Unit 1 STRX Flashcards
Explain the pros, cons, and common uses of an X-ray
Pros: Inexpensive, portable/mobile, widely used, high spatial resolution (very small structures observed)
Cons: Uses ionizing radiation, low contrast resolution, low temporal resolution (movement ruins images)
Common uses: chest, abdomen, skeletal system
Explain the pros, cons, and common uses of Computed Topography
Pros: High spatial resolution, High contrast resolution, post-processing allows for additional manipulation of contrast, can be shown in any plane (axial, sagittal, coronal)
Cons: low temporal resolution, expensive, uses ionizing radiation
Common uses: wide variety of uses
Explain the pros, cons, and common uses of Ultrasound
Pros: High temporal resolution, medium-high spatial resolution, medium contrast resolution, inexpensive, portable, widely used, no radiation, very safe
Cons: Limited visualization
Common uses: first choice in female pelvic and pediatric patients
Explain the pros, cons, and common uses of MRI
Pros: High contrast resolution, medium-high spatial resolution, no radiation
Cons: low temporal resolution, very expensive, safety issues (giant magnet)
Common uses: Neurologic imaging and soft tissue
Explain the pros, cons, and common uses of Flouroscopy
Pros: medium spatial resolution, high temporal resolution (real time visualization), can be mobile
Cons: low contrast resolution, substantially higher radiation than Xray
Common uses: GI, IR, surgical navigation
Explain the pros, cons, and common uses of Nuclear Medicine
Pros: allows to concentrate on specific body tissues
Cons: Low spatial, contrast, and temporal resolution, uses radiation (CT machine, radioisotopes)
Common uses: diagnosing/treating hyperthyroidism, thyroid cancer, lymphomas, bone cancer
Explain the pros, cons, and common uses of Positron Emission Tomography (PET-CT)
Pros: High spatial resolution, high contrast resolution, locates hidden metastases
Cons: Low temporal resolution, uses radiation (positron), VERY expensive
Common uses: diagnosis and follow up of cancer, heart disorders, and brain disorders
Put the following in order of density how it would appear on imaging: fat, calcium, air, metal, soft tissue/fluid
Air (least dense, blackest)
Fat
Soft Tissue/Fluid
Calcium
Metal (most dense, whitest)
What is seen as the cornerstone of cross-sectional imaging?
CT
What is seen as the cornerstone of cross-sectional imaging?
CT
Explain how the following images are created: Xray, CT, MRI, Ultrasound, Fluoroscopy, Nuclear Medicine, PET
X-ray: Beam of ionizing radiation is passed through pt, the beams not absorbed by the body are projected onto image plate
CT: Rotating X-ray displays 3D image via computer algorithms
MRI: Uses potential energy of body’s hydrogen atoms
Ultrasound: uses acoustic energy above the audible frequency to create sound waves, the reflected waves create an image on the screen
Fluoroscopy: Continuously emits X-ray beams
Nuclear Medicine: radiopharmaceuticals are injected, swallowed or inhaled and travels through the body emitting gamma rays which are detected by camera
PET: positron-producing radiopharmaceutical injected into pt and the positron decay is tracked to construct an image
Describe the steps of collection and submission of tissue for pathological evaluation.
Selection, Processing (Fixation, Dehydration, Clearing, Infiltration), Embedding, Trimming, Staining, Interpretation
Describe the steps preparing tissue for examination (Processing, Embedding, Sectioning, Staining)
Fixation: tissue placed in solution which inactivates degrative enzymes and cross-link proteins to preserve cell and tissue structure (formalin)
Dehydration: Tissue transferred through increasing strengths of ethanol
Clearing: Alcohol removed with xyline
Infiltration: tissue placed in paraffin until completely infiltrated with wax
Embedding: Tissue placed in small mold to harden in correct orientation
Staining: Different stains used for different parts of tissue
What is the purpose of processing tissue and what could happen if tissue is not processed properly?
To make tissue “cuttable” and “mountable” to maintain the anatomic integrity through slicing process
Tissue could lose anatomic integrity, wrong diagnoses made, wrong pt informed
Contrast the sampling methods of cytology
Exfoliative: scraping, brushing, or falling off into fluid (urine)
Aspiration: collecting cells via fine needle or endoscopically (joints, pancreas)
Pap Smear: invasively scraping cells of cervix
Explain the pros, cons, and common uses of Dual Energy X-ray Absorptiometry (DEXA)
Pros: Generates quantitative information about bone-density, non-invasive, low cost
Cons: Uses radiation
Common uses: bone density
Superficial extrinsic back muscles
Trapezius, Latissimus dorsi, Levator scapulae, Rhomboids
Intermediate extrinsic back muscles
Serratus posterior superior, serratus posterior inferior
Intrinsic back muscles
Superficial layer: splenius muscle (cervicis and capitis)
Intermediate layer: iliocostalis, longissimus, spinalis
Deep layer: semispinalis, multifidus, rotatores
What back muscles origin is the fascia of the back?
Latissimus dorsi
What artery supplies the serratus posterior muscles?
Intercostal arteries
What are the four tissue types, their functions, and their levels of ECF?
Epithelium - line cavities, secretion - little ECF, tightly packed together
Connective - protection, support - a lot of ECF, needs for movement
Muscle - contraction, peristalsis - moderate ECF
Nervous - sending electrochemical signals - very little ECF
Characterize the structure and function of this tissue.
Epithelium - lining of cavities, tightly packed, acts as a barrier to only allow certain substances in, little ECF
Characterize the structure and function of this tissue.
Nervous - sends electrochemical signals - very little ECF
Characterize the structure and function of this tissue.
Muscle - contraction, peristalsis - moderate ECF
Characterize the structure and function of this tissue.
Connective - provides protection and support - needs a lot of ECF for movement
Identify the patients that potentially have Sickle Cell Disease
Lane 5 - homozygous of SCD
Lanes 7, 9, 11 - Sickle Cell Trait
Describe and differentiate Southern, Northern and Western blotting.
Southern - DNA probe on DNA target molecule
Northern - DNA probe on RNA target molecule
Western - Antibody probe on Protein target molecule
What are the basic steps in a PCR reaction?
Denaturation (95C), Annealing (15C), Elongation (72C)
What bones form via Intramembranous ossification?
Which form via Endochondral ossification?
Clavicle, flat bones of the face, skull bones
Literally everything else
When reading a CT scan, which direction do you view the radiograph from?
From the feet looking toward the head
Appearance of an MRI - general shading
Air and bone - black
Tissues with moderate signal (more water) - grey
Tissues with high signal (less water) - white
What structures do somatic nerves innervate?
Skeletal muscle (efferent to skeletal muscle)
What structures do autonomic nerves innervate?
Smooth muscle (organs, blood vessels), cardiac muscle, glands
How many efferent neurons are involved in somatic pathways?
Autonomic pathways?
One neuron
Two neurons - preganglionic and postganglionic
What NT are involved in somatic pathways?
Autonomic?
Ach
Sympathetic: Ach and NE
Parasympathetic: Ach
What spinal levels correlate with the sympathetic and parasympathetic systems?
Sympathetic: T1-L2 thoracolumbar
Parasympathetic: cranium and S2-S4 craniosacral
Briefly describe the sympathetic pathway of an efferent neuron to a blood vessel or sweat gland of the body wall or extremities.
Synapse in the sympathetic ganglion (paravertebral)
Same level - postganglionic exits through grey communicating rami
Different level - travels up/down sympathetic trunk, then exits through GCR
Briefly describe the sympathetic pathway of an efferent neuron to a thoracic organ (above the diaphragm).
Synapse in the sympathetic ganglion (paravertebral)
Postganglionic exits through visceral nerve to synapse on plexus
Briefly describe the sympathetic pathway of an efferent neuron to an abdominal organ (below the diaphragm).
Synapse in the prevertebral ganglion
Postganglionic exits through named nerve
Briefly describe the sympathetic pathway of an efferent neuron to a suprarenal gland
Synapse in the gland itself
Briefly describe the sympathetic pathway of an afferent neuron from a visceral organ back to the spinal cord.
Unipolar neuron follows sympathetic efferent pathway back, through white communicating rami, to dorsal root ganglia
Briefly describe the parasympathetic pathway of an efferent nerve to the blood vessels of the pelvis
Leaves ventral horn, passes or passes through WCR and sympathetic trunk (without synapsing), exits through splanchnic nerve, synapses on terminal ganglia in blood vessel
What is the function of this connective tissue?
Type 1 Collagen makes up tendons, ligaments, ECM
most abundant proteins in the body
What is the function of this connective tissue?
Reticulin fibers often support individual cells
best seen with silver stain
What is the function of this connective tissue?
Elastic fibers have ability to stretch and return to original conformation
abundant in large blood vessels, organs, and ligaments
What are the major constituents of the Ground Substance?
Water, proteoglycans, glycoproteins, glycosaminoglycans
Assume you had 500 children present to your clinic with “strep-like” symptoms last year and all of them were screened with a rapid strep test. Of these, 100 actually had strep throat.
Sensitivity 90%; Specificity 95%
- How many children with strep infection will have tested positive?
- How many children with strep infection will have tested negative?
- How many children without strep infection will have tested positive?
- How many children without strep infection will have tested negative?
90 with strep will test positive
10 with strep will test negative
20 without strep will test positive
380 without strep will test negative
Sensitivity detects true positives
Specificity detects true negatives
Where are these nerves going?
To innervate the vessels and sweat glands of the body wall
Where is this nerve going?
To innervate a thoracic organ (above the diaphragm) via the visceral nerve
Where is this nerve going?
To innervate an abdominal organ (below the diaphragm) via the splanchnic nerve
What nerves are these and where are they going?
Dark purple is sympathetic efferent going to innervate an abdominal organ (below the diaphragm) via the splanchnic nerve
Light purple is a sympathetic afferent coming from the abdominal organ back to the spinal cord
What nerves are these and where are they going?
Blue is a parasympathetic efferent going to synapse on a neuron on the cell wall via the splanchnic nerve
Orange is a parasympathetic afferent returning to the spinal cord
What are the borders of the femoral triangle?
Sartorius
Adductor longus
Inguinal Ligament
What is the function of these cells?
Goblet cells secrete mucus to protect mucous membranes
Label the ligaments
- Anterior Cruciate Ligament (ACL)
- Lateral Collateral Ligament
- Lateral Meniscus
- Medial Meniscus
- Medial Collateral Ligament
- Posterior Cruciate Ligament (PCL)
- Anterior Cruciate Ligament (ACL)
- Lateral Collateral Ligament
- Lateral Meniscus
- Posterior Cruciate Ligament (PCL)
What is an open canalicular system?
the system where dense and alpha-granules release product into, helps aid in rapid degranulation
What are pro-platelets and where are they shed?
Cytoplasmic projections from megakaryocytes shed into bone marrow sinusoids
Name the body part, imaging modality, orientation, and window
CT pulmonary angiogram
CT
Axial
Soft-tissue window
Name the body part, imaging modality, orientation, and window
What is the abnormality?
Brain
CT
Axial
Brain window
Brain hemorrhage (brain window shows fluid as bright)
What is the unhappy triad of knee joint?
Medial Collateral Ligament, Medial meniscus, and ACL tear
Pathway of lymphatic vessels accompanying great saphenous vein
superficial inguinal lymph nodes –> deep inguinal –> external iliac lymph nodes –> common iliac lymph nodes –> lumbar lymphatic trunks
Pathway of lymphatic vessels accompanying small saphenous vein
popliteal lymph nodes –> deep inguinal lymph nodes –> external iliac lymph nodes –> common iliac lymph nodes –> lumbar lymphatic trunks
Deep lymphatic vessel pathway
popliteal lymph nodes –> deep inguinal –> external iliac –> common iliac –> lumbar lymphatic trunks
(same as small saph)
Gluteal lymphatic pathways
Superior and inferior gluteal lymph nodes –> internal, external and common iliac –> lateral lumbar lymph nodes
Lymphatic drainage from the foot
Popliteal lymph nodes –> deep inguinal –> external iliac –> common iliac –> lumbar trunk
What is the function of the ground substance?
provides lubrication and allows diffusion of molecules needed for metabolism between cells and the vascular system
Identify the nerve roots from which the tibial nerve is derived
anterior division of anterior rami of L4-S3
A patient severs their tibial nerve, what would be the typical clinical presentation you would expect?
Inability to plantarflex (tibial nerve supplies posterior leg) and loss of sensation of sole of foot (medial and lateral plantar n.)
What are the attachments of the lateral meniscus?
Medial portion of popliteus tendon
Posterior aspect of PCL
medial femoral condyle
Why is the ankle more stable in dorsiflexion than plantarflexion?
The trochlea of the talus is narrower posteriorly and so articulation with the tibia and fibular is better in dorsiflexion
Branches of what nerves supply the ankle joint?
Tibial, deep and superficial fibular, saphenous, sural
