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Skel Rad A > Midterm > Flashcards

Midterm Flashcards

1
Q

How many bones in the appendicular skeleton? Axial skeleton?

A 
Appendicular = 126
Axial = 80
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2
Q

Last bone to ossify?

A

Clavicle

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3
Q

Name the 3

A

Ectoderm
Mesoderm
Endoderm

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4
Q

T or F

Bone is derived from Ectoderm

A

False

Mesoderm

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5
Q

Where is the primary centre of ossification on a long bone?

A

Diaphysis

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6
Q

Name the site of secondary ossification on a long bone

A

Epiphysis

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7
Q

Name the 3 parts of a long bone

A

Epiphysis
Metaphysis
Diaphysis

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8
Q

What is the strongest thickest part of a long bone?

A

Diaphysis

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9
Q

What are the 2 types of bone formation processes?

A

Intramembranous

Endochondral

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10
Q

What type of bone formation do Flat bones fall under?

A

Intramembranous

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11
Q

Name the bones ossified in a membrane

A 
Parietal
Temporal
Upper occipital 
Frontal
....
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12
Q

T or F

Primary ossification of long bones helps widen the bone

A

False

Lengthen

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13
Q

T or F

Secondary ossification occurs within epiphysis and apophyses

A

True

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14
Q

Endochondral ossification is associated with what bones?

A

Tubular bones
Vertebrae
Ethmoids
Inferior conchae

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15
Q

What is an apophysis?

A

A protuberance

Functions as the attachment site for ligaments & tendons

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16
Q

What is known as the site of attachment of tendons and ligaments, is highly vascularized with high metabolic activity?

A

Enthesis

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17
Q

T or F

Periosteum is visible on films

A

False!

You don’t see it unless it gets irritated from infection or malignancy

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18
Q

List the 4 functions of the periosteum

A
  1. Attaches the cortex via outer fibrous extensions called Sharpey’s Fibers
  2. Maintains caliber of bone by appositional bone growth
  3. Provides a transitional zone of attachment for muscles, ligaments, and tendons
  4. Serves as a source of vascular profusion for the outer third of the cortex.
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19
Q

Aka’s for Physis

A

Physeal plate

Growth plate

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20
Q

T or F

The blood supply to the metaphysics and distal end of a bone in a child is continuous

A

False
This is describing and adult.
In children vascular supply DOES NOT cross growth plate.

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21
Q

In an infant do any of the metaphyseal blood vessels penetrate the cartilaginous growth plate to supply the epiphysis?

A

Yes

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22
Q

name the zones of the of the growth plate from the epiphysis to the metaphysics

A
  1. Resting Zone
  2. Zone of Proliferation
  3. Zone of Hypertrophy
  4. Zone of Degeneration
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23
Q

T or F

If the resting zone is injured growth will stop

A

True

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24
Q

What zone attaches the growth plate to the epiphysis

A

Resting Zone

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25
Q

What zone is where bone lengthens due to active growth of chondrocyte?

A

Zone of Proliferation

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26
Q

What is the weakest portion of the growth plate?

A

Zone of hypertrophy

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27
Q

In what zone will Salter-Harris fractures occur?

A

Zone of hypertrophy

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28
Q

What is a function of the zone of degeneration?

A

Attaches growth plate to metaphysis

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29
Q

T or F

Cancellous bone makes up 80% of total bone mass

A

False

Compact!

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30
Q

On what bone is the coracoid process found?

A

Scapula

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31
Q

Where is the conoid process found?

A

Clavicle

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32
Q

What bone is the coronoid process on?

A

Ulna

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33
Q

Name the categories used to classify bone diseases

A 
Congenital 
Arthritis
Trauma
Blood (hematological)
Infection 
Tumor
Endocrine, nutritional, metabolic
Soft tissue
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34
Q

Name the 3 categories of Behaviour of Lesions

A
  1. Osteolytic
  2. Osteoblastic
  3. Mixed Lesion
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35
Q

What colour on a film will Osteolytic lesions appear? Osteoblastic

A 
lytic = black colour
blastic = bright white
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36
Q

We can further classify Osteolytic Lesions into what 3 categories?

A

Geographic
Motheathen
Permeative

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37
Q

Permeative lesions will appear how on films?

A

Very tiny pin holes. They appear as the tinniest of holes compared to Motheaten and Geographic

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38
Q

T or F

Geographic lesions are malignant

A

False

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39
Q

What type of lesions can be classified as both benign and malignant?

A

Motheaten

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40
Q

Is a geographic lesion fast or slow growing?

A

Slow

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41
Q

T or F

Geographic lesions typically have ill defined borders

A

False

Sharp well defined borders

42
Q

T or F

Geographic lesions have a narrow zone of transition

A

True

43
Q

Describe the borders of a moth-eaten lytic lesion

A

Ragged borders

2-5 mm

44
Q

punched out lesions = ?

A

Multiple Myeloma

45
Q

T or F

Permeative lytic lesions have a narrow zone of transition

A

False

Wide!!

46
Q

Osteoblastic aka _________

A

Osteogenic

47
Q

eccentric means?

A

off centre

48
Q

T or F

Sharp margins = malignancy

A

False

Benign

49
Q

Poorly defined or long zone of transition will generally signify malignancy or benign?

A

Malignancy

50
Q

What is the most frequent imaging modality to evaluate skeletal system? Why

A

Plain Film Radiography

-Cheap and available

51
Q

What % of bone loss needs to happen in order to see it on a plain film?

A

30-50%

52
Q

How big does a lesion need to be to see it on a plain radiograph?

A

1-%cm

53
Q

T or F

Plain film radiographs are specific and sensitive

A

False

Specific but insensitive

54
Q

Advantages of Plain Film Radiography?

A

Readily available
Relatively inexpensive
Non-invasive

55
Q

Disadvantages of Plain Film Radiography?

A

Lack of soft tissue discrimination
Decreased sensitivity in detecting osseous lesion
Technical artifacts
Ionizing radiation

56
Q

What does DEXA stand for?

A

Dual Energy E-ray Absorptiometry

57
Q

Why is a DEXA used?

A

To evaluate bone density

58
Q

What is a T-Score in regards to DEXA scans?

A

The patients age vs. avg 30 yo

59
Q

What is a Z-score

A

The patients score vs. avg female the same age

60
Q

T or F
In Dexa scans….
> -1 = osteopenia

A

False

This is normal

61
Q

What score would classify a patient as osteopenia with a DEXA

A

-1 to -2.5

62
Q

What is a contrast study?

A

This is when injectable dye is inserted into the blood

63
Q

What the disadvantages of Contrast Examinations

A

Invasive
Operator and interpreter dependent
Only see structural surface
May miss small lesions

64
Q

What is Myelography

A

Exam of spine and spinal cord with an injection of contrast into the subarachnoid space.

65
Q

What pathologies can be dx with Myelography?

A

Spinal Stenosis
Nerve Root Disease
Disc Disease

66
Q

Disadvantages of Myelography?

A

Risk of infection
Nerve root damage and dural tears
Headaches

67
Q

What does a bone scan look for?

A

Increased metabolic activity - infection or tumour

68
Q

T or F

Bone scans are very sensitive and not very specific

A

True

69
Q

Dark spots on a bone scan are called?

A

Hot Spots

70
Q

T or F

For a CT scan and bone is white.

A

True

71
Q

In regards to an MRI T1 is used to see fat or water?

A

Fat

72
Q

What MRI is used to see fluid?

A

T2

73
Q

In a T1 MRI do the disks look black or do they look white?

A

Black

74
Q

What does osteopenia mean?

A

Osteopenia is a term used to describe general radiolucent bone. Osteopenia is loss of bone density.

75
Q

Name the three types of osteoporosis.

A
  1. Generalized
  2. Regionalized
  3. Localized
76
Q

List some conditions associated with generalized osteoporosis.

A

Malignant bone disease, senile and postmenopausal, acromegaly, alcohol, hemolytic anemia, heparin therapy, hyperparathyroidism, steroids

77
Q

What loss of bone density must be present in order to see osteoporosis on x-ray?

A

30–50%

78
Q

Typically osteoporosis is seen in females and males in what decade of life?

A

Emails: 5-6th decade of life.

Males: 6–7th decade of life.

79
Q

What are some complications associated with osteoporosis?

A

Fractures – spinal compression fractures [most under diagnosed]

Increased thoracic kyphosis [spinal stenosis]

Other fractures – proximal femur humorus and radius

80
Q

What is the name of the triangle in the pelvis associated with bone loss and osteoporosis?

A

Wards Triangle

81
Q

What are the radiographica findings/features of Osteoporosis

A

Increased radiolucency - osteopenia
Cortical thinning - pencil thing
Altered trabecular patterns

82
Q

What specific changes can be seen in the spine radiographically with osteoporosis?

A 
Curve changes
decreased bone density
trabecular changes
cortical thinning
changes in vertebral shape
83
Q

What is the major weight-bearing trabeculae?

A

Principle compressive group

84
Q

From where does the principal compressive group run?

A

From the medial metaphyseal cortex to superior femoral head

85
Q

What trabecular pattern runs from the lateral cortex inferior to the greater trochanter?

A

Principle tensile group

86
Q

T or F the secondary compressive group extend in an arch-like pattern medially

A

False

This is describing the principle tensile group

87
Q

What is it called when a bone is not strong enough to withstand normal physiological stress?

A

Insufficiency fracture

88
Q

Where is regional migratory osteoporosis most commonly seen?

A

In lower extremities

89
Q

What are some conditions associated with localized osteoporosis

A

Infection
Inflammatory arthritis
Neoplasm

90
Q

What is Sudeck’s Atrophy

A

overactive sympathetic nervous system -> leads to immobilization = decreased osteoblastic activity and increased osteoclastic activity.

91
Q

A lack of Ca++ deposited in osteoid tissue is associated with what condition?

A

Osteomalacia

92
Q

T or F

Osteomalacia has normal bone quality and decreased bone quantity

A

False

This is osteopenia.
Malacia has normal quantity and decreased quality

93
Q

What are some causes of Osteomalacia

A

Deficiency in Vit D, Calcium, Phosphorus or dietary chelators
Absorption problems - gastric abnormalities, biliary disease or enteric malabsorption.
Neoplasm
Fibrous Dysplasia

94
Q

Clinical findings for Osteomalacia include…

A

General muscle weakness
Bone pain on palpation
Deformitites - usually weight bearing bones

95
Q

Describe the Radiographic findings of osteomalacia

A 
Decreased bone density (low bone mineral content)
Mottled trabecular pattern
Loss of cortical definition - thinner
Pseudo fractures
Deformities.
96
Q

Name some of the aka’s for Pseudo-fractures

A

Looser lines
Milkman’s Syndrome
Umbau Zone

97
Q

Where are the most common sites for pseudo fractures?

A

Femoral necks
Pubic and ischial rami
Ribs
Axillary border of scapulae

98
Q

What are rachitic rosary?

A

Costochondral bumps on the anterior rib cage that are associated with Rickets.

99
Q

T or F

With Rickets it is uncommon for soft tissue to swell around the growth plates.

A

False

100
Q

T or F

A more narrow growth plate is seen with children with Ricket’s

A

False - widened growth plate of long bones

101
Q

Describe what a “paintbrush metaphysis” looks like

A

Irregular, frayed and cupped metaphyseal margin

Skel Rad A (2 decks)

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