Test #1 Flashcards by Caleb Spreiter

Areas of normal uptake in bone scintigraphy?

Long bone metaphyses, thyroid, kidneys, sternum, spine, S.I., bladder

How well did you know this?

Not at all

Perfectly

Type of forces that produce fxs?

Torsion, compression, shearing, rotation, angulation(bending)

How well did you know this?

Not at all

Perfectly

Types of incomplete fxs?

Green stick, torus, bowing, stress

How well did you know this?

Not at all

Perfectly

What to look for to detect a fx?

Abnormal line of lucency, offset of the cortex, increased bone density, soft tissue swelling, obliteration or displacement of myofascial planes, periosteal & endosteal responses, joint effusion, intracapsular fat (FBI sign), double cortical line, irregular metaphyseal corners, zone of impaction

How well did you know this?

Not at all

Perfectly

Factors which influence fx healing?

Pt’s age, site & type of fx, position of the fragments, status of blood supply, quality of immobilization or fixation, complications

How well did you know this?

Not at all

Perfectly

What are the phases of the circulatory/inflammatory phase?

Cellular phase, vascular phase, primary callus phase

How well did you know this?

Not at all

Perfectly

Steps during cellular phase

Hematoma, Inflammatory response, granulation tissue replaces the hematoma

How well did you know this?

Not at all

Perfectly

Steps during the vascular phase

Ingrowth of new blood vessels leading to hyperemia, increased osteoclastic activity, hair growth, tan skin

How well did you know this?

Not at all

Perfectly

Circulatory phase occurs when?

First 5-30 days

How well did you know this?

Not at all

Perfectly

What happens during the Reparative/metabolic phase?

Callus formation becomes more orderly & woven bone is replaced by more mature bone

How well did you know this?

Not at all

Perfectly

How long does the Reparative/Metabolic phase last?

4-6 weeks in the young & 6-15 weeks in adults

How well did you know this?

Not at all

Perfectly

What happens during the remodeling/mechanical phase?

Bone is deposited & removed according to Wolff’s law, restoration of the medullary cavity & bone marrow

How well did you know this?

Not at all

Perfectly

How long does the Remodeling/Mechanical phase last?

May take months or years to complete

How well did you know this?

Not at all

Perfectly

What happens in first 5-10 days following a fx?

Resorption of the fx line occurs creating an increase in width of the actual fx line

How well did you know this?

Not at all

Perfectly

What happens 10-30 days following a fx?

“Veil” of new bone formation adjacent to fx site (callus)

How well did you know this?

Not at all

Perfectly

Immediate complications of delayed union/nonunion?

Articular injury, compartment syndrome, fat emboli

How well did you know this?

Not at all

Perfectly

Intermediate complications of delayed union/nonunion?

Osteomyelitis, hardware failure, RSDJ, myositis, delayed union

How well did you know this?

Not at all

Perfectly

Delayed complications of delayed union/nonunion?

Osteonecrosis, DJD, osteoporosis, nonunion, malunion

How well did you know this?

Not at all

Perfectly

Contributing factors to nonunion?

Distraction
Inadequate immobilization (99% of problems)
Infection
Impaired circulation (avascular necrosis)
Soft tissue b/w fragments

How well did you know this?

Not at all

Perfectly

M/C site for non-union?

Mid-clavicle, ulna, tibia

How well did you know this?

Not at all

Perfectly

5 P’s assoc. w/ Volkmanns Ischemic Contracture?

Pulselessness
Pain
Pallor
Paresthesia
Paralysis

How well did you know this?

Not at all

Perfectly

Premature DJD is M/C where?

Weight bearing joints (hip, knee, ankle)

How well did you know this?

Not at all

Perfectly

What views are in a head series?

AP Caldwell, AP Towns, L & R Lateral, Base view, Waters view (shows sinuses)

How well did you know this?

Not at all

Perfectly

Most spinal trauma is secondary to?

MVAs & falls

How well did you know this?

Not at all

Perfectly

Most common sites for spinal fxs?

C1-C2 - cord injury less common b/c canal is large C5-C7 - canal is smaller so cord injuries more common T12-L1

What type of forces disrupt ligaments?

Rotational & shearing forces

What is located in the anterior column of the spine?

ALL, ant. annulus fibrosis, anterior body

What is located in the middle column of the spine?

PLL, pos. annulus fibrosis, pos. body

What is located in the pos. column of the spine?

Neural arch & intervening soft tissues

For an injury to be considered stable what column has to be intact?

Middle column

If an injury disrupts 2 of 3 columns is it considered stable or unstable?

Unstable

What is the M/C mechanism of spinal injury?

Flexion

Types of hyperflexion injuries

Bilateral facet dislocation, Clay-Shovelers, Hyperflexion sprain/strain, Odontoid process fx, Simple wedge fx, Flexion teardrop fx

What is the most unstable fx in the C-spine compatible w/ life?

Flexion teardrop fx

Types of hyperextension injuries

Extension teardrop fx, fx of pos. arch of C1, Hangman's fx, Articular pillar/facet fx, spinous process fx, Hyperextension sprain/strain

Types of rotation injuries

Laminar/facet fx (extension), Transverse process fx (C-7), Unilateral facet dislocation (flexion), Rotary atlantoaxial fixation

Types of lateral flexion injuries

Uncinate process fx, Transverse process fx (M/C)

Lateral flexion injuries are usually located where?

Junction of TVP & pedicle

Types of shearing injuries

Fx/dislocation in thoracic & lumbar spine, Atlanto-occipital dislocation

Types of dislocation injuries

Chance fx (seat belt fx), Atlanto-occipital dislocation

List findings that suggest instability

Increased angulation b/w vert. bodies that is at least 11degs greater than adjacent segments, ant. or pos. translation greater than 3.5mm, segmental spinous process widening, facet joint widening, lateral tilting of vertebral bodies

A majority of signs of cervical trauma can be visualized on what view?

Neutral lateral view

What segments need to be shown on a neutral lat. view of the C-spine?

C7 & T1

The retropharyngeal space should be no more than?

7mm

The retrotracheal space should be no more than?

21mm

Minimum views of a 3-view cervical series?

APOM, APLC, neutral lateral

Most common fx of C1?

Pos. arch fx of atlas

M/C location of extension teardrop fx is C-spine?

C2/C3

Important clue indicating an articular pillar/facet fx?

Acute cervical radiculopathy

M/C location for articular/pillar fx of C-spine?

C4-C6 (C6)

This fx usually has a "horizontal facet sign"?

Articular pillar/facet fx

2 types of fxs that result from compression injuries?

Jefferson's fx & burst fx

This fx will show bilateral offset or spreading of the lat. masses known as the "Overlap sign"?

Jefferson's fx

Posteriorly displaced fragments may produce spinal cord injury in this type of fx?

Burst fx

This fx is assoc. w/ MVAs, wrestling, diving; caused by abrupt flexion, direct blow extension?

Clay-Shoveler's fx

This fx is assoc. w/ the "double spinous process" sign?

Clay-Shovelers

3 types of fusion

Synostosis (congenital), Ankylosis (pathological), Arthrodesis (surgical)

This is seen in Down's syndrome, inflammatory arthritides, & Jefferson's fx?

Transverse ligament disruption

3 things that suggest injuries?

Soft tissue changes, zone of impaction, step defect

Types of stable Fxs

Pos. arch fx of atlas, extension teardrop fx, Jefferson's fx, Simple wedge fx, Clay-Shovelers fx, Type I odontoid process fx, Type III odontoid process fx, Unilateral facet dislocation

Types of unstable fxs

Hangman's fx, Articular pillar/facet fx, Burst fx, Flexion teardrop fx, Hyperflexion strain/sprain, Bilateral facet dislocation, Transverse ligament disruption, Type II odontoid process fx

Test #1 Flashcards

(61 cards)