Surface and Radiological Anatomy Practice Questions

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: 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.

Q: In the shown lateral view, the structure marked with arrowhead is?

Trachea. ***Trachea*** - This is a lateral view of the thorax, and the **trachea** is the most anterior conduit in the superior mediastinum, visible as an **air-filled structure** anterior to the esophagus. - The arrowhead points to a vertical air column in the anterior aspect, consistent with the expected anatomical location and appearance of the **trachea**. *Pulmonary artery* - The **pulmonary artery** lies anterior to the main bronchi and usually branches before this level, and it is a vascular structure, not an air-filled lumen. - It would appear as a soft tissue density, not a radiolucent (dark) air-filled structure on an X-ray. *Left atrium* - The **left atrium** is located posteriorly to the ascending aorta and pulmonary artery, and it is a cardiac chamber, not an air-filled tubular structure. - It is also a soft tissue density and would not be visible as a distinct air-filled lumen on a lateral chest X-ray in this position. *Esophagus* - The **esophagus** is located posterior to the trachea, running behind it in the mediastinum. - While it is a tubular structure, it is usually not air-filled unless there is swallowed air or a pathology (e.g., hiatus hernia), and it would be located *behind* the structure indicated by the arrowhead.

Q: Highest point of iliac crest is seen at?

L4. ***L4*** - The **highest point of the iliac crest** typically corresponds to the level of the **L4 vertebral body**. - This anatomical landmark is crucial for procedures like **lumbar punctures** and determining the location for **epidural anesthesia**. *L3* - The L3 vertebral level is generally located slightly **above the highest point of the iliac crest**. - While close, it is not the most consistent anatomical correlation for the highest point. *S2* - The **S2 vertebral level** is significantly **below the iliac crests**, marking the approximate midpoint of the sacroiliac joint. - This level is used as a landmark for the **dermatome of the posterior thigh**. *S1* - The **S1 vertebral level** is also located **below the iliac crests**, forming the most superior segment of the sacrum. - It is used as a landmark for the **dermatome of the lateral foot and posterior leg**, and corresponds to the ankle jerk reflex.

Question 1

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 2

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

Accepted Answer

C

Answer

A

Answer

B

Answer

D

Question 3

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 4

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 5

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 6

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 7

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 8

Identify the lines shown in the following image:

Accepted Answer

Langer's lines

Answer

Hinderer's lines

Answer

Dermatomes

Answer

Blaschko's lines

Question 9

In the shown lateral view, the structure marked with arrowhead is?

Accepted Answer

Trachea

Answer

Pulmonary artery

Answer

Left atrium

Answer

Esophagus

Question 10

Highest point of iliac crest is seen at?

Accepted Answer

L4

Answer

L3

Answer

S2

Answer

S1

Surface and Radiological Anatomy — MCQs

Surface and Radiological Anatomy — MCQs

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