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RANZCR Anatomy study materials
RANZCR Anatomy study resources

RANZCR Anatomy practice questions

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Question 1Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which nerve passes through the foramen ovale of the sphenoid bone?

  1. Ophthalmic division of the trigeminal nerve
  2. Mandibular division of the trigeminal nerve Correct answer.
  3. Maxillary division of the trigeminal nerve
  4. Facial nerve

Explanation

The foramen ovale transmits the mandibular division of the trigeminal nerve (V3) together with the accessory meningeal artery and the lesser petrosal nerve. The maxillary division passes through the foramen rotundum and the ophthalmic division through the superior orbital fissure. The facial nerve exits the skull through the stylomastoid foramen.

Question 2Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On a chest radiograph, the right hemidiaphragm is normally positioned at which level during full inspiration?

  1. At the same level as the left hemidiaphragm
  2. About one intercostal space higher than the left Correct answer.
  3. About two intercostal spaces higher than the left
  4. About one intercostal space lower than the left

Explanation

The right hemidiaphragm is normally about one intercostal space (roughly 1.5 to 2 cm) higher than the left because the liver elevates the right side and the heart and stomach displace the left. Marked elevation or reversal of this relationship suggests pathology such as phrenic palsy or subphrenic collection.

Question 3Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

The artery of Adamkiewicz most commonly arises from which segmental level?

  1. T4 to T6 on the right
  2. L4 to L5 on the left
  3. C6 to C7 bilaterally
  4. T8 to L1 on the left Correct answer.

Explanation

The great anterior radiculomedullary artery usually arises from a left-sided intercostal or lumbar artery between approximately T8 and L1, most often around T9 to T12. Its location is critical because occlusion during aortic surgery can cause anterior spinal cord infarction.

Question 4Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which structure forms the medial wall of the middle ear cavity?

  1. Promontory of the cochlea Correct answer.
  2. Tympanic membrane
  3. Mastoid antrum
  4. Tegmen tympani

Explanation

The medial wall of the middle ear is the labyrinthine wall, whose most prominent feature is the promontory formed by the basal turn of the cochlea. The tympanic membrane forms the lateral wall and the tegmen tympani forms the roof.

Question 5Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a lesion at the cerebellopontine angle. Which cranial nerve is most frequently affected first by a vestibular schwannoma?

  1. Vestibulocochlear nerve Correct answer.
  2. Facial nerve
  3. Trigeminal nerve
  4. Glossopharyngeal nerve

Explanation

Vestibular schwannomas arise from the vestibular portion of the eighth cranial nerve, so sensorineural hearing loss and tinnitus are the earliest symptoms. Larger tumours may then compress the trigeminal and facial nerves as they traverse the cerebellopontine angle.

Question 6Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the course of the ureter in relation to the iliac vessels?

  1. It passes posterior to the internal iliac vein within the true pelvis
  2. It crosses anterior to the external iliac artery at the pelvic brim
  3. It crosses the gonadal vessels anteriorly in the lower abdomen
  4. It crosses anterior to the common iliac artery bifurcation near the sacroiliac joint Correct answer.

Explanation

The abdominal ureter descends on the psoas muscle and crosses anterior to the bifurcation of the common iliac artery near the sacroiliac joint to enter the pelvis. This landmark is used when tracing the ureter on CT.

Question 7Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which coronary artery supplies the atrioventricular node in the majority of people?

  1. Right coronary artery Correct answer.
  2. Left circumflex artery
  3. Left anterior descending artery
  4. Left main coronary artery

Explanation

In most individuals the atrioventricular node is supplied by a branch of the right coronary artery, which also supplies the sinoatrial node in roughly 60 percent of people. The left circumflex may supply the AV node in a minority, particularly in left-dominant circulations.

Question 8Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On an abdominal CT, the portal vein is formed by the union of which two veins?

  1. Left and right gastric veins
  2. Hepatic veins and inferior vena cava
  3. Inferior mesenteric vein and splenic vein
  4. Splenic vein and superior mesenteric vein Correct answer.

Explanation

The portal vein forms behind the neck of the pancreas from the confluence of the superior mesenteric vein and the splenic vein. The inferior mesenteric vein usually drains into the splenic vein rather than directly into the portal vein.

Question 9Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which muscle forms the anterior wall of the axilla?

  1. Serratus anterior
  2. Pectoralis major Correct answer.
  3. Teres major
  4. Subscapularis

Explanation

The anterior wall of the axilla is formed by the pectoralis major and minor with the clavipectoral fascia. The posterior wall comprises the subscapularis, teres major and latissimus dorsi, while the medial wall is the serratus anterior over the rib cage.

Question 10Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following structures lies within the cavernous sinus?

  1. Internal carotid artery and abducens nerve Correct answer.
  2. Hypoglossal nerve and vertebral artery
  3. Optic nerve and ophthalmic artery
  4. Facial nerve and vestibulocochlear nerve

Explanation

The cavernous sinus contains the internal carotid artery and the abducens nerve, with the oculomotor, trochlear and ophthalmic divisions of the trigeminal nerve embedded in its lateral wall. The abducens nerve is unique among the ocular motor nerves in lying freely within the sinus.

Question 11Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the normal position of the thyroid gland relative to the trachea?

  1. Posterior to the oesophagus within the mediastinum
  2. Anterior and lateral to the trachea below the larynx Correct answer.
  3. Anterior to the hyoid bone in the submental region
  4. Lateral to the carotid sheath within the parapharyngeal space

Explanation

The thyroid gland lies anterior and lateral to the trachea in the lower neck, below the larynx, with its isthmus crossing in front of the second to fourth tracheal rings. The carotid sheath lies posterolateral to each lobe.

Question 12Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following structures is the primary site of CSF absorption?

  1. Perivascular spaces
  2. Ependymal lining
  3. Choroid plexus
  4. Arachnoid granulations Correct answer.

Explanation

Cerebrospinal fluid is produced mainly by the choroid plexus and is absorbed into the dural venous sinuses through arachnoid granulations. These granulations project into the superior sagittal sinus and other venous channels.

Question 13Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient presents with a scaphoid fracture. Which vascular feature predisposes the proximal pole to avascular necrosis?

  1. The scaphoid has a single end-artery from the ulnar artery
  2. Blood supply enters mainly at the proximal pole
  3. The scaphoid is supplied only by the anterior interosseous artery
  4. Blood supply enters mainly at the distal pole and dorsal ridge Correct answer.

Explanation

The scaphoid receives most of its blood supply from branches of the radial artery entering the dorsal ridge and distal pole, with retrograde flow toward the proximal pole. A fracture through the waist can therefore interrupt supply to the proximal fragment and cause avascular necrosis.

Question 14Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical relationship of the left renal vein?

  1. It passes posterior to the aorta and anterior to the superior mesenteric artery
  2. It passes anterior to the aorta and posterior to the superior mesenteric artery Correct answer.
  3. It crosses anterior to the inferior vena cava
  4. It drains directly into the left gonadal vein

Explanation

The left renal vein is longer than the right and crosses anterior to the aorta but posterior to the superior mesenteric artery, where it may be compressed in nutcracker syndrome. It drains into the inferior vena cava and receives the left gonadal, adrenal and lumbar veins.

Question 15Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which structure separates the parotid gland from the submandibular gland?

  1. Buccinator muscle
  2. Masseter muscle
  3. Stylohyoid ligament
  4. Mandible Correct answer.

Explanation

The body of the mandible lies between the parotid gland, which occupies the retromandibular region, and the submandibular gland, which lies in the submandibular triangle medial to the mandible. The stylohyoid ligament and masseter are related but do not separate these glands.

Question 16Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical basis for the submental lymph node group?

  1. Nodes lying between the anterior bellies of the digastric muscles Correct answer.
  2. Nodes lying within the carotid sheath
  3. Nodes lying in the supraclavicular fossa
  4. Nodes lying along the posterior border of the sternocleidomastoid

Explanation

The submental nodes lie in the submental triangle between the anterior bellies of the digastric muscles and above the hyoid bone. They drain the chin, lower lip and floor of the mouth and are classified as level IA nodes.

Question 17Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best explains why the appendix is variable in position?

  1. It is retroperitoneal and fixed to the iliac fossa
  2. It is attached to the caecum at a fixed pelvic position
  3. It is suspended by the falciform ligament
  4. It has a mesoappendix that permits mobility of the tip Correct answer.

Explanation

The appendix has a mesoappendix that allows the tip to occupy pelvic, retrocaecal, subcaecal or paracaecal positions. This variability explains the range of clinical presentations of appendicitis and the difficulty of locating it at surgery.

Question 18Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following structures is most directly at risk during a transjugular liver biopsy via the hepatic vein?

  1. Inferior vena cava wall Correct answer.
  2. Bile duct
  3. Right renal artery
  4. Right portal vein branch

Explanation

The transjugular route passes a needle through the hepatic vein into liver parenchyma, and the main structural risk is inadvertent puncture of the inferior vena cava or liver capsule. The portal triad structures are smaller and less directly traversed by the biopsy needle.

Question 19Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On an MRI of the knee, which structure is best seen on a sagittal fluid-sensitive sequence as a low-signal band within the anterior intercondylar region?

  1. Posterior cruciate ligament
  2. Patellar tendon
  3. Medial collateral ligament
  4. Anterior cruciate ligament Correct answer.

Explanation

The anterior cruciate ligament runs obliquely from the anterior tibial intercondylar area to the medial aspect of the lateral femoral condyle and appears as a low-signal band on sagittal fluid-sensitive images. The posterior cruciate ligament lies more posteriorly and is larger and more vertically oriented.

Question 20Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical course of the recurrent laryngeal nerve on the right side?

  1. It passes directly to the larynx without looping
  2. It loops around the right common carotid artery
  3. It loops around the right subclavian artery Correct answer.
  4. It loops around the aortic arch

Explanation

The right recurrent laryngeal nerve branches from the vagus and hooks around the right subclavian artery before ascending to the larynx. The left recurrent laryngeal nerve loops around the aortic arch lateral to the ligamentum arteriosum.

Question 21Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best explains the imaging appearance of the falx cerebri on CT?

  1. It is not normally visible on unenhanced CT
  2. It appears as a midline hyperdense line because it is a dural reflection Correct answer.
  3. It appears as a ring-enhancing structure around the ventricles
  4. It appears as a midline hypodense line because it contains CSF

Explanation

The falx cerebri is a dural reflection and appears as a thin midline hyperdense line on unenhanced CT, often calcified in older adults. It does not contain CSF and is not a ring-enhancing structure.

Question 22Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the arterial supply of the stomach?

  1. Direct branches from the aorta
  2. Superior mesenteric artery branches only
  3. Coeliac trunk branches including left gastric, splenic and common hepatic arteries Correct answer.
  4. Inferior mesenteric artery branches only

Explanation

The stomach receives a rich arterial arcade from branches of the coeliac trunk: the left gastric artery, splenic artery branches including the short gastric and left gastro-omental arteries, and the common hepatic artery via the right gastric and right gastro-omental arteries. This collateral supply is why gastric ischaemia is uncommon.

Question 23Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a lesion compressing the lateral aspect of the third part of the duodenum. Which structure is most likely to be compressed?

  1. Superior mesenteric artery Correct answer.
  2. Common bile duct
  3. Inferior vena cava
  4. Right renal artery

Explanation

The third part of the duodenum crosses anterior to the aorta and inferior vena cava but posterior to the superior mesenteric artery and vein. Compression between the SMA and aorta causes superior mesenteric artery syndrome.

Question 24Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the location of the cisterna magna?

  1. Within the lateral ventricle
  2. Between the cerebellum and the occipital bone, posterior to the medulla Correct answer.
  3. Between the cerebral hemispheres above the corpus callosum
  4. Between the pons and the clivus

Explanation

The cisterna magna lies in the posterior cranial fossa between the cerebellum and the occipital bone, communicating with the fourth ventricle via the median aperture and with the spinal subarachnoid space. It is a common site for CSF sampling and for assessment of subarachnoid haemorrhage.

Question 25Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best explains the normal appearance of the psoas muscle on an abdominal radiograph?

  1. It is not normally visible on plain radiography
  2. It produces a soft-tissue shadow with its lateral margin visible Correct answer.
  3. It produces a gas-filled lucency on the right
  4. It produces a calcified line along the spine

Explanation

The psoas muscles form soft-tissue shadows whose lateral margins may be visible on a well-penetrated abdominal radiograph, extending inferolaterally from the lumbar spine. Obliteration of the psoas margin suggests retroperitoneal pathology such as haematoma or abscess.

Question 26Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical course of the thoracic duct at the level of the aortic arch?

  1. It lies within the pericardial sac, anterior to the ascending aorta.
  2. It lies anterior to the aortic arch, crossing the left vagus nerve.
  3. It lies posterior to the aortic arch, between the aorta and the vertebral column. Correct answer.
  4. It lies lateral to the aortic arch, within the left pleural cavity.

Explanation

The thoracic duct ascends through the posterior mediastinum, passing behind the aortic arch and between the descending aorta and the vertebral column. It then continues superiorly to reach the left venous angle. Knowledge of this relationship is important when interpreting posterior mediastinal masses or planning thoracic surgery.

Question 27Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On a chest radiograph, which of the following best explains why the right hemidiaphragm is normally higher than the left?

  1. The right hemidiaphragm has a stronger muscular contraction.
  2. The right lung has a larger volume than the left lung.
  3. The liver occupies the right upper quadrant and elevates the right hemidiaphragm. Correct answer.
  4. The left hemidiaphragm is depressed by the stomach bubble.

Explanation

The right hemidiaphragm is typically about 1.5 to 2 cm higher than the left because the liver lies beneath it, occupying the right upper quadrant. The left hemidiaphragm is lower due to the presence of the stomach and spleen. This asymmetry is a normal finding on chest radiographs.

Question 28Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical relationship of the middle meningeal artery to the skull?

  1. It runs between the periosteal and meningeal layers of the dura mater. Correct answer.
  2. It runs within the falx cerebri.
  3. It runs within the pia mater.
  4. It runs within the subarachnoid space along the cerebral cortex.

Explanation

The middle meningeal artery is a branch of the maxillary artery and enters the skull through the foramen spinosum. It courses between the periosteal and meningeal layers of the dura mater, grooving the inner table of the skull. This location predisposes it to injury in temporal bone fractures, causing epidural haematoma.

Question 29Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a fracture through the surgical neck of the humerus. Which nerve is most at risk of injury?

  1. Radial nerve
  2. Median nerve
  3. Ulnar nerve
  4. Axillary nerve Correct answer.

Explanation

The axillary nerve winds around the surgical neck of the humerus, accompanied by the posterior circumflex humeral artery. Fractures at this site can injure the nerve, leading to deltoid weakness and sensory loss over the lateral shoulder. The radial nerve is at risk with midshaft humeral fractures, not surgical neck fractures.

Question 30Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical basis for the appearance of the gastric fundus on an erect abdominal radiograph?

  1. The fundus is obscured by the liver.
  2. The fundus contains a gas bubble because it is the highest part of the stomach. Correct answer.
  3. The fundus is always fluid-filled and appears as a soft-tissue density.
  4. The fundus is located in the right upper quadrant.

Explanation

On an erect radiograph, gas rises to the highest part of the stomach, which is the fundus. This creates the gastric air bubble, typically seen under the left hemidiaphragm. The amount of gas varies with posture and recent food intake.

Question 31Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical location of the cisterna chyli?

  1. Posterior to the right kidney.
  2. Within the left supraclavicular fossa.
  3. Within the lesser sac of the peritoneum.
  4. Anterior to the lower thoracic vertebral bodies, at the level of T12–L1. Correct answer.

Explanation

The cisterna chyli is a dilated sac at the lower end of the thoracic duct, located anterior to the lower thoracic and upper lumbar vertebral bodies, typically at T12–L1. It receives lymph from the lumbar and intestinal trunks. It lies retroperitoneally, to the right of the aorta.

Question 32Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a lesion compressing the lateral aspect of the third part of the duodenum. Which structure is most likely to be affected?

  1. Common bile duct
  2. Superior mesenteric artery
  3. Right gonadal vein Correct answer.
  4. Inferior vena cava

Explanation

The third part of the duodenum crosses anterior to the inferior vena cava and the right gonadal vein. A lesion at its lateral aspect can compress the right gonadal vein, which ascends to drain into the inferior vena cava. This relationship is important in assessing retroperitoneal masses.

Question 33Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On an MRI of the knee, which structure is best seen on a sagittal fluid-sensitive sequence as a low-signal band within the high-signal cartilage?

  1. Meniscofemoral ligament
  2. Anterior cruciate ligament
  3. Transverse ligament
  4. Medial meniscus Correct answer.

Explanation

The menisci appear as low-signal triangular structures on fluid-sensitive sequences, contrasting with the high-signal articular cartilage. The medial meniscus is best evaluated on sagittal images. Its low signal is due to fibrocartilage.

Question 34Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which of the following best describes the anatomical course of the ureter in relation to the iliac vessels?

  1. It passes through the inguinal canal.
  2. It crosses anterior to the common iliac artery at the pelvic brim. Correct answer.
  3. It passes anterior to the external iliac artery.
  4. It crosses posterior to the common iliac vein.

Explanation

The ureter descends retroperitoneally and crosses anterior to the common iliac artery at the pelvic brim, near the bifurcation. It then continues into the pelvis to reach the bladder. This relationship is a key landmark in abdominal and pelvic imaging.

Question 35Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which cranial nerve passes through the internal acoustic meatus together with the facial nerve?

  1. Optic nerve
  2. Vestibulocochlear nerve Correct answer.
  3. Glossopharyngeal nerve
  4. Hypoglossal nerve

Explanation

The internal acoustic meatus transmits the facial nerve (CN VII) and the vestibulocochlear nerve (CN VIII) along with the labyrinthine artery. These two nerves travel together from the posterior cranial fossa into the petrous temporal bone.

Question 36Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which vertebral level typically marks the termination of the spinal cord as the conus medullaris in adults?

  1. T12
  2. L1-L2 Correct answer.
  3. S1
  4. C7

Explanation

In adults the spinal cord normally ends as the conus medullaris at approximately the L1-L2 disc level. Below this the dural sac contains the cauda equina, which is why lumbar puncture is performed at L3-L4 or below.

Question 37Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which vessel is the first branch of the aortic arch encountered by blood leaving the left ventricle?

  1. Brachiocephalic trunk Correct answer.
  2. Left subclavian artery
  3. Left common carotid artery
  4. Right subclavian artery

Explanation

The brachiocephalic trunk is the first and largest branch arising from the aortic arch, dividing into the right subclavian and right common carotid arteries. The left common carotid and left subclavian arteries arise sequentially further along the arch.

Question 38Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which lobe of the brain lies immediately superior to the tentorium cerebelli?

  1. Frontal lobe
  2. Temporal lobe
  3. Parietal lobe
  4. Occipital lobe Correct answer.

Explanation

The tentorium cerebelli separates the occipital lobe above from the cerebellum below. The temporal lobe rests on the tentorial surface laterally, so the occipital lobe is the structure directly superior to the tentorial apex region.

Question 39Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Through which foramen does the maxillary division of the trigeminal nerve leave the middle cranial fossa?

  1. Foramen rotundum Correct answer.
  2. Superior orbital fissure
  3. Foramen spinosum
  4. Foramen ovale

Explanation

The maxillary nerve (V2) exits through the foramen rotundum in the greater wing of the sphenoid to reach the pterygopalatine fossa. The mandibular division leaves through the foramen ovale, and the ophthalmic division through the superior orbital fissure.

Question 40Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which structure forms the medial boundary of the femoral triangle?

  1. Iliopsoas
  2. Inguinal ligament
  3. Sartorius
  4. Adductor longus Correct answer.

Explanation

The femoral triangle is bounded by the inguinal ligament superiorly, the sartorius laterally and the adductor longus medially. Its floor is formed by iliopsoas and pectineus, with the femoral vessels and nerve lying within it.

Question 41Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which rib articulates with the sternal angle (angle of Louis)?

  1. First rib
  2. Fourth rib
  3. Second rib Correct answer.
  4. Third rib

Explanation

The sternal angle marks the joint between the manubrium and the body of the sternum, and the second costal cartilage articulates at this level. This landmark also approximates the level of the carina and the T4-T5 disc.

Question 42Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a laceration in the anatomical snuffbox with brisk bleeding. Which artery is most likely injured?

  1. Anterior interosseous artery
  2. Radial artery Correct answer.
  3. Brachial artery
  4. Ulnar artery

Explanation

The radial artery passes over the scaphoid and trapezium in the floor of the anatomical snuffbox, where it is vulnerable to injury. Its superficial palmar branch and dorsal carpal branches arise in this region.

Question 43Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient develops foot drop after a fibular neck fracture. Which nerve is injured?

  1. Common fibular nerve Correct answer.
  2. Tibial nerve
  3. Sural nerve
  4. Obturator nerve

Explanation

The common fibular (peroneal) nerve winds around the neck of the fibula superficially, making it vulnerable to direct trauma. Injury causes loss of dorsiflexion and eversion, producing a foot drop.

Question 44Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a lesion at the level of the carotid bifurcation compressing the structure lying between the internal and external carotid arteries. Which structure is most likely affected?

  1. Hypoglossal nerve
  2. Vagus nerve
  3. Glossopharyngeal nerve Correct answer.
  4. Accessory nerve

Explanation

The carotid body and the glossopharyngeal nerve (with its sinus nerve) lie in the crotch between the internal and external carotid arteries. Compression or tumour here can affect baroreceptor and chemoreceptor function mediated by CN IX.

Question 45Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On an abdominal CT, a mass is seen arising from the region of the adrenal gland on the left. Which structure lies immediately anterior to the left adrenal gland?

  1. Right crus of the diaphragm
  2. Inferior vena cava
  3. Aorta
  4. Body of the pancreas Correct answer.

Explanation

The left adrenal gland lies anteromedial to the upper pole of the left kidney, with the body and tail of the pancreas lying anterior to it. The left crus of the diaphragm lies medial and posterior, and the aorta lies medial.

Question 46Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a pulmonary embolism in a branch of the left pulmonary artery. Which structure does that artery cross anteriorly before entering the hilum?

  1. Left atrium
  2. Left main bronchus Correct answer.
  3. Oesophagus
  4. Descending aorta

Explanation

The left pulmonary artery arches over the left main bronchus, crossing it anteriorly and superiorly to reach the hilum. This relationship distinguishes it from the right pulmonary artery, which lies anterior to the right main bronchus.

Question 47Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a deep laceration of the palm with loss of opposition of the thumb and loss of sensation over the thenar eminence. Which nerve is injured?

  1. Median nerve Correct answer.
  2. Anterior interosseous nerve
  3. Radial nerve
  4. Ulnar nerve

Explanation

The recurrent branch of the median nerve supplies the thenar muscles including opponens pollicis, and the palmar cutaneous branch supplies the thenar skin. The ulnar nerve supplies most intrinsic hand muscles but spares the thenar compartment.

Question 48Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

Which structure lies in the porta hepatis posterior to the portal vein?

  1. Common bile duct
  2. Epipioic foramen Correct answer.
  3. Ligamentum teres
  4. Hepatic artery

Explanation

The epiploic foramen (of Winslow) lies posterior to the free edge of the lesser omentum, which contains the portal triad. Its boundaries include the portal vein anteriorly and the inferior vena cava posteriorly.

Question 49Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

On a chest radiograph, the azygos vein is seen forming the azygos arch. At which level does it arch over the right main bronchus?

  1. T2
  2. T10
  3. T8
  4. T4 Correct answer.

Explanation

The azygos vein arches forward over the right main bronchus at approximately the T4 level before draining into the superior vena cava. This corresponds to the level of the sternal angle and the carina.

Question 50Clinical Radiology Examination Phase 1 (Anatomy and applied imaging fundamentals)

A patient has a pituitary macroadenoma extending laterally into the cavernous sinus. Which structure is most likely compressed first to cause diplopia?

  1. Olfactory tract
  2. Abducens nerve Correct answer.
  3. Facial nerve
  4. Optic nerve

Explanation

The abducens nerve runs freely within the cavernous sinus lateral to the internal carotid artery, making it the most medial and most vulnerable of the ocular motor nerves there. It is typically affected first by cavernous sinus pathology, causing lateral rectus palsy.