Radiology Flashcards

Question

Regarding IRR17 give 5 safety features advised

Answer 1

\* Controlled area \* Warning sign for controlled area \* A sign that lights up to indicate when equipment is on \* Light and audible sound during exposure \*Exposure with continuous pressure only \* Exposure stops automatically

Answer 2

As low as reasonably practicable. Minimises exposure and dose

Answer 3

Rectangular collimation 40-50mm, FSD 20-30cm, Fastest film available F speed or digital, 60-70kV. Aluminium filtration. Beam diameter no greater than 60mm at end of spacer

Answer 4

Ensures regulations and training are followed

Answer 5

Advises on risk, regulations, training, quality etc

Answer 6

Paralleling; no contact but object and receptor are parallel and beam perpendicular to receptor. Bisecting angle; in contact but not parallel and beam perpendicular to receptor

Answer 7

Medico-legal Best practice IRMER17 Records Audit

Answer 8

legal person, safety, make sure equipment in line with IRR17, staff follow regulations

Answer 9

Check patient demographics, clinically justify radiograph, be trained

Answer 10

Justifies exposure, benefits vs risks, check no recent relevant radiographs

Answer 11

Check patient demographics, ALARP, takes exposure, processes and reports

Answer 12

Maxillary sinus

Answer 13

Pneumatized maxillary sinus. When the sinus extends into an old extraction site

Answer 14

Pterygomandibular fissure. The space between the posterior border of the maxilla and the lateral pterygoid plate

Answer 15

Lateral pterygoid plate; thin bony extension of the spenoid bone

Answer 16

Hamulus; small bony spine extending downward below the lateral pterygoid plate

Answer 17

Glenoid fossa

Answer 18

Articular eminence

Answer 19

Zygomaticotemporal suture

Answer 20

Zygomatic air cells

Answer 21

Zygomatic process

Answer 22

External auditory meatus

Answer 23

Mastoid process

Answer 24

Middle cranial fossa

Answer 25

Infra orbital foramen

Answer 26

Infra orbital canal

Answer 27

Nasal cavity

Answer 28

Nasal turbinates

Answer 29

Incisive foramen

Answer 30

Ghost image of hard palate

Answer 31

Palatine torus (Hard palate appears thicker than normal)

Answer 32

Periapical. OPT Occlusal Supplemental include CBCT PA mandible Occipitomental view

Answer 33

Location Shape (often spherical or egg shaped, most grow by hydrostatic pressure) Margins (often well defined, often corticated) Locularity (unilocular, multi, pseudo) Multiplicity (single, bilateral, multiple, multiple may indicate a syndrome)

Answer 34

Occur in tooth bearing areas. Most common cause of body swelling in the jaws. Account for 90% of all cysts in the oral and maxillofacial region. All lined with epithelium

Answer 35

Rests of malassez - remnants of hertwigs epithelial root sheath Rests of Serres - remnants of the dental lamina Reduced enamel epithelium - remnants of the enamel organ

Answer 36

Inflammatory odontogenic cyst. Always associated with a non vital tooth Initiated by chronic inflammation at apex of tooth due to pulpal necrosis Incidence; more common in 4th and 5th decades, affects males and females equallly, 60% occur in maxilla, can involve any tooth Often asymptomatic unless infected. Typically slow growing with limited expansion

Answer 37

Well defined round/oval radiolucency Corticated margin continuous with lamina dura of non vital tooth Larger lesions may displace adjacent structures. Long standing lesions may cause external root resorption and/or contain dystropic calcificaiton

Answer 38

A residule cyst is when a radicular cyst persists after loss of tooth (of after successful RCT) Clinical history important to avoid mis diagnosis. A lateral radicular cyst is related to a lateral canal. Located at the side of the tooth instead of the apex.

Answer 39

A developmental odontogenic cyst. Associated with crown of unerupted (and usually impacted) tooth eg mandibular 3rd molar or maxillary canine. Cystic change of dental follicle. Most common in 2nd to 4th decades. Affects males more than females More common in the mandible

Answer 40

Corticated margins attached to cemento-enamel junction of tooth. Larger cysts may begin to envelope root of tooth. May displace involved tooth Tend to be symmetrical initially. Larger cysts may begin to expland unilaterally. Variable displacement of cortical bone ie bony expansion

Answer 41

Consider cyst if follicular space \>4mm (measure from surface of crown to edge of follicle) Assume cyst if \>10mm Consider cyst if radiolucency is asymmetrical.

Answer 42

A developmental odontogenic cyst. No specific relationship to teeth. Most common in 2nd and 3rd decades More common in males than females More common in the mandible, and more common posteriorly Often have scalloped margins. 25% are multilocular Often cause displacement of adjacent teeth. Root resorption uncommon. Characteristic expansion (can expand mesio distally without bucco lingual expansion) High chance of recurrance due to thin friable lining and difficulty of surgery

Answer 43

Basal cell naevus syndrome; multiple OK multiple carcinomas plamar and plantar pitting Calcification of intracradial dura mater known as Gorlin-Goltz syndrome

Answer 44

Developmental non odontogenic cyst. Arises from nasopalatine duct epithelial remnants Most common in 4th to 6th decades More common in males than females Often asymptomatic Pt may note a salty discharge Larger cysts may displace teeth or cause swelling in palate Always involve the midline but not always symmetrical Non keratinised stratified squamous and modified respiratory

Answer 45

Need a PA and/or standard maxillary occlusal radiograph. Corticated radiolucency between/over roots of central incisors Often uniloclear May appear heart shaped due to superimposition of anterior nasal spine. CBCT indicated for surgical planning If radiolucency \<6mm assume it is the incicive fossa Incisive fossa not visibly corticated

Answer 46

Non odontogenic cyst without an epithelial lining. AKA simple/traumatic bone cyst Most common in 2nd decade Males more than females Mandible more than maxilla Can occur in association with other bone pathology eg fibro-osseous lesions

Answer 47

Usually asymptomatic and an incidental finding Rarely pain or swelling Radiologically; Majority in premolar/molar region of mandible but can also occur in non tooth bearing areas Variable definition and cortication May have scalloped margins giving a pseudoloclear appearance May project up between the roots of adjacent teeth

Answer 48

Not a cyst but commonly mistaken as one. It is actually a depression in the bone. (cortical bone preserved) Only occur in mandible and almost exclusively lingual. Contains salivary or fatty tissue Most common in 5th and 6th decades Often in angle or posterior body Often inferior to IAC Asymptomatic Well defined, often corticated radiolucency Rarely displaces adjacent structures

Answer 49

Aspirational biopsy (drainage of contents) Incisional biopsy (partial removal) Excisional biopsy (complete removal)

Answer 50

Wide bore needle 5-10ml syrings Can get; air, blood, pus or cyst fluid Cyst fluid can be clear straw coloured fluid in inflammatory or developmental cysts. White or cream semi solid may indicate keratocyst May be unable to withdraw plunger

Answer 51

Taken to obtain a sample of the lining for histological analysis Usually under LA Select area where lesion appears superficial. Raise mucoperiosteal flap Remove bone as required using rongeurs or a round bur Incise and remove a section of linin Procedure may be combined with marsupialisation

Answer 52

All of the cystic lesion is removed. Treatment of choice for most cysts. Advantages; whole lining can be examined pathologically, primary closure, little aftercare needed. Contraindications/disadvantages; Risk of mandibular fracture with very large cysts Dentigerous cyst? May wish to preserve tooth Old age/ill health Clot filled cavity may become infected. Incomplete removal of lining may lead to recurrance Damage to adjacent structures

Answer 53

Creation of a surgical window in the wall of the cyst, removing the contents of the cyst and suturing the cyst wall to the surrounding epithelium. Encourages the cyst to decrease in size and may be followed by enucleation at a later date. Idications; if enuculeation would damage surrounding structures eg IAC Difficult to access area May allow eruption of teeth affected by the dentigerous cyst. Elderly or medically compromised patients unable to wishtand extensive surgery Very large cysts that would risk jaw fracture if enucleation was performed Can combine with enucleation as a later procedure

Answer 54

Simple to perform May spare vital structures.

Answer 55

Opening may close and cyst may reform Complete lining not available for histology Difficult to keep clean, lots of aftercare needed. Long time to fill in An obturator is used to keep marsupialisation window open

Answer 56

Condyle of mandible

Answer 57

Coronoid process

Answer 58

Sigmoid notch

Answer 59

Ramus of mandible

Answer 60

Styloid process

Answer 61

Styloid ligament ossicles

Answer 62

Inferior border of mandible

Answer 63

External oblique line

Answer 64

Posterior border of ramus

Answer 65

Submandibular fossa

Answer 66

Genial tubicles

Answer 67

Body of hyoid bone superimposed on mandible

Answer 68

Palatoglossal air space

Answer 69

Soft palate

Answer 70

1% of all lesions sent to histopathology come back as OT Benign\>malignant 100:1 Most asymptomatic and discovered investigating unerupted teeth Pain usually secondary to infection Most arise within bone

Answer 71

Epithelial Mesenchymal Mixed ONLY mixed tumours can have dentine/enamel formation

Answer 72

Benign epithelial tumour Locally destructive but slow growing Typically painless Most common in 4th to 6th decades 80% occur in posterior mandible Male more than Female Radiologically 85% multicystic. Unicystic carries lower recurrance rate Histilogica

Answer 73

Epithelial; ameloblastoma. Adenomatoid odontogenic tumour. Calcifying epithelial odontogenic tumour Mesenchymal; odontogenic myxoma Mixed; odontoma

Answer 74

Benign epithelial tumours Locally destructive but slow growing Typically painless Most common in 4th to 6th decades 80% occur in posterior mandible male more than female Radiological; 85% multicystic, unicystic lower rate of recurrence Histological; follicular, flexiform, desmoplastic Margins well defined and corticated. Potentially scalloped Adjacent structures can be displaced, thinning on bony cortices 'knife edge' extended root resorption

Answer 75

Surgical resection with margin Recurrance relatively common, up to 15% Risk of malignant change \<1% Ameloblastic carcinoma

Answer 76

Benign epithelial tumour Classic presentation - unilochlear radiolucency with internal calcifications around crown of unerupted maxillary canine Incidence/presentation; 3% of odontogenic tumours Most common in 2nd decade female more than male Mostly anterior maxilla 75% associated with unerupted tooth Similar to dentigerious cyst but attached to CEJ Impedes eruption Unilocular Majority have internal calcifications External root resorption is rare

Answer 77

Benign epithelial tumour Most common in 5th decade male more than female Post mandible most common Slow growing 50% associated with UE tooth Internal radiopacities

Answer 78

Benign mesechymal tumour Most common in 3rd decade female = male mandible more than maxilla well defined small lesions unilocular larger soap bubble appearance slow growth m-d scallops between tooth, may displace if large management; curettage or resection. 25% recurrance rate

Answer 79

Benign mixed tumour Malformation of dental tissue Similarities to teeth; do not grow indefinitely, surrounded by dental follicle, lie above IAC Most common in 2nd decade Female = male Compound; ordered dental structures (resembles multiple mini teeth) more common in maxilla Complex - disorganised mass more common in post mandible

Radiology Flashcards

(106 cards)