Anatomy Random

Question 1

What are the boundaries of the mesorectum

Answer 1

Anterior/post/med/lat – fascial boundary surrounding the fat immediately around the rectum
If you can’t seen the fascial boundaries:
- Post – anterior edge of presacral space
- Ant – gyne/GU structures +1cm where the bladder is to account for filling variation
- Lat – medial edge of the levator ani (lower pelvis) and pelvic brim (in upper pelvis)
- Superior – transition to sigmoid from rectum
- Inferior – anorectal junction

Question 2

Cervix: what are the boundaries of the parametria?

Answer 2

ant: bladder wall
Post: mesorectal fascia
Laterally: internal obtrurators or pelvic sidewall
Sup: broad ligament
Inf: urogenital ligament

Question 3

cervix: what is included in CTV45:

Answer 3

upper half of vagina, uterus, parametria, pelvic nodes (int/ext iliac, obtrurator, presacral; to aortic bifurcation unless lesion is less than 4cm then do not include common iliacs. (NOTE: DOES NOT INCLUDE 1CM OF BLADDER BC WE MAKE AN ITV, UNLIKE IN PROSTATE OR RECTUM)
-> if ≥ node at common iliac or above or ≥3 pathologic nodes, then contour 3cm cranial to the highest pathologic node , or at the minimum level L2.

Question 4

Breast: what is CTV seroma?

Answer 4

A: Lumpectomy bed and surgical clips + 1cm, carve off anterior surface of pec muscles and 5mm off skin, not crossing midline (Alliance). PTV = 7mm (excluding heart).

Question 5

Where does the styloid process come off of?

Answer 5

The mastoid LOL

Question 6

What structures pass through the parotid gland?

Answer 6

facial nerve (CN7)
external carotid
stensen’s duct (parotid duct)

Question 7

5 benign conditions which may cause clubbing:

Answer 7

Sarcoidosis, ILD, IBD, cirrhosis, and TB (chronic infection leading to hypoxia)

Question 8

Why do patients get a virchow node

Answer 8

bc thoracic duct empties into the left subclavian vein = supraclav node: from thoracic and GI tumors.

Question 9

Ddx spinal tumor:

Answer 9

Intramedullary tumor: ddx: ependymoma, glioma, metastasis, medulloblastoma

Intradural: lepto, schwannoma, meningioma

Question 10

Diagnosis of NF1, what is it associated with? What about NF2?

Answer 10

NF1: lisch nodules eye, neurofibromas, cafe au lait maccules (more than 6), axillary freckling, optic glioma; MPNST

NF2: bilateral vestibular schwannomas!!!!!!

Question 11

Ddx of lytic bone lesions:

Answer 11

Fibrous dysplasia
Osteoblastoma
Giant cell tumor
Metastasis/Myelona
Aneurysmal bone cyst
Chondroblastoma
Hyperparathyroidism
Infection
Non-ossifying fibroma
Enchondroma
Simple bone cyst

Question 12

Ddx malignant paranasal sinus tumors:

Answer 12

Adenoid cystic carcinoma, SCC, salivary carcinoma, lymphoma, SNUC, sarcoma, esthesioneuoblastoma

Question 13

Immediate management of SCVO

Answer 13

elevate bed, oxygen, steroids, stent, start RT/chemo

Question 14

Ddx solitary lung nodule

Answer 14

Malignant: primary NCLC vs SCLC vs Met
Benign: infectious: tb, granulomatous disease, fungal infection vs benign: hamartoma, hemhorrage, abscess, round pneumonia, sarcoidosis

Question 15

Which branch of VII innervates taste and joins the lingual branch of the trigeminal nerve?

Answer 15

Chorda Tympani

Question 16

First echelon LN drainage for:
Cervix
Helix
Anal canal
BOT

Answer 16

Cervix = external iliac
Helix = pre-auricular
Ing Anal canal = inguinal femoral: below the dentate line
BOT = jugulodiagstric nodes: 2,3,4

Question 17

Lacrimal gland tumor and ddx

Answer 17

adenocarcinoma, pleomorphic adenoma, adenoid cystic carcinoma, lymphoma, sarcoid, orbital pseudotumor, infection

Question 18

What radiographic lung parynchyma findings from breast radiaiton?

Answer 18

Ground glass opacities, lung fibrosis, airspace consolidation

Question 19

What syndrome has multiple mucosal hyperpigmented maccules and on lips? What cancers and other condition is this associated with?

Answer 19

Peutz-Jeugers Syndrome: multiple colon polyps as well. Associated with CRC, small bowel, breast cancer.