osteopetrosis?

A

With such a high increase in density of the bones, the technical factors will need to be increases. The kVp will need to be increased but not above 75 for extremities, as the scatter will be greater.

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70
Q

What is achondroplasia?

A

The failure of the cartilage that becomes bone to form properly, thus not allowing ossification to proceed as it should

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71
Q

What is achondroplasia caused by?

A

An abnormal gene located on one of the chromosomes

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72
Q

What disease is the most common cause of disproportionate short stature occurring in 1 in 15,000 to 1 in 25,000 live births?

A

achondroplasia

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73
Q

Who is most affected by achondroplasia?

A

it occurs in all races and both sexes

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74
Q

What is are physical signs of an individual with achondroplasia?

A

They have short extremities while the trunk and skull are of normal size. Often the arms are shorter than the lower extremities. Lordosis of the lumbar spine, bowed legs, and a bulky forehead with a saddle shaped nose. Nasal passages are narrowed and the jaw is small so that the teeth may be crowded and poorly aligned

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75
Q

What happens to the technique when radiographing an infant with achondroplasia?

A

because the cartilage is not ossified as it should, radiographs will not require the higher kVp settings

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76
Q

What is osteopenia?

A

A nonspecific radiographic finding that indicates increased radiolucency of bone

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77
Q

What are the two types of osteopenia?

A

Osteoporosis and osteomalacia

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78
Q

What is osteoporosis?

A

When osteoblasts fail to lay down sufficient amount of bone matrix, an abnormal decrease in bone density occurs

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79
Q

What are the prime factors associated with osteoporosis?

A

Age, gender, race

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80
Q

Who is affected most by osteoporosis?

A

Occurs more often in women and among Whites and Asians than in African Americans

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81
Q

What are the different variety of clinical conditions osteoporosis may occur in?

A

Secondary and primary

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82
Q

What is more common, primary osteoporosis or secondary?

A

Primary (not associated with underlying cause)

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83
Q

What are some of the common locations of osteoporosis?

A

Spine, pelvis, hips, femurs, distal radius/hand, and proximal humerus/shoulder

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84
Q

What do radiographs show when imaging people with osteoporosis?

A

Lack of density in the bones die to loss of calcium and thin cortices with fewer trabeculae

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85
Q

What happens to technical factors when imaging an individual with osteoporosis?

A

Technical factors (particularly kVp) should be decreased so as mot to overexpose the image and cause a repeat radiograph

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86
Q

What is the best modality for osteoporosis?

A

DEXA

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87
Q

What is osteomalacia?

A

It is an abnormal decrease in bone caused by a lack of calcium and phosphorus. This leads to softening of the bone in an adult.

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88
Q

What is a cause of osteomalacia?

A

Vitamin D deficiency and pregnancy

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89
Q

If osteomalacia occurs before the growth plate at the epiphysis closes in children, what is it called?

A

Rickets

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90
Q

What is another name for rickets?

A

Infantile osteomalacia

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91
Q

What is a common manifestation in Rickets?

A

Bowing of the legs

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92
Q

What are other radiographic signs in individuals with osteomalacia?

A

Generalized reduction in bone density due to decreased number of trabeculae

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93
Q

What is osteodystrophy?

A

A disturbance in the growth of bone due to lack of vitamins

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94
Q

What are a few causes of osteodystrophy?

A

Lack of vitamins and renal failure

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95
Q

Brown tumors are associated with what?

A

Osteodystrophy

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96
Q

What are brown tumors caused by?

A

Large amounts of osteoclasts that “eat” away the inside of the bone, causing a lesion

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97
Q

What does increased osteoclastic activity result in?

A

Subperiosteal bone resorption

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98
Q

What disease is characterized by lace-like patterns of the outer cortex of the digits, femur, and humerus?

A

Osteodystrophy

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99
Q

What disease is associated with radiographic images with a fuzzy, moth-eaten appearance of the skull known as the “salt and pepper” skull?

A

Osteodystrophy

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100
Q

When renal osteodystrophy occurs in the spine, what is it called?

A

A “rugger jersey spine”

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101
Q

What is osteomyelitis?

A

Infection of the bone and bone marrow

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102
Q

What is osteitis?

A

Infection of only the bone

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103
Q

What is osteitis mostly caused by?

A

Staphylococci bacteria carried through the blood, but it can also be caused directly if bacteria enter the bone from outside due to conditions such as a compound fracture

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104
Q

What is the usual site for development of osteomyelitis?

A

Long bones of the lower limbs

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105
Q

What happens when osteomyelitis occurs and inflammation causes a rise in pressure within the bone , but the periosteum constricts buildup causing the vessels in the bone to become compressed?

A

The bone will die within 24 to 48 hours

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106
Q

What is dead bone called?

A

Sequestrum

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107
Q

What does dead bone cause on a radiographic image?

A

It causes a linear opacity

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108
Q

What is Osteitis deformans or Paget disease?

A

Overproduction of bone

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109
Q

What kind of disease is Osteitis deformans or Paget disease?

A

Idiopathic disease

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110
Q

Who is Osteitis deformans or Pagets disease more common in?

A

Men over 55 years of age

111
Q

Where does osteitis deformans or Pagets disease occur?

A

Principally at the skull, tibias, and vertebrae

112
Q

What happens to bones in osteitis deformans or Pagets disease?

A

It becomes softened because of the over action of osteoclasts removing calcium, causing the to bow

113
Q

What is the appearance on images in those with osteitis deformans or Pagets disease?

A

Cotton wool

114
Q

What does osteochondritis dissecans mean?

A

Bone dissected or separated from cartilage

115
Q

What are the two forms of osteochondritis dissecans?

A

Legg-Calve-Perth disease and Osgood-Schlatter disease

116
Q

What is Legg-Calve-Perths disease?

A

A common lesion of the head of the femur

117
Q

Who is most affected by Legg-Calve-Perths disease?

A

Young boys around the age of 3 to 12; however, it can occur in females

118
Q

What bone is affected in Legg-Calve-Perths disease?

A

The head of the femur at the center of the epiphysis

119
Q

What happens to the femoral head when an individual has Legg-Calve-Perths disease?

A

It becomes flattened and splayed

120
Q

What is the hallmark of Legg-Calve-perths disease?

A

Flattened femoral head that remains even after the lesion has healed and the bone regains some of its structure

121
Q

What are the earliest clinical signs of Legg-Calve-Perths disease?

A

Pain and trendelendburg gait, a limp

122
Q

What modality is useful fro evaluation of Legg-Calve-Perths disease in the early stages before the epiphysis has ossified?

A

MRI

123
Q

What is Osgood-Schlatter disease?

A

It is characterized as a painful incomplete separation, avulsion, or strain of the epiphysis of the tibial tuberosity from the proximal anterior tibial shaft

124
Q

Who is most likely to be affected by Osgood-Schlatter disease?

A

It is more common in males between 10 and 15 years of age

125
Q

What is said to be the cause of Osgood-Schlatter?

A

A traumatically induced avulsion due to repeated knee flexion against a tight quadriceps muscle

126
Q

What are the symptoms of Osgood-Schlatter?

A

Soft tissue swelling and pain

127
Q

What do radiographic images show with Osgood-Schlatter disease?

A

Epiphyseal seperation and fragmentation on the lateral knee image

128
Q

What are the two different categories of neoplastic bone changes?

A

Benign and malignant

129
Q

What diseases/conditions are considered benign?

A

Fibrous dysplasia, bone cyst, exostosis chondroma (osteochondroma), endochondroma, and osteoclstomas

130
Q

What is fibrous dysplasia?

A

Fibrous displacement of osseous tissue

131
Q

What happens in fibrous dysplasia?

A

Osteoblasts fail to undergo normal morphologic differentiation and maturation

132
Q

What is the age patients seen with fibrous dysplasia and what ages are most common?

A

Patients ranging from 10 to 70 years, but most often seen in the 20s and 30s

133
Q

What bones are involved with fibrous dysplasia?

A

The long bones, ribs, and facial bones

134
Q

What is common with fibrous dysplasia?

A

Pathologic fractures are common because of expansion of the bone causing thin, eroded cortices

135
Q

What does a radiograph show in fibrous dysplasia?

A

well-circumscribed lesions in the shaft of a long bone containing bands of sclerosis causing a multicolor effect

136
Q

What is a bone cyst?

A

A wall of fibrous tissue filled with clear fluid, occurring in the proximal humerus and knee of adolescents and young adults

137
Q

Who is most affected by bone cysts?

A

Males outnumber females by a ratio of 3:1

138
Q

TRUE OR FALSE
Bone cysts are usually noted on a radiograph but are detected only when pain due to cyst growth or a pathologic fracture occurs

A

FALSE
Bone cysts are NOT usually noted on a radiograph but are detected only when pain due to cyst growth or a pathologic fracture occurs

139
Q

When bone cysts do appear on radiographs, what is there appearance?

A

They show a lucent focus with a thin cortex and sharp boundary. There may also be septa to cause a loculated appearance

140
Q

What is the classical sign shown in radiographs with bone cysts?

A

Fallen fragment sign, which occurs with pathologic fractures through a bone cyst

141
Q

What is another modality used to best show bone cysts?

A

CT. CT scans of a bone cysts show a fluid density within a well-defined lesion with bony septations within it

142
Q

What is a chondroma?

A

A cartilaginous tumor that is sharply delineated with a thin inner cortex, as seen on the radiographic image. The underlying bone is completely normal

143
Q

What are the two benign types of chondroma?

A

Exostosis and Endochondroma

144
Q

What is the most common benign type of chondroma?

A

Exostosis

145
Q

What is another name for exostosis?

A

Osteochondroma

146
Q

What is the most common benign skeletal growth or tumor?

A

Osteochondroma

147
Q

Who is more likely to be affected by osteochondroma?

A

Males. 2:1 over females

148
Q

Unless surrounding nerves or blood vessels are disturbed, most osteochondroma are?

A

Asymptomatic

149
Q

Where does osteochondroma arise from and how does it grow?

A

It arises from the cortex and grows parallel to the bone

150
Q

In which direction does osteochondroma point?

A

Away from the adjacent joint and is capped by radiolucent cartilage

151
Q

What is exostosis caused by?

A

Localized bone overgrowth at a joint, seen often at the knee

152
Q

What is an enchondroma?

A

It is a slow-growing benign tumor that arises in the medullary canal of bone that are localized and small

153
Q

What bones are most affected by enchondroma?

A

Bones of the hands and feet of adolescents and young adults

154
Q

The more centrally local an enchondroma is the what?

A

The greater possibility of malignant transformation

155
Q

What are osteoclastomas?

A

They are benign tumors seen in young people in their early 20s

156
Q

What is another word for osteoclastomas?

A

Giant cell tumors

157
Q

Are osteoclastomas popular?

A

Yes, they are relatively common, representing about 15% of all primary tumors

158
Q

What is the most common location of osteoclastomas?

A

in the long bones arising from the epiphysis after closure

159
Q

What are osteoclastomas seen as on radiographs?

A

large lytic lesions separated by thin strips of bone

160
Q

What appearance is seen on radiographs when imaging patients with osteclastomas?

A

Soap bubble appearance

161
Q

What procedure is done to ensure that osteclastomas are removed completely?

A

Surgical intervention

162
Q

What are the four chief primary malignant tumors of bone?

A

Chondrosarcoma, osteogenic sarcoma, Ewing sarcoma, and multiple myeloma

163
Q

Of the bone primary malignant tumors of bone, which is the most easily identifiable on radiographic images?

A

Multiple myeloma

164
Q

What is a chondrosacroma?

A

it is the third most common malignant bone tumor

165
Q

Who is most affected by chondrosarcoma?

A

Men. It occurs two times more often in men over the age of 45 than in women

166
Q

What bones are the sites of a chondromsarcoma?

A

The pelvis and long bones

167
Q

What happens when the primary chondrosacroma is removed?

A

There is often rapid growth or metastasis and prolonged recovery times

168
Q

What do radiographic images reveal with chondrosarcoma?

A

A large, radiolucent lesion with an oval or round shape

169
Q

What is Ewing sarcoma?

A

It is the most common primary malignant bone tumor seen in a child of 5 to 15 years of age

170
Q

How common is Ewing sarcoma overall?

A

It ranks as the fourth most common primary malignant tumor

171
Q

Where does Ewing sarcoma occur?

A

It occurs in the diaphysis of long bones

172
Q

What is Ewing Sarcoma often misdiagnosed with because of the constant low-grade pain, fever, and leukocytosis that are present?

A

Osteomyelitis

173
Q

What is the appearance of Ewing sarcoma on a radiographic image?

A

Onion peel appearance because of the stratified new bone formation caused by healing

174
Q

What is the best modality for Ewing Sarcoma?

A

Nuclear medicine bone scan is the best

175
Q

What is the survival rate of Ewing Sarcoma?

A

There is a 5-year survival rate in only about 5% of all Ewing sarcoma cases

176
Q

What is usually necessary to help prevent metastasis with Ewing Sarcoma?

A

Amputation

177
Q

What is osteogenic sarcoma?

A

A highly malignant primary tumor occurring at 10 to 30 years of age, with the peak incidence rate at 20 years of age

178
Q

What is another name for osteogenic sarcoma?

A

Osteosarcoma

179
Q

Where does osteogenic sarcoma most often occur?

A

In the long bones, particularly at the lower ends of the femurs and upper ends of the humerus or radius

180
Q

Radiographically, how does osteogenic sarcoma appear on images?

A

Dense areas, radiolucent areas, or mixed areas that give it a sunray appearance

181
Q

What happens to the periosteum in Osteogenic Sarcoma?

A

The periosteum is lifted from the bone by the tumor

182
Q

What is the survival rate for Osteogenic Sarcoma?

A

5 year survival rate in about 20% of cases even if the patient is otherwise healthy

183
Q

What bones are particularly affected by multiple myeloma?

A

Flat bones

184
Q

Who is affected most by multiple myeloma?

A

The disease is rare in persons younger than 40 years of age and is most often seen in persons over the age of 50 years

185
Q

Where does multiple myeloma actually arise from and where does it occur?

A

Multiple myeloma actually arises from the bone marrow plasma cells and occurs in bone marrow that is actively hemopoietic. Therefore, it is not a true osseous tumor

186
Q

What is the hallmark radiographic sign of multiple myeloma?

A

Punched-out osteolytic lesions, not unlike a “Swiss cheese” effect

187
Q

What is the overall prognosis in patients with multiple myeloma?

A

The overall prognosis is poor. Over 90% of patients die within 3 years of diagnosis

188
Q

What is the average survival rate in patients with multiple myeloma?

A

33 months

189
Q

Which are more common, metastatic bone tumors or primary bone tumors?

A

Metastatic bone tumors

190
Q

A metastatic tumor is the first sign of what?

A

First sign that cancer is present somewhere else in the body; usually, the breast, lung, prostate, and kidney

191
Q

How do metastatic tumors reach the skeleton?

A

Through circulatory system or lymph system or by invasion

192
Q

What type of fractures occur as a result of the tumor weakening the bone?

A

Pathologic fractures

193
Q

What bones are the first to be affected by metastatic?

A

Bones that contain red cone marrow such as the spine, skull, ribs, pelvis, and femurs

194
Q

What is the most frequent injury to the skeletal system?

A

Fracture

195
Q

What is a fracture?

A

A discontinuity of a bone caused by force applied either directly or indirectly to the bone

196
Q

Fractures of long bones can lead to what?

A

Shock because as much as one liter of blood can be lost in the surrounding tissue

197
Q

What is necessary for the healing of fractures?

A

Bleeding which leads to inflammation and the formation of fibrous tissue

198
Q

What does blood, lymph, and tissue form at a fracture site?

A

Fibrin clot

199
Q

What are embedded into a fibrin clot?

A

Fibroblasts that form a stabilizing type of tissue called granulation tissue that becomes a temporary callus that knits the fracture

200
Q

What is a callus?

A

A fibrocartilaginous mass

201
Q

What is a complete fracture?

A

one that occurs through the entire section of the bone

202
Q

What is an incomplete fracture?

A

A fracture that breaks only one cortex

203
Q

What is another name for an incomplete fracture?

A

A fissure

204
Q

What is a closed fracture?

A

A fracture in which skin is not broken

205
Q

What has to happen in order for a fracture to be considered open?

A

The skin or mucosal surface must be pierced by at least one end of the fracture bone

206
Q

What are simple fractures?

A

When the bone is divided into two complete pieces

207
Q

What is a comminuted fracture?

A

When the bone may be shattered but there must only be three or more fragments

208
Q

What terms describe the direction of the fracture in relation to the long axis of the bone?

A

Transverse, spiral, oblique, longitudinal

209
Q

What is a stellate fracture?

A

A star-shaped fracture, particularly on the patella or the calvarium

210
Q

What does displacement refer to?

A

The lateral positioning of fragments

211
Q

What does distraction refer to?

A

The gap between the fragments

212
Q

What does dislocated mean?

A

the bones that form a joint no longer articulate

213
Q

What is subluxation?

A

partial dislocation

214
Q

What is the term used when healing does not occur in the normal time?

A

Delayed union

215
Q

What is malunion?

A

When the bone ends have not been properly reduced and are misaligned, which impairs normal function

216
Q

What is nonunion?

A

When the bone ends never join at all

217
Q

What are the most common types of fractures?

A

Plastic, greenstick, torus, epiphyseal, fatigue, pathologic, avulsion, compression, Galeazzi, Monteggia, Colles, Smith, Bennett, boxer’s, bimalleolar, and trimalleolar

218
Q

What is a plastic fracture?

A

It occurs when the soft young bone bends, but the cortex does not actually break

219
Q

What is a greenstick fracture?

A

A break in the cortex but only on one side of the shaft

220
Q

What is a torus fracture?

A

A type of greenstick fracture in which a driving force pushes down the shaft of bone, causing the cortex to fold back onto itself

221
Q

What is a epiphyseal fracture?

A

It occurs through un-united areas of epiphyses

222
Q

What is a fatigue fracture?

A

It occurs at sties of maximum stress, usually the metatarsal bones

223
Q

What is another name for a fatigue fracture?

A

March fracture or stress fracture

224
Q

What is a pathologic fracture?

A

A fracture that occurs when normal stress is placed on diseased areas of bone

225
Q

What is an avulsion fracture?

A

When a small chip of bone breaks away when a joint has dislocated

226
Q

What is a compression fracture?

A

Compressing forces applied to both sides of the bone

227
Q

What is the Galeazzi fracture?

A

A fracture of the radial shaft at the junction of the middle and distal thirds. It is associated with dislocation of the distal ulna

228
Q

What is the Monteggia fracture?

A

It involves the proximal third of the ulna with anterior dislocation of the radial head

229
Q

What is the hallmark indication of a Monteggia fracture?

A

The sail sign

230
Q

What fractures occur at the wrist?

A

Colles and Smith fractures

231
Q

What is a colles fracture?

A

Occurs when the distal radius fractures with the fragment being displaced posteriorly

232
Q

What is a Smith’s fracture?

A

Occurs when the distal radius fractures with the fragments being displaced anteriorly

233
Q

What are the most common fractures seen in hands?

A

Bennett fractures

234
Q

What is a Bennett fracture?

A

A fracture at the base of the first metacarpal (thumb) with proximal displacement

235
Q

What is a Boxer’s fracture?

A

A fracture that occurs at the neck of the fifth metacarpal

236
Q

What is a bimalleolar fracture?

A

A fracture of the lateral and medial malleoli of the ankle

237
Q

What is a trimalleolar fracture?

A

Fracture of the lateral, medial, and posterior malleoli of the ankle

238
Q

What is a Pott fracture?

A

Bimalleolar fracture with an avulsion fracture of the medial malleolus caused by abduction and external rotation of the ankle

239
Q

How does the shoulder dislocate?

A

Anteriorly, with the head slipping into the subglenoid fossa

240
Q

How does the hip dislocate?

A

Posteriorly against the sciatic notch

241
Q

What is arthritis?

A

It is an inflammation of the joint, but there can be degenerative changes without infection

242
Q

What is the most common joint disease?

A

Arthritis

243
Q

What is the most common type of arthritis?

A

Osteoarthritis

244
Q

What is osteoarthritis?

A

Noninflammatory deterioration of the articular cartilage with new bone forming at the surface of the join

245
Q

What is another name for osteoarthritis?

A

Degenerative joint disease (DJD)

246
Q

What do radiographic images of the joint show on someone with osteoarthritis?

A

Spurring, or in severe cases, mild subluxation or loose bodies within the joint space

247
Q

What is rheumatoid arthritis?

A

It is an autoimmune disease characterized by chronic and progressive inflammatory involvement of the joints and atrophy of the muscles

248
Q

What joints does RA affect?

A

Small joints of the hands and feet

249
Q

Who is most often affected by RA?

A

Women in their 30s and 40s three times more often than males

250
Q

What is the cause of RA?

A

There is no known cause

251
Q

What are the symptoms of RA?

A

Inflammation of the synovial membrane causing pain, stiffness, and thickening of the tissue

252
Q

What do radiographs show in the early stage of RA?

A

Soft-tissue swelling around the joints

253
Q

What do radiographs show in the later stages of RA?

A

A decrease in the joint space, with eroded bone ends a subluxation

254
Q

What are some examples of deformities associated with RA?

A

Ulnar deviation of the wrist with either “boutonniere deformity” (flexion) or “swan neck deformity” (hyperextension) of the proximal interphalangeal joint occurs

255
Q

What is ankylosing spondylitis?

A

A chronic inflammatory disorder that predominantly affects the sacral iliac joints and lumbar spine

256
Q

What is another name for ankylosing spondylitis?

A

rheumatoid spondylitis

257
Q

What is ankylosing spondylitis a common cause of?

A

Chronic lower back pain

258
Q

What is the age of onset with ankylosing spondylitis?

A

Between 15 and 35 years with an averago age of approximately 26 years

259
Q

90% of patients who have ankylosing spondylitis are which gender?

A

Male

260
Q

Where does ankylosing spondylitis start?

A

In the lower spine and progresses upward

261
Q

What happens when ankylosing spondylitis reaches the thoracic area?

A

Kyphosis develops and breathing becomes difficult due to limit chest expansion

262
Q

What is the hallmark appearance on a radiograph with ankylosing spondylitis?

A

Bamboo-spine

263
Q

What is the most common non-arthritic ailment of joints?

A

Bursitis

264
Q

What is Bursitis?

A

An inflammation of the synovial bursa caused by excess stress on the joint

265
Q

Where is Bursitis usually found?

A

In the shoulder

266
Q

What might the radiographs show when imaging Bursitis?

A

Calcified deposits in the tendon about the greater tuberosity of the humerus

267
Q

What is Spondylolisthesis?

A

The forward displacement of one vertebra on top of another, usually occurring at the L5/S1 junction

268
Q

What is spondylolisthesis usually caused by?

A

Some kind of defect of the pedicle

269
Q

What is spondylitis?

A

Inflammation of the spinal vertebrae

270
Q

What is spondylosis?

A

A condition of the spine characterized by fixation and stiffness

271
Q

What are disk herniations?

A

When the fibrous ring of the disk degenerates to the point that the pulpy nucleus is forced out of the disk

272
Q

Where are disk herniations common?

A

In the lumbar spine area

273
Q

What do radiographs show in regards to disk herniations?

A

narrowing of the disk

274
Q

What do CT and MRI demonstrate in regards to disk herniations?

A

The extent of the damage

Chapter 2 Pathology (1 decks)

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