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Pathology > Skeletal System > Flashcards

Skeletal System Flashcards

1
Q

A vertebra that takes on characteristics on both sides of a major division of the spine

A

Transitional Vertebra

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2
Q

A transitional vertebra of C7-T1 is what?

A

An extra rib

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3
Q

A transitional vertebra of T12-L1 is what?

A

rib articulating with transverse process

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4
Q

A transitional vertebra of L5-S1 is what?

A

Expanded transverse process (unilateral or bilateral)

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5
Q

Posterior defect of the spinal canal-failure to close properly

A

Spina Bifida

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6
Q

A mild form of spina bifida in which there is a splitting of the bony neural canal at the L5-S1 level

A

Spina Bifida Occulta

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7
Q

Large defects are associated with spinal cord abnormalities & lead to what?

A

Muscular abnormalities and lack of bladder or bowel control.

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8
Q

Slight ________ of skin or tuft of _______ over the site of lesion/defect in Spina Bifida

A

dimpling/ hair

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9
Q

Herniation of meninges from large defects in the lumbar or cervical spine

A

Meningocele

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10
Q

Herniation of meninges & portion of spinal cord or nerve roots

A

Myelomeningocele

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11
Q

What is the appearance of spina bifida

A
  1. Large bony defects, absence of laminae & increased interpedicular distance
    2, Soft tissue mass posterior to spine
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12
Q

Another name for Marble Bone Disease

A

Osteopetrosis

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13
Q

A rare hereditary bone dysplasia in which failure of the resorptive mechanism of calcified cartilage interferes with the normal replacement by mature bone. Prevents bone marrow from forming (brittle bone-stress fx)

A

Osteopetrosis

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14
Q

With Osteopetrosis, what do you need to do for technique

A

increase in technique due to generalized increase in bone density.

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15
Q

Brittle Bone Disease

A

Osteogenesis Imperfecta

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16
Q

Disorder of connective tissue with severe osteoporosis. Thin, defective cortices (low kvp). Its Characterized by multiple fractures (exuberant callus formation, bizarre deformaties).

A

Osteogenesis Imperfecta

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17
Q

What disease of the bone sometimes may be confused with Child Abuse because of the presentation of multiple fractures in different stages of the healing process?

A

Osteogenesis Imperfecta

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18
Q

Diminished proliferation of cartilage in the growth plate-Most common form of dwarfism

A

Achondroplasia

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19
Q

What is the appearance of Achondroplasia?

A
  1. Progressive narrowing of interpedicular distance from superior to inferior (opposite of normal).
  2. Scalloping of posterior margins of lumbar vertebral bodies.
  3. Long bones appear short & thick
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20
Q

Acetabulum does not completely form causing head of femur to become displaced superiorly and posteriorly. Ligaments & tendons / unilateral or bilateral. Mostly occurs in females

A

Congenital Hip Dysplasia

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21
Q

What views are needed to demonstrate congenital hip dysplasia?

A

AP and bilateral frog leg (cleaves)

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22
Q

Chronic systemic disease of unknown cause. Inflammation and overgrowth of synovial tissue. Periarticular soft tissue swelling, symmetric joint destruction & deformity.

A

Rheumatoid Arthritis

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23
Q

In Rheumatoid Arthritis where is it most commonly found and in whom?

A

Small bones of hands and feet (crippling deformity).

Females/ avg age is 40 years

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24
Q

How does Rheumatoid Arthritis begin?

A

As an inflammation of the synovial membrane that lines the joints.

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25
Q

Excessive exudate (fluid) causes what in Rheumatoid Arthritis?

A

proliferation of synovium

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26
Q

Rheumatoid Arthritis results in what?

A

a mass that causes erosion of articular cartilage and underlying cortex (development of ankylosis-bone fusion across joint).

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27
Q

In Rheumatoid Arthritis the destruction of cartilage causes what?

A

narrowing of joint space

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28
Q

Ulnar deviation in the hands is common in what disease?

A

Rheumatoid Arthritis

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29
Q

Progressive form of arthritis involving the spine and SI joints.

A

Ankylosing Spondylitis

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30
Q

To whom does Ankylosing Spondylitis often occur in?

A

Males 20-40 years of age

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31
Q

What appearance does this describe? Bilateral narrowing & fuzziness of SI joints. Calcification of bones of spine with ossification of vertebral ligaments (Polar spine/bamboo spine). Fusion of the vertebra

A

Ankylosing Spondylitis

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32
Q

Another name for Reiter syndrome

A

Reactive arthritis

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33
Q

Reiter syndrome is characterized by what 3 things?

A

arthritis, urethritis, and conjunctivitis (eye infection)

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34
Q

Reiter syndrome is a variant of what?

A

rheumatoid arthritis

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35
Q

What disease is associated with bacterial infections of GI & genitourinary systems. Affects SI joints, heel & toes. Asymmetric involvement of SI joints. Basically a reaction to bacteria in the body.

A

Reiter Syndrome

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36
Q

Another name for degenerative joint disease

A

Osteoarthritis

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37
Q

What is a gradual deterioration of articular cartilage with hypertrophic bone formation.

A

Osteoarthritis

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38
Q

Osteoarthritis affects what joints?

A

weight bearing joints

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39
Q

What disease has this appearance-
Irregular narrowing of joint spaces due to thinning of cartilage (RA has even narrowing of joint space). Osteophytes (Bone spurs)

A

Osteoarthritis

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40
Q

Inflammation of the bursae

A

Bursitis

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41
Q

Bursitis is caused by?

A

repeated physical activity, trauma, rheumatoid arthritis, gout, or infection

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42
Q

What pathology is not visualized on images. But might be seen with deposits of calcification in adjacent tendon (calcific tendinitis).

A

Bursitis

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43
Q

Acute or chronic inflammation of bone & bone marrow caused by a pathogenic microorganism that was introduced by the bloodstream, adjacent infection or direct introduction (trauma/surgery).

A

Bacteria Osteomyelitis

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44
Q

What does Bacteria osteomyelitis affect?

A

Long bones and vertebra

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45
Q

What forms as an abcess which leads to an inflammatory reaction within bone causing an increase in bone pressure?

A

Bacteria Osteomyelitis

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46
Q

What is the acute stage of bacteria osteomyelitis?

A

Soft tissue swelling in affected area

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47
Q

What is the chronic stage of bacteria osteomyelitis?

A

Extensive bone destruction with irregular, sclerotic reaction throughout bone. Sequestrum (avascular dead bone). Involcrum (new bone).

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48
Q

Generalized or localized deficiency of bone matrix. Accelerated resorption of bone, decreased bone formation. Loss of bone mass and Density

A

Osteoporosis

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49
Q

With osteoporosis, what is fractures due to and how much bone density is lost?

A

due to porous, brittle bones. 50-70% bone density loss (lower kvp)

50
Q

What pathology has the appearance of a picture frame where the density of vertebra decreases and the cortex appears as a dense thin line and is most evident in the spine and pelvis?

A

Osteoporosis

51
Q

Insufficient mineralization of the adult skeleton with a lack of calcium in tissues and failure of bone tissue to calcify?

A

Osteomalacia

52
Q

What pathology has the appearance:
Softening of bone- bending
loss of bone density
Cortex is thin making borders appear indistinct

A

Osteomalacia

53
Q

Systemic disease of infancy and childhood that is a deficiency of vitamin D in diet or lack of exposure to sunshine and a deficiency in calcification.

A

Rickets/infantile osteomalacia

54
Q

What pathology has the appearance of cupped or frayed metaphysis in long bones and is best seen in ribs, tibia, humerus, and wrist.

A

Rickets/infantile osteomalacia

55
Q

Disorder in metabolism of purine (a component of nucleic acids) in which an increase in the blood level of uric acid leads to the deposition of uric acid crystals in the joints, cartilage, and kidney.

A

Gout

56
Q

In whom and where does Gout usually occur?

A

Males. Most commonly affects 1st MTP jt.

57
Q

What are early signs of gout?

A

Joint effusion and periarticular swelling

58
Q

Clumps of urate crystals (Tophi) form along margins of articular cortex & erode underlying bone leading to small punched out defects @ joint margin (rat bite erosion) ….occurs in what pathology?

A

Gout

59
Q

Osteitis deformans is another name for?

A

Pagets Disease

60
Q

What pathology is the destruction of bone, followed by a reparative process, results in a weakened, deformed, and thickened bony structures that tend to fracture easily.

A

Pagets disease

61
Q

What are the two stages of Pagets Disease?

A

Osteolytic stage (destruction) and Osteoblastic stage (abnormally soft and poorly mineralized material).

62
Q

In whom and where does Pagets disease normally occur?

A

Men/ middle life (3% at 40 years)/elderly. Common site is Pelvis. Can also occur in femur, skull, tibia, vertebra, clavicles, and ribs.

63
Q

What pathology has the appearance in the PELVIS of coarsening of trabeculae along iliac margins- thickening of pelvic brim cortical thickening with a coarse, thickened trabeculae pattern (picture frame pattern).

A

Pagets Disease

64
Q

What pathology has the appearance in the SKULL of radiolucencies in destructive phase and cotton-wool appearance in reparative phase?

A

Pagets disease

65
Q

A disorder that usually begins during childhood, is characterized by the proliferation of fibrous tissue within the medullary cavity. It gradually expands and weakens bone-loss of trabecular markings/widening of bone.

A

Fibrous Dysplasia

66
Q

Where does Fibrous Dysplasia mostly occur?

A

Singe bone or bones of one extremity (adult). Throughout entire skeleton (children and mostly females). Long bones (femur and tibia), ribs and facial bones.

67
Q

What pathology has the appearance of Well defined radiolucent areas depending on amount of tissue. They are completely radiolucent. Has a ground-glass or soap bubble density. Multiocular appearance. Irregular bands of sclerosis may cause cyst-like lesions

A

Fibrous Dysplasia

68
Q

Another name for avascular necrosis (AVN) that is caused by loss of blood supply

A

Ischemic necrosis of bone

69
Q

What is the most common site for Ischemic necrosis of bone?

A

Femoral head. Intially- bone appears denser. Structural failure- radiolucent subcortical band or crescent sign which represents fracture line. Progression- pattern of lytic and sclerotic areas with flattening of femoral head and new bone formation.

70
Q

What is a benign projection of bone with a cartilaginous cap that arises during childhood or teens years in males?

A

Osteochondroma/exostosis

71
Q

Where does osteochondroma/exostosis occur?

A

Occurs in epiphyseal plate and grows laterally- typically knee area. Cortex blends with normal bone and grows up and away from nearest joint. If cap becomes malignant- osteosarcoma or chondrosarcoma.

72
Q

What is a slow growing tumor composed of cartilage arising in medullary cavity that does not invade surrounding tissue and expands the cortical bone (thinning and scalloping of cortex-leads to fx. Its also has a radiolucent lesion with small calcifications.

A

Enchondroma

73
Q

What does enchondroma effect?

A

Small bones of hands/feet.

74
Q

What is another name for Giant Cell Tumor

A

Osteoclastoma

75
Q

What begins as a lucent lesion in metaphysis and extends to subarticular cortex and does not involve joint.

A

Giant Cell Tumor or Osteoclastoma

76
Q

Who and where gets Giant Cell Tumor or Osteoclastoma

A

20 to 40 years/ women/ distal femur or proximal tibia

77
Q

What pathology has the appearance of multiple large bubbles separated by thin strips of bone (expands toward shaft).

A

Osteoclastoma or Giant Cell Tumor

78
Q

What is a tumor of teenagers or young adults/males (3x more likely) that if found in the femur/tibia that originates from osteoblastic cells.

A

Osteoid Osteoma

79
Q

What pathology has the appearance of small, round or oval, lucent center (nidus) surrounded by a large, dense sclerotic zone of cortical thickening.

A

Osteoid Osteoma

80
Q

What is a wall of fibrous tissue filled with fluid (fluid filled lesion) that occurs in proximal humerus or femur?

A

Simple bone cyst

81
Q

What pathology has the appearance of radiolucent with well-defined margins from normal bone surrounding lesion. Cyst may be surrounded by a thin rim of sclerotic bone. Oval configuration with long axis parallel to host bone.

A

Simple bone cyst.

82
Q

What is another name of osteogenic sarcoma

A

Osteosarcoma

83
Q

What is a highly aggressive neoplasm that is most often located in bone marrow. As tumor grows, it lifts periosteum from the cortical bone (Codmans triangle) and lays down spikes of new bone radiating from origin (Sunray or sunburst appearance).

A

Osteosarcoma

84
Q

Where and whom does Osteogenic Sarcoma in?

A

Long bones (knee). Affects 10-25 years of age (75%). Older individuals with pagets disease or after high level radiation exposure to bone. Poor prognosis- lung mets

85
Q

Pre-existing cartilaginous lesion (10%) or arises anew (90%). Osteochondroma/enchondroma. Develops later 35-60 years in men. Its grows more slowly/ metastasizes later.

A

Chondrosarcoma

86
Q

What pathology has the appearance that affects long bones- originates in rib/scapula/vertebrae that contains calcifications within mass and destroys bone (Scalloping and cortical destruction).

A

Chondrosarcoma

87
Q

What is a primary tumor arising in bone marrow of long bones that involves bone more diffusely with uniform thickening, lesions tend to be very extensive-involving entire shaft of bone and is extremely malignant

A

Ewing Sarcoma

88
Q

Whom does ewing sarcoma affect?

A

Children and young adults/males

89
Q

What pathology has the appearance of ill-defined area of bone destruction involving a large central portion of shaft of long bone. Fusiform layered periosteal reaction (onionskin appearance) parallel to shaft. Moth eaten bone destruction

A

Ewing sarcoma

90
Q

Widespread malignancy of plasma cells that infiltrate bone producing multiple osteolytic lesions throughout.

A

Multiple myeloma

91
Q

Who does multiple myeloma affect?

A

40 to 70 years of age. Highly malignant.

92
Q

What pathology has the appearance of swiss cheese on a lateral skull and diffuse, osteoporosis with discrete punched-out, osteolytic regions throughout skeletal system.

A

Multiple myeloma.

93
Q

Most common malignant bone tumor

A

Bone Metastases

94
Q

How is Bone Mets spread?

A

Bloodstream or lymphatic vessels or by direct extension

95
Q

What are the most common primary tumors (mets)

A

Breast, lung, prostate, kidney and thyroid.

96
Q

What is the most common sites for bone mets

A

Spine, pelvis, ribs, skull, humerus and femur.

97
Q

What is the appearance of mets?

A

Irregular, poorly defined lucent lesions or poorly defined increased densities depending on site of origin.

98
Q

A fracture composed of more than 2 fragments

A

communited

99
Q

An elongated triangular fragment detached from two other larger fragments of bone

A

butterfly

100
Q

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

A

segmental

101
Q

Fatigue fracture. Response of bone to repeated stress

A

Stress fracture.

102
Q

What are the most common sites of stress fractures?

A

2nd and 3rd metatarsals, calcaneus, tib/fib, femur, and ischial and pubic rami

103
Q

What kind of fracture is first visualized 10-20 days after onset of symptoms and has a transverse or oblique thin line of radiolucency or callus formation without evidence of fracture line.

A

Stress fracture.

104
Q

What kind of fracture occurs in bone at an area of weakness caused by a process such as a tumor, infection or metabolic bone disease. most common underlying- mets or multiple myeloma. Most often in spine, femur and humerus.

A

Pathologic fracture.

105
Q

Incomplete fracture with the opposite cortex intact. Happens in infants and children.

A

Incomplete fracture (greenstick)

106
Q

A fracture in which one cortex is intact with buckling of the opposite cortex

A

Torus (Buckle) - incomplete fracture

107
Q

A deformation caused by a stress that is too great to permit a complete recovery of normal shape but less to produce a fracture

A

Bowing- incomplete fracture

108
Q

Transverse fracture through distal radius with dorsal/posterior angulation. Associated avulsion fracture of ulnar styloid process. Usually caused by a fall on an outstretched hand. Most common fracture of the wrist.

A

Colles Fracture

109
Q

A fracture with anterior angulation

A

Smiths fracture.

110
Q

Isolated fracture of ulna shaft associated with anterior dislocation of radius at elbow

A

monteggia fracture

111
Q

a combination of a fracture of radial shaft and dorsal/posterior dislocation of ulna at wrist.

A

Galeazzi Fracture

112
Q

Fracture involving medial and lateral malleoli

A

Bimalleolar

113
Q

Fracture involving the medial lateral and posterior malleoli

A

Trimalleolar

114
Q

Fracture of both malleoli with ankle dislocation

A

Potts

115
Q

most frequent injury to the foot. Transverse fracture at base of 5th metatarsal. Avulsion injury that results from plantar flexion and inversion of foot.

A

Jones fracture.

116
Q

Communited fracture of ring of atlas (1st vertebrae) Involves anterior/posterior arches. Causes displacement of fragments

A

Jefferson Fracture

117
Q

Located at base of dens (C2) at junction with body. Usually transverse fracture

A

odontoid process fracture

118
Q

Results from acute hyperextension of head on neck. Fracture of C2 arch anterior to interior facet. Associated with anterior subluxation of C2 on C3. Results from MVA

A

Hangmans fracture

119
Q

Avulsion fracture of a spinous process in lower cervical or upper thoracic spine.

A

Clay shovelers fracture

120
Q

Transverse fracture of lumbar vertebrae often associated with significant visceral injuries

A

Seat belt fracture.

121
Q

Cleft in pars interarticularis without displacement. Bilateral, 5th lumbar vertebra, predisposes to forward displacement of one vertebra on the other

A

Spondylolysis

122
Q

Defect in the parts interacticularis with displacement

A

Spondylolithesis

Pathology (2 decks)

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