Pathology Test 3

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2 highly specialized connective tissues: bone and cartilage
bone is an: organic matrix in which inorganic salts (calcium and phosphate) are deposited
Parts of bone are:: diaphysis
epiphysis
medullary cavity
shaftlike portion: diaphysis
ends of bone: epiphysis
hollow tube like structure within the diaphysis: medullary cavity
membranes of bone: periosteum
endosteum
covers the outer surfaces of teh bone except at a joint surfaces, contains network of blood vessels from which nutrient arteries: periosteum
- inner membrane that lines the medullary cavity: endosteum
types of bone are: compact and cancellous
dense and structureless; consists of comples structural units called haversion systems; found in shafts of long bones: compact
weblike matrix of marrow filled spaces and trabaculae; irregular bones: cancellous
Until linear growth of bone is complete, the epiphysis remains separated from the diaphysis by a cartilaginous plate called the: epiphyseal cartilage.
When the bone is finished growing, the epiphyseal plate ossifies, and the epiphysis and diaphysis fuse. Where they meet results in a slight flaring called the: metaphysis.
Epiphyseal cartilage grows then ossifies resulting in an increase in length of long bones. Diameter increases by the action of: osteoblasts and osteoclasts.
Films of wrists and hands can be taken to evaluate physiologic age and growth potential, and for predicting adult stature. Example order would say,⬝Bone age wrist.⬝ Findings are based on radiographic atlas of ____ from thousands of exams on Amer: Greulich and Pyle
bone formation =: ossification
Bone destruction =: resorption
Bones also develop within a connective tissue membrane =: intramembranous ossification
Flat bones grow in size by the addition of osseous tissue to their outer surfaces = _____ They cannot grow by expansion.: appositional growth.
Bones perform 4 basic functions:: 1. They serve as the supporting framework of the body and protect the vital organs.

2. Serve as levers on which muscles can contract and shorten and thus produce movement at a joint.

3. Red bone marrow within certain bones is the major site of production of blood cells.

4.Serve as the major storehouse for calcium salts. The maintenance of a normal level of calcium, which is essential for survival, depends on a balance in the rates of calcium movement between the blood and bones.
one that has characteristics of vertebrae on both sides of a major division of the spine.: transitional vertebrae
transitional vertebrae Most frequently occur at the ____ junction and contain expanded transverse processes, which may form actual unilateral or bilateral joints with the sacrum.: lumbosacral;
posterior defect of the spinal canal resulting from failure of the posterior elements to fuse properly. Occurs in 5% of live births: spina bifida
Mild, insignificant form =_______ = splitting of the bony neural canal at the L5 or S1 level: spina bifida occulta
______-associated malformations include clubfeet, gait disturbances, and bladder incontinence.: Meningocele
Rare â€œmarble bonesâ€: osteopetrosis
Failure of the resorptive mechanism of calcified cartilage interfering with the normal replacement by mature bone, prevents bone marrow from forming: osteopetrosis
Brittle Stress fractures occur often Pt. may become anemic due to lack of blood-producing marrow.: osteopertrosis
Varies in severity and age of clinical presentation = can be fatal at birth or in utero involving entire skeleton to essentially asymptomatic that can be an incidental radiographic finding: osteopetrosis
Symmetric, generalized increase in bone density. Most commonly seen in vertebrae, pelvis, and cranial base Chalky white or opaque: osteopetrosis
what do you do to technical factors for osteopetrosis?: increase
Inherited, generalized disorder of connective tissue characterized by multiple fractures and an unusual blue color of the normally white sclera of the eye.: osteogeneis imperfecta
Adult patients are normally wheel-chair bound because the skeletal structure does not support their body weight. â€œbrittle bone diseaseâ€: osteogenesis imperfecta
2 forms of osteogenesis imperfecta: congenital and then the regular
most serious, fractures present at birth, usually die within a few days, Wormian bones within the skull (ossification of the skull progresses slowly, leaving wide sutures and multiple juxtasutural accessory bones within a suture.: congenital (osteogenesis imperfecta)
â€“ most common and least severe, often mistaken for Battered Child Syndrome: Osteogenesis imperfecta tarda
osteogenesis imperfecta: Repeated fractures

Severe osteoporosis

Thin, defective cortices

Exuberant callus formation that may simulate a malignant tumor

Bizarre deformaties

Lower exposure factors in advanced stages
Most common form of dwarfism Results from diminished proliferation of cartilage in the growth plate (decreased: achondroplasia
Autosomal dominant Does not affect membranous bone formation: achondroplasia
characteristics of achondroplasia: nearly normal trunk size; large head with frontal bulging, saddle nose, jutting jaw, and prominent butt that gives impression of lumbar lordosis
Progressive narrowing of the interpedicular distances from above downward, the opposite of normal: achondroplasia
Posterior scalloping of lumbar vertebral bodies Decreased enchondral bone formation giving appearance of shortened long bones that are thick with a wide metaphysis ______: (Erlenmeyer flask deformity)

achondroplasia
Most common congenital hip disorder More common in firstborn females (83%) and 10X more common in breech fetal presentations Results from incomplete acetabulum formation: congenital hip dysplasia
Ortolaniâ€™s sign =: infant is place supine, hips flexed and then abducted while the femur is pressed, this will dislocate the hip resulting in a clicking sound = â€œhip clickâ€ =
Trendelenburgâ€™s sign =: infant is placed on affected side and opposite knee is lifted, the pelvis drops on the normal side where is remains horizontal on the other side
Chronic systemic disease of idiopathic etiology Appears primarily as noninfectious, inflammatory arthritis of hands and feet Women are affected 3X more frequently than men Average onset is 40: rhematoid arthritis
rheumatoid arthritis Gradual and slowly progressive Leads to crippling deformity of affected joints or spontaneous remissions of variable length Usually ______ Often progresses______ toward trunk until almost every joint in the: symmetric;proximally
rhematoid arthritis Begins as an inflammation of the ______ that lines the joints Excessive exudate causes proliferation of the synovium = causes ______ Erosion occurs because inflammatory cells produce lytic enzymes.: synovial membrane; erosion of the articular cartilage and underlying bony cortex, fibrous scarring, and even the development of ankylosis
Usually begins in the SI joints Causes bilateral and symmetric involvement: anklosing spondylitis
Blurring of the articular margins and patchy sclerosis generally progress to narrowing of the joint space and may lead to complete fibrous and bony ankylosis: ankylosing spondylitis
Characterized by arthritis, urethritis, and conjunctivitis Primarily affects young men and appears to be a postinfectious syndrome after certain types of venereal (Chlamydia) or gastrointestinal infections: Reiters syndrome
Reiters Syndrome Most frequently involves the_____, ____,____ Tends to asymmetric and primarily involves the feet rather than the hands: SI joints, heel, and toes
Rheumatiod like destructive process involving the peripheral joints that develops in patients with typical skin changes of psoriasis: Psoriatic Arthritis
Psoriatic Arthritis Involves ____of the hands and feet: distal interphalangeal joint
Asymmetric Little or no periarticular arthritis Bony ankylosis of interphalangeal joints of hands and feet and resorption of the terminal tufts of the distal phalanges: psoriatic arthritis
psoriatic arthritis Erosions and hypertrophic changes occurring in the ___________: origin and insertion of the tendons and ligaments
Degenerative joint disease Loss of cartilage and reactive new bone formation Part of the wear and tear aging process: osteoarthritis
what joints does osteoarthritis tend to affect: Tends to affect the wt-bearing joints (spine, hip, knee, ankle) and the interphalangeal joints of the fingers
Narrowing of the joint space, caused by thinning of the articular cartilage: osteoarthritis
Small bony, spurs (osteophytes) along the margins of the articular edges of the bones Sometimes due to repeated trauma or subjection to abnormal stresses because of orthopedic deformities or the result of a septic or inflammatory arthritis that: osteoarthritis
Chronic, indolent infection that has an insidious onset and a slowly progressive course Usually involves only one joint: tuberculous arthritis
tuberculous arthritis usually affects what?: spine, hips, and knees
Joint effusion leads to soft-tissue swelling Cartilage and bone destruction occur relatively late in the course of TB arthritis, tends to involve the periphery of the joint, sparing the maximal wt-bearing surfaces that are destroyed in pyogenic art: tuberculous arthritis
treatment of arthritis: Should protect affected joints, maintain mobility, and strengthen muscles

Lifestyle changes, use of support devices, drugs, and surgery

Rest and exercise

Medications such as NSAIDs, antimetabolites (methotrexate = a cytoxic drug), prostaglandin inhibitors such as aspirin and ibuprofen

Surgery involves replacing joints with new artificial joints to increase mobility
what are bursae: fluid-filled sacs near the joint spaces that reduce friction during movement
bursitis is not what?: visulaized on plain radiographs
a rotatator cuff is a musculoteninous structure composed of the ___, ____, ____, and ______: musculotendinous structure composed of the teres minor, infraspinatous, supraspinatus, and subscapularis muscles.
Rupture of the rotator cuff produces: a communication between the shoulder joint and subacromial bursae that can be demonstrated by arthrography.
osteomyleitis: Inflammation of the bone (osteitis) and bone marrow (myelitis) that is caused by a broad spectrum of infectious organisms that reach bone by hematogenous spread, by extension from an adjacent sit of infection, or by direct introduction of organisms (trauma or surgery)
Acute hematogenous osteomyleitis tends to: involve bones with rich red marrow
osteomyleitis In infants and children, the metaphyses of long bones, especially the ____ and ____, are most often affected: femus and tibis
____and ____are the most common organisms when discussing osteomyleitis: staphylococci and streptococci
In adults, acute hematogenous osteomyelitis primarily occurs in the: vertebrae and rarely involves the long bones
Incidence and severity of osteomyelitis have decreased since the: advent of antibiotics
Begins as an abscess of the bone: osteomyleitis
Osteomyleitis Pus produced by acute inflammation spreads down the ______. Once the infectious process has reached the outer margin of the bone, it raises the ______________.: medullary cavity and outward to the surface; periosteum from the bone and may spread along the surface for a considerable distance
osteomyelitis Earliest evidence in a long bone is a localized, _________: deep soft-tissue swelling adjacent to the metaphysis
Osteomylitis _____causes displacement or obliteration of the normal fat planes adjacent to and between the deep muscle bundles, unlike skin infections, in which the initial swelling is superficial: Inflammation
Osteomyleitis Initial bony change is subtle areas of _______: metaphyseal lucency reflecting resorption of necrotic bone
Osteomyleitis Bone destruction becomes more prominent, producing a ragged, _______: moth-eaten appearance bone,
Osteomyleitis Eventually, a large amount of new bone surrounds the cortex in a thick, irregular bony sleeve (______) Disruption of cortical blood supply leads to _____: involucrum); bone necrosis
Osteomyleitis Segments of avascular dead bone (___) remain as dense as normal bone and are clearly differentiated from the _____: sequestra);demineralized infected granulation tissue and pus about them
loss of bone density: osteoporosis
two groups of osteoporosis: primary/idiopathic and secondary
Osteoporosis Primary/Idiopathic 3 types:: Juvenile Osteoporosis
Afflicts younger people and the cause is idiopathic rather than metabolic

Postmenopausal
Lack of estrogen

Senile
Most common type
Juvenile Osteoporosis: afflicts yournger ppl and the cause is idiopathic rather than metabolic
postmenstrual osteoporosis: lack of estrogen
senile osteoporosis: most common
secondary osteoporosis: cause by other diseases
Radiographic Appearance of osteoporosis:: Cortical thinning
Most evident in the spine and pelvis
Insufficient mineralization of the adult skeleton Lack of Vitamin D Other causes Chronic kidney failure Certain renal diseases: osteomalacia
Radiographic Appearance of osteomalacia:: Loss of bone density

Cortical borders are often indistinct

Bowing deformities

Deepening of the acetabular cavities
Childhood equivalent of osteomalacia Rickets occurs before the unification of the diaphysis and epiphyses where osteomalacia occurs after epiphyseal closure: rickets
Rickets occurs before the: unification of the diaphysis and epiphyses where osteomalacia occurs after epiphyseal closure
Radiographic Appearance of rickets:: Radiograph knees, wrists & ankles

Bowing deformity with greenstick fractures

Decreased density between the ossified portion of the epiphysis and the end of the shaft.
Uric acid crystals are deposited in the joints, cartilage and kidney.: gout
Clinical Symptoms of gout:: Painful arthritis
Initially attacks one joint (big toe)
Radiographic Appearance for gout Early: Joint effusion

Periarticular swelling

Punched-out erosions with thin sclerotic margins and overhanging edges (rat bite appearance)
Radiographic Appearance for gout Late: Late
Large, lumpy, soft tissue swelling
pagets disease ______in the early stages Radiographic findings found in 10% of all those over 60 Twice as common in ______: Asymptomatic;men than women
symptoms of pagets: Symptoms
Pain in
Back
Hips
Pelvis
extreme cases of pagets: Extreme cases:
Deafness
Difficult movement
Head size increases
Headaches
Heart failure
etiology of pagets: Unknown
Theory:
Early viral infection (mumps) may be dormant and come up later

Increase in bone cell activity which causes an increase in vasculature / increased cardiac output
complications of pagets: Complications

Structural deformities:

Compression of spinal cord
Heart failure
Treatment for pagets: Treatment
Drug Therapy
Surgery may be performed
Radiographic appearance for skull-- Pagets: Early: osteoporosis
Late: irregular islands of sclerosis / cotton wool appearance
Appearance for spine for Pagets: Spine
Enlargement of the vertebral body
Appearance for pelvis when a pt has Pagets disease: Pelvis
Most common and often the initial site
Coarsening of the iliac margins
A chronic and progressive condition that results from hyper-secretion of growth hormone from the pituitary gland.: acromegaly
Over production before the onset of puberty Before epiphyseal closure: gigantism
radiographic appearance of acromegaly: Ballooning of the sella turcica
Prominent tufts on the terminal phalanges with widening of the metacarpophalangeal joints
A well defined sclerotic edge is: almost always benign
An ill-defined sclerotic or lytic edge is: likely to be aggressive
adjacent cortex indicates:: Any destruction indicates malignancy
Bone expansion with an intact cortex indicates: a slow growing lesion
Active periosteal reaction in the absence of trauma indicates ____ Causes:: an aggressive lesion

Osteomyleitis
Malignant bone tumor / Ewingâ€™s Sarcoma
Patchy calcification of a popcorn type indicates_____ Diffuse ill-defined calcification suggests __________: a cartilage tumor

osteoid formation and indicates an osteosarcoma.
A soft tissue swelling suggests a _____The better defined the mass, ________ The more ill-defined, _________: tumor; the more likely it is to be a neoplasm

the more likely it is to be edema caused by an infection

;
Certain lesions occur at certain: sites
Benign projection of bone with a cartilaginous cap that arises in childhood or the teens Especially around the knee: osteochondroma
Slow growing benign cartilaginous tumor arising in the medullary canal Affects children and young adults Site Small bones of the hands and feet: endochondroma
radiographic appearance of an endochondroma: Lesion is localized, radiolucent cystic defect

May be calcifications

Pathological fractures may develop
In children and young adults Usually before 30 Occurs at the end of long bones, primarily the knee Locally destructive but does not cause metastases or kill the patient: giant cell tumor
appearance of a giant cell tumor: Radiographic Appearance:
Large bubbles separated by thin strips of bone.
Most often occur in the outer table of the skull, sinuses and mandible: osteoma
appearance of an osteoma: Well circumscribed, extremely dense round lesions
Develops in teenagers / young adults There is local pain that is worse at night Occurs in the femur or tibia: osteoid osteoma
appearance of an osteoid osteoma: Small, round or oval center surrounded by large, dense sclerotic zone of cortical thickening
True fluid filled cyst with a wall of fibrous tissue Asymptomatic Pathologic fractures can develop: simple bone cyst
appearance of a simple bone cyst: Expansive lucent lesion, demarcated from adjacent normal bone and may have a thin rim of sclerosis
Consists of numerous blood filled arteriovenous communications: aneurismal bone cyst
appearance Expansible, eccentric cyst like lesions that causes marked ballooning of the thinned cortex: aneurismal bone cyst
Most common of the malignant tumors Disease of the young 10 â€“ 25 Rarely seen after age of 50 Usually occurs in males Common Location Ends of the long bones / knee: osteogenic sarcoma
appearance of osteogenic sarcoma: Periosteum is lifted from bone by the tumor and new bone is laid down â€“ Sun Ray Effect

Codmanâ€™s Triangle
A thin periosteal elevation and subsequent new bone formation
Spread by the bloodstream and metastases often first appears in the lungs: osteogenic sarcoma
treatment of osteogenic sarcoma: Surgery
Amputation
Radiation Therapy
Chemotherapy
etiology of osteogenic sarcoma: idiopathic
symptoms of osteogenic sarcoma: bone pain-dull and localized

tumor masses that can be felt
Occurs at early age ( 5 â€“ 15) rarely after 30 Usually affects males Invades the bone more diffusely than osteogenic sarcoma It does not begin at the ends of the bone rather it progresses to the flat bones like the scapula, sternum, vert: ewings sarcoma tumor
appearance of ewing sarcoma tumor: diffuse involment in the grater part of the shaft with bone destruction
treatment of ewing sarcoma tumor: Radiation Therapy
It is very responsive to radiation but tends to return

Amputation if there is no metastases
A neoplasm (tumor of bone marrow) of immature plasma cells that infiltrate bone to cause osteolytic lesions throughout the skeleton Flat Bones Vertebra, skull, pelvis, ribs In late stages it infiltrates the body organs: multiple myeloma
Strikes mostly men between 50 â€“ 70 More common in blacks than caucasians: multiple myeloma
Prognosis is poor because it is usually not diagnosed until it has infiltrated the bone: multiple myeloma
52% of the patients die within 3 months, 90% within two years of diagnosis: multiple myeloma
symptoms of multiple myeloma: Constant back pain
Achyness
Joint swelling
Pathologic fractures
Even loss of height (up to 5⬝or more) due to compression of the vertebrae
appearance of multiple myeloma: Multiple punched out osteolytic lesions scattered throughout the skeletal system
treatment to multiple myeloma: Chemotherapy
Local Radiation Therapy
Renal Dialysis
Laminectomy
Death follows complications such as renal failure, hyperuricemia and dehydration: multiple myeloma
most common skeletal abnormality seen in a general radiology practice: fractures
A fracture is: defined as a disruption of bone caused by mechanical forces applied either directly to the bone or transmitted along the shaft of a bone
Fractures are described and classified by:: Extent

Direction

Position

number of fracture lines

integrity of the overlying skin
A fracture that results in discontinuity between two or more fragments: complete
causes only partial discontinuity, with a portion of the cortex remaining intact: incomplete
the overlying is intact; if the overlying skin is disrupted, the fracture is open, or compound.: closed
Bone is separated into two or more and often numerous fragments Seen in sever vehicular accidents an gunshot wounds: comminuted
Runs at a right angle to the long axis of a bone Most commonly the result of a direct blow or a fracture within pathologic bone.: transverse
Runs a course of approximately 45ï… to the long axis of the bone Is the result of angulation or both angulation and compression forces: oblique
Encircles the shaft Generally longer than an oblique fracture Caused by torsional forces.: spiral
Generally small fragments torn off from bony prominences They are usually the result of indirectly applied tension forces within attached ligaments and tendons rather than direct blows: avulsion
Composed of more than two fragments: comminuted
Results from a compression force that causes compaction of bone Trabeculae and results in decreased length or width of a portion of a bone Compression fractures most commonly occur in the vertebral body as a result of flexion of the spine.: compression
Is the response of bone to repeated stresses, no one of which is sufficient to cause a fracture: stress of fatigue
Occurs in bone at an area of weakness Most Common Cause: Metastatic cancer Breast cancer in women Lung cancer in men: pathologic
An incomplete fracture with the opposite cortex intact _____ are found almost exclusively in infants and children because of the softness of their cancellous bone.: greenstick
A fracture is ____ when a plane of cleavage exists in the bone without angulation or separation: undisplaced
______ refers to separation of bone fragments; the direction of displacement is described by the relation of the distal fragment with respect to the proximal fragment and is usually measured in terms of the thickness of the shaft: displacement
Refers to displacement of a bone so that it is not in contact with its normal articulation: dislocation
The overall goal of fracture treatment is: to restore function and stability with an acceptable cosmetic result and a minimum of residual deformity
In external, or closed, reduction the fracture is treated by: manipulation of the affected body part without surgical incision
____ is a surgical procedure in which there is direct or indirect manipulation of the fracture fragments and usually the application or insertion of some type of appliance or device to achieve and maintain the reduction: Open reduction
_____ is accomplished by the use of splints or casts: External fixation
______ uses metal plates and screws, wires, rods, or nails, either alone or in combination, to maintain the reduction: Internal fixation
The radiographic evidence of _______ is a continuous external bridge of callus (calcium deposition) that extends across the line of fracture and unites the fracture fragments.: fx healing
______ is the healing of fragments of a fracture in a faulty position. This leads to impairment of normal function or cosmetic appearance that may require surgical correction.: Malunion
is an ill-defined term that is arbitrarily applied to any fracture that takes longer to heal than the average fracture at that anatomic location: delayed union
refers to a condition in which the fracture healing process has completely stopped and the fragments will remain ununited even with prolonged immobilization: nonunion
Pathologic fx The most common underlying process is _____: metastatic malignancy or multiple myeloma
In children, developmental diseases such as osteogenesis imperfecta, osteopetrosis, or nutritional deficiencies (rickets, scurvy) may result in: pathologic fractures
Refers to multiple, repeated physically induced injuries in young children caused by parents or guardians: battered child syndrome
appearance of battered child syndrome: Multiple fractures of varying age in various stages of healing

Fractures of the corners of metaphyses with or without associated epiphyseal displacement

Exuberant subperiosteal new bone formation along the shafts of long bones
Skull fractures or widening of the cranial sutures are commonly associated Another highly suggestive finding is one or more fractures at otherwise unusual sites (fractured only by direct blows), such as the ribs, scapula, sternum, spine, or lateral: battered child syndrome
Transverse fracture through the distal radius with dorsal (posterior) angulation and often overriding of the distal fracture fragment In more than half the cases there is an associated avulsion fracture of the ulnar styloid process: colles fx
is usually caused by a fall on the outstretched hand and is the most common fracture about the wrist: Collesâ€™ fracture
Identical to Collesâ€™ fracture except that when the wrist is placed in the lateral position, the distal radius is displaced anterior or forward about 30 degrees: smiths fx
Most common fractures involving the carpal bones They are usually transverse and occur through the central part (waist) of the bone: navicular fx
A transverse fracture of the neck of the fifth metacarpal with volar (palmar) angulation of the distal fragment This injury typically is the result of a blow struck with the fist: boxers fx
Five distinct variations of epiphyseal plate in which there is trauma with hemorrhage into the growth plate Results in retardation or cessation of growth When occurring in the lower limb it may result in a shorter limb and a permanent limp: salter fx
The floor of the orbit is the most common portion of the orbit to sustain fracture: blow out fx
classic radiographic finding in blow-out fractures is the: presence of a polypoid mass (the tear-drop) protruding from the floor of the orbit into the maxillary antrum
The tear-drop represents _____in a blow out fx: the herniated orbital contents
In the detection of fractures about the elbow, a valuable clue is displacement: of the normal elbow fat pads (fat pad sign)
On lateral projections of the elbow, the anterior fat pad normally appears as a_____ closely applied to the anterior surface of the distal end of the humerus.: radiolucency
Most fractures of the forearm involve both the radius and ulna If only one bone is fractured, it is essential to examine both the elbow and the wrist to exclude the possibility of proximal or distal joint dislocation: fxs of forearm
involves both malleoli (of tibia and fibula) with dislocation of the ankle joint A bimalleolar fracture refers to one involving both the medial and the lateral malleoli: potts fx
Because of the mechanism of injury, the fracture on one side is transverse, whereas the opposite fracture is oblique or spiral Trimalleolar fractures involve the posterior lip of the tibia in addition to the medial and lateral malleoli and usually: potts fx
The ____is by far the most commonly dislocated joint in the body: shoulder
About 95% of_____dislocations are anterior and the result of external rotation and abduction of the arm: shoulder
Fractures and dislocations of the spine may be the result of :: Direct trauma

Hyperextension-flexion injuries (whiplash)

Normal stresses in abnormal bone (osteoporosis, metastatic destruction)
The anterior column is composed of the: vertebral bodies, intervertebral disks, and anterior and posterior longitudinal ligament
The posterior column is formed by: facets, apophyseal joints, pedicles, laminae, spinous processes, and all the intervening ligaments
If one of the two columns remains intact, the injury is considered: stable.
If both columns are disrupted, the injury is considered: unstable.
Two goals of Radiographer in eval of spine: Determine whether a fracture or dislocation is present

Whether the injury is stable or unstable
is comminuted fracture of the ring of the atlas that involves both the anterior and posterior arches and causes displacement of the fragments: Jefferson fracture
Fractures of the odontoid process are usually transverse and located at the base of the dens at its junction with the body On an open mouth view, a lucency between the upper central incisor teeth often overlaps the dens; this must be differentiated: c spine
the result of acute hyperextension of the head on the neck: hangmans fx
It appears as a fracture of the arch of C2 anterior to the inferior facet and is usually associated with anterior subluxation of C2 on C3.: hangmans fx
transverse fracture of a lumbar vertebra that is often associated with significant visceral injuries There is a horizontal fracture of the vertebral body that extends to involve some or all of the posterior elements: seat belt fx
a cleft in the pars interarticularis that is situated between the superior and inferior articular processes of a vertebra.: spondylolysis
Occurs in about 5% of the population, these clefts are usually bilateral, most commonly involve the fifth lumbar vertebra, and predispose to the forward displacement of one vertebra on the other.: spondylolysis
_____is the term for a defect in the pars interarticularis without displacement If displacement occurs, the condition is called ______: Spondylolysis

spondylolisthesis.
May demonstrate the lucent cleft in the pars interarticularis even if no displacement has occurred: spondylolisthesis
The diagnosis of spondylolysis without displacement may require an ______ of the lumbar spine, on which the appearance of the posterior elements has been likened to that of a Scotty dog.: oblique projection
The pedicle and transverse process form the: eye and nose
The superior and inferior articular processes form the: ear and leg
The pars interarticularis forms the ____-, which is â€œfracturedâ€ in a patient with spondylolysis: neck

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