Applied Anatomy/Radiology

Question 1

Where does arch of aorta begin and end?

Answer 1

T4/T5

Question 2

What accessory muscles of respiration are used when pt leans forward and fixes their arms e.g. onto back of chair?

Answer 2

Serratus anterior

Question 3

What is a flail segment?

Answer 3

Three or more contiguous ribs are fractured in two or more places

That bit of ribcage moves on its own

Question 4

Eyebrow sign on CXR

Answer 4

Free gas under diaphragm - pneumoperitoneum

Question 5

AXR signs of pneumoperitoneum

Answer 5

Inner and outer bowel edges
Outline of falciform ligament
Umbilical ligament outlines
Triangular pockets of gas

Question 6

What does splenic laceration look like on CT?

Answer 6

High attenuation/dense fluid around spleen - blood
Darkening of patch on spleen - laceration

Question 7

Dual blood supply to artery

Answer 7

Portal vein
Hepatic artery

Question 8

Loss of blood flow to kidney looks like?

Answer 8

Kidney looks darker/less white on CT

Question 9

Def of comminuted fracture

Answer 9

Fracture of more than 2 parts

Question 10

Cause of avulsion fracture

Answer 10

Detachment of ligament from bone

Question 11

Signs indicating elbow fracture on XR (radial head)

Answer 11

Anterior sail sign
Posterior fat pad

Question 12

Colles vs Smith fracture angulation

Answer 12

Colles - dorsal, dinnerfork
Smith - volar

Question 13

Type of scaphoid fracture causing AVN

Answer 13

Waist fracture
- causes AVN of proximal scaphoid

Question 14

Where do lateral and medial circumflex arteries supplying neck of femur branch from?

Answer 14

Fermoral and profunda femoris arteries

Question 15

Twisting ankle can result in what type of fracture?

Answer 15

Malleolar spiral fracture

Question 16

Features of lower left lobar collapse

Answer 16

Volume loss on the left with elevation of the hemidiaphragm, left hemithorax looks small
Increased density in left retrocardiac region
Loss of clarity medial aspect left hemidiaphragm
Left hilum displaced downwards

Question 17

Features of upper let lobar collapse

Answer 17

Volume loss on the left, elevation of the left hemidiaphragm
Loss of clarity of the heart shadow
‘veil like opacity’ diffuse opacification of the left hemithorax

Question 18

Features of upper right lobar collapse

Answer 18

Volume loss on the right
Loss of clarity of the upper right mediastinum
Density in the right upper zone, elevation of the horizontal fissure

Question 19

Features of middle right lobar collapse

Answer 19

Loss of clarity of the right heart border
Density in the right lower zone,
Right hemidiaphragm preserved

Question 20

Features of lower right lobar collapse

Answer 20

Volume loss on the right
Loss of clarity of the right hemidiaphragm
Density in the right lower zone, depression of the horizontal fissure

Question 21

Review areas on CXR

Answer 21

Apices - pancoast, pneumothorax
Behind heart - consolidation, hiatus hernia
Below diaphragm - free gas, lines/tubes, bowel obs
Bones/soft tissue - fractures, subcut emphysema

Question 22

What is an air bronchogram?

Answer 22

1. The bronchus must contain air.
2. The surrounding lung must not

Question 23

Unilateral pleural effusion?

Answer 23

Prob cancer unless proven otherwise

Question 24

Signs of HF on CXR

Answer 24

A - alveolar oedema (bat wing opacities)
B - Kerley B lines
C - cardiomegaly
D - dilated upper lobe vessels
E - pleural effusion

Question 25

Normal position of ET tube

Answer 25

normal tip 5 cm above carina width 2/3 tracheal diameter cuff should not expand the trachea

Question 26

Malposition features of ET tube

Answer 26

tip may extend past the carina malposition most commonly seen is the tip in the right main bronchus May have entered the oesophagus

Question 27

Normal position of NG tube

Answer 27

subdiaphragmatic position in the stomach - identified on a plain chest radiograph as overlying the gastric bubble - at least 10 cm beyond the gastro-oesophageal junction.

Question 28

Where do you insert central lines or PICC lines?

Answer 28

Central lines - via right and left internal jugular or subclavian veins (CVC) Peripherally inserted central catheters (PICC) - via cephalic, basilic or brachial veins

Question 29

Why is it important that central lines are placed in central vein?

Answer 29

To ensure adequate blood flow for proper dilution of meds

Question 31

Where does appendix originate from?

Answer 31

Midgut

Question 32

US findings in appendicits

Answer 32

Aperistaltic, non-compressible, dilated appendix Round when compressed Periappendiceal collection of fluid Target sign/donut appearance

Question 33

CT findings in appendicitis

Answer 33

Appendiceal dilatation and inflammation Wall thickening and enhancement Thickening of caecal apex Focal wall nonenhancement = necrosis

Question 34

Gold standard imaging for ureteric stones

Answer 34

CT KUB

Question 35

Inv for acute diverticulitis

Answer 35

CT with IV contrast to confirm presence of diverticula - might see perforation on CXR

Question 36

US findings in acute cholecystitis

Answer 36

Gallbladder wall thickening Pericholecystic fluid

Question 37

CT findings in acute cholecystitis

Answer 37

Distension/wall thickening [finish card]

Question 38

Why is US used in pancreatitis?

Answer 38

To assess if gallstones is the cause

Question 39

CT findings in pancreatitis

Answer 39

Diffuse parenchymal enlargement Indistinct margins = inflammation Surrounding retroperitoneal fat stranding Vasc complications (SMV filling defect) Infected necrosis/abscess formation

Question 40

Huge volume of gas under diaphragm on CXR?

Answer 40

Perforation

Question 41

CT findings in perforation

Answer 41

Free fluid Distribution gas (shows up black) Defect in wall Localised inflam change

Question 42

AXR findings in small bowel obs

Answer 42

Valvulae conniventes are visible (basically small bowel haustra, looks like stack of coins) Loops of bowel are central Dilatation >2.5 - 3 cm Distal pauctiy of gas

Question 43

CT findings in small bowel os

Answer 43

Dilated small bowel lops >2.5cm from outer wall to outer wall Normal calibre or collapsed loops distally Small bowel faeces sign Sometimes rare causes e.g. gallstone ileus

Question 44

XR findings in large bowel obs

Answer 44

Peripheral >5cm Haustra Colonic distension Collapsed distal colon Small bowel dilatation if incompetent IC valve

Question 45

CT findings in large bowel obs

Answer 45

To confirm diag/cause and localise lesion Non-dependent gas = dying bowel

Question 46

What is non dependent gas?

Answer 46

Gas sitting underneath fluid in bowel Means gas is building up in bowel wall as it dies V bad sign

Question 47

ABG findings in bowel ischaemia

Answer 47

Metabolic acidosis High lactate

Question 48

CT findings in bowel ischaemia

Answer 48

Lack of enhancement of lumen of vessel Mucosal/serosal enhancement is reduced or incr Altered wall thickness Dilated loops of bowel Pneumatosis intestinalis Mesenteric oedema/free fluid

Question 49

CT findings in ruptured AAA

Answer 49

Retroperitoneal haemorrhage adjacent to the aneurysm - presents w pain, hypotension, pulsatile/expansile abdo mass

Question 50

Which pts have dilated bile ducts?

Answer 50

Older pts Pts who have had gallbladder removed

Question 51

Why does a clot show up hyperattenuated on CT?

Answer 51

Stagnant collection of blood/clot - full of iron (metal) which shows up dense on CT

Question 52

Define gliosis in brain

Answer 52

Scarring of brain parenchyma adjacent to lesion/infarct - hypoattenuated on CT

Question 53

3 main causes of subdural haemorrhage

Answer 53

Infants - NAI YAs - RTA Elderly - falls

Question 54

Shape differeneces between subdural and extradural haemorrhage

Answer 54

Subdural - semilunar Extradural - biconvex

Question 55

When's the only time you do an emergency MRI?

Answer 55

Spinal emergency e.g. cord compression

Question 56

Visual pathway for superior and inferior visual fields?

Answer 56

PITS Parietal - inferior Temporal - superior