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FALL 2024: Pathology > Week 3: Skeletal System Pt 2 > Flashcards

Week 3: Skeletal System Pt 2 Flashcards

1
Q

The pineal gland and pituitary gland are controlled by the

A

Hypothalamus

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2
Q

Hypothyroidism

A

Under activity of them thyroid gland

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3
Q

Hyperthyroidism

A

Over activity of the thyroid gland

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4
Q

Bone Densitometry/DXA

A

An important modality in the evaluation of osteoporosis. DXA units readily show bone density by evaluating the bone mass of the distal radius, femoral neck, and lumbar spine. The results of bone densitometry are used in combination with routine laboratory tests of blood and urine to determine loss of bone mass. Bone mineral densitometry reports indicate the amount of bone mass present and compare the density of an individual to norms used during evaluation

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5
Q

Osteopenia

A

A radiographically visible decrease in bone density

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6
Q

Osteoporosis

A

a commonly known metabolic bone disorder in which the structural integrity of the trabecular pattern of bone is destroyed and is identified as a bone mass less than 648 mg/cm2

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7
Q

Primary Osteoporosis vs Secondary Osteoporosis

A

•Primary osteoporosis: most common, may be further classified as postmenopausal or senile(old age)
•Secondary osteoporosis: most often associated with an existing disease of the endocrine system or is the result of a medication

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8
Q

Cause of Osteoporosis and the effect on the bone structure:

A

• Thinning cortical bone & enlargement of the medullary canal; without diameter changes
• Bones become “porous”
• Subject to compression fractures
• Bones cave from weakened structure

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9
Q

Osteoporosis etiology: Is it genetic, congenital, hormonal, metabolic, or chromosomal?

A

Metabolic (and hormonal)

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10
Q

Is osteoporosis additive or destructive? Do we increase of decrease technique?

A

Destructive, decrease the technique

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11
Q

Best modality for Osteoporosis

A

Bone mineral densitometry, radiography

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12
Q

Osteomalacia

A

a condition caused by lack of calcium in tissues and failure of bone tissue to calcify

*also known as Rickets if it occurs before growth plate closure

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13
Q

If osteomalacia occurs before growth plate closure, it is known as ______
•What causes this?

A

•Rickets
•Caused by a lack of vitamin D and calcium in a child’s diet. However, rickets can also be caused by a genetic defect or other underlying health conditions

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14
Q

Etiology of Paget’s disease?

A

Unknown

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15
Q

Two stages of Paget’s Disease are

A

► Osteolytic: breakdown of bone
► Osteoblastic: replaced by soft and poorly mineralized bone

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16
Q

Paget’s radiographic appearance

A

Cotton wool

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17
Q

Modality to help detect Paget’s

A

Nuclear medicine

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18
Q

Is Paget’s disease additive or destructive?

A

can be considered both an additive condition because of the increased bone growth and a destructive condition because the added bony matrix is much less dense

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19
Q

What is Acromegaly?

A

an endocrine disorder caused by a disturbance in the function of the pituitary gland; this disorder primarily affects the skeletal system

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20
Q

Acromegaly etiology

A

caused by excessive secretion of GH in adults

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21
Q

Acromegaly Radiographic appearance

A

Radiography demonstrates enlarged sella turcica & changes in skull bones

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22
Q

Acromegaly modality choice

A

MRI is modality of choice to evaluate the pituitary gland

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23
Q

Acromegaly physical characteristics

A

prominent forehead and jaw, widened teeth, and abnormally large, spade-like hands, and a coarsening of facial features

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24
Q

Fracture

A

a discontinuity of bone caused by mechanical forces either applied to the bone or transmitted directly along the line of a bone

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25
Q

Epistaxis

A

Nosebleed usually present with a nose fracture

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26
Q

Dislocation (luxation)

A

joint dislocation, or luxation, results when a bone is out of its joint and not in contact with its normal articulation

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27
Q

Subluxation

A

a partial dislocation, often occurring with fracture

28
Q

Benefits of digital imaging in fracture evaluation

A

helpful in evaluating soft tissue structures surrounding a skeletal fracture because images can be manipulated to demonstrate details of both soft tissue and bone

29
Q

T or F: Radiography is important for skeletal trauma evaluation

A

True

30
Q

T or F: Wet fiberglass or plaster cast requires routine exposure factors

A

False, exposure factors must be increased

31
Q

T or F: One projection is enough for evaluating trauma

A

False, at least 2

32
Q

T or F: Long bone trauma requires joints above and below to be radiographed

A

True

33
Q

Identify the responsibilities of the radiographer while imaging patients suspected of fracture

A

• Set appropriate technique to optimize visualization of bony and soft tissue structures
• Cast, no cast
• Assess the patient
• Inquire how injury occurred
• Communicate with radiologist
• Note points of tenderness, pain
• Provide detailed patient history

34
Q

Delayed union vs Malunion vs Nonunion

A

•Delayed union: fracture that does not heal within the usual time
•Malunion: a fracture that heals in a faulty position
•Nonunion: a fracture in which healing does not occur and the fragments do not join

35
Q

Open (Compound) Fracture

A

•Bone has penetrated the skin
•Potential to lead to Osteomyelitis

36
Q

Closed (Simple) Fracture

A

the skin is not penetrated which reduces the chance of infection

37
Q

Impacted Fracture

A

Fractured bone end is jammed into the cancellous tissue of another fragment

38
Q

Comminuted Fracture

A

Sometimes, one or more fragments separate along the edges of the major fragment in addition to the major line of the fracture.

39
Q

Complete, Noncomminuted Fracture

A

one in which the bone has separated into two fragments. The fracture may be recognized according to the direction of the fracture line. A spiral, transverse, or oblique fracture is an example of this type

40
Q

Avulsion Fracture

A

Fragment of bone is pulled away from the shaft

41
Q

Incomplete Fracture

A

Those in which only part of the bony structure gives way, with little or no displacement. A common example is the greenstick fracture.

42
Q

Greenstick Fracture

A

Incomplete fracture, cortex breaks on one side without separation or breaking of the opposing cortex

43
Q

Growth Plate Fracture

A

Involve the end of a long bone of a child. The fracture may be limited to growth plate cartilage and is thus not directly visible unless displacement occurs, or it may extend into the metaphysis, epiphysis, or both

44
Q

Stress Fracture

A

Usually occur as a result of an abnormal degree of repetitive trauma. They are generally found at the point of muscular attachments, as in the tibia or fibula of a runner.

45
Q

Fatigue Fracture

A

Occur at sites of maximal strain on a bone, usually in connection with unaccustomed activity. Most frequently, fatigue fractures are found in the metatarsals, particularly the second metatarsal

46
Q

Occult Fracture

A

In an occult fracture, clinical signs are manifested without radiologic evidence. Follow-up examination within 10 days reveals bone reabsorption or displacement at the fracture site. The most common sites for occult fractures are the carpal scaphoid and the ribs

47
Q

Differentiate between:
•Closed reduction:
•Open reduction:

A

•Closed reduction: The most common treatment is splinting, casting, or both. Requires that a local or general anesthetic be given to the patient for pain management.
•Open reduction: Required when orthopedic hardware is needed to maintain fracture reduction or when an open fracture needs to be irrigated (flushed out)

48
Q

What is the Salter-Harris system and briefly describe the “grading”

A

Fractures are numbered I through VI, with I being least severe and VI being most severe. Comparison projections are often used with such fra­ctures to compare growth plate appearances, and MRI may be used to further evaluate epiphyseal separations. Healed injuries of this type may result in an alteration of the length of the involved bone. Because of possible length discrepancies, frequent radiographic examinations may be required, often up to years after the injury.

49
Q

Colles Fracture

A

Fracture through the distal inch of radius. The fragment is angled backward on the shaft.

50
Q

Smith Fracture

A

Displacement of the distal fragment toward the palmer aspect of the hand

51
Q

Boxer’s Fracture

A

occurs on the fifth metacarpal (occasionally fourth) as a result of a blow to or with the hand

52
Q

Bennett Fracture

A

Fracture and dislocation of the first carpometacarpal joint. An Avulsion fracture.

53
Q

Monteggia Fracture

A

Fracture of the proximal third of the ulnar shaft, with anterior dislocation of the radial head

54
Q

Pott Fracture

A

Dislocation of the ankle joint and fracture of both malleoli in the ankle

55
Q

Trimaleolar Fracture

A

Involves the medial and posterior malleoli of the tibia and lateral malleolus of the tibia

56
Q

The most common wrist fracture is ________ and when present, it externally resembles a(n) ________

A

Colles fracture; dinner fork

57
Q

The most common metacarpal fracture is the ________

A

Boxer’s fracture

58
Q

Discuss the significance of the “fat pad sign”

Radiographically, how might the following indicate the presence of a fracture?
•Posterior fat pad:
•Anterior fat pad:

A

The elbow “fat pad sign” may be an indicator of a nonvisualized underlying fracture of the bones of the elbow.

•Posterior fat pad: Visualization of a posterior fat pad is considered a sign of a possible underlying fracture or dislocation. If the joint capsule is distended by fluid as a result of a fracture, the posterior fat pad becomes displaced from bone and is visible on the lateral projection of the elbow
•Anterior fat pad: In the elbow, normally a small accumulation of fat is present adjacent to the anterior surface of the distal humerus and the anterior surface of the proximal radius. The anterior fat pad may also be displaced, giving a sail-shaped appearance.

59
Q

Differentiate between the following and identify the bones affected in each injury.
•Tripod fracture:
•Blowout fracture:

A

•Tripod fracture: The zygoma is fractured at all three sutures: frontal, temporal, and maxillary.
•Blowout fracture: A direct blow to the front of the orbit that transfers the force to the orbital walls and floor.

60
Q

Which bone has the slowest healing time following a traumatic injury?

A

Mandible

61
Q

The most frequently fractured facial bone is the

A

Nasal bone

62
Q

Describe the Hills-Sachs deformity:

A

A compression fracture of the humeral head. It occurs on the superior and posterior head of the humerus because of impaction of the humeral head against the glenoid labrum during dislocation

63
Q

Another term (and acronym) for Battered child syndrome is:

A

Nonaccidental trauma (NAT)

64
Q

Describe Shaken Baby Syndrome or Abusive head trauma:
•How does it occur?
•What modalities are useful in diagnosing this condition?

A

•Abusive head trauma, a severe type of physical abuse that affects the child’s head and neck.

•How does it occur? Shaking of the child causes whiplash injury to the neck and brain trauma such as a subdural or subarachnoid hematoma, with no evidence of trauma to the external cranium. High morbidity & mortality rate: 25%

•What modalities are useful in diagnosing this condition? CT & MRI

65
Q

Describe Avascular necrosis:

•What anatomical structures are most likely to be affected?
•Which modality can best demonstrate this condition in the early stages?

A

Bone death resulting from inadequate blood supply.

•What anatomical structures are most likely to be affected? hip, knee, shoulder, or carpal scaphoid
•Which modality can best demonstrate this condition in the early stages? MRI

66
Q

Giant Cell Tumor (GCT)

A

•Aggressive neoplasms characterized by a “soap bubble” appearance
•Lucent lesion in the metaphysis, usually at the distal femur (Merrills)
•Decrease exposure factors (Osteoclastic disease)

FALL 2024: Pathology (10 decks)

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