Surface and Radiological Anatomy — MCQs
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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?
The following procedure is being performed. Identify the markings:
Identify the marked blood vessel in the image.
The image shows $\qquad$ (marked by green arrow):
The structure marked as $X$ is:
The area marked in CT scan is:
Which of the following structures of the scapula is palpable in infraclavicular fossa?
Which of the following tests is shown in the image provided?
The image shows:
The image shows angiography of the external carotid artery. Structure labeled '5' represents:
Surface and Radiological Anatomy Indian Medical PG Practice Questions and MCQs
Question 61: 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?
- A. T4-T5 intervertebral disc (Correct Answer)
- B. T5-T6 intervertebral disc
- C. T3-T4 intervertebral disc
- D. T2-T3 intervertebral disc
Explanation: ***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.
Question 62: The following procedure is being performed. Identify the markings:
- A. A = Sternocleidomastoid muscle, B = Thyroid cartilage, C = Cricoid cartilage (Correct Answer)
- B. A = Sternocleidomastoid muscle, B = Cricoid cartilage, C = Thyroid cartilage
- C. A = Cricoid cartilage, B = Sternocleidomastoid muscle, C = Thyroid cartilage
- D. A = Thyroid cartilage, B = Cricoid cartilage, C = Sternocleidomastoid muscle
Explanation: ***A = Sternocleidomastoid muscle, B = Thyroid cartilage, C = Cricoid cartilage*** The image depicts a procedure being performed on the anterior neck with anatomical landmarks identified: **Structure A - Sternocleidomastoid muscle:** - Large paired muscle on the lateral aspect of the neck - Extends from mastoid process and superior nuchal line to sternum and clavicle - Important landmark for neck procedures and regional anatomy **Structure B - Thyroid cartilage:** - Largest cartilage of the larynx - Forms the laryngeal prominence (Adam's apple) - Located at the level of C4-C5 vertebrae - Superior to the cricoid cartilage **Structure C - Cricoid cartilage:** - Complete ring-shaped cartilage of the larynx - Located inferior to the thyroid cartilage at C6 vertebral level - Only complete ring of cartilage in the respiratory tract - Important landmark for cricothyroidotomy *Incorrect Option: A = Sternocleidomastoid muscle, B = Cricoid cartilage, C = Thyroid cartilage* - Reverses the positions of thyroid and cricoid cartilages - Anatomically, thyroid cartilage is always superior to cricoid *Incorrect Option: A = Cricoid cartilage, B = Sternocleidomastoid muscle, C = Thyroid cartilage* - Misidentifies the lateral muscle as a midline cartilage structure *Incorrect Option: A = Thyroid cartilage, B = Cricoid cartilage, C = Sternocleidomastoid muscle* - Incorrectly identifies midline laryngeal structures as lateral muscle and vice versa
Question 63: Identify the marked blood vessel in the image.
- A. Middle cerebral artery
- B. Anterior cerebral artery
- C. Internal carotid artery (Correct Answer)
- D. Basilar artery
Explanation: ***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
Question 64: The image shows $\qquad$ (marked by green arrow):
- A. Superior orbital fissure
- B. Optic canal (Correct Answer)
- C. Anterior ethmoidal foramen
- D. Posterior ethmoidal foramen
Explanation: ***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.
Question 65: The structure marked as $X$ is:
- A. Genu of corpus callosum
- B. Internal capsule (Correct Answer)
- C. Splenium of corpus callosum
- D. Thalamus
Explanation: ***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.
Question 66: The area marked in CT scan is:
- A. Mammillary body (Correct Answer)
- B. Massa Intermedialis
- C. Pons
- D. Clivus
Explanation: ***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
Question 67: Which of the following structures of the scapula is palpable in infraclavicular fossa?
- A. A
- B. B
- C. C (Correct Answer)
- D. D
Explanation: ***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.
Question 68: Which of the following tests is shown in the image provided?
- A. Catalase production
- B. Oxidase test (Correct Answer)
- C. Nitrate reduction
- D. Urease test
Explanation: ***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.
Question 69: The image shows:
- A. Lowenstein Jensen media
- B. Wilson-Blair medium
- C. Loeffler serum slope
- D. Selenite F broth (Correct Answer)
Explanation: ***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.
Question 70: The image shows angiography of the external carotid artery. Structure labeled '5' represents:
- A. Ascending pharyngeal artery (Correct Answer)
- B. Lingual artery
- C. Occipital artery
- D. Posterior auricular artery
Explanation: ***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
Practice by Chapter
Surface Landmarks of the Head and Neck
Practice Questions
Surface Landmarks of the Thorax
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Surface Landmarks of the Abdomen
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Surface Landmarks of the Limbs
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Radiographic Anatomy
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CT Anatomy
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MRI Anatomy
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Ultrasonographic Anatomy
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Angiographic Anatomy
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Sectional and Cross-sectional Anatomy
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Anatomical Correlations in Common Imaging
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Interventional Radiological Anatomy
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