Surface and Radiological Anatomy Practice Questions

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: The blood vessel marked as $X$ in the CT angiography image is:

P2 PCA. ***P2 PCA*** - The image displays a CT angiography of the **Circle of Willis**. The vessel marked 'X' is a segment of the **posterior cerebral artery** (PCA). - The PCA is conventionally divided into four segments: P1 (pre-communicating), P2 (peduncular), P3 (quadrigeminal), and P4 (cortical). The 'X' points to the segment of the PCA that is distal to the posterior communicating artery, indicating the **P2 segment**. *P1 PCA* - The **P1 segment** of the PCA is the initial part, located between the basilar artery bifurcation and the posterior communicating artery. - The vessel marked 'X' is clearly **distal to the connection point** where the posterior communicating artery would typically join, thus it is not the P1 segment. *Internal carotid artery* - The **internal carotid arteries** typically ascend higher and give rise to the anterior and middle cerebral arteries, forming the anterior circulation. - The vessel marked 'X' is part of the **posterior circulation**, originating from the basilar artery system, not the internal carotid artery. *M1, Middle cerebral artery* - The **M1 (main trunk) segment of the middle cerebral artery** extends laterally from the internal carotid artery. - The vessel marked 'X' is situated more posteriorly and medially, clearly identifying it as part of the **posterior cerebral artery**, and not the middle cerebral artery.

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: The dermatome level of the structure indicated in the image is: (Recent NEET Pattern 2019)

T10. ***T10*** - The dermatome for **T10** corresponds to the level of the **umbilicus**. - This is a crucial anatomical landmark for dermatomal assessment, neurological examination, and clinical correlation. - The T10 dermatome is consistently tested in NEET-PG examinations. *T12* - The dermatome for **T12** is located just inferior to the umbilicus, typically corresponding to the **suprapubic region** or inguinal area. - It does not correspond to the umbilicus itself. *L1* - The dermatome for **L1** is generally located in the **inguinal region** and upper anterior thigh. - This is significantly lower than the umbilicus. *L3-L4* - **L3-L4** refers to a **vertebral level**, not a dermatomal level. - While the umbilicus is anatomically located at approximately the L3-L4 vertebral level, the question asks for the **dermatome**, which is T10. - Dermatomes and vertebral levels should not be confused.

Q: The image shows:

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Q: What is the location of Erb's point during auscultation?

C=3rd intercostal space left parasternal line. ***C=3rd intercostal space left parasternal line*** - **Erb's point** is a classic auscultation area located at the **third intercostal space** just to the left of the sternum. - While not corresponding to a specific single valve, it is where the sounds of **aortic** and **pulmonary regurgitation** can often be heard. *A=2nd intercostal space right parasternal line* - This location corresponds to the **aortic area**, primarily used for listening to the **aortic valve**. - It's optimal for detecting **aortic stenosis** and accentuation of the second heart sound (S2) due to aortic closure. *B=2nd intercostal space left parasternal line* - This is the **pulmonary area**, used for auscultating the **pulmonary valve**. - It is best for hearing murmurs related to **pulmonic stenosis** and **pulmonary hypertension**. *D=5th intercostal space left parasternal line* - This area is typically the **mitral area (apex)**, or occasionally just medial to it, for listening to the **mitral valve**. - It is optimal for assessing **mitral stenosis** and **regurgitation**, as well as the point of maximal impulse (PMI).

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

Q: Which artery is labeled as '3' in the given angiogram?

Posterior cerebral artery. ***Posterior cerebral artery*** - The arrow labeled '3' points to the **posterior cerebral artery (PCA)**, which originates from the **basilar artery** and supplies the posterior cerebral hemispheres. - This artery is a key component of the **Circle of Willis**, responsible for perfusing the **occipital lobes**, parts of the temporal lobes, and midbrain. - The PCA courses laterally around the midbrain after branching from the basilar artery terminus. *Anterior cerebral artery* - The ACA arises from the internal carotid artery and courses **medially** above the optic chiasm. - It supplies the **medial surfaces** of the frontal and parietal lobes, not the posterior structures shown at position 3. *Middle cerebral artery* - The MCA is the **largest branch** of the internal carotid artery and courses **laterally** through the Sylvian fissure. - It supplies the **lateral convexities** of the cerebral hemispheres, not the posterior circulation shown at position 3. *Basilar artery* - The basilar artery is formed by the **confluence of the vertebral arteries** and runs along the **ventral pons**. - It is a **midline structure** that gives rise to the PCAs, rather than being the lateral branch shown at position 3.

Q: The Gut blood vessel marked (Red arrow) in the angiogram is: (Recent NEET Pattern 2018-19)

Superior mesenteric artery. ***Superior mesenteric artery*** - The image shows an **abdominal angiogram** with a vessel arising from the anterior aspect of the aorta and branching extensively, consistent with the **superior mesenteric artery (SMA)**. - The SMA typically supplies the **midgut structures**, which include the duodenum (distal to the major duodenal papilla), jejunum, ileum, cecum, ascending colon, and the proximal two-thirds of the transverse colon. *Inferior mesenteric artery* - The **inferior mesenteric artery (IMA)** originates lower down the aorta, usually at the level of L3, and supplies the hindgut (distal one-third of the transverse colon, descending colon, sigmoid colon, and rectum). - The branching pattern and location in the angiogram do not match the expected origin and distribution of the IMA. *Splenic artery* - The **splenic artery** is a branch of the celiac trunk, which arises higher than the vessel shown and typically courses towards the left to supply the spleen, stomach, and pancreas. - Its branching pattern and location are distinctly different from the vessel highlighted in the image, which is clearly supplying mesenteric structures. *Gastroepiploic artery* - The **gastroepiploic arteries** (right and left) are branches primarily supplying the greater curvature of the stomach and the greater omentum. - These arteries are much smaller and are situated along the stomach, not originating directly from the aorta in this manner or having such a widespread mesenteric distribution.

Q: Identify the lines shown in the following image:

Langer's lines. ***Langer's lines*** - The image displays lines that represent the **natural orientation of collagen fibers** within the human skin, which are known as Langer's lines (also called cleavage lines). - Making surgical incisions **parallel to these lines** can result in better wound healing and less scarring. - Named after **Karl Langer**, an Austrian anatomist who described these lines in 1861. *Hinderer's lines* - While **Hinderer** described relaxed skin tension lines (RSTLs) used in plastic surgery, these are **different from Langer's lines**. - The image shows Langer's lines specifically, which are based on **collagen fiber orientation**, not relaxed skin tension. *Dermatomes* - **Dermatomes** are areas of skin mainly supplied by a single **spinal nerve root**. - They represent **neurologic segments** and do not correspond to the collagen fiber orientation shown in the image. *Blaschko's lines* - **Blaschko's lines** are invisible lines of skin cell migration that become visible in certain **genetic or acquired dermatological conditions**. - They represent a **mosaic pattern** due to different cell populations and are distinctly different from the structural collagen lines shown.

Question 1

The area marked in CT scan is:

Accepted Answer

Mammillary body

Answer

Massa Intermedialis

Answer

Pons

Answer

Clivus

Question 2

The blood vessel marked as $X$ in the CT angiography image is:

Accepted Answer

P2 PCA

Answer

P1 PCA

Answer

Internal carotid artery

Answer

M1, Middle cerebral artery

Question 3

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

Accepted Answer

C

Answer

A

Answer

B

Answer

D

Question 4

The dermatome level of the structure indicated in the image is: (Recent NEET Pattern 2019)

Accepted Answer

T10

Answer

T12

Answer

L1

Answer

L3-L4

Question 5

The image shows:

Question 6

What is the location of Erb's point during auscultation?

Accepted Answer

C=3rd intercostal space left parasternal line

Answer

A=2nd intercostal space right parasternal line

Answer

B=2nd intercostal space left parasternal line

Answer

D=5th intercostal space left parasternal line

Question 7

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

Question 8

Which artery is labeled as '3' in the given angiogram?

Accepted Answer

Posterior cerebral artery

Answer

Anterior cerebral artery

Answer

Middle cerebral artery

Answer

Basilar artery

Question 9

The Gut blood vessel marked (Red arrow) in the angiogram is: (Recent NEET Pattern 2018-19)

Accepted Answer

Superior mesenteric artery

Answer

Inferior mesenteric artery

Answer

Splenic artery

Answer

Gastroepiploic artery

Question 10

Identify the lines shown in the following image:

Accepted Answer

Langer's lines

Answer

Hinderer's lines

Answer

Dermatomes

Answer

Blaschko's lines

Surface and Radiological Anatomy — MCQs

Surface and Radiological Anatomy — MCQs

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