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From which germ layer is bone formed?
Mesodermal tissue.
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What kind of cartilage does long bone develop from?
Hyaline cartilage.
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What is the name for a primary center of ossification?
Diaphysis.
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What is the name of the secondary ossification center?
Epiphysis.
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In the first stage of the ossification process, what transforms into bone?
Embyronic connective tissue (NOT cartilage).
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What kind of bone involves intramembranous ossification?
Flat bone.
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What else does intramembranous ossification participate in?
Healing.
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In the second stage of the ossification process, where does the ossification take place?
Within the cartilage.
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Primary endochondral ossification transforms what into bone?
Cartilagenous tissue: which lengthens the bone.
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Where does secondary endochondral ossification take place?
Within epiphyses & apophyses.
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Where is the growth plate located?
Between the primary & secondary growth centers, as a thing plate of cartilage.
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What 4 types of bone is secondary ossification associated with?
- 1. Tubular bone.
- 2. Vertebrae.
- 3. Ethmoids.
- 4. Inferior conchae.
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Name the 4 steps for bone growth.
- 1. Resting zone: attaches the growth plate to the epiphysis.
- 2. Zone of Proliferation: bone is lengthened via active chondrocytes.
- 3. Zone of Hypertrophy: chondrocytes mature.
- 4. Zone of Degeneration/ossification: dying chondrocytes = ossification.
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Which zone of bone growth is affected by injury?
Step #1: Resting Zone... if injured, growth stops.
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Which growth zone is affected by cell death?
Step #2: the zone of proliferation: if cell death occurs, growth stops.
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Which growth zone is the weakest portion, and does not have active growth?
- Step #3: zone of hypertrophy.
- Salter-Harris fractures may occur.
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What is a Salter Harris Fracture?
- A fracture involving the growth plate or epiphyseal plate.
- Common in children.
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In which zone does the growth plate attach to the metaphysis?
Step #4: the zone of degeneration/ossification.
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Bone is 70% what?
Minerals (hydroxapetitie).
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What are osteoblasts?
Bone forming cells.
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What are osteoclasts?
Bone remodeling & reabsorption cells.
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What are osteocytes?
- Living cells of bone.
- Within lamellar bone.
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What are the 2 types of bone?
- 1. Compact.
- 2. Cancellous.
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What percentage of bone is compact bone?
80%.
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Name 3 a/k/a's for cancellous bone.
- 1. Trabecular.
- 2. Spongy.
- 3. Medullary.
- Internal cavity of bone.
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Phosphorus levels are inversely related to what?
Calcium.
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Which hormone is involved with bone growth?
- Somatototropin.
- Gigantism: increased somatotropin before physeal closure.
- Acromegaly: increased somatotropin after physeal closure.
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What are the 2 main functions of parathormone?
- 1. Stimulate & control the rate of bone remodeling.
- 2. Influence the control of the plasma level of calcium.
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What is an apophysis?
- Secondary growth center.
- Attachment site for ligaments & tendons.
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What is an enthesis?
- Site of attachment of tendons & ligaments.
- Highly vascularized, high metabolic activity.
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Name a tubular bone with 3 epiphyses.
Humerus: head, trochlea, & capitulum.
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Name a tubular bone with 2 apophyses.
Femur: greater & lesser trochanter.
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What are the 4 functions of periosteum?
- 1. Attaches to cortex (via sharpey's fibers).
- 2. Maintains bone by appositional bone growth.
- 3. Provides a transitional zone of attachment for muscles, tendons, & ligaments.
- 4. Source for vascularization.
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What does CATBITES stand for?
- Congenital.
- Arthritis.
- Trauma.
- Blood.
- Infection.
- Tumor.
- Endocrine/nutritional/metabolic.
- Soft tissue.
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Which type of lesion is destructive, has sharp borders, is less aggressive, is slow growing, & has a narrow zone of transition?
Lytic lesion.
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What are the 3 types of lytic lesions?
- 1. Geographic.
- 2. Moth-eaten.
- 3. Permeative.
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What is the diameter for a moth-eaten lytic lesion?
2-5 mm.
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What are the 3 examples of moth-eaten lytic lesions?
- 1. Myeloma.
- 2. Mets.
- 3. Lymphoma.
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What is an a/k/a for osteoblastic lesions?
Osteogenic.
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If the mitchell marker is behind the spinous, is it an anterior or posterior view?
Behind the spinous = anterior.
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Is the film anterior or posterior if the film is behind the body?
Closer to body = posterior.
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3 things to remember with a solid periosteal reaction?
- 1. Slow growing.
- 2. Uninterrupted.
- 3. Thickening.
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Which type of periosteal response grows unevenly?
- Lamellated or onion-skin.
- New layer forms when the tumor stops growing.
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Which type of response grows fast & evenly?
Sunburst or hair-on-end or spiculated.
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Which year did Roentgen discover x-rays?
- 1895.
- Same year as chiropractic.
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What percentage of bone loss to you need for x-rays to pick it up?
30-50%.
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What does DEXA stand for?
- Dual
- Energy
- X-ray
- Absorptiometry
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NEED TO COMPLETE CARDS FOR IMAGING.... CARDS FOR METABOLIC DISORDERS ARE DONE.
SORRY....
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With osteoporosis is the quantity or quality of bone affected?
- Quantity decreased.
- Quality normal.
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What is the name of the descriptive term which means poverty of bone?
Osteopenia: general radiolucent bone.
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Which 3 areas of the body are affected by Generalized Osteoporosis?
- 1. Axial skeleton.
- 2. Pelvis.
- 3. Proximal long bones.
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What is the cause of Generalized Osteoporosis?
Decrease in bone density.
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What is Generalized Osteoporosis most commonly due to?
- 1. Postmenopausal females.
- 2. Aging.
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Which age does bone loss begin at?
35 years of age.
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Bone loss stimulates which bone cell activity?
Osteoclastic activity: bone remodeling & resorption.
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What is the percentage for bone loss with cortical bone? And trabecular?
- Cortical bone: 1% per year... stronger bone.
- Trabecular bone: 2% per year.
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Name 3 complications of osteoporosis.
- 1. Spinal compression fractures: mostly undiagnosed.
- 2. Increased thoracic kyphosis (= spinal stenosis).
- 3. Other fractures: proximal femur, humerus, radius.
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What is the hallmark sign on radiograph for a compression fracture?
The anterior height is less than the posterior height in the vertebral body.
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What are the names of the 3 vertebral changes in regards to osteoporosis?
- 1. Vertebra plana: flat like pancake.
- 2. Wedged vertebrae.
- 3. Biconcave deformity.
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What are the names of the 3 trabecular patterns associated with Ward's Triangle?
- 1. Principal compressive group.
- 2. Secondary compressive group.
- 3. Principal tensile group.
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Which group is the last to be obliterated?
- The principal compressive group.
- Strongest type: thickest & most densely packed.
- Weight bearing.
- From the medial metaphsyeal cortex to the superior femoral head.
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Which group is thin & widely separated?
- The secondary compressive group.
- Begins at the lesser trochanter & curves toward the greater trochanter.
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Which group extends in an arch like pattern medially?
- The principal tensile group.
- From the lateral cortex, inferior to the greater trochanter.
- Terminates in the inferior portion fo the femoral head.
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Name 3 other fractures associated with osteoporosis.
- 1. Distal radius.
- 2. Humeral neck.
- 3. Ankle malleoli.
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Insufficiency fractures occur when bone is not strong enough to withstand normal physiological stress. Where are the 3 most common locations?
- 1. Spine.
- 2. Hip.
- 3. Distal radius.
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Which type of osteoporosis results from immobilization?
- Regionalized osteoporosis.
- Post traumatic.
- RSDS: overactive sympathetic system.
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What causes Transient Osteoporosis of the hip?
Pregnancy: left hip always.
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Which type of osteoporosis is idiopathic, localized, occurring in lower extremities, & skips joints?
Regional migratory osteoporosis.
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Which form of osteoporosis results from infection?
Localized osteoporosis: focal, infection, inflammatory arthritis, neoplasm.
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Softening of the bone describes which condition?
- Osteomalacia: caused by a lack of Ca++ deposited in osteoid tissue.
- Rickets in children.
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With osteomalacia the quantity of bone decreases. True or false?
False: QUALITY decreases.
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The Spine Radiographs article proves what?
That radiology specialists get more specific results.
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