Practice ospe questions 2 Flashcards
What type of radiological image is shown in the given image?
Acceptable answers:
Magnetic Resonance Imaging
MRI
Magnetic Resonance
Coronal MRI
Explanation:
The image is an MRI taken in the coronal plane.
An MRI shows up visceral structures, muscles and fatty tissue better than does a CT scan, as can be seen from the diaphragm and the muscles around the shoulder joint, as well as the white-coloured fatty tissue in the surrounding body wall.
Identify the structure shown by the arrow in the given image.
Acceptable answers:
Superior vena cava
SVC
Explanation:
Rounded structures showing up white in the given CT
image are usually blood vessels (the structures showing
up black contain air, ie, the lungs and trachea/bronchi).
The arrowed vessel to the right of the
Ascending aorta is superior vena cava.
The structure indicated by the arrow represents which type of bone growth?
Acceptable answers:
Interstitial growth
Interstitial bone growth
Interstitial
Explanation:
The arrowed structure is an epiphyseal plate.
But the question asks for the type of bone growth, not for the arrowed structure itself, and therefore the answer “epiphyseal plate” would be incorrect here.
Bones grow in length by means of epiphyseal plates, ie, interstitial growth (growth within the bone), and in width by means of appositional growth from the surrounding periosteum.
Bones ossify (ie, form bone tissue) by means of endochondral ossification (mainly long/limb bones) and intramembranous ossification (mainly flat bones of the skull).
Where is the structure shown in the square box typically found? – be specific
Acceptable answers:
Compact bone
Cortical bone
Explanation:
The image shows Haversian Systems or osteons.
These are found only in compact or cortical bone, not in spongy or trabecular bone.
What type of joint is indicated by the arrow?
Acceptable answers:
Synovial hinge joint
Hinge joint
Synovial hinge
Hinge
Explanation:
The joint shown is a posterior view of the elbow or humero-ulnar joint. But the question asks for the type of joint, not the name of the joint, so elbow or humero-ulnar would be incorrect answers here.
One further point: If the joint is of a synovial type, it is better to specify this by answering “synovial hinge” rather than just “hinge”, though “hinge” would still receive the mark.
Name the joint formed by the bony structures shown by the arrows
Acceptable answers:
Knee
Knee joint
Tibiofemoral joint
Patellofemoral joint
Explanation:
The arrows point to the distal condyles of the femur (posterior view). These condyles articulate with the tibia in the knee or tibiofemoral joint.
However, these condyles also articulate anteriorly with the patella, and so patellofemoral joint would also be accepted as a correct answer.
Name the bone underlying the skin at X
Acceptable answers:
Metacarpal
Metacarpal bone
5th metacarpal
Fifth metacarpal
Explanation:
In the hand, the thumb is the 1st digit and the thumb metacarpal is the 1st metacarpal, and so the little finger is the 5th digit containing the 5th metacarpal.
This situation is similar for the foot, where the big toe is the 1st digit.
Identify the bone labelled X
Tibia
Explanation:
The bone labelled X is the larger medial bone of the leg – the tibia. It articulates inferiorly with the talus at the ankle joint (a synovial hinge joint), and also laterally with the lateral bone of the leg – the fibula (a fibrous joint or syndesmosis).
Please note – there is no such bone as the “tibula”!
In the given image what tissue occupies the space indicated by the arrow? – be specific
Acceptable answers:
Hyaline cartilage
Explanation:
The arrow indicates the epiphyseal plate of a growing/child’s bone (proximal phalanx).
But the question asks for the name of a tissue, not a structure, and hence the answer “epiphyseal plate” would be incorrect: epiphyseal plate is not the name of a tissue.
What is the action on the shoulder joint of the muscle compartment indicated by the arrow?
Acceptable answers:
Extension
Explanation:
The arrow points to the posterior muscle compartment of the arm, specifically the triceps brachii muscle. The action of this muscle compartment on both the shoulder and the elbow joint is extension.
The image shows the muscles of the posterior thigh.
Name 1 joint upon which these muscles act
Acceptable answers:
Hip
Hip joint
Knee
Knee joint
Explanation:
The muscles of the posterior thigh are also known as the “hamstrings”, of which there are 3. These act to extend the hip joint and flex the knee joint.
In the given image which vertebral column movement is most limited in the region shown in green?
Acceptable answers:
Flexion
Forward flexion
Explanation:
The vertebrae coloured green are the thoracic
vertebrae. Owing to the orientation of their
articular facets in the coronal plane as well as
their attachment to the ribs, and the ribs to the
sternum, forward flexion of the thoracic vertebrae
is very limited.
What is found in the structure labelled X? - be specific
Acceptable answers:
Cell bodies of sensory fibres
Sensory cell bodies
Sensory cells
Sensory nerve fibres
Sensory nerve cell bodies
Afferent neurons
Explanation:
The spinal cord is viewed from posterior in the image.
X shows the dorsal root ganglion (DRG) of the
spinal cord dorsal root. The DRG contains the cell bodies of the sensory or afferent nerve fibres.
. Name the type of fibres carried in the arrowed structure
Acceptable answers:
Sympathetic postganglionic
Sympathetic postsynaptic
Sympathetic postganglionic motor
Sympathetic postsynaptic motor
Unmyelinated sympathetic
Explanation:
The spinal cord is viewed obliquely from posterior.
The arrow points to the grey ramus communicans which is coming from the sympathetic ganglion (after having synapsed there) to go back to join the spinal nerve. The grey ramus communicans contains unmyelinated postganglionic sympathetic motor fibres.
Answers such as “motor” or “sympathetic” or “unmyelinated” on their own are too non-specific to be awarded the mark.
Identify the orange-coloured structure labelled X in the given image
Acceptable answers:
Conus medullaris
Conus
Explanation:
The image shows the spinal cord. X points to the inferior termination of the spinal cord at L1 or L1/L2 in the adult, or L3 in a child. The spinal cord terminates in a cone-shaped structure, hence X is conus medullaris.
Just “conus” is acceptable, but for an OSPE it is better to write conus medullaris out in full.
The image shows the contents of the spinal column. Identify the structure labelled X
Acceptable answers:
Arachnoid mater
Explanation:
X indicates the arachnoid mater (at the inner surface of the dura, the arachnoid mater is closely adherent).
The pia is affixed to the spinal cord and, therefore, cannot be reflected.
Arachnoid mater is a transparent thin connective tissue sheath, sometimes difficult to identify. Sub-arachnoid space is between the pia and arachnoid mater, which contain cerebrospinal fluid (CSF).
Dura is the outermost tuff, thick fibrous sheath. Epidural space is located between the vertebral body and the dura mater. Subdural space is located between the dura and the arachnoid mater.
Often both dura and arachnoid mater of meningeal layers are reflected together.
The image shows the bronchial tree. Identify the structure indicated by the red arrow in the given image - be specific
Acceptable answers:
Left primary bronchus
Left main bronchus
Explanation:
The structures shown in the image are relatively easy to recognise,
ie, the bronchial tree. Here, it would just be a case of orientation, ie,
left or right. Since we know that the left main bronchus is the
more horizontal bronchus relative to the right one, the correct answer is
left main bronchus or left primary bronchus.
The question also states “be specific”. So you would need to put in
your answer the word “left”: Just answering “main bronchus” or
“primary bronchus” would therefore not be given a mark. In addition,
just giving “left bronchus” as your answer is not being sufficiently
specific as there are a number of orders of bronchi, ie, primary,
secondary, tertiary, etc.
The image shows the lungs covered by pleura.
The pleural membrane indicated by X develops from which embryological structure? – be very specific
Acceptable answers:
Somatic layer of lateral plate mesoderm
Lateral plate mesoderm – somatic layer
Somatic mesoderm
Explanation:
X indicates the parietal pleura. This is also indicated by the fact that the two vertical vessels shown in the image are the
internal thoracic vessels, which we know lie superficial to the
parietal pleura.
Parietal pleura is embryologically derived from the somatic layer of the lateral plate mesoderm (whereas the visceral pleura is derived from the splanchnic layer of the lateral plate mesoderm). So the correct answer would need to include at the very least the words “somatic” and “mesoderm”.
Structure labelled X is innervated by which spinal root levels?
Acceptable answers:
C3-C5
C3-5
C3,,4, 5
C3, C4, C5
Explanation:
Read the question very carefully. It asks for
spinal root levels (or values). We know that the phrenic nerve innervates the diaphragm and this has root values C3-C5. Therefore, “phrenic nerve” given as an answer in this instance would be incorrect and not given any marks as it is the root values of the phrenic nerve that is being asked for here.
The image shows structures lying on the posterior abdominal wall. Identify the structure labelled X
Acceptable answers:
Inferior Vena Cava
IVC
Explanation:
The image shows the 2 kidneys and the 2 main vessels found
on the posterior abdominal wall, ie, the IVC and descending aorta.
But which vessel is which? If you try to remember that the right side
of the abdominal wall (and also the thorax for that matter)
is the “venous” side and the left side the “arterial” side
(principally because the right atrium of the heart receives venous
blood), then structure X becomes more obvious, ie, being the IVC
The image shows the superior mediastinum.
Identify structure labelled X - be specific
Acceptable answers:
Left brachiocephalic vein
L. Brachiocephalic vein
Explanation:
In the superior mediastinum, the veins tend to be more
superficial than the arteries, as well as having a slightly darker/blue/grey colour relative to the lighter-coloured arteries (though this is not always the case in cadaveric specimens!!): Therefore, X shows a vein ravelling towards the right atrium of the heart as does vein labelled X in the image. Vein labelled X is formed from the union of the left subclavian vein (“brachium”) and the left internal jugular vein (“cephalic”) at the root of the neck and is therefore the left brachiocephalic vein.
But you would need to say “left” in your answer as the question states to be specific and the left brachiocephalic vein is longer than the right so they are not equivalent structures just to say “brachiocephalic vein”.
The sound of which heart valve is heard with a stethoscope placed at X?
Acceptable answers:
Pulmonary
Pulmonary valve
Pulmonary semilunar valve
Explanation:
This is really just a case of learning these, but there is a ‘logic’ to it too: If you imagine the heart and the great vessels in situ in the image, then you would remember that the pulmonary trunk is inclined toward the left as it leaves the heart (whereas the ascending aorta first inclines to the right as it leaves the heart). Therefore, the sound made by the pulmonary valve (lying behind the sternum) is “pushed” by the sternum also towards the right, and so X would indicate the sound of the pulmonary valve. (However, to learn all this fully, one should also study the positions of the heart sounds relative to the sternum and the costal cartilages/ribs).
(Just giving “semilunar valve” would obviously be insufficient as an answer).
Identify the vessel indicated by the arrow.
Acceptable answers:
Long saphenous vein
Great saphenous vein
Explanation:
The arrow points to a blue/grey-coloured superficial vessel, which indicates that this is a vein. The vessel is seen travelling up anterior to the medial malleolus (clue – visible big toe is medial!). Therefore, this is the long/great saphenous vein (which will drain into the femoral vein proximally in the anterior thigh).
You would, however, need to state either “long” or “great” as well as “vein” in your answer, since there is also a small or lesser saphenous vein in the posterior leg, and the structure is not an artery or a nerve.
The image shows the base of the neck. Lymph is returned to the area labelled X via which lymphatic vessel?
Acceptable answers:
Thoracic duct
Explanation:
X points to the area where the left subclavian vein joins with the left internal jugular vein to form the left brachiocephalic vein, and we know that this is the point at which the thoracic duct drains its lymph from all parts of the body except the right upper quadrant.
So the correct answer is thoracic duct. It would not be acceptable to give the answer as “thoracic lymphatic vessel/channel” as this is not how the structure is termed in anatomy (even if true technically).
the given image shows an isolated heart. Identify the vessel indicated by the pointer
Acceptable answers:
Right marginal artery
Marginal artery
Explanation:
The image shows the heart in anterior view because the apex is pointing to the left. Thus we can see the right atriunm and ventricle and between these, the right coronary artery (RCA). Branching off the the RCA near the inferior margin of the heart is the right marginal artery as indicated by the pointer.
Both marginal artery or right marginal artery are acceptable correct answers, but you would need to say “artery” in your answer since we know that lying in the same position is the small cardiac vein, which clearly is not a branch of the RCA.
The image shows the heart in posterior view. From which embryological structure does the vessel shown by the pointer develop?
Acceptable answers:
Sinus venosus
Explanation:
The heart in the image is in posterior view because the apex is pointing towards the right. The vessel indicated by the pointer is dark/grey in colour and therefore a vein. It is lying between the left atrium and the left ventricle inferiorly, ie, in the coronary sulcus. Therefore, it is the coronary sinus (also because the other veins are draining into it). And we know from embryology that the coronary sinus develops from the sinus venosus of the primitive heart tube.
(To just say “heart tube” as your answer would be far too non-specific to be awarded the mark).
The image shows the venous drainage of the heart wall in posterior view. Identify the vessel labelled X.
Acceptable answers:
Middle cardiac vein
Explanation:
The orientation of the heart shown in the image would be a bit tricky if you were not told this in the question wording – but you are! So always read the question first very carefully.
On the posterior surface we can see a darkly coloured vessels running vertically between the two ventricles towards the coronary sinus. Therefore, we know that this must be a vein – in this case the middle cardiac vein (which lies adjacent to the posterior interventricular artery were the latter present in the image).
Remember: The veins draining the heart wall are cardiac veins; the arteries supplying the heart wall are coronary arteries. So do not confuse these 2 terms by giving as your answer “middle coronary vein”: Such vessel does not exist!
In which intercostal space is the structure labelled X found?
Acceptable answers:
5th left intercostal space
Fifth left ic space
5th left ic space
5th left ic space midclavicular line
5th left
Explanation:
The image shows a normal AP chest x-ray.
X indicates the apex of the heart. We know from surface anatomy that the apex of the heart lies in the 5th left intercostal (ic) space in the midclavicular line
However, the question just asks for the intercostal space (ie, 5th left), not for the plane (ie, midclavicular line), so any answer with the words “5th” and “left” in it would be acceptable. BUT, it is always much better to give a full and accurate answer to such a question so as to avoid all doubt.
. From which embryological structure does the smooth part of the heart chamber labelled X develop?
Acceptable answers:
Sinus venosus
Right horn of sinus venous
Sinus venous – right horn
Sinus venosus – r. horn
Explanation:
The heart chamber shown is the right atrium (RA).
The smooth part and the rough part of the RA develop from separate embryological structures. The rough part develops from the primitive atrium of the heart tube, whereas the smooth part develops from the right horn of the sinus venosus of the primitive heart tube.
As the question does not state “be specific”, “sinus venosus” is acceptable as the correct answer, but “right horn of sinus venosus” would be the specific answer if so asked.
Name the fibrous connection labelled X in the given image
Acceptable answers:
Ligamentum arteriosum
L. Arteriosum
Explanation:
The image shows the adult heart. The fibrous connective tissue structure labelled X is the remnant of the connection in the foetal heart between the left pulmonary artery and the aortic arch. In the foetus this vessel would be patent (open) before birth, ie, called the ductus venosus, which is an arterial shunt bypassing the still non-functional foetal lungs.
As the ductus venous becomes ligamentous at birth and an adult heart is the one shown, “ductus venosus” would not be acceptable as a correct answer here.
(Similar foetal arterial shunts are the foramen ovale (also bypassing the foetal lungs), and the ductus venosus, bypassing the foetal liver)).
The given diagram shows the foetal circulation. Name the adult structure derived from structure labelled X
Acceptable answers:
Ligamentum venosum
Explanation:
The foetal liver is only partly functional.
Therefore, much of the oxygenated blood arriving at the liver in the umbilical vein (red-hatched vessel) needs to be shunted via the ductus venosus into the inferior venal cava, as shown by vessel labelled X in the diagram. At birth the ductus venosus becomes ligamentous (fibrous) and thus non-patent, ie, the ligamentum venosum
Identify the congenital vascular abnormality shown in the given image
Acceptable answers:
Double aortic arch
Persistence of 4th right primitive aortic arch
Non-regression of 4th right primitive aortic arch
Non-regression of right aortic arch
Explanation:
The image shows two aortic arches encircling the trachea (as well as the oesophagus seen lying just behind the trachea). Normally, there is present in the adult only the left sided aortic arch. So, in the shown congenital abnormality, the right aortic arch has persisted after birth. This usually results from non-regression of the 4th right aortic arch, or the right dorsal aorta, or both, in the primitive aortic arch arrangement.
