Radiological Anatomy Practice Questions

Q: The lateral view chest X-ray shows:

Major fissure. ***Major fissure*** - The image clearly shows an oblique line running from the mid-thoracic region superiorly and posteriorly to the diaphragm anteriorly, which is characteristic of the **major (oblique) fissure** on a lateral chest X-ray. - This fissure separates the **upper and middle lobes from the lower lobe** in the right lung, and the upper lobe from the lower lobe in the left lung. *Minor fissure* - The minor (horizontal) fissure is typically seen as a **horizontal line** on the lateral view, running from the mid-axillary line to meet the major fissure anteriorly. - It is located between the **upper and middle lobes** of the right lung only and is not depicted by the annotated line. *Azygos fissure* - An azygos fissure is an **anatomical variant** caused by the atypical migration of the azygos vein during development, creating a deep fissure in the superior aspect of the **right upper lobe**. - It would appear as a curvilinear line forming a "tear-drop" shape and is not represented by the oblique line shown. *Transverse fissure* - "Transverse fissure" is another name for the **minor (horizontal) fissure**. - As described earlier, its appearance and location on a lateral chest X-ray are distinct from the oblique line indicated.

Q: Identify the structure shown in CT abdomen section. (Recent NEET Pattern 2018-19)

Portal vein. ***Portal vein*** - The arrow points to a vessel receiving blood from the splenic and superior mesenteric veins, which is characteristic of the **portal vein** entering the **liver parenchyma**. - The portal vein is typically seen anterior to the **inferior vena cava** and posterior to the **common hepatic artery** at this level. *Inferior vena cava* - The **inferior vena cava (IVC)** is a large, retroperitoneal vessel located posterior to the liver and to the right of the aorta. - The structure indicated by the arrow is clearly within the liver substance, not in the typical position of the IVC. *Splenic vein* - The **splenic vein** runs horizontally behind the body of the pancreas and joins with the superior mesenteric vein to form the portal vein. - The vessel shown is within the liver, distal to the formation of the portal vein. *Superior mesenteric vein* - The **superior mesenteric vein (SMV)** typically runs vertically in the mesentery and joins the splenic vein to form the portal vein. - The indicated structure is within the liver hilum, not in the anatomical location of the SMV.

Q: Identify the marked structure in the CT abdomen section shown below? (Recent NEET Pattern 2018-19)

Superior mesenteric artery. **Superior mesenteric artery** - The arrow points to a circular, **contrast-filled vessel** anterior to the aorta and posterior to the pancreatic head, characteristic of the **superior mesenteric artery (SMA)** - The SMA originates from the **anterior aspect of the aorta at L1 level** and supplies the midgut structures - In arterial phase CT, the SMA shows **bright contrast enhancement** and appears as a round structure between the aorta and pancreatic uncinate process *Incorrect: Aorta* - The **aorta** is the larger, more posterior vessel with a crescent or oval shape in axial sections - While the SMA branches from the aorta, the marked structure is clearly anterior to the main aortic lumen *Incorrect: Inferior vena cava* - The **IVC** is located to the **right of the aorta** in axial CT sections - The marked structure is **anterior and to the left**, not in the expected IVC position - The IVC would show less enhancement in arterial phase imaging *Incorrect: Superior mesenteric vein* - The **SMV** typically runs to the **right and slightly anterior** to the SMA - In arterial phase CT, the SMV shows **less intense opacification** compared to the arterial structures - The marked structure shows arterial-phase enhancement, indicating it is an artery, not a vein

Q: A 25-year-old female presents with neck pain and tingling sensation in her left arm. An X-ray of the cervicothoracic region is obtained. What is the radiological finding shown in the image?

Cervical rib. ***Cervical rib*** - The image displays an extra rib arising from the **C7 cervical vertebra**, which is characteristic of a cervical rib. - This **supernumerary rib** extends towards the sternum or first thoracic rib, a classic radiological finding. *Costochondritis* - **Costochondritis** is an inflammation of the cartilage connecting the ribs to the sternum, which is typically a clinical diagnosis, not visible on X-ray. - An X-ray would not show inflammatory changes in cartilage or soft tissue, making this diagnosis unlikely based on imaging alone. *Fracture of 2nd rib* - A **fracture of the 2nd rib** would appear as a discontinuity or break in the normal bony architecture of the second rib. - The image does not show any signs of a broken rib; instead, it shows an **extra, well-formed rib-like structure** originating from the cervical spine. *Spondylolisthesis* - **Spondylolisthesis** involves the anterior displacement of one vertebral body over another, usually in the lumbar spine. - This condition is also not visible in the provided image, which focuses on the cervicothoracic junction and shows an **anatomic variation** rather than vertebral slippage.

Q: Radiologic views used for fracture Mandible (body and Ramus) are all EXCEPT:

Submentovertex. ***Submentovertex*** - The **Submentovertex (SMV) view** is primarily used to assess the **zygomatic arches**, base of the skull, and sphenoid sinuses, not typically for mandibular body or ramus fractures. - While it can provide some information about the medial aspects of the mandible, it offers **limited structural detail** crucial for diagnosing fractures in the body and ramus. *Lower occlusal* - **Lower occlusal films** are useful for visualizing the **anterior mandible**, including the symphysis and parasymphysis regions, and the lingual aspect of the body. - They can provide detailed views of these specific areas but are not the primary view for comprehensive assessment of the entire body or ramus. *Lateral obliques* - **Lateral oblique views** are highly effective for visualizing the **body, angle, and ramus** of the mandible, providing a good representation of these regions without superimposition from the contralateral side. - This projection allows for assessment of fracture displacement and angulation in the lateral and postero-lateral aspects of the mandible. *Orthopantomogram* - An **Orthopantomogram (OPG)**, also known as a panoramic radiograph, provides a comprehensive view of the **entire mandible** and maxilla on a single film. - It is an excellent screening tool for identifying fractures in the **condyle, ramus, angle, body, and symphysis** of the mandible due to its broad coverage.

Q: The perorbital view is carried out for -

Internal auditory meatus. ***Internal auditory meatus*** - The **perorbital view** (also known as the **Stenvers view**) is specifically used to visualize the internal auditory meatus. - This projection helps in assessing the internal auditory canal for conditions such as **acoustic neuromas** or other lesions that may affect the **auditory and facial nerves**. *Petrous apex* - While the petrous apex is part of the temporal bone, it is better visualized by other projections like the **submentovertex (SMV)** view or specialized CT/MRI scans. - The perorbital view's primary focus is on the **internal auditory meatus** rather than the entire petrous apex. *Bilateral mastoid pathologies* - Bilateral mastoid pathologies are typically assessed using views like the **Schuller's view** or **Law's view**, which provide better visualization of the **mastoid air cells** and their involvement. - The perorbital view is not optimized for comprehensively evaluating **bilateral mastoid processes**. *Mastoid process* - The mastoid process, a part of the temporal bone, is usually best seen on different projections such as the **Law's view** or **Schuller's view**. - The perorbital view provides only a limited and often obscured view of the **mastoid process** due to its specific angulation for the internal auditory meatus.

Q: The Transorbital view is carried out for:

Optic canal. ***Optic canal*** - The **Transorbital (or Rhese)** view in radiography is specifically designed to visualize the **optic canal (optic foramen)**. - This projection uses an oblique angle through the orbit to provide a clear view of the optic canal without superimposition from other dense bone structures. - The optic canal transmits the optic nerve and ophthalmic artery, making its visualization clinically important in cases of trauma, tumors, or suspected optic nerve pathology. *Internal auditory meatus* - The **internal auditory meatus (IAM)** is best visualized using **Stenvers view** or **Pöschl view**, which are specifically designed to project the petrous portion of the temporal bone. - These views provide optimal demonstration of the IAM, which transmits the facial nerve (CN VII) and vestibulocochlear nerve (CN VIII). - The transorbital view does not adequately demonstrate the IAM due to its different anatomical focus. *Mastoid process* - The **mastoid process** is typically visualized using views like **Schuller's view** or **Law's view**, which are specifically tailored to show the mastoid air cells and bony contours. - The transorbital view does not optimally demonstrate the mastoid process; instead, it focuses on anterior skull base structures. *Bilateral mastoid pathology* - Evaluating **bilateral mastoid pathology** would require views that clearly show both mastoids, such as a **Townes view** or specialized mastoid projections like **dual Schuller's views**. - The transorbital view is a unilateral projection primarily focused on the optic canal rather than a comprehensive bilateral assessment of the mastoids.

Q: Which term describes the internal appearance of a lesion?

Mixed density. ***Mixed density*** - **Mixed density** refers to a lesion that consists of both solid and cystic components, or areas of different tissue attenuation, which describes its **internal appearance**. - This term is commonly used in **imaging studies** (e.g., CT, MRI) to characterize the internal composition of a mass or lesion. *Pedunculated* - **Pedunculated** describes a lesion that is attached to a surface by a **stalk-like structure**. - This term refers to the **external shape** or attachment of a lesion, not its internal composition. *Circular* - **Circular** describes the **external shape** of a lesion when viewed from a certain angle, indicating a rounded or disc-like outline. - It does not provide information about the **internal characteristics** or contents of the lesion. *Discoid* - **Discoid** describes a lesion that is **flat and disk-shaped** or roundish with a flattened or slightly raised surface. - This term characterizes the **overall external morphology** of a lesion, not its internal structure or density.

Q: The best view to visualize zygomatic arches is

Jug Handle view. ***Jug Handle view*** - The **Jug Handle view**, also known as the **submentovertex (SMV) view**, is optimal for visualizing the entire course of both **zygomatic arches**, projecting them free from superimposition by other facial bones. - This projection requires the patient's head to be tilted back so that the central ray passes through the neck and enters the skull vertically, allowing for a clear, unobstructed image of the arches. *Skull PA view* - A **PA (posteroanterior) skull view** primarily demonstrates the frontal bone, orbits, and nasal cavity. - While it shows portions of the zygoma, the **zygomatic arches are often superimposed** by other cranial structures, making detailed assessment difficult. *Orthopantamogram* - An **Orthopantamogram (OPG)** is a panoramic dental X-ray that provides a broad view of the maxilla, mandible, and temporomandibular joints. - It offers a **limited or distorted view of the zygomatic arches**, as its primary purpose is dental assessment, not detailed facial bone evaluation. *Occipito mental view* - The **occipitomental view**, also known as the **Waters' view**, is excellent for visualizing the **maxillary sinuses**, orbits, and nasal bones. - While it shows the **zygomaticomaxillary complex**, it does not provide a true tangential projection of the entire zygomatic arch, which is often partially obscured by other structures.

Q: Which of the following structures is best visualised using Schuller's view and Law's view?

Mastoid air cells. ***Mastoid air cells*** - **Schuller's view** is an **oblique lateral radiograph** specifically designed to visualize the mastoid air cells, the **tegmen mastoideum**, and the **sigmoid sinus**. - **Law's view**, another lateral oblique projection, also provides excellent visualization of the mastoid air cells and the surrounding bony structures. *Sphenoid sinus* - The **sphenoid sinus** is best visualized with lateral and submentovertex (SMV) views, not Schuller's or Law's views. - These projections are critical for assessing sinus opacification, **mucoperiosteal thickening**, or presence of fluid levels. *Carotid canal* - The **carotid canal** requires specialized views like the **Stenvers view** or advanced imaging techniques like **CT scans** and **MRI** for optimal visualization. - Standard skull radiographs like Schuller's and Law's views do not adequately demonstrate the intricacies of the carotid canal. *Foramen ovale and spinosum* - The **foramen ovale** and **foramen spinosum** are located at the base of the skull and are best visualized using the **submentovertex (SMV)** or **Hirtz view**, or with cross-sectional imaging. - These foramina transmit the **mandibular nerve**, lesser petrosal nerve, accessory meningeal artery, and middle meningeal vessels, respectively.

Question 1

The lateral view chest X-ray shows:

Accepted Answer

Major fissure

Answer

Minor fissure

Answer

Azygos fissure

Answer

Transverse fissure

Question 2

Identify the structure shown in CT abdomen section. (Recent NEET Pattern 2018-19)

Accepted Answer

Portal vein

Answer

Inferior vena cava

Answer

Splenic vein

Answer

Superior mesenteric vein

Question 3

Identify the marked structure in the CT abdomen section shown below? (Recent NEET Pattern 2018-19)

Accepted Answer

Superior mesenteric artery

Answer

Aorta

Answer

Inferior vena cava

Answer

Superior mesenteric vein

Question 4

A 25-year-old female presents with neck pain and tingling sensation in her left arm. An X-ray of the cervicothoracic region is obtained. What is the radiological finding shown in the image?

Accepted Answer

Cervical rib

Answer

Costochondritis

Answer

Fracture of 2nd rib

Answer

Spondylolisthesis

Question 5

Radiologic views used for fracture Mandible (body and Ramus) are all EXCEPT:

Accepted Answer

Submentovertex

Answer

Lower occlusal

Answer

Lateral obliques

Answer

Orthopantomogram

Question 6

The perorbital view is carried out for -

Accepted Answer

Internal auditory meatus

Answer

Petrous apex

Answer

Mastoid process

Answer

Bilateral mastoid pathologies

Question 7

The Transorbital view is carried out for:

Accepted Answer

Optic canal

Answer

Internal auditory meatus

Answer

Mastoid process

Answer

Bilateral mastoid pathology

Question 8

Which term describes the internal appearance of a lesion?

Accepted Answer

Mixed density

Answer

Pedunculated

Answer

Circular

Answer

Discoid

Question 9

The best view to visualize zygomatic arches is

Accepted Answer

Jug Handle view

Answer

Skull PA view

Answer

Orthopantamogram

Answer

Occipito mental view

Question 10

Which of the following structures is best visualised using Schuller's view and Law's view?

Accepted Answer

Mastoid air cells

Answer

Sphenoid sinus

Answer

Carotid canal

Answer

Foramen ovale and spinosum

Radiological Anatomy — MCQs

Radiological Anatomy — MCQs

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