1
Q
Neoplasm
A
Abnormal growth of new tissue
- autonomous
- excessive
- disorganized
Growth can form tumors
2
Q
Tumor
A
Swelling
3
Q
Oncology
A
the study of tumors
4
Q
Oncologist
A
Doctor who specializes in the study of tumors
5
Q
Benign tumor
A
- encapsulated
- similar to normal cells
- resemble tissue of origin
- slow growing
6
Q
Malignant tumor
A
- invasive, fast growing
- cells vary “undifferentiated”
- Not inherent to tissue of origin
- rapid growth
- able to metastasize
7
Q
Not all malignant cells are capable of Metastasis:
3 methods are….
A
- Lymph
- Hematogenous
- Transcoelemic
8
Q
Metastasis
A
Metastasis or metastatic disease (sometimes abbreviated mets), is the spread of a disease from one organ or part to another non-adjacent organ or part.
9
Q
Suffix for Benign tumors
A
oma
10
Q
Carcinoma
A
Epithelial tissue
11
Q
Sarcoma
A
for supportive and connective tissue
12
Q
Not all tumors are labeled sarcoma or carcinoma:
A
- Lymphoma
- Leukemia
- Glioma
- Blastoma
13
Q
Hodgkins Disease
A
Hodgkin disease is a type of lymphoma. Lymphoma is cancer of lymph tissue found in the lymph nodes, spleen, liver, and bone marrow. The first sign of Hodgkin disease is often an enlarged lymph node. The disease can spread to nearby lymph nodes. Later it may spread to the lungs, liver or bone marrow
14
Q
Ewings sarcoma
A
- Occurs 5-15 yrs
- may involve shafts of long bonesm pelvis, ribs
- lesion originates in medullary canal causing the bone to expand, breaking through the cortex and elevating the periosteum
- onion skin or laminated appearance
15
Q
Kaposi sarcoma
A
Kaposi’s sarcoma is a cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat or in other organs. The patches are usually red or purple and are made of cancer cells and blood cells. The red and purple patches often cause no symptoms, though they may be painful. If the cancer spreads to the digestive tract or lungs, bleeding can result. Lung tumors can make breathing hard.
16
Q
Carcinogens
A
cause cancer
17
Q
7 Warning signs.. CAUTION
A
- Change in bowel habits, bladder function
- A sore that doesnt heal
- Unusual bleeding
- Thickening of a lump in breast or elsewhere
- Indigestion or difficulty swallowing
- Obvious change in wart or mole
- Nagging cough or hoarseness
18
Q
TNM
A
- T# - size of tumor
- N# - lymph node spread
- M# - spread to other organs
Staging: 0-4
Low # - less spreading
High # - more serious
19
Q
Lung Tumors and Cancer
A
- Benign tumors are uncommon
- Pulmonary mets are more common than primary (cotton ball appearance)
20
Q
CT evaluation can detect presense of calcificatrion…
A
- Benign tumors have calcified center
- Malignant tumors have no calcifications
21
Q
Bone Cyst
A
- Radiolucent, well defined margins from normal surrounding bone
- Occasionally cyst will be surrounded by sclerotic bone
- seen in younger patients (3-14)
- benign tumor
22
Q
Enchondroma
A
- Cartlaginous tumor usually seen in hands, feet, ribs, sternum, and spine
- Osteolytic lesion appears radiolucent, may have areas of calcification
- expansion into cortical bone may cause thinning of cortex
- benign tumor
23
Q
Osteochondroma
A
- Exostosis
- excessive bone growth
- most common benign tumor
- asymptomatic
- osteoblastic lesion appears radiopaque, cortex of lesion blends with normal bone.
- Growth tends to protrude up and away from nearest point.
- benign tumor
24
Q
Osteoma
A
- Uncommon lesion mostly found in the skull or facial bones
- asymptomatic - significant when causes an obstruction, impinges brain or eye
- solitary, dense, well circumscribed lesion of compact bone
- benign tumor
25
Osteoid osteoma
* small solitary lesion found in any bone
* arises from cortical bone, erodes underlying tissue causing lytic lesion
* central area of radiolucency surrounded by sclerotic bone
* benign tumor
26
Bone Mets
* most common bone malignancy seen in adults
* most frequently affects ribs, pelvis, skull, spine, humerus, femur
* Mets alter bone density and structure
* Malignant tumor
27
Osteosarcoma
* Most common primary malignancy of bone
* can occur at any age though most occur before 20 yrs
* Frequently found in long bones
* periosteum may lift off bone and forum a cuff, osteoblastic activity
* Malignant Tumor
28
Chondrosarcoma
* composed of atypical cartilage
* pelvis, rib, shoulder are common sites
* tumor destroys bone as it extends through cortex and into surrounding soft tissue
* xray has moth eaten appearance
* Malignant Tumor
29
Giant Cell
"Osteoclastoma"
* Can be benign or malignant
* affects ends of long bones
* begins in medullary canal, expands outward producing "club like" deformity
* mass of lytic or cystic areas surrounded by thin shell of bone
* "bubble like appearance"
30
Multiple Myeloma
* plasma cell proliferation confined to bone marrow
* bone pain, anemia, bleeding disorders
* diffuse osteoporosis with osteolytic regions "punched out" appearance
31
Stomach Tumors
* Benign tumors rare
* Usually begin as ulcers
* Use endoscopy - biopsy for Diagnosis
* G! series, irregualr, rounded filling defects, altered or thickened mucosa
* CT used for staging
32
Liver Tumors
* Leading reciepient of mets from other organs
* Sx- jaundice, elevated bilirubin, abd pain, wt loss, ascites, hepatomegaly
* Treatment includes chemotherapy
33
Ascites
Fluid in abdominal cavity
34
Colon Tumors
* Common malignancy
* 50% occur below mid descending colon with most occurring in rectosigmoid area
* often begins as benign polyp which undergoes a malignant transformation
* Sx- bloody stools, changes in bowel movements, anemia, tenderness
* Two types:
* *Pedunculated** (stalk like)
* *Sessile** (broad surface)
* "Apple Core Lesion"
35
Urinary Tumors
**Wilms Tumor:**
* Nephroblastom occurs under age 5
* Kidney cancer that occurs in children
* usually asymptomatic, palpable mass, may experience hemauria, hypertension
**Renal Cell Carcinoma**:
* Occurs more in males
* Idiopathic, associated with chronic inflmmation from stones, smoking and food additives
* Sx - hematuria, wt loss, pain
**Bladder Carcinoma**:
* Tumors are uncommon, always malignant
* smoking, coffee, artifical sweetners, industrial carcinogens
36
1. Idiopathic
2. Iatrogenic
1. unknown cause
2. resulting from tx by a physician
37
Asymptomatic
* Exhibiting or producing no symptoms
38
Hematuria
* Blood in urine
39
Bone Structures:
Periosteum
* Outer Membrane
40
Cortical bone
* Compact, outer bone
41
Cancellous bone
* Spongy, porous bone (trabecula)
42
Medullary Cavity
* Marrow
43
Diaphysis
* Shaft of the bone
44
Epiphysis
* expanded end of the bone
45
Metaphysis
* Growth zone (b/t diaphysis and epiphysis) area of great metabolic growth
46
Ossification
* Process of replacing cartilage with bone
47
Osteoblast
* Bone forming
48
Osteoclast
* remove and remodel old bone
49
Bone Diagram 1
Label Bone diagram
50
Bone Diagram 2
Label
51
Osteogenous Imperfecta
* Congenital
* lack of osteoblastic activity causes bones to become brittle and easily fractured
* Blue tinge eyes
* X ray will show new and old healing, decreased bone density
52
Osteopetrosis
* inherited disorder
* deficiency in osteoclast, faulty bone resorption.. causes increase in bone density
* chalk or marble bones
53
Osgood Schlatter Disease
* incomplete separation or avulsion of the tibial tuberosity
54
Legg-Calve-Perthes
* occurs in the head of the femur
* ischemic necrosis results in flattened femoral head
* loss of blood flow
55
Osteoporosis
* Loss of bone density
* reduction in calcified bone mass results in porous, brittle bones
* found in pelvis, spine, distal extrem.
* thin cortex in long bones, wedging or compression fx in spine
56
Ricketts
* Vitamin D deficiency causes bones to soften (bow and fx)
* Dec in bone density
* Happens in younger kids
57
Pagets Disease
* Idiopathic, metabolic disorder, genetic predisposition
* 2 simultaneous stages:
a. Osteolytic (bone destruction)
b. Osteoblastic (soft, poorly mineralized bone replaces normal tissue)
* Skull, spine, pelvis and long bones affected
* X rays show cortical thickening, course trabecular patterns, mixed radiolucent and radiopaque areas
* Cotton wool appearance
58
Osteomyelitis
* Localized bone infection that can spread throughout bone
* causes bone destruction, joint stiffness and growth impairment
* X ray shows swelling, loss of cortical margins, patchy destruction of cancellous bone
59
Rheumatoid Arthritis
* Chronic inflammation and overgrowth of synovial tissues which progressively destroy cartilage, bone and supporting structures
* can involve any joint but hands, feet, and knees most affected
* X ray shows soft tissue swelling, cortical erosion, _uniform joint space narrowing_
60
Osteoarthritis (DJD)
degenerative joint disease
* most common type of arthritis
* non inflmmatory deterioration of joint cartilage from normal wear and tear of aging.
* Affects weight bearing joints and IP joints in hands
* x rays show _asymmetric joint space narrowing_, _osteophytes_ (spurs), sclerosis of subchondral bone
61
Gout
* inherited form of arthritis
* metabolic problems lead to increased levels of uric acid which covert to sodium urate crystals that are deposited in joints
62
Ankylosing Spondylitis
* Bamboo spine
* calcification of the anterior longitudinal ligament
* form of rheumatoid arthritis
* starts in SI joints and moves up from lumbar to cervical
* SI joint is fused
63
Spondylolisthesis
* Forward displacement of 1 vertebra on top of another, usually seen in L5-S1
* Graded depending on degree of displacement
64
Scoliosis
* Lateral curvature of the spine
* most include rotation of vert which produces rib cage deformities
* poor posture, discrepancies in leg length, muscle disorders
65
Spina Bifida
* congenital disorder, neural arches fail to close or are absent (gap in bone)
* **Meningocele** - meninges protrude through gap, no nerves involved
* **Myelocele** - spinal cord protrudes through a defect in meninges and spine
* **Myelomeningocele** - both meninges and spinal cord herniate through defect; most severe form
66
Bursitis (calcific tendonitis)
* inflammation of the bursae
* deposition of calcification in adjacent tendons causes pain and limit motion
67
Fracture
* most common skeletal abnormality
* traumatic injury that disrupts the continuity of the bone, "broken"
* damage occurs to bone, surrounding tissue, blood vessels, and nerves
* When swelling and fusion, fat pads are pushed out
68
Fraction classifications
1. Direction
2. Integrity of overlying skin
3. Shape
4. Position
5. Number of Fragments
69
Types of fractures
1. Complete - goes through both cortex
2. Incomplete - goes through only one cortex
3. Compound - open fx (through skin)
4. Comminuted - multiple fragments
70
Incomplete Fracture (Greenstick)
* common in kids
* soft, pliable bones absorb force and bow
* fx occurs away from site of impact
71
Incomplete Fracture (Torus)
* driving force pushes down, causing cortex to fold back on itself "buckle"
72
Types of Fx by direction
* Transverse - runs at right angle to long axis of bone
* Oblique - runs 45 degrees to long axis of bone
73
Spiral Fracture
* encircles shaft, longer than oblique
74
Shapes, Fragments and integrity
* **Avulsion** - small fragment torn away from bony prominence
* **Stellate** - star shaped fx
* **Impaction** - cortical shaft is pushed into cancellous bone (humerus and femur)
* **Compression** - usually occurs in the spine as a result of the compressing force
* **Stress fracture** - fatigue or "march" fracture. Occurs at site of maximum stress from repeated trivial trauma to normal bone
75
Pathological Fracture
* Fx occurs when normal stress is placed on diseased bone
76
Displacement - position of fragments
**Undisplaced** - no angulation or separation of fragments
## Footnote
**Displaced** - separation of fragments described by relationship of distal fragment with respect to proximal fragment. Measured in terms of shaft thickness
77
Subluxation
* not a complete dislocation; partial
78
Dislocation
* describes the displacement of bone that is not in contact with normal articulation
* incomplete dislocation; partial seperation of articular surfaces
***Shoulder dislocation** - dislocates anteriorly*
***Hip dislocation** - dislocates posteriorly*
79
Colles Fracture
* transverse fx of distal radius with posterior displacement of distal fragment.
* Occurs from falling on outstretched hand
80
Smith Fracture
* Fx of distal radius with anterior displacement of distal fragment
81
Monteggia Fracture
* Fx involves proximal 1/3 of ulna with anterior dislocation of radial head
* essential to include both joints
82
Galezzi Fracture
* Fx of the radial shaft with posterior dislocation of the ulna at the wrist
* important to include both joints
83
Bennett Fracture
* fracture of the base of the 1st metacarpal
84
Potts Fracture
* Bi-Malleolar fracture (ankle)
85
Boxer's Fracture
* transverse fx of neck of 5th metacarpal
86
Jone's Fracture
* base of 5th metatarsal. Results from plantar flexion and inversion
87
Salter Harris
* Epiphyseal plate fractures
* Occurs in kids
* Classified 1-5
88
Jefferson Fracture
* Comminuted fracture of ring of the atlas
89
Hangmans Fracture
* Fracture of C2, associated with C2, C3 subluxation
90
Clay Shovelers Fracture
avulsion fracture spinous process of lower cervical/upper thoracic
91
Etiology
* the cause of disease
92
Manifestations
* observable changes that result from cellular changes
1. Signs (objective)
2. Symptoms (subjective)
3. Syndrome (combo of sx from a single cause that form a distinct clinical picture
93
Acute
* sudden onset
94
Chronic
* slow development, lasts longer than 6 months
95
Functional Disease
* function of organ impaired.
* Structure unchanged
* Onset without lesions, physiological changes
96
Structural Disease
* Physical and biochemical changes within cells.
* Organs altered to pathological state
97
Congenital
* present at birth
* may be genetic, non genetic, or both
* cause frequently unknown
* influenced by the environment
98
Hereditary
* transferred from one generation to the next
* may not be detected until later in life
* genetic
99
Hyperplasia
* Abn inc in size due to inc number of cells, norm arrangement
100
Neoplasia
* Abnormal uncontrolled growth
101
Hypertrophy
* increased size of organ due to inc in cell size
102
Atrophy
* Progressive wasting away of any part of the body, resulting in impaired function or loss of function
1. **Senile** - age related, brain tissue shrinks
2. **Dis-use** - body part not used
3. **Pressure** - steady pressure
4. **Endocrine** - decreased hormone production
103
Exogenous
* injury caused by external agents
104
Endogenous
* Internal agents
105
Vascular Insufficiency
* obstruction of blood flow
1. Ischemia - deficient blood flow
2. Necrosis - cell death
3. Infarct - localized area of ischemic necrosis
106
Immunologic Disorder
* changes in immune system; autoimmune
107
Metabolic Disturbances
* production of enzymes, hormones, secretory products, fluids and electrolyte balance
108
Cell Diagram
109
Inflammation
* body's reaction to injury. Initial phase of healing, localizes/isolates and destroys
110
Rubor
redness
111
Calor
Heat
112
Dolor
Pain
113
Tumor
swelling
114
Abrasion
a wearing, grinding, or rubbing away by friction
115
Laceration
A jagged wound or cut
116
Sprain
* An injury to a ligament when the joint is carried through a range of motion greater than its normal range without dislocation or fracture
117
Strain
* to overexercise
118
Ecchymosis
* The passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin
119
Abscess
* localized, spherical lesion filled with pus and bacteria
120
Empyema
* Accumulation of pus in body filled cavity
121
Cellulitis
* spreading infection of subcutaneous tissue
122
Ulcer
* depressed lesion of skin
123
Granuloma
* Localized area of chronic inflammation often with central necrosis
124
Bacteremia
* Bacteria in the blood
125
Septicemia
* Systemic infection-pathogens present in blood, having spread from infection in one part of the body
126
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Skeletal/Neoplasms
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