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Skel Rad A > Mid Term - Second Half of Notes > Flashcards

Mid Term - Second Half of Notes Flashcards

(126 cards)

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1
Q

Which tubular bone has 3 epiphyses?

A

Humerus

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2
Q

which tubular bone has two apophyses?

A

Femur

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3
Q

4 functions of periosteum

A
  1. attaches to cortex via shapeys fibers
  2. maintains caliber of bone by appositional bone growth
  3. provides a transitional zone for attachments
  4. serves as a source of vascualr perfusion outer third of cortex.
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4
Q

3 different systems for blood supply in bone?

A
  1. nutrient artery (70%)
  2. Epiphyseal - metaphyseal arteries (30%)
  3. periosteal arteries
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5
Q

Bone venous drainage (3)

A
  1. emissary veins
  2. cortical venous channels
  3. periosteal capillaries
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6
Q

Bone island - one lesion aka?

A

osetopoikolosis

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7
Q

bone island - many small lesions?

A

osteopoikolosis

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8
Q

Cancerous malignant bone tumor

A

osteosarcoma

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9
Q

Lucent, Geographic, moth-eaten, permeative = ?

A

Osteolytic

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10
Q

Brodies Abscess

A
  1. related to infection

2. creates hole in bone

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11
Q

Mixed?

A

Psoriatic arthritis

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12
Q

Periosteal Rx - Local

A

Fx’s , Infections , tumors

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13
Q

Periosteal Tx - Diffuse

A

Hypervitaminosis A, normal periosteal new bone in child, battered child syndrome.
HPT - hyperparathyroidism - classic ex.

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14
Q

Laminated

A

Ewings Sarcoma

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15
Q

Spiculated

A

Osteosarcoma

1. aggressive

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16
Q

Geographic

A

giant cell tumor, simple bone cyst

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17
Q

moth-eaten

A

Metastatic disease

Multiple myeloma

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18
Q

permeative

A

metastatic disease

multiple myeloma

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19
Q

Probable indicators for taking xray

A
  1. night pain

2. explainable weight loss

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20
Q

NON-indicators for taking an x-ray (why not to)

A
  1. pregnant
  2. no clinical indication
  3. pre-employment
  4. patient education
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21
Q

who discovered x-rays?

When?

A

Wilhelm Conrad Roentgen

1895

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22
Q

first nobel prize for x-ray date?

A

1901

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23
Q

5 radiographic densities

A
  1. air
  2. water
  3. fat
  4. bone
  5. metal
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24
Q

Downfall of plain film?

A

limited diagnostic sensitivity

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25
% of bone loss needed on film to see on xray with naked eye?
30-50%
26
Advantages of plain film?
1. readily available 2. relatively inexpensive 3. non invasive
27
Disadvantages of plain film?
1. lack of soft tissue discrimination | 2. decreased sensitivity
28
Which imaging is "old school" and we don't use any more?
Tomography
29
Disadvantage of tomography?
1. high dose radiation because a. creates more radiation b. long exposure time c. possible time for patient to move
30
Arthrography - contrast examination
1. water soluble contrast 2. most common joint = knee 3. now - MRI
31
Arthrography advantage?
readily available
32
arthrography disadvangtage?
1. invasive 2. operator and interperter dependent 3. only see structural surface3 4. may miss small lesions
33
Myelography is an exam of?
spine and spinal cord
34
myelography needs?
injections of contrast into the subarachnoid space, most common at L2/3
35
Advantages of myelography ?
1. good for diagnosing a. spinal stenosis b. nerve root disease c. disc disease
36
Disadvantages of Myelography?
1. risk of infection 2. iatrogenic complications (nerve root damage) 3. headaches
37
Discography | Media? INto?
Water soluble contrast media | into IVD- under fluoroscopic control
38
what 4 aspects of disc are assessed with discography?
1. volume of contrast injected 2. pain response 3. pattern of contrast distribution 4. amount of resistance to injection
39
Advantages of discography?
Morphological analysis of disc | Function aspect of pain provocation
40
Disadvantages of discography?
1. increased radiation 2. invasive procedure a. risk of infection b. nerve damage c. exacerbation of pain
41
Radionuclide imaging
Bone Scan
42
radioactive isotope ?
technetium 90 - highlights metabolically active areas in the bone
43
half life of TQ 99?
6 hours
44
TQ excreted by?
kidneys
45
isotope collects in ______. may or may not light up depending on the ____ of the patient
"hot spots" | Age
46
Common Hot spots
``` Metaphysis of long bone bladder thyroid kidneys sternum spine costochondral junctions SI joints at site of injection ```
47
Bone scan detects?
Skeletal metastasis tumors infection arthritis
48
AVN = ?
Avascular Necrosis
49
advantages of bone scan?
only need 3-5% bone destruction to see on scan | 10x more sensitive than plain film
50
disadvantages of bone scan?
scan of activity can by many ddx
51
bone scan is _______ but not _____
sensitive, specific
52
Ultrasound - most common?
MC
53
ultrasound used to diagnose abnormalities/masses in the ?
1. abdomen 2. pelvis 3. vasculature (abdominal aorta/carotid if calcified?
54
ultrasound advantages?
1. non invasive 2. no ionizing radiation 3. can visualize soft tissues adjacent to articulation
55
disadvantages of ultrasound?
1. can't see medullary cavity of bone | 2. operator independent
56
CT =?
Computed Tomography
57
CT invented by whom? when?
Godfrey Hounsfield, london in 1972
58
CT equipment?
X-ray source, radiation detector, and electronic devices mounted on a gantry
59
CT image =
thin slice of anatomy, only AXIAL plane
60
Two types of windows for CT scan?
Bone window and Soft tissue window
61
Bone will always be _____ on CT scan?
white
62
Gantry?
housing for all equipment for CT
63
CT can evaluate?
1. neoplasms 2. metabolic diseases 3. trauma * 4. infections 5. spinal syndromes 6. chest lesions**** gold standard
64
advantages of CT
great view of bony and soft tissue anatomy
65
disadvantages of CT
``` motion artifacts large patient - degraded image radiation dose may be high longer scanning time able to detect soft tissue difference ```
66
Spatial resolution
the sharpness of an image at its interface
67
contrast resolution
the ability to distinguish one soft tissue from another
68
attenuation
the specific absorbed energy of an x-ray beam AFTER it passes through a given tissue
69
Hounsfield Unit (HU) - goes with what scan?
unit of radiographic density in CT
70
HU of air?
-1000
71
HU of water?
0
72
HU of bone?
+ 1000
73
HU of muscle?
50
74
HU of white matter?
45
75
HU of blood
20
76
HU of CSF
15
77
HU of fat?
-100
78
Bone window shows differences between?
medullary and cortical bone
79
bone window, soft tissue densities appear?
dark grey
80
Soft tissue window cant differentiate?
cortical and medullary bone
81
Soft tissue window: bone appears but you can differentiate _____/______ as bight white?
cortical/medullary
82
to image DENSE TISSUE what level HU is used?
+1000
83
Indications for a spinal CT?
1. trauma to the spine*** 2. osseous spinal stenosis 3. lumbar disc herniations 4. patient with implantable device (pacemaker) that cant have MRI
84
Contradictions to CT
Metallic artifacts near area of interest | claustrophobia
85
Reading a CT image
Axial slices looking as if your looking at patients feet slides are backwards - your right = patients left
86
Gives you an idea of what your looking at so you know what level your at?
Scout views
87
What modality uses Tchnetium 99?
Bone scan
88
Two modalities that use radiatioN?
X-ray and fluoroscopy
89
First MRI?
1977
90
MRI uses?
magnets
91
MRI magnetic strength measured in ???
Tesla - T
92
MRI image production involves?
hydrogen protons + external magnetic field
93
Hydrogen atoms used b/c?
1. abundant in living tissue 2. paramagnetic properties (spin with dipole) 3. odd number of protons
94
TR - repetition time?
the time interval between the two 99 degree pulses
95
TE = echo time
the time between the pulse and detection of the MR signal
96
T1 looks for?
fat (will be bright white)
97
Long TR and long TE =? and looks for?
T2, Water (will be bright)
98
Long TR and Short TE =?
all tissues - shows where anatomy is
99
Which sequence would be produced with a long TR and a long TE?
T2
100
Advantages of MRI
1. excellent soft tissue contrast 2. early detection 3. dosent use radiation
101
disadvantages of MRI
1. claustrophobia 2. metal in body prohibited 3. expensive
102
Most common metabolic disease of bone?
osteoporosis
103
osteoporosis
increased porosity of bone
104
osteoporosis spares ______ oriented stress traveculae
vertically
105
Osteoporosis - pseudo -__________ appearance
pseudo- hemangiomatous (vertical is defined)
106
Osteoporosis. Decrease in bone ______ but the ______ is normal.
quantity, | quality
107
type of osteoporosis discussed in class
generalized
108
GO (General osteoporosis) most commonly due to?
1. postmenopausal women 2. age 3. secondary to hormone, Ca+ intake, activity level and diet
109
GO decreased bone density in whole skeleton, especially >
vertebral bodies, pelvis, proximal long bones
110
bone loss begins at_____ age?
35
111
Bone loss begins because of?
decrease in hormones and stimulated esteoclastic activity
112
conditions associated with GO?
``` 1. malignant bone disease 2, .senile an/or postmenopausal ***** most common 3. acromegaly 4. alcoholism 5. hemolytic anemia 6. Heparin therapy 7. hyperparathyroidism 8. Steroids ```
113
cortical bone loss per year?
1%
114
trabecular bone loss per year?
2%
115
by age 65, % of bone loss?
20-40%
116
at menopause, bone loss increases by _____ fold
10
117
Reduction in skeletal mass: females: decade? before 80, after 80? males: decade?
``` F = 5-6th decade, 4:1, 1:1 M = 6-7th decade ```
118
GO complications
FX's - spinal compression Most undiagnosed anterior vertebral wedging increased thoracic kyphosis
119
radiological features of GO?
``` increase in radiolucency a. osteopenia b. 30-50% bone loss Cortical thinning a. altered trabecular patterns (vertical striations) ```
120
Spine radiological features of GO
1. curve changes 2. decreased bone density 3. cortical thinning 4. changes in vertebral shapes 5. wedged vertebra 6. biconcave deformity
121
Pelvis and femora radiological features of GO
1. ostopenia 2. trabecular changes 3. Fx's - pubic rami and proximal femur 4. DJD
122
Trabecular changes
evaluate the trabecular pattern of the proximal femur for severity
123
what consists of 3 groups of trabeculae
Ward's triangle
124
Confluence of 3 patterns =
triangle radioluency
125
As the osteoporosis increases in severity, wards triangle gets ______ and more _____
bigger, obvious
126
3 Trabecular patterns of wards triangle
1. principle compressive group 2. secondary compressive group 3. principal tensile group

Skel Rad A (1 decks)

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