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MSK 1 > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Purpose of Bone:

A

Storage of Ca+ + (In form of CaPO4).

Protection of vital organs.

Support for body and mechanical basis for movement.

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2
Q

what are the two forms of bone growth

A

intramembranous ossification or endochondral ossification (chondrification)

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3
Q

Intramembranous ossification

A

Direct ossification of the mesynchyme

Occurs during the embryonic period within the mesynchymal tissue, without prior cartilage formation

Formation of the periosteum

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4
Q

endochondral ossification

A

Mesenchyme is chondrified into a cartilaginous bone model

Bone forms later by replacing the membranous model with calcified cartilage

Occurs only in the presence of blood supply

Advances the ends of the cartilaginous model

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5
Q

when do Secondary centers of ossification form

A

Birth

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6
Q

where do long bone grow from

A

growth at the epiphysis

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7
Q

where do short bones grow from

A

growth plate for entire bone

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8
Q

The length of bone increases only by

A

Interstitial growth within the cartilage
Endochondral ossification

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9
Q

epiphysis and metaphysis movement

A

Interstitial growth of cartilage moves epiphysis further from metaphysis

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10
Q

Calcification

A

death and replacement of cartilage (endochondral ossification)

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11
Q

What is Appositional Growth:

A

growth in width

Activity of the osetoblasts

Located in the deep layer of the periosteum

Intramembranous ossification

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12
Q

what is Interstitial growth

A

increase in the length of bones

Endochondral ossification

Growth at the metaphysis and diaphysis of a long bone

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13
Q

Four Zones of the epiphyseal plate

A

Zone of resting cartilage

Zone of young proliferation

Zone of maturing cartilage

Zone of calcifying cartilage

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14
Q

Zone of resting cartilage

A

Anchors the epiphyseal plate to the epiphysis
Contains immature chondrocytes and delicate vessels

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15
Q

Zone of young proliferation

A

Site of the most active interstitial growth

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16
Q

Zone of maturing cartilage

A

Enlargement and maturation of the cartilage cells near the metaphysis

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17
Q

Zone of calcifying cartilage

A

Structurally the weakest zone

Active boney deposition on the metaphysis

Were the cells are ossifying – weakness

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18
Q

what are Chondrocytes

A

cells that produce the cellular matrix and eventually differentiate into osteoblasts (secrete osteoid which hardens to new bone)

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19
Q

why does Bone Growth and Remodeling occur

A

Occurs because of the growth of long bones

Occurs due to factors that demand removal of calcium from the bone
Occurs because the Haversian systems are continually being eroded

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20
Q

how is Bone Balance maintained

A

Bone balance is the result of osteoblastic vs. osteoclastic activity

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21
Q

Juvenile has a + or - bone balance

A

postive

Lay down more bone

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22
Q

Geriatric has a + or - bone balance

A

negative

Absorbing more bone

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23
Q

Wolff’s Law

A

(Law of Physical Stress)

Bone is deposited in sites subjected to increased stress

Bone is resorbed from sites of decreased stress

Alignment of trabecular systems is along the lines of stress

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24
Q

on a curved bone which side is more bone laid down on vex or cave

A

Marked cortical thickening is observed on the concave (compressive) side of a curved bone

Electrical properties of bone (-) on the concave side (deposition) (+) on the convex side (resorption)

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25
Q

Long

A

Tubular (e.g. Humerus and Femur) have a body and 2 ends

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26
Q

Short

A

Cuboidal (e.g. Carpals and Tarsals) found only in the foot or wrist

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27
Q

Flat

A

Protective function (e.g. bones of cranial vault) help to form the walls of cavities

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28
Q

Irregular

A

Bones of the face

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29
Q

Sesamoid

A

Protect tendons from wearing (e.g. patella) (resembled sesame seeds)

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30
Q

where are RBC formed

A

bone marrow

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31
Q

Compact Bone

A

(Cortical)

Very dense, little space

Highly organized lamellar network of fibers, packaged in osteons.

Fibers in each layer or osteon oriented in different directions

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32
Q

Trabecular Bone

A

Cancellous

Less dense, more space than compact

More metabolically active

Contain blood vessels, nerve fibers and fat

Hemopoietic tissue

Flat bones, metaphyseal regions of long bones

More flexible

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33
Q

Mechanical Properties of Bone

A

Must deal with various types of loading

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34
Q

types of loading that bones deal with

A

Compression, Tension, Torsion, Shear

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35
Q

where is compression felt

A

Compression is felt on every bone because of gravity (weight bearing)

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36
Q

what can take some of the tension force felt by bone away

A

muscles

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37
Q

Bending Mechanisms: Tension Failure

A

Transverse Fractures
Greenstick Fractures
Oblique Fractures

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38
Q

transverse, greenstick, oblique - which one heal the best

A

oblique - This heals because the is more SA and more area for blast and clast to lay down

Greenstick - Will heal better because the periosteal sheath is still intact

transverse: Hard to heal

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39
Q

Twisting Failure due to what kind of movement

A

torsion

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40
Q

Traction Failure leads to what kind of fracture

A

Avulsion fracture

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41
Q

Compression Failure leads to what kind of fracture

A

compressive fracture

42
Q

what is Torus fractures

A

buckle fracture

43
Q

What is the most common frx in lower forearm in young children

A

Torus (buckle) frxs of distal metaphysis of radius & ulna

FOOSH

44
Q

Salter-Harris fracture

A

fracture that can occur to a growth plate

45
Q

Salter-Harris Classification type 1

A

Plane of separation along the epiphyseal plate through the zone of cartilage transformation

46
Q

type 1 blood supply and future growth

A

Blood supply intact and future growth is normal

47
Q

Type 1 is cause by

A

Usually produced by a shearing type force

48
Q

type 1 periosteum

A

Periosteal attachments will sometimes remain intact

49
Q

Salter-Harris Classification type 2

A

Most common (75%)

Fracture extends across the corner of metaphysis

50
Q

Type 2 healing and blood

A

Future growth is considered normal because blood supply remains intact

51
Q

type 2 peri

A

Periosteal hinge remains intact

52
Q

Salter-Harris Classification type 3

A

Rare

This isan intra-articular fracture extending from the physis into theepiphysis

Usually occurs at distal tibia

53
Q

type 3 future growth

A

Future growth usually normal but displaced fractures produce an irregular articular surface

54
Q

Salter-Harris Classification type 4

A

Intra-articular fracture that extends throught the epiphyseal plate and into the metaphysis

55
Q

type 4 future growth

A

ORIF with “perfect” fixation needed to have any chance at union

May lead to nonunion/malunion with progressive disturbance of growth

56
Q

Salter-Harris Classification type 5

A

Crushing injuries, jumping from heights
Diagnosis is difficult secondary to lack of displacement

57
Q

type 5 blood supply and future growth

A

May lead to permanent damage with a complete or partial cessation of growth leading to limb length discrepancy and deformity

58
Q

intraarticular fracture

A

a fracture that crosses a joint surface

59
Q

agulated fracture

A

The two ends of the broken bone are at an angle to each other

60
Q

Fracture translation

A

the movement of fractured bones away from each other

61
Q

distracted fracture

A

A fracture resulting in increased overall bone length, is due to distraction (widening) of the bone components.

62
Q

Overriding–

A

A displaced fracture where the bone fragments overlap

63
Q

Callus

A

A soft callus (a type of soft bone) replaces the blood clot that formed in the inflammatory stage

The callus holds the bone together, but isn’t strong enough for the body part to be used

64
Q

Application of weight bearing in remodeling stage of fracture healing is good or bad

A

good for healing

will grow stringer in the direction of compressive loads

65
Q

factors that effect fracture healing time

A

Age of the Patient

Site and Configuration of the Fracture

Initial Displacement of the Fracture

Blood Supply to Fracture Fragments

66
Q

age and fracture healing

A

Younger Patients Heal Faster
Intact CV system
More metabolic activity

67
Q

Bones surrounded by muscle vs. bones that lie subcutaneously or within joints- which heal faster

A

Bones surrounded by muscle heal faster than bones that lie subcutaneously or within joints

because of blood supply

68
Q

Cancellous bone healing vs. compact bone

A

Cancellous bone heals faster than compact bone

less structure

69
Q

Epiphyseal separations vs. epiphyseal fractures healing

A

Epiphyseal separations heal faster than epiphyseal fractures

70
Q

Non-displaced vs. displaced fractures healing rate

A

Non-displaced fractures with intact periosteal sleeve heal twice as fast as displaced fractures.

The greater the displacement, the longer the healing time

71
Q

Reduced vascularization and non-union.

A

Reduced vascularization increases risk of non-union.

72
Q

what are Nonunion fracture

A

Fractures that still allow free movement of the bone ends at 3-4 months after injury demonstrate delayed union

are classified as hypervascular (hypertrophic) or avascular (atrophic) based upon their capability of biologic reaction (vitality of the bone ends).

73
Q

Reduced vascularization realtionship with avascular necrosis

A

Reduced vascularization increases risk of avascular necrosis

74
Q

Avascular necrosis is most common where

A

more common with intra-articular fractures, especially of the femoral head/neck, femoral condyles, proximal and talar neck.

75
Q

when do you use Protection Alone

A

Sling

Undisplaced stable fractures of ribs, phalanges, metacarpals, clavicle (in children)

Mild compression fractures of spine

Impaction fracture of proximal humerus

76
Q

when do you use Immobilization by External Splinting without Reduction

A

Undisplaced but unstable fracture

77
Q

what is External Splinting without Reduction

A

Relative immobilization: can still move other aspects of the extremity.

Casts, splints

78
Q

Closed Reduction followed by immobilization

A

Displaced fracture where surgeon predicts reduction can be done accurately and maintained without need for surgery.

79
Q

Closed Reduction with External Fixation

A

Severely comminuted unstable fractures
Open fractures with extensive soft tissue damage including arteries and nerves

80
Q

Closed Reduction with Internal Fixation

A

Can reduce fracture without surgery but cannot maintain it with immobilization

Unstable fracture of femoral neck

Place pins and screws after reduction is achieved.

81
Q

Open Reduction Internal Fixation (ORIF)

A

Used when closed reduction is impossible

Displace avulsion fractures, intra-articular fractures

Soft tissue entrapment in fracture

Displaced fracture crossing epiphyseal plate in children.

82
Q

fever may be a sign of

A

infection

83
Q

Persistent signs of inflammation around the joint of the fracture may be a sign of

A

infection

84
Q

Radiodensity

A

Refers to the amount of radiation an object absorbs.

85
Q

Radiopaque

A

Easily absorbs radiation therefore they are more radiant dense

86
Q

Radiolucent

A

Easily penetrated by radiation, less dense and permit the x-ray beam to pass through them

87
Q

Air in Xray

A

black

88
Q

Fat in x ray

A

– Gray black

89
Q

water in x ray

A

Gray

90
Q

bone in x ray

A

White

91
Q

contrast media in x ray

A

White outline

92
Q

in x ray does the density of an object matter

A

yes, think of block of cheese

93
Q

Arthrogram

A

inject the body with heavy metals

Detailed view of what’s happening inside your joints

Improves visualization

94
Q

Myelogram

A

Spine – Subarachnoid space where it mixes with CSF
Look for problems in the spinal canal

95
Q

Discogram

A

Nucleus: contrast liquid is injected into the center of one or more spinal discs

Back pain

96
Q

Arteriogram

A

X ray of Specific Vessels

97
Q

CT Scans

A

radiography that gives slices of the body

Provides greater visualization of soft tissue but can’t pick up histological changes.

98
Q

MRI T1

A

Shorter time between pulses

T1 images distinguish fat from CSF or those with high water content

Soft tissue appears gray

99
Q

MRI T2

A

Longer time between pulses

Fat and CSF are both hyper-intense, but fat can be suppressed

Muscle injury will appear bright with it’s increase in water content

100
Q

what is T1 good at showing

A

the difference in fluid from fat

101
Q

what is T2 good at showing

A

“fat surpressed” and shows clearer visualization of discs and the fluid

muscle injury with show bright because of the swelling

MSK 1 (14 decks)

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