Quiz 2

Question 1

What is a fracture

Answer 1

A break in the structural continuity of bone or cartilage

Question 2

The 2 types of fractures

defintions

Answer 2

Closed and Open

C: skin and soft tissues overlying the fracture are intact
O: skin is perforated regardless of wound size

Question 3

Radiologic descriptions of fractures (7)

Answer 3

1. anatomical size and extent of fx
2. type
3. alignment
4. direction
5. special fx feature
6. abnormalities
7. abnormal stresses of pathological processes

Question 4

Extra vs Intra articular

Answer 4

E: the fracture line does not extend into the joint
I: the fracture line does extend into the joint

Question 5

Complete fx

Incomplete fx

Answer 5

All cortices of the bone have been disrupted and now there are at least 2 fragments

Only one side of the bone is broken and the other remains intact or is just bent slightly

Question 6

Displacement of fx fragment

types of displacement

Answer 6

when position is lost (a loss of apposition or contact btw broken fragment surfaces)

medial, lateral, superior, inferior, oblique

Question 7

Nondisplaced fx

Answer 7

some amount of contact remaining btw fx fragments

Question 8

What can cause displacement of a fx

Answer 8

distractionoverriding, rotation of fx fragments

Question 9

For alignment what axis do you look on

Answer 9

Longitudinal

Question 10

Line directions of fx

characteristics

which one is most common in children

Answer 10

transverse - result of bending force
longitudinal - approx. parallel to bone shaft
oblique - diagonally oriented
spiral - torsional force causing fx spiral around the long axis

spiral

Question 11

If there are more than 2 fragments in a fx it is called

Answer 11

comminuted fx

Question 12

Fx with special features that is due to compression forces w/ axial loading

the 2 forms of it

Answer 12

impaction

depression - surface of 1 bone driven into surface of another
compression - both bone surfaces are forced together (of similar size)

Question 13

Subluxation is mostly common at

Sublux and dislocation is the most common injury associated with

Answer 13

joints

fx

Question 13

Fx with special features: what is avulsion

where does this usually occur

Answer 13

fragments are pulled away from the main body of bone

bony prominences

Question 14

When there is still some contact with joint surfaces

When there is no joint surface contact

Answer 14

subluxation

dislocation

Question 15

Where the new growth plate goes

Answer 15

metaphysis

Question 16

Impaction fx that results in buckling of the cortex

Answer 16

torus fx

Question 17

diaphysis fx
metaphyseal fx
physeal fx
epiphyseal fx

Answer 17

central shaft
expanding end
epiphyseal plate
epiphysis

Question 18

Salter Harris classification stands for

Answer 18

Straight across
Above
Lower
Through
ERasure of growth plate (rammed)

Question 19

Fx healing phases for adults

for kids

remodeling phase for kids depends on

Answer 19

Inflammatory (10%), Reparative (40%) - soft/hard callus, Remodeling (60-70%)

Inflammatory, Reparative - soft/hard callus, Remodeling - skeletal age (measure of skeletal maturity)

skeletal maturity

Question 20

fx reduction

closed vs open

fx fixation

external vs internal

Answer 20

restoration of displaced fragments to normal anatomic positions

C: fragments physically guide back into position via manipulation and/or traction
O: surgery necessary to achieve best anatomical alignment

method of maintain fx fragments in postition after reduction to achieve healing

E: casts, splints used to maintain closed reductions
I: devices, and/or bone grafts used surgically to stabilize the fx

Question 20

Epiphseal fx - Salter Harris classification system

Type 1 - 5 characteristics

Answer 20

1: fast healing, rarely needs surgery
2: fast healing, most common type (more in boys, increases incidence in teens)
3: requires ORIF
4: requires ORIF
5: has the most impact on growth rate potential, possible permanent growth arrest

Question 21

Fx that takes the longest to heal

Fx that takes the shortest to heal

Answer 21

scaphoid

middle phalanx and toes

Question 22

Computed tomography is the same as?

What does it use?

What are the components?

Answer 22

Conventional radiography

Motorized X-ray source that rotates around the pt

X-ray tube, beam, detector, and motorized table

Question 23

How is an axial image viewed? How is the radio density?

Answer 23

Transverse slice, viewed as if pt is in supine and viewer is looking up feet to head while facing pt Same as X-rays, dense = white, less dense structures = dark

Question 24

Contrast resolution? Spatial resolution? What is it determined by?

Answer 24

Demonstrates small changes in tissue contrast Ability to distinguish 2 neighboring structures as separated, detectors must be able to identify a gap between them. The # of pixels used to construct a digital image

Question 25

Clinical uses of CT How is it compared to MRI (cost and time) Limitations

Answer 25

Subtle and complex fx, evaluating degeneration changes, spinal stenosis Less expensive and time consuming High radiation exposure and may miss different tissues

Question 26

ACR Appropriateness Criteria function Purpose

Answer 26

Facilities appropriate imaging decisions for specific clinical conditions Helps provide enhance quality of care and efficacious use of radiology

Question 27

For CT scans slices are digitally stacked and the _____ the slice the better the resolution

Answer 27

thinner

Question 28

What is an MRI

Answer 28

a cross sectional imaging technology that uses a magnetic field and radiofrequency signals to cause hydrogen nuclei to emit signals converted to images by a computer

Question 29

The 3 elements of the MRI scanner

Answer 29

gradient coils radiofrequency coils computer

Question 30

What position is the patient in for an MRI How does an MRI work

Answer 30

supine, cannot be done sitting or standing the magnetic field in the scanner causes hydrogen nuclei in water molecules to align to the magnetic field

Question 31

Compare and contrast T1 vs T2 weighted images for what it highlights is the realignment fast or slow (timing of radio frequency pulse sequences)

Answer 31

T1 - images highlight fat tissues within the body, fast realignment FAT is bright, nonfat is dark T2 - images highlight fat and water tissues within the body, slower realignment FAT and WATER both bright

Question 32

Advantages of MRI (2) Disadvantages (2)

Answer 32

no ionizing radiation great for soft tissue detail high cost excess time to produce an image

Question 33

common complications seen on an MRI

Answer 33

hand and wrist: ligament and tendon tears hip: synovitis knee: meniscal and ligament injuries (diagnosed with an accuracy of 95%) ankle and foot: lesions of the tendon and chronic ankle stability

Question 34

Contraindications/ Precautions (3) Variations of MRIs (5)

Answer 34

cardiac pacemaker large area tattoos (iron content) metal foreign objects in eyes or other areas MRI with contrast FLAIR (fluid attenuation inversion recovery) MRA (magnetic resonance angiography) MR arthrography MR myelography

Question 35

How does MRI with contrast work What is used to evaluate

Answer 35

uses a contrast medium, usually gadolinium, which is injected intravenously to improve resolution of the tissues blood vessels, tumors, inflammation etc

Question 36

Processing technique that can attenuate some signals (such as CSF) What is this used for?

Answer 36

FLAIR evaluation of infarctions, MS, and head injuries

Question 37

A general technique based on MRI imagine to visualize blood vessels (most commonly arteries) What can it visualize?

Answer 37

MRA vessels of the neck, brain etc

Question 38

Type of MRI commonly used to visualize glenohumeral and hip joints for labral or ligament tears What is injected

Answer 38

MR Arthrography gadolinium into the joint

Question 39

MR Myelography What is this often used to detect

Answer 39

noninvasive technique that does not require contrast injected into the subarachnoid space spinal stenosis