Intro to Pathology/Skeletal System Test

The cause of a disease it known as

etiology

Long lasting effects from an acute illness are referred to

as sequelae

Iatrogenic reactions are

adverse responses due to treatment itself

Idiopathic reactions are adverse events with

no known etiology

A group of signs and symptoms are referred to as

syndrome

symptoms are defined as

subjective patient perceptions of their disease

signs are defined as

observable manifestations

The diagnosis of a disease is termed the

identification of the disease

predicted outcome is termed the

prognosis

Diseases that add atomic number, thickness or density (concentration of matter) are known as?

additive

The epidemiology of disease is the

investigation of disease in large groups.

prevalance is termed

the number of cases in a population of disease

incidence is termed

the number of new cases found in a given period of disease.

The mortality rate refers to

average number of deaths caused by a particular disease in a population

Morbidity refers to

incidence of sickness sufficient to interfere with a person's normal routine.

The 22 pairs of autosomal chromosomes in each cell along with a sex chromosome ( XX for female, XY for male) make up what is known as the?

Human genome

Congenital diseases are

inherited

One of the major causes of congenital diseases are

abnormalities in the number of chromosomes.

Each parent normally delivers 22 autosomal (non-sex) chromosomes and 1 sex chromosome to each cell for a total of?

46 chromosomes

In the case of Down syndrome, there ends up being?

1 extra chromosome 21

What % of all live births show one or more congenital diseases?

2-3%

What is caused by developmental disorders genetically transmitted from either parent to child through abnormalities of individual genes in chromosomes?

Hereditary diseases

A disease that results from the body's reaction to a localized injurious agent?

Inflammation

Infective diseases are caused by?

Invasion by microorganisms

Toxic diseases are caused by?

Poisoning by biologic substances

Allergic diseases caused by?

Overreaction of body's own defenses

Autoimmune disorders are?

Disease in which the body forms antibodies that injure patient's own tissues

Rheumatoid arthritis is a autoimmune disorder where?

the body attacks joints and causes swelling of synovial membranes

Capillary dilation causes?

Increased blood flow

Increased capillary permeability causes?

Extravasation of fluid

Attraction of leukocytes causes?

attraction of white blood cells to site of necrosis

Systemic response causes?

Fever leukocytosis

Factors affecting the rate of aging are?

Atherosclerosis, Osteoporosis, Osteoarthritis

Metabolic Disease is caused by?

the disturbance of the normal physiologic function of the body

Endocrine disorders include?

Hypersecretion, Insufficient secretion

Traumatic Disease may result from?

mechanical forces such as crushing or twisting of a body part or from the effects of ionizing radiation on the body

Neoplastic disease results in?

new, abnormal tissue growth

Benign tumors are denoted by?

the suffix "oma"

Malignant tumors are denoted by adding the tissue type to the word root?

- adeno = tissue type meaning glandular and carcinoma indicating cancer.

TNM system emerged in the?

1950s and endorsed by AJCC

T- is?

tumor size

N— is?

Node (lymph node involvement)

M— is?

metastases

What is pathogenesis?

the sequence of events producing cellular changes that ultimately lead to observable changes

Compact Bone

dense, outer portion of the bone

Cancellous bone

what the medullary cavity is made up of

Trabeculae

weblike bony structure referred to as trabecular pattern

Osteoblasts

bone forming cells responsible for bone growth and thickening, ossification and regeneration

Osteoclasts

cells responsible for bone remodeling

Diaphysis

the shaft of a long bone

Epiphysis

expanded end of long bone

Metaphysis

growth zone between the epiphysis and the diaphysis

Synarthrodial

immoveable joint

Amphiarthrodial

slightly moveable joint

diarthroidal

freely moveable joint

MRI shows what best

soft tissues, joints and bone marrow

CT shows what best

Shows cortical bone better than MRI and helical CT is often used to explore bone tumors due to its high contrast

Quantitative computed tomography (QCT)

used in evaluating bone mass loss, especially within the vertebral bodies of the spine.

Nuc Med/PET

Modality of choice in detection and staging of metastatic disease

Nuc Med and PET are used to diagnose

osteomyelitis, trauma, inflammatory and degenerative arthritis, avascular necrosis, osteonecrosis of the mandible, condylar hyperplasia, metabolic bone disease, Paget disease, bone graft viability, complications of the prosthetic joints, and reflex sympathetic dystrophy.

Osteogenesis Imperfecta

(Brittle Bone Disease)

•Congenital

• Autosomal dominant

• Bowing, fractures, lack of density

• Requires decreased exposure factors

• RA decreased calcium, bowing, fx's

Achondroplasia

Normal trunk size, short extremities

•Failure of cartilage at epiphysis in

long bones to convert to normal bone

•RA - Long bones are short

• Bone age studies can be used to indicate normal vs abnormal

bone growth

The Ilizarov procedure has been used in

an attempt to lengthen the shortened limbs in achondroplasia patients

Osteopetrosis

•Increased bone density, defective

contour of bones

Effects long bones, spine, pelvis

Requires increased exposure

• Includes several diseases:

- Craniotubular dysplasias - Albers-Schonberg Disease

Syndactyly

webbed toes

Polydactyly

extra fingers or toes

Clubfoot (Talipes)

• Inverted feet

• Unable to bear wt.

It is diagnosed by use of the Kites position and is corrected through splinting. It is most common in males.

Scoliosis

Lateral curvature of spine

Transitional vertebrae

•Vertebra takes on appearance of

vertebra on each side of major

spinal division

Most common between thoracic and lumbar

Spinal bifida

•Incomplete closure of vertebral arch

No spinous process in back

meningocele

Herniation of meninges only

Meningomyelocele

Herniation of the meninges and spinal cord

Anencephaly

• Lack of brain or cranial vault

May have normal facial bones

Death shortly after birth

developmental dysplasia of the hip (DDH)

A malformation of the acetabulum the acetabulum does not form completely, the head of the femur is displaced superiorly and posteriorly. Diagnosed using sonography

Osteomyelitis

•Infection of the bone and/or bone marrow

with pathogenic bacteria

•Dense bone (sequestrum) surrounded

by decreased density (involucrum)

Does not show on radiograph for 10 - 14 days

DX by nuc med and MRI

Potts Disease (TB of bone)

•Bacterial inflammatory disease

• Commonly effects hip, knee &

spine

•RA - Worm-eaten appearance

• Starts in epiphysis & may involve articular cartilage &

joint space

• May result in softening & collapse

of vertebrae

Degenerative arthritis

Effects articular cartilage

Inflammatory arthritis

Effects synovial membranes

Infectious Arthritis

•Caused by pyogenic bacteria

• RA - Increased joint space with

bony destruction

• Tx - Antibiotic therapy

Rheumatoid Arthritis

•Inflammatory disease with adult onset 30 - 40 yrs. old

• Overgrowth of synovial membranes

• Effects peripheral joints of hands & feet first

• RA ankylosis of joints, dislocation

• Requires increased exposure

ankylosing spondylitis

•May be termed "spondylitis"

• Arthritis of the spine

• Adult onset 20 - 40 yrs. old

• RA - Bamboo Spine, rigid fused spine

• Requires increased exposure

• May be hereditary

Gouty arthritis

•Results from increase in uric acid salts in joint spaces

• Inherited metabolic disease

• Often effects metatarsophalangeal jt.

• Assoc. with radiolucent kidney

stones

Osteoarthritis

•Degenerative joint disease effecting cartilage

• May be

1) Primary - Normal deterioration of

joint

2) Secondary - Result of trauma or other disease conditions

• RA - Narrowed joint space, possible

osteophytes

• Tx non-steroidal anti-inflammatory drugs (NSAIDS), exercise & surgery

• Requires decreased exposure

spondylosis causes

degeneration of the joints and vertebrae.

Tenosynovitis

Inflammation of the tendon and synovial membrane enclosing it

Bursitis

Inflammation of the bursae

Ganglion cysts

Cystic swelling connected with a tendon sheath in a joint space

Osteoporosis

•Abnormal decrease in bone density

• Primarily post-menopausal disease

• Lack of osteoblastic activity

• Hormonal, dietary factors contribute to disease

• RA - Most noticeable in spine (compression fx.'s) with osteopenia

• Requires decreased exposure factors

DX with DEXA scan

Osteomalacia

•Failure of bones to calcify

• Occurs due to inability to absorb calcium, vitamin D & phosphorus

• Dx - Best dx. with lab tests

• RA - Osteopenia with bands of

radiolucency in bone (peudofractures),

otherwise similar to osteoporosis

Known as Rickets if it occurs before growthplate closure (gowth plates look fuzzy)

Requires decreased exposure

Pagets Disease

•Metabolic disorder characterized

by bony destruction (osteolytic stage)

and over-replenishment (osteoblastic stage) with poorly mineralized bone

• Etiology unknown

•Effects men more often than women

• May lead to fractures & nerve

impingement

• RA - Mixed areas of radiolucent &

radiopaque densities

• Requires increased exposure

Occult fractures

Indicated by the posterior or supinator fat pads

(not normally seen) on a lateral radiograph of the elbow.

Colles fracture

Fracture of the distal of radius with posterior displacement of the fracture often accompanied by an avulsion fracture of the distal ulna.

Monteggias fracture

Fracture of the proximal ulna with radial head dislocation

Potts fracture

Fracture of the distal tibia and fibular malleoli, with ankle dislocation.

Tri malleolar fracture

Involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus. The trauma is sometimes accompanied by ligament damage and dislocation.

Linear cerebral fractures

Straight, radiolucent, non- branching lines

Depressed cerebral fractures

•Overlapped

- Curvilinear lines

Le fort fracture

- Horizontal, bilateral fracture ofthe maxillae

Anterior hip dislocation

anteriorly displaced femoral head above that of the acetabulum

Posterior hip dislocation

a posteriorly displaced head below that of the acetabulum