Chapter 4 pathology workbook

bone; cartilage
The two highly specialized connective tissues in the skeletal system are

compact; cancellous
The two major types of bone are

periosteum; endosteum
The two membranes associated with the bone are

dense; structureless
The compact bone appears ______ and ________.

cancellous; spongy
Weblike bone structure consisting of marrow-filled spaces is ______ or _________.

Cancellous bone appears as ________ on the radiographic image.

Linear bone growth occurs at the ________ plate.

osteoblast; osteoclast
The two special types of bone cells are _______ and ______.

ossification; resorption
The term for bone formation is ______ and the term for bone destruction is _________.

intramembranous ossification
The skull and flat bones do not have a cartilagionous stage in bone formation so bone development occurs through _________.

The diameter of the long bone expands or grows by ______ in the periosteum, producing new bone.

support, protect, lever, storehouse, and production
What are the five basic functions bones perform?

A vertebra that has characteristics of the spinal column above and below is considered a ______ vertebra.

spina bifida
A splitting of the bony neural canal is referred to as _______.

The most common form of dwarfism is __________, which is the result of diminished proliferation of cartilage in the growth plate.

_________ is characterized pathologically by loss of cartilage and reactive new bone formation.

_________ is inflammation of the small fluid-filled sac located near the joint to reduce friction caused by movement.

A deep soft tissue swelling with obliteration or displacement of the fat pads and subtle metaphyseal lucencies describes ________.

Vitamin D deficiency in adults causes a loss of _________ as a result of the lack of calcium and phosphorus.

The most common metabolic disease of the skeletal system is ______ disease, which affects both osteoblasts and osteoclasts

An _______ bone cyst contains numerous blood-filled arteriovenous communications.

The continuous external bridge of calcium deposit that extends across a fracture line is _______.

A fracture that may heal in a faulty position, resulting in impairment of function, is called __________.

rheumatoid arthritis
_______ __________ is a chronic systemic disease of unkown case, usually occurring in the small joints of the hand and feet.

bone formation from cartilage

intramembranous ossification
connective tissue bone formation

compact bone
dense structureless outer bone

end of the shaft where the bone flares and becomes the epiphysis

ends of long bones where growth occurs

fibrous membrane covering the outer surface of the bone

appositional growth
ossification of flat bones on their outer surfaces

membrane that lines the medullary cavity

medullary cavity
portion of bone where blood production occurs

resorbing bone cell enlarging the diameter of the medullary cavity

shaftlike portion of the bone

spongy bone
area that contains trabeculae

paget’s disease
“cotton wool” skull appearance

a cleft in the pars interarticularis between the superior and inferior articular processes in the vertebra

a deposit of uric acid in the joint

a malignant turmor of cartilaginous origin that may originate anew or within a preexisting cartilaginous lesion

abnormal decrease in bone density due to lack of calcium deposit

ewing’s sarcoma
arises in the bone marrow of long bones and affects young adults

benign bone projection with a cartilaginous cap

osteogenesis imperfecta
brittle bone disease

caused by a vitamin deficiency in children

osteogenic sarcoma
classic “sunburst” pattern with elevated periosteum

degenerative arthritis

failure of cartilage to form properly, resulting in dwarfism

infection of the bone and its marrow

inflammation of the fluid-filled sac usually due to repeated physical activity

spina bifida
lack of neural tube closure

marble bone disease

pott’s disease
most commonly affects the thoracic and lumbar spine with poorly marginated bone destruction often associated with an abcess

fibrous dysplasia
proliferation of fibrous tissue in the medullary cavity

herniated intervertebral disk
rupture of central nucleus pulposus, most frequently L4-L5

unicameral bone cyst
true fluid-filled area surrounded by a fibrous wall

bone response to repeated stress

composed of more than two fragments

discontinuity between two or more fragments

disruption of overlying skin

encircles the bone shaft

fracture healing process stops

fragment torn from bony prominence

incomplete fracture with the opposing cortex intact

occurs at a right angle to the long axis of bone

overlying skin is intact

runs approximately 45 degrees to the bone shaft

seperation of bone fragments

ankle dislocation with fractured malleoli

avulsion fracture at the base of the fifth metatarsal

clay shoveler’s
avulsion fracture of the spinous process

C2 fracture of the arch, usually associated with anterior subluxation of C2-C3

comminuted fracture of the ring of the atlas

isolated fracture of the ulna with associated dislocation of the radius in the elbow

seat belt
transverse fracture of the lumbar vertebra

transverse fracture of the neck of the fifth metacarpal

transverse fracture of the waist of this carpal bone

transverse fracture through distal radius with dorsal angulation

when the spine curves in a lateral direction, it is known as

the most common metabolic disease of the skeletal system is _____ disease, which affects both osteoblasts and osteoclasts

b) fibrous dysplasia
excessive proliferation of fibrous tissue in the medullary cavity describes
a) achondroplasia
b) fibrous dysplasia
c) osteomalacia
d) gout

b) spondylolisthesis
the displacement of L-4/L-5 due to slippage of the inferior and superior intervertebral facets is
a) spondylolysis
b) spondylolisthesis
c) ruptured intervertebral disk
d) a Jefferson fracture

a) a mylelomeningocele
a herniation of the meninges is
a) a mylelomeningocele
b) a meningocele
c) spina bifida occulta
d) a Chiari II malformation

c) osteopetrosis
bone that fails to resorb and causes a loss of bone marrow is referred to as
a) osteomalacia
b) osteoporosis
c) osteopetrosis
d) osteogenesis imperfecta

d) osteogenesis imperfecta
severe osteoporosis and thin defective cortices resulting in multiple fractures occur in patients with
a) osteomalacia
b) osteoorosis
c) osteopetrosis
d) osteogenesis imperfecta

d) congenital hip dysplasia
the hip may “pop” out of joint and a “click” may be felt or heard on clinical evaulation in children with
a) chondromas
b) herniated vertebral disks
c) club feet
d) congenital hip dysplasia

b) rheumatoid arthritis
_____ may undergo spontaneous remission and has symmetrical involvement
a) osteoarthritis
b) rheumatoid arthritis
c) psoriatic arthritis
d) infectious arthritis

a) osteoporosis
in _____ localized bone deficiency occurs as a result of decreased bone mass per unit volume
a) osteoporosis
b) osteomalacia
c) osteopetrosis
d) osteomyelitis

a) gout
after repeated attacks,the inflammatory reaction produces evidence of joint effusion and clumps of crystal urate in patients affected with
a) gout
b) osteoarthritis
c) pyogenic arthritis
d) osteomyelitis

c) rickets
the disease process that results in a descreased absorption of calcium due to a vitamin deficiency is
a) osteopetrosis
b) osteomyelitis
c) rickets
d) scurvy

b) growths parallel to the long axis of a bone
osteochondromas are
a) dense round lesions usually in the outer skull table
b) growths parallel to the long axis of a bone
c) usually found in the small bones of the hands and feet
d) tumors that originate from osteoblastic cells in the bony cortices

b) inferoposterior vertebral displacement
scoliosis is
a) superoanterior vertebral displacement
b) inferoposterior vertebral displacement
c) lateral vertebral displacement
d) posterior sacral displacement

c) sacrum is displaced completely posteriorly from the fifth lumbar vertebra
a first-degree spondylolisthesis is diagnosed when the
a) sacrum is displaced forward
b) fifth lumbar vertebra is displaced forward one fourth of the thickness of the sacrum
c) sacrum is displaced completely posteriorly from the fifth lumbar vertebra
d) fifth lumbar vertebra is displaced anteriorly three quarters of the thickness of the sacrum

d) standing flexion and extension lateral lumbar spine projections
in the diagnosis of spondylolysis, which additional projections will be most helpful
a) standing AP and lateral lumbar spine projections
b) oblique lumbar spine projections
c) flexion and extension lateral lumbar spine projections
d) standing flexion and extension lateral lumbar spine projections

b) decrease kv or d) decrease kv and ma
*Depending on protocol
for patients with severe osteoporosis, how should the exposure factors be adjusted
a) increase kv and ma
b) decrease kv
c) decrease ma
d) decrease kv and ma

d) increase ma and kv
osteopetrosis requires changes in the exposure factors-the radiographer should
a) decrease SID
b) increase kv
c) increase ma
d) increase ma and kv

a) DEXA scan
the modality of choice to demonstrate cortical bone loss in osteoporosis is a
a) DEXA scan
b) quantitative CT scan
c) plain radiograph
d) NM bone scan

b) Paget’s disease
the early stage of this disease process is seen as sharply demarcated radiolucency, which represents the destructive phase of
a) Pott’s disease
b) Paget’s disease
c) gout
d) osteomyelitis

a) slow growing benign cartilaginous tumors
enchondromas are
a) slow-growing benign cartilaginous tumors
b) benign projections of bone with cartilaginous caps
c) eccentric lucent lesions in the metaphysis
d) well-circumscribed, extememly dense round lesions

d) unicameral bone cyst
an expansive lucent lesion with a thin sclerotic rim is a
b) bone island
c) aneurysmal bone cyst
d) unicameral bone cyst

a) enchondromas
which tumors arise in the medullary cavity of the small bones of the hands and feet
a) enchondromas
b) endodermomas
c) osteochondromas
d) osteosarcomas

a) CT
for osteoid osteoma, what modality is used to best demonstrate the nidus
a) CT
b) MRI
c) US
d) radiography

c) MRI
the most sensitive imaging modality to demonstrate ischemic necrosis is
a) CT
b) NM
c) MRI
d) plain radiographs

b) rickets
insufficient mineralization of the immature skeleton causing a cupped and frayed metaphysis in long bones is
a) osteomalacia
b) rickets
c) osteoporosis
d) Paget’s disease

b) Paget’s disease
a cotton-wool radiographic appearance is visualized in the reparative phase of
a) Pott’s disease
b) Paget’s disease
c) multiple myeloma
d) osteopetrosis

a) radiography
which is the least sensitive modality to demonstrate osteomyelitis because of its inability to demonstrate early destruction
a) radiography
b) CT
c) MRI
d) NM

b) osteoporosis
although the DEXA scan involves less radiation exposure for the patient, quantitative CT is one modality to demonstrate which disease
a) osteopetrosis
b) osteoporosis
c) osteomalacia
d) osteoma

d) unstable
the spine consists of an anterior colum and a posterior column. when both columns are disrupted the injury is considered
a) displaced
b) stable
c) undisplaced
d) unstable

a) Jones
which fracture is a transverse fracture at the base of the fifth metatarsal
a) Jones
b) Pott’s
c) boxer’s
d) Galeazzi’s

a) navicular
it is common in what type of fracture for the healing process to halt and that fragments to remain separate, creating a serious complication, possibly necrosis
b) pathologic
c) boxer’s
d) Jones

b) osteogenic sarcoma
the malignant bone tumor most commonly found in the metaphysis of the knee is a
a) osteochondroma
b) osteogenic sarcoma
c) chondrosarcoma
d) multiple myeloma

a) ewings sarcoma
which tumor causes destruction of the medullary cavity, producing an “onionskin” periosteal reaction
a) Ewing’s sarcoma
b) osteosarcoma
c) chondrosarcoma
d) osteoid osteoma

d) standing lateral lumbar spine image
to evaluate and grade spondylolisthesis, the radiologist needs a
a) standing AP lumbar spine image
b) oblique lumbar spine image
c) lateral lumbar spineimage
d) standing lateral lumbar spine image

a) CT myelogram
to best deomonstrate a herniation of a intervertebral disk requires which of the following procedures
a) CT myelogram
b) PET body scan
c) US of the spinal cord
d) NM bone scan

a) seat belt
which fracture is a transverse fracture of the spine often associated with significant visceral injuries
a) seat belt
b) hangman’s
c) clay shoveler’s
d) Jefferson’s

b) lead
ingestion of which substance is interchangeable with that of calcium in the body, causingdense transverse bands in the metaphysis
a) hypervitaminosis
b) lead
c) vitamin K
d) increased caloric intake

c) standing with equal stance
to best image scoliosis, the patient should be
a) recumbent bending away fro the curvature
b) recumbent prone
c) standing with equal stance
d) recumbent bending toward the curvature

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