Surface and Radiological Anatomy Practice Questions

Q: On palpation at the site marked by the red arrow on the image, a bony ridge is felt. What is the vertebral level of the marked arrow?

T4-T5 intervertebral disc. ***T4-T5 intervertebral disc*** - The arrow points to the **sternal angle** (Angle of Louis), which is the palpable transverse ridge at the junction of the **manubrium** and the **body of the sternum**. - This important anatomical landmark is located at the level of the **intervertebral disc** between the **T4 and T5** thoracic vertebrae and marks the site of articulation of the **second costal cartilage**. *T3-T4 intervertebral disc* - This vertebral level is superior to the sternal angle. - The **spine of the scapula** is a surface landmark that corresponds approximately to the level of the **T3** vertebra. *T2-T3 intervertebral disc* - This vertebral level is significantly superior to the location marked. - The **suprasternal notch** (jugular notch) of the manubrium corresponds to the level of the intervertebral disc between **T2 and T3**. *T5-T6 intervertebral disc* - This level is inferior to the sternal angle. - It would correspond to a point lower on the body of the sternum, rather than the manubriosternal junction.

Q: Identify the marked blood vessel in the image.

Internal carotid artery. ***Internal carotid artery*** - The image shows a **magnetic resonance angiography (MRA)** of the cerebral vasculature displaying the Circle of Willis - The marked vessel (number 6) represents the **internal carotid artery** as it enters the cranial cavity after emerging from the neck - This segment is located **before the ICA bifurcates** into the middle and anterior cerebral arteries - The anatomical position and course are characteristic of the **supraclinoid segment** of the internal carotid artery *Incorrect: Middle cerebral artery* - The middle cerebral artery is a **terminal branch** of the internal carotid artery, not the parent vessel - It courses laterally through the **lateral sulcus (Sylvian fissure)** rather than ascending vertically - Would be located more **superiorly and laterally** in this view *Incorrect: Anterior cerebral artery* - The anterior cerebral artery is also a **terminal branch** of the internal carotid artery - It courses **medially and anteriorly** above the optic nerve, not in the position shown - Typically appears as a **smaller caliber vessel** compared to the parent ICA *Incorrect: Basilar artery* - The basilar artery is part of the **posterior circulation**, formed by vertebral arteries - Located in the **midline at the base of the pons**, posterior to the Circle of Willis - Would be seen in the **posterior aspect** of the image, not in the lateral supraclinoid position marked

Q: The image shows $\qquad$ (marked by green arrow):

Optic canal. ***Optic canal*** - The green arrow points to a rounded opening superior and medial to the larger, irregular opening, which is characteristic of the **optic canal**. - The optic canal transmits the **optic nerve (CN II)** and the **ophthalmic artery** from the orbit to the middle cranial fossa. *Superior orbital fissure* - The **superior orbital fissure** is typically a larger, more irregular, and elongated opening located lateral and inferior to the optic canal. - It transmits multiple structures including **cranial nerves III, IV, V1, VI**, and the **superior ophthalmic vein**. *Anterior ethmoidal foramen* - The **anterior ethmoidal foramen** is a much smaller opening, typically found on the medial wall of the orbit, between the frontal and ethmoid bones. - It transmits the **anterior ethmoidal nerve** and vessels to the ethmoid sinuses and nasal cavity. *Posterior ethmoidal foramen* - The **posterior ethmoidal foramen** is also a small opening, located posterior to the anterior ethmoidal foramen on the medial wall of the orbit. - It transmits the **posterior ethmoidal nerve** and vessels.

Q: The structure marked as $X$ is:

Internal capsule. ***Internal capsule*** - The arrow points to a white matter structure composed of ascending and descending tracts, located between the **thalamus** and the **basal ganglia**. - Its characteristic 'V' shape on axial imaging, with an anterior and posterior limb, confirms it as the **internal capsule**. *Genu of corpus callosum* - The **genu of the corpus callosum** is the anterior-most part of the large commissural fiber bundle connecting the cerebral hemispheres. - It would be located more anteriorly and medially, forming the anterior wall of the lateral ventricles. *Splenium of corpus callosum* - The **splenium of the corpus callosum** is the posterior-most part of the corpus callosum. - It would be seen more posteriorly, caudal to the pineal gland. *Thalamus* - The **thalamus** is a large, ovoid mass of gray matter located deep within the brain, superior to the brainstem. - It forms the lateral wall of the third ventricle and is adjacent to the internal capsule, but the arrow points specifically to the white matter tract.

Q: The area marked in CT scan is:

Mammillary body. ***Mammillary body*** - The arrow points to a small, rounded structure located on the **ventral surface of the hypothalamus**, characteristic of the mammillary body - Mammillary bodies are part of the **limbic system** and play a crucial role in **memory formation** and **recollection** - These paired structures are visible on midsagittal brain imaging as small rounded projections *Massa Intermedialis* - The massa intermedia (interthalamic adhesion) is a flattened band of tissue connecting the two halves of the **thalamus** across the third ventricle - Located more **superiorly and centrally** within the diencephalon, not ventrally as shown *Pons* - The pons is a larger, bulbous structure located anterior to the **cerebellum** and superior to the medulla, forming part of the brainstem - It is much more **posterior and inferior** to the marked area *Clivus* - The clivus is a **bony structure** at the skull base, formed by the **sphenoid** and **occipital bones** - It is a radiological landmark but represents bone, not brain parenchyma as indicated by the arrow

Q: Which of the following structures of the scapula is palpable in infraclavicular fossa?

C. ***C - Coracoid Process*** - The **coracoid process** is a hook-like bony projection from the superior border of the scapula that extends anteriorly and laterally. - It is located approximately **2.5 cm below the lateral third of the clavicle** in the **infraclavicular fossa** (also called the deltopectoral triangle). - The coracoid process is the **only structure of the scapula that is palpable anteriorly** in the infraclavicular fossa, making it an important surgical landmark. - It can be felt by deep palpation in the infraclavicular region, just medial to the deltoid muscle. *A - Glenoid Cavity* - The glenoid cavity is the shallow, pear-shaped articular surface on the lateral angle of the scapula that receives the head of the humerus. - It is deeply positioned and completely covered by the humeral head and surrounding soft tissues (rotator cuff muscles, joint capsule). - It is **not palpable** from any surface location, including the infraclavicular fossa. *B - Acromion* - The acromion is the lateral continuation of the spine of the scapula, forming the highest point of the shoulder. - It articulates with the lateral end of the clavicle at the acromioclavicular joint. - The acromion is palpable at the **tip of the shoulder laterally**, not in the infraclavicular fossa which is located more medially and anteriorly. - It forms part of the superior boundary of the shoulder region, well lateral to the infraclavicular fossa. *D - Inferior Angle of Scapula* - The inferior angle is the lowest point of the scapula, located at approximately the level of the 7th rib or T7 vertebra. - It is palpable on the **posterior thoracic wall**, particularly when the arm is moved. - It is located posteriorly and inferiorly, nowhere near the anterior infraclavicular fossa.

Q: Which of the following tests is shown in the image provided?

Oxidase test. ***Oxidase test*** - The image displays two test tubes, one showing a positive result (purple color change indicating **cytochrome c oxidase** activity) and the other showing a negative result (no color change). - The **oxidase test** is used to identify bacteria that produce cytochrome c oxidase, an enzyme involved in the electron transport chain. *Catalase production* - The **catalase test** involves adding hydrogen peroxide to a bacterial colony; a positive result is indicated by the rapid formation of bubbles (oxygen gas). - This image does not show bubbling, nor is it typical for a catalase test to be performed in a test tube with a color indicator like this. *Nitrate reduction* - The **nitrate reduction test** determines the ability of bacteria to reduce nitrate to nitrite or nitrogen gas. - This test involves adding reagents to detect nitrite (red color) or zinc dust to detect unreduced nitrate, which is not what is depicted in the image. *Urease test* - The **urease test** detects the enzyme urease, which hydrolyzes urea into ammonia and carbon dioxide, leading to an increase in pH and a color change to pink/red with a pH indicator. - While it involves a color change (often pink), the specific colors and experimental setup in the image (purple/blue for positive, yellow/orange for negative) do not match a typical urease test.

Q: The image shows:

Selenite F broth. ***Selenite F broth*** - This image displays **Selenite F broth**, a **selective enrichment medium** typically used for the isolation of *Salmonella* and *Shigella* species. - The characteristic **pale blue-green color** is due to the oxidation of the selenite salt. *Lowenstein Jensen media* - **Lowenstein Jensen media** is a solid, egg-based medium that usually appears **green** and is used for the cultivation of **Mycobacterium tuberculosis**. - It would typically be a solid slant rather than a liquid broth, and the color is distinctly different. *Wilson-Blair medium* - **Wilson-Blair medium** (Bismuth Sulfite Agar) is a solid, opaque medium, generally appearing **black** due to the presence of bismuth sulfite, used for isolating *Salmonella typhi*. - It is a solid agar medium, not a liquid broth as shown in the image. *Loeffler serum slope* - **Loeffler serum slope** is a solid, yellowish-white medium containing inspissated serum, primarily used for the isolation and cultivation of **Corynebacterium diphtheriae**. - It would be a solid slanted surface, not a blue-green liquid broth.

Q: The image shows angiography of the external carotid artery. Structure labeled '5' represents:

Ascending pharyngeal artery. ***Ascending pharyngeal artery*** - The image displays an **angiography of the external carotid artery**, and structure labeled '5' clearly represents the **ascending pharyngeal artery** - This artery is typically a **slender branch arising from the medial aspect** of the external carotid artery, **ascending vertically** along the pharynx - It is the **smallest and most medial branch** of the external carotid artery *Lingual artery* - This is labeled as structure '2' in the angiography - Arises from the **anterior surface** of the external carotid artery at the level of the hyoid bone - Courses anteriorly to supply the tongue *Occipital artery* - This is labeled as structure '4' in the angiography - Arises from the **posterior aspect** of the external carotid artery - Courses posteriorly and superiorly to supply the posterior scalp *Posterior auricular artery* - This is labeled as structure '6' in the angiography - Arises from the **posterior aspect** of the external carotid artery above the occipital artery - Courses posteriorly to supply the auricle and scalp behind the ear

Question 1

On palpation at the site marked by the red arrow on the image, a bony ridge is felt. What is the vertebral level of the marked arrow?

Accepted Answer

T4-T5 intervertebral disc

Answer

T5-T6 intervertebral disc

Answer

T3-T4 intervertebral disc

Answer

T2-T3 intervertebral disc

Question 2

The following procedure is being performed. Identify the markings:

Accepted Answer

A = Sternocleidomastoid muscle, B = Thyroid cartilage, C = Cricoid cartilage

Answer

A = Sternocleidomastoid muscle, B = Cricoid cartilage, C = Thyroid cartilage

Answer

A = Cricoid cartilage, B = Sternocleidomastoid muscle, C = Thyroid cartilage

Answer

A = Thyroid cartilage, B = Cricoid cartilage, C = Sternocleidomastoid muscle

Question 3

Identify the marked blood vessel in the image.

Accepted Answer

Internal carotid artery

Answer

Middle cerebral artery

Answer

Anterior cerebral artery

Answer

Basilar artery

Question 4

The image shows $\qquad$ (marked by green arrow):

Accepted Answer

Optic canal

Answer

Superior orbital fissure

Answer

Anterior ethmoidal foramen

Answer

Posterior ethmoidal foramen

Question 5

The structure marked as $X$ is:

Accepted Answer

Internal capsule

Answer

Genu of corpus callosum

Answer

Splenium of corpus callosum

Answer

Thalamus

Question 6

The area marked in CT scan is:

Accepted Answer

Mammillary body

Answer

Massa Intermedialis

Answer

Pons

Answer

Clivus

Question 7

Which of the following structures of the scapula is palpable in infraclavicular fossa?

Accepted Answer

C

Answer

A

Answer

B

Answer

D

Question 8

Which of the following tests is shown in the image provided?

Accepted Answer

Oxidase test

Answer

Catalase production

Answer

Nitrate reduction

Answer

Urease test

Question 9

The image shows:

Accepted Answer

Selenite F broth

Answer

Lowenstein Jensen media

Answer

Wilson-Blair medium

Answer

Loeffler serum slope

Question 10

The image shows angiography of the external carotid artery. Structure labeled '5' represents:

Accepted Answer

Ascending pharyngeal artery

Answer

Lingual artery

Answer

Occipital artery

Answer

Posterior auricular artery

Surface and Radiological Anatomy — MCQs

Surface and Radiological Anatomy — MCQs

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