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Pathology Disease Processes
Pathology Disease Processes
Disease Processes
AAA (Abdominal Aortic Aneurysm)
a localized dilatation (ballooning) of the abdominal aorta
occur below the origin of the renal arteries (below the kidneys)
can increase and rupture leading to massive hemorrhage which can be fatal
appears curvilinear calcification in the wall of an aneurysm
can be treated by surgical graft or stent placement
achondroplasia
most common form of dwarfism
defective ossification of the growth plate
intelligence is not impaired but individuals have short limbs and trunk, normal size head
adenocarcinomas
arise in the peripheral area of the lung (outside areas of the lung)
spreads to the other lung as well as liver, kidney, bone, and the brain
slower growing tumor
tends to have a more favorable outcome
radiographs can reveal obstruction or atelectasis but can’t predict cell type but can detect
a lesion 2 years before symptoms occur
aneurysm
localized dilatation of an artery usually involving the aorta
saccular- involves only 1 side of the arterial wall
fusiform – bulging of the entire circumference of the vessel wall
appears as curvilinear calcification in the wall of an aneurysm
can be treated by surgical graft or stent placement
ankylosing spondylitis
rheumatoid arthritis that affects males in the 3 rd decade of life
referred to as “bamboo spine” because it usually affects the spine and SI joints
begins in the lumbar area first as low back pain then moves up to the thoracic and cervical
areas
it can involve the aorta
vertebral bodies look square rather than cylindrical
atelectasis
a collapse of all or part of the lung
can be acute (quick onset) or chronic (long term)
caused by obstruction of a bronchus caused by fluid consolidation, or iatrogenic
(misplaced endotracheal tube), pleural effusion (fluid accumulation within the pleural
space)
mimics pneumonia
appears as plate-like streaks, increased density
atherosclerosis
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bone cyst
idiopathic
more prevalent in young males
75% are found in distal femur and proximal tibia and humerus
some relationship to trauma or hemorrhagic disorder
appear lytic lucency in the central part of the long bone with thinning of the cortex,
accompanied by symmetrical expansion
can be unicameral (solitary cavity), multicameral/multilocular (contain numerous cavities),
aneurysmal ) usually unicameral and can become very large – assoc. with a fracture)
bronchiectasis
weakening of the wall of the bronchus due to chronic inflammation becoming permanently
dilated
affects the lower lobes bilaterally
appears as a peribronchial thickening
areas of ateletasis
“honeycomb pattern”
PFT (pulmonary function test) - group of tests that measure how well the lungs take in and
release air and how well they move gases such as oxygen from the atmosphere into the
body's circulation
bursitis
inflammatory of the bursae, small fluid-filled sacs located near the joints that reduce the friction
caused by movement
repeated physical activity commonly causes bursitis
trauma, rheumatoid arthritis, gout or infections can also cause inflammation
more common in the shoulder
appears as calcified tendonitis
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croup
viral infection of young children
bark-like cough
laryngitis with laryngeal spasm
obstruction of upper airway (subglottic portion of trachea) in neck
AP soft tissue neck is done to demonstrate narrowing of subglottic region
dissection
separation of layers
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emphysema
the most common chronic disease of the lung
usually associated with COPD
dilatation of the air spaces accompanied by destruction of walls of the alveoli
environmental
“barrel chested” appears on CXR as large, oversized lungs with increased blackening or
radiolucency
destruction of the distal bronchioles where the lung bases appear flat
lower technique to see any masses
empyema
pus in the pleural space from the spread of an adjacent infection
indistinguishable from pleural effusion
loculated fluid appears as an air-fluid level within it
epiglottitis
thickening of epiglottic tissue and the surrounding pharyngeal structures ; acute infections of the
epiglottis (flap of cartilage at the base of the tongue that covers the opening to the air passages
when swallowing, preventing food or liquids from entering the windpipe trachea)
acute infections most commonly in children are caused by Haemophilus influenzae
affects the supraglottic area or supraglottis
appears as rounded thickening epiglottic shadow
gout
disorder in the metabolism of purine (a component of nucleic acids) in which an increase in the
blood level of uric acid leads to the deposition of uric acid crystals in the joints, cartilage, and
kidney
primary gout is caused by several inherited enzyme defects that cause overproduction of
uric acid
secondary gout, hyperuricemia is caused by an overproduction of uric acid, which in turn
may be caused by increased turnover of nucleic acids, drugs, or a decrease in the
excretion of uric acid resulting in kidney failure
affects the first metatarsophalangeal joint and may attack any joint
appears as joint inflammation (effusion) or urate crystals (tophi) in joint space
HTN (Hypertension)
high blood pressure
leading cause of strokes and CHF
cardiac output of systolic (highest pressure in the peripheral arteries that occurs when the
left ventricle contracts) and diastolic (lower pressure in the peripheral arteries when the
left ventricle is relaxing and filling with blood from the left atrium)
arteriography – detects renovascular lesions
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meniscal tear
a tear in the cartilages, or menisci, that are located between the femur and tibia bones in the
lower leg
common cause of knee pain due to the lack of cushion
caused by acute trauma, but tears more frequently reflect a degenerative process caused
by the chronic trauma inherent in human knee function
MRI – tears have a high signal intensity
MI (Myocardial Infarction)
an episode in which some of the heart's blood supply is severely cut off or restricted, causing the
heart muscle to suffer and die (necrosis) from lack of oxygen
commonly known as a heart attack
can result from atherosclerosis, a thrombus, or a spasm of a coronary artery
onset of MI is characterized by a crushing, viselike chest pain that may radiate to the left
arm, neck, jaw, or epigastrium and sometimes stimulates the sensation of acute
indigestion or a gallbladder attack
appear s vessel calcifications
multiple myeloma
a widespread malignancy of plasma cells that may be associated with bone destruction, bone
marrow failure, hypercalcemia, renal failure, and recurrent infection
mainly it is a cancer of the plasma cells in bone marrow that affects people between ages
40-70
causes little or no stimulation of new bone formation
appears as multiple punched-out lesions
osteoarthritis
common generalized disorder characterized pathologically by loss of joint cartilage and reactive
new bone formation
causes are wear and tear of the aging process
affects the weight-bearing joints such as the hip, spine, knee, ankle, and also the ip joints
of the fingers
appears as irregular narrowing of joint space with small bony spurs (steophytes)
osteochondromas
a benign projection of bone with a cartilaginous cap
occurs in the epiphyseal plate and grows laterally
can convert to malignancy if it becomes thicker and contains calcifications
contains cortex an medullary portion
appearance: tumor runs parallel to long bone and points away from nearest joint
osteogenic sarcoma
malignant tumor composed of osteoblasts that produce osteoids and spicules of calcified bones
metaphysis of long bone and most common in the knee
arise in persons of age 10 – 25 or older persons who have preexisting bone disorder
“sunburst” pattern or Codman’s triangle
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osteoma
tumor composed of bone tissue
often arise in the outer table of the skull, the paranasal sinuses (especially frontal and
ethmoid), and the mandible
appear as well-circumscribed, extremely dense, round lesions that are rarely larger than 2
cm in diameter
no treatment needed
osteomylitis
bone infection usually the spread of bacteria from a distant location. can spread through the bone
from the periosteum, cortex, and marrow causing bone destruction; can also lead to an abscess
soft tissue swelling with loss of the fat planes, eventual loss of cortical margins, patchy
destruction of cancellous bone (latticework)
bone scans and MRI are very useful for progression
osteopetrosis
failure of resorption of cartilaginous intercellular substance, the growth plate does not mature
resulting in bone retardation and brittleness
congenital condition having many eponyms (named after)
marble bones, chalk bones, ivory bones
thickening and increased density of soft bone (exact opposite of osteoporosis)
osteoporosis
generalized or localized loss of bone mass in the entire skeleton
result of accelerated bone resorption (osteoclastic process) and a decrease in new bone
replacement (osteoblastic process)
cortical thinning appears as a relatively dense and prominent thin line
Paget’s disease
osteitis deformans – long bone, vertebrae, and skull deformity
first the bone is soft and bowing occurs net the bone becomes increasingly hard and
brittle.; also associated with neoplasms such as osteogenic sarcoma
increased bone expansion and density resembling a cotton-wool appearance
pathologic fractures
occurs in a bone that has been weakened by a preexisting condition
most common cause is metastatic malignancy or multiple myeloma
appears as vertebral collapse or bone destruction (radiolucency due to underlying cause)
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pericardial effusion
accumulation of fluid within the pericardial space surrounding he heart interfering with cardiac
function
caused by bacteria, viruses, neoplastic involvement, or idiopathic
appears as an enlargement of the cardiac silhouette
plaque
fatty material of the inner arterial wall
develop in the intima and produce progressive narrowing and often complete occlusion of
large and medium-size arteries
a characteristic of atherosclerosis
atherosclerotic plaques appear as irregular distributed densities along the course of an
artery and can often calcify
pleural effusions
accumulation of fluid in the pleural space
common causes are CHF, PE, TB, or abdominal diseases (ascites, pancreatitis)
appears as costophrenic angle blunting
fluids look white or opaque and may be free fluid or loculated
best seen on upright or affected side down decubitus (lateral decubitus)
removal of air or drain fluid
pneumonia
acute infection of the lung parenchyma
6-8th leading cause of death
caused by bacteria, viruses, or fungus
inflammation by microorganisms
can cause scarring
has 4 types of pneumonia:
1. alveolar or air-spaced (lobar): involves mostly the alveoli of an entire love w/o
involving the bronchi; mass of consolidated fluid; lateral view must be
included to establish degree of segmental involvement
2. broncho or bacterial pneumonia (lobular): patchy or irregular distribution of
disease that involves the inflammation of the bronchi and bronchioles, and
alveoli; patchy, irregular distribution is localized on one or more lobes around
the bronchi
3. interstitial or viral or pneumonitis: caused by a virus and no exudate (fluid) is
present; involves the wall and lining of the alveoli and the interstitial
supporting structure; acquired secondarily as a complication from measles,
chicken pox, or flu; Farmer’s lung is the inhalation of crop dust; linear or
reticular (mesh) pattern; honeycomb lung
4. aspiration: esophageal or gastric contents aspirated into the lungs; multiple
alveolar densities; posterior segments of the upper and lower lobes most
commonly affected if bedridden; Not contagious; patchy opacification
pneumothorax
presence of air in the pleural cavity, with partial or complete collapse of the lung
causes are trauma, lung biopsy, ruptured esophagus, mets
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pulmonary edema
normal fluid accumulation in the pulmonary tissues
appears as a “butterfly or bat wing”
vascular markings not sharp
treatment: reduction of edema
pulmonary embolism
blood clot most often in the lower lobes of the lung
originates in the deep veins of the legs
emboli can break loose and travel to the lung and block the pulmonary artery causing
infarction
potentially fatal
increased radiolucency distal to the embolus from depressed perfusion of the vessels
wedge-shaped density at the base of the lung
usually not seen on CXR
treatment includes anticoagulants, thrombolytic or vena cava filter placement
rheumatoid arthritis
chronic systemic disease of unknown cause that appears primarily as a noninfectious
inflammatory arthritis of the small joints of the hands and feet
symmetric destruction affects women 3xs more frequently and the average onset age is
40
occurs in small joints symmetrically
CT - synovial inflammation (soft tissue mass) causes narrowing of atlantoaxial articulation
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fatality rate is 3%
appears: no abnormality in early stages, focal infiltrates that progress into patch
infiltrates, then areas of consolidation
spina bifida
posterior defect of the spinal canal resulting from failure of the posterior elements to fuse
properly
cervical, thoracic, or lumbar/sacral spine
spondylolisthesis
forward movement of one vertebra on another as a result of fracture of the neural arch resulting
into two parts
most common in the 5th lumbar in which there is forward shift of L5 on the sacrum
demonstrated on the L5-S1 spot film.
spondylolysis
loss of bony continuity of the neural arch of a vertebra
occurs at the junction of the lamina
usually effecting the 4th and 5th lumbar
squamous carcinoma
most common type of lung cancer
arises in the major central bronchi
produces a narrowing of the bronchi and leads to pneumonia
spread to the lymph nodes which spread throughout the body (bone, brain)
slow growing
radiographs can reveal obstruction or atelectasis but can’t predict cell type but can detect
a lesion 2 years before symptoms occur
TB (Tuberculosis)
highly infectious (contagious), inflammatory, and chronic disorder
most deadly and common major infectious disease today
can be found in other organs
transmitted by inhalation of infected droplets such as a cough, spit, sneeze, or speaking
has nodular lesions, patchy infiltrates, calcium deposits
CXR’s cannot always distinguish active from inactive
thought of as vampirism
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Types of Fractures
avulsion
fracture occurring where a joint capsule ligament, tendon, or muscle is pulled from a bone, taking
with it a fragment of the bone to which it was attached; occur at sites of muscle origin. (As in the
olecranon process)
boxer’s
a transverse fracture of the neck of the 5 th metacarpal with volar (palm) angulation of the distal
fragments
closed
a fracture in which the bone does not pierce the skin
Colles’
forked fracture of the distal radius posteriorly and a chip fracture of the ulnar styloid
comminuted
fracture of a bone is which the separated parts are splintered or fragmented
complete
a bone fracture in which the bone is split completely across
compound
a fracture in which the broken bone is exposed through a wound in the skin
compression
a fracture (as of a vertebra) caused by compression of one bone against another
depressed
a fracture especially of the skull in which the fragment is depressed below the normal surface
greenstick
partial bone fracture, usually occurring in children, in which the bone is bent but only broken on
one side
hangman’s
result of acute hyper-extension of the head on the neck
incomplete
a bone fracture extending partly across the bone
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Jefferson
comminuted fracture of the ring to the atlas, involves both the anterior and the posterior arches
and causes displacement of the fragments
open
a fracture in which broken bone fragments lacerate soft tissue and protrude through an open
wound in the skin
Pott’s
complete break of the medial malleolus a type of avulsion fracture
bimalleolar – fracture of the lateral and medial malleolus
trimalleolar – has 3 components: the medial and lateral malleolus and the posterior distal
tibia
stress
a fracture of bone caused by repeated application of a heavy load, such as the constant pounding
on a surface by runners, gymnasts, and dancers
subluxaton
partial loss of continuity of the joint surfaces
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