Final

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(a) A high kV radiograph optimizes the detection of calcification.

(a) False - a low KV radiograph.

(a) The hemiazygos vein at the level of the fourth thoracic vertebra crosses the vertebral column behind the aorta, oesophagus and thoracic duct.

(a) False - at the level of T8.

(a) The inferior sagittal sinus is usually identified at catheter angiography.

(a) False - it lies in the free margin of the falx cerebri, seen only rarely in adult angiography but more commonly in children.

(a) In a B-mode study, the wall of the normal carotid artery produces two parallel echopoor layers with a hyperechoic strip between them.

(a) False - it produces two parallel echoes, which represent the intima and adventitia with the intervening echopoor layer of the media.

(a) The mucosa of the pylorus appears echopoor.

(a) False - mucosa is echobright and muscle is echopoor.

(a) The anteroposterior view of the plain radiograph is taken with the legs rotated externally.

(a) False - rotated internally to compensate for the anteversion of the femoral neck.

(a) In adults the right main-stem bronchus is steeper than the left.

(a) True

(a) The anterior junctional line is usually straight and extends to the right ventricle.

(a) True

(a) The cystic artery to the gall bladder usually arises from the right hepatic artery.

(a) True

6. Concerning the suprarenal glands: (b) They lose 80% of their weight in the first 2 to 3 weeks after birth.

(b) False - 80% of the adrenal gland is fetal cortex and this undergoes haemorrhagic necrosis after birth causing loss of 30% of weight in the first few weeks.

(b) They communicate with the transverse sinuses via the inferior petrosal sinus on each side.

(b) False - via the superior petrosal sinus on each side.

(b) The blind ending hind gut is closed by the cloacal membrane.

(b) True

(b) The normal choroid plexus and the pituitary gland enhance on post- contrast CT images.

(b) True - other structures to enhance are the cranial arteries, veins, dural venous sinuses and the infundibulum.

(c) False - enters the middle cranial fossa through the foramen spinosum. The anterior division is prone to damage in fractures of the skull, giving rise to an extradural haematoma.

(d) Congenital absence of one kidney occurs in about one in 100 births.

(d) False - 1 in 2400 births

(d) The gastroduodenal artery is anterior to the head of the pancreas.

(d) False - GDA is anterior to the neck of the pancreas.

(d) The third part of the duodenum lies posteriorly to the transverse colon.

(d) False - it is the second part of the duodenum

(d) The blood flow in the arterial tree is usually unidirectional.

(d) False - numerous anastomoses allow multi-directional flow.

(d) The claustrum is a thin sheet of white matter between the putamen and insula.

(d) False - the claustrum is a thin sheet of grey matter

(d) The lymphatic drainage of the anal canal is to the internal iliac nodes.

(d) False - the lymph from the upper half of the anal canal drains into the inferior mesenteric nodes. The lower half drains into the superficial inguinal nodes.

(d) The duodenal lymphatic drainage is primarily to the coeliac nodes.

(d) False - the proximal duodenum is drained via pancreatico-duodenal nodes to the gastroduodenal nodes and to the coeliac nodes. The distal duodenum drains to the pancreatico-duodenal nodes which drain into the superior mesenteric nodes.

(d) The posterior part of the floor of the anterior cranial fossa is formed by the lesser wing of sphenoid.

(d) True - the posterior border of the lesser wing is the sphenoid ridge, meningiomas of skull base arise in this location.

(d) The accessory hemiazygos vein may drain into the left brachiocephalic vein

(d) True-through the left superior intercostal vein. It may join the hemiazygos and/or drain into the azygos vein at the level of T7

(e) On ultrasound of the hips, the beta angle assesses the anteversion of the neck of the femur.

(e) False - assesses the prominence of the labrum. Dysplastic hips have low alpha angles and high beta angles.

(e) The tympanic portion of the temporal bone is a border of the internal auditory cana

(e) False - it forms part of the external auditory canal.

(e) The coronoid process of the mandible can be felt in front of the tragus.

(e) False - the condyloid process lies in front of the tragus and moves forwards and downwards if the mouth is opened. The coronoid process can be identified by placing a finger in the angle between the zygomatic arch and the masseter muscle.

(e) The membranous labyrinth is of high signal intensity on T1-weighted MRI.

(e) False - this contains fluid therefore has high signal intensity on T2-weighted MRI. The saccule and utricle situated anteriorly and posteriorly within the vestibule cannot be resolved separately by MRI.

(e) The bronchopulmonary segments are based on the pulmonary arterial system.

(e) False based on the divisions of the bronchi

(e) The Eustachian valve directs blood flow from the IVC into the right atrium in the adult.

(e) False the Eustachian valve in fetal life serves to direct oxygenated blood from IVC into the foramen ovale. It is rudimentary in adult life.

(e) The inferior pulmonary ligaments are pleural reflections from the pericardium

(e) False they are pleural reflections that hang down from the hila and from the mediastinal surface of each lower lobe to the mediastinum and to the medial part of the diaphragm.

(e) The hiatus for the IVC is posterior to that of the aorta and oesophagus.

(e) False- the most anterior of the three diaphragmatic hiati is the the hiatus for the IVC, which is in the central tendon immediately beneath the right atrium.

(e) The veins of the upper lobe are posterior to the arteries and bronchi

(e) False- the veins of the upper lobe are anterior to the arteries and bronchi.

(e) CT pulmonary angiography (CTPA) is performed using catheters placed in a femoral vein.

(e) False-CTPA is performed to diagnose major pulmonary emboli using a cannula placed in any peripheral vein and is relatively non-invasive compared to conventional pulmonary angiography.

(e) The left pulmonary artery passes anterior to the left main bronchus.

(e) False-it arches over the left main bronchus and left upper lobe bronchus to descend postero-lateral to the left lower lobe bronchus.

(e) The posterior intercostal vein drains into the internal thoracic vein.

(e) False-posterior intercostal veins drain into the brachiocephalic vein and azygos system. The anterior veins drain into the musculo-phrenic and internal thoracic veins

26. The superior vena cava: partly (e has direct drainage from the internal mammary veins.

(e) False-the internal mammary veins drain into the corresponding brachiocephalic veins.

(e) The minor fissure separates the right middle lobe from the right lower lobe.

(e) False-the minor fissure separates the anterior segment of the right upper lobe from the right middle lobe.

(e) The sinuses of valsalva are below the valve in the aortic root.

(e) False-the sinuses of valsalva are just above the aortic valve in the aortic root. They are three focal dilatations. The left coronary artery arises from the left posterior sinus, and the right coronary artery arises from the anterior sinus. The right posterior sinus is the non-coronary sinus.

(e) The interlobular septa are seen usually on conventional CT.

(e) False-they can just be appreciated on HRCT

(e) The left posterior ventricular vein accompanies the posterior descending artery

(e) False-this vein accompanies the obtuse marginal branches of the left coronary artery

(e) Each half of the vertebral arch of the sacrum appears at 16-20 weeks of fetal life.

(e) True

(e) On a PA projection, the left superior intercostal vein may project lateral to the aortic arch as a small nipple.

(e) True

(e) The cavum vergae extends anterior to the foramen of Monro above the fornix.

(e) True

(e) The right renal artery is posterior to the IVC.

(e) True

(e) The third part is superficial and may be used for arterial puncture

(e) True

(e) The main arterial supply to the lumbar enlargement is through the artery of Adamkiewicz.

(e) True - also known as the arteria radicularis magna, this artery usually arises between T9 and L1 segments, from the tenth or eleventh thoracic radicular arteries. However, its origin is inconstant and paraplegia may result as a complication of aortography due to varying amounts of contrast medium being directed towards the spinal arteries via the lumbar arteries, particularly in aortic stenosis.

(e) The commonest supernumerary bone of the wrist joint is the os radiale.

(e) True - lies immediately distal to the radial styloid.

(e) the sacrotuberous ligament defines the posterior limit of the lesser sciatic foramen.

(e) True - runs from the ischial tuberosity to the side of the sacrum and coccyx and to the posterior inferior iliac spine.

(a) The superior gluteal artery is a branch of the external iliac artery.

(e) True - runs up on the deep surface of the anterior abdominal wall and enters the rectus sheath.

(e) The left epiploic artery is a branch of the left gastro-epiploic artery.

(e) True - the left epiploic artery, a branch of the left gastro-epiploic is located in the posterior layers of the greater omentum below the transverse colon. It anastomoses with the right epiploic to form the arcus epiploicus magnus of Barkow.

(e) Arthrography is usually performed in only the inferior compartment

(e) True - this is done for joint function, to diagnose joint perforation and anterior dislocation. More recently, MRI is the technique of choice.

e) left SVC results from a persistent left cardinal vein.

(e) True -in 0.3 % to 0.5 % of healthy population and in 4.4% to 12.9 % of those with congenital heart disease. It usually drains into the coronary sinus, which then communicates with the right atrium

(e) The right paratracheal stripe extends down as far as the right tracheobronchial angle.

(e) True-air containing trachea and lung are separated by a thin layer of fat on the right, giving rise to the 'stripe. This is broadened at the right tracheobronchial angle by the azygous vein which lies between the airway and the lung.

(e) The foramen ovale is due to two overlapping defects, which act like a valve

(e) True-the septum secundum grows to the right of septum primum, is never complete and has a lower free edge. It extends low enough to overlap the foramen secundum and closes it. Ten per cent of individuals have anatomically patent but functionally sealed foramen.

(e) The intercostal stripe is seen on axial CT as a linear opacity of soft tissue density at the intercostal space.

(e) True-two layers of pleura, extrapleural fat, innermost intercostal muscle and endothoracic fascia.

(a) A separation of up to 5 mm in the alignment of the lateral borders of the lateral masses of the atlas and axis vertebra in adults is acceptable.

(a) False - 2 mm in adults: 3 mm in children.

(a) High resolution computerised tomography (HRCT) is the examination of choice for the contents of the internal auditory meatus.

(a) False - MRI is the examination of choice for the contents of the internal auditory meatus and the cerebellopontine angles cistern.

(a) at birth are the same size as the kidney

(a) False - at birth they are about one-third the size of the kidney and atrophy until the second year of life after which slow growth occurs until pubery to reach adult size - about one-thirtieth the size of the kidney.

(a) The cisterna magna lies between the pons and the postero-inferior surface of the cerebellum.

(a) False - between the medulla and the postero-inferior surface of the cerebellum.

(a) The quadrigeminal cistern is echopoor in the neonate.

(a) False - contrary to expectations, this CSF-filled space is echobright and the reasons are not fully understood.

(a) The neural tube expands to form the three primary vesicles during the twelfth week of intrauterine development.

(a) False - during the fourth week of intrauterine development.

(a) In most cases two views are enough to exclude scaphoid fractures.

(a) False - four views are necessary, as fractures are easily missed - antero- posterior, 30° antero-posterior, lateral and scaphoid centred view.

(a) It extends from the base of the tongue to the level of C6.

(a) False - from the base of the skull to the lower border of the cricoid cartilage at the level of C6, where it becomes continuous with the oesophagus.

(a) The internuclear cleft develops during fetal life to differentiate into the central nucleus pulposus and the peripheral annulus fibrosus.

(a) False - in the second or third decade an internuclear cleft develops, which represents compacted collagenous fibres oriented transversely, due to invagination of the inner annular lamellae.

(a) It is closed superiorly where it is related to the lower part of the fourth ventricle.

(a) False - it is closed inferiorly around the central canal continuous with that of the spinal cord and open superiorly with the lower part of the fourth ventricle.

(a) On T2-W MRI the junctional zone is a low signal intensity band in the submucosa.

(a) False - no submucosa exists between the endometrium and myometrium. The junctional zone represents the inner myometrium.

(a) The vertebra are visible as two ossification centres in the body and one in each lamina.

(a) False - one ossification centre in each lamina and one in the body. On ultrasound these are seen as a triangle with the base posterior, in an axial view of the abdomen.

(a) The femoral artery is punctured at its point of minimal pulsation, to prevent haematoma formation.

(a) False - point of maximal pulsation usually as it passes over the medial third of the femoral head.

(a) The splenic artery is intraperitoneal during most of its course.

(a) False - retroperitoneal most of its course and enters the lienorenal ligament before entering the spleen.

(a) The nasion overlies the suture between the frontal and ethmoid bones.

(a) False - the nasion overlies the suture between the frontal and nasal bones.

(a) The caudate lobe of the liver lies in the greater sac.

(a) False - the omental reflections divide the caudate from the quadrate lobe. The caudate lobe lies in the lesser sac and the quadrate lobe lies within the greater sac. Mnemonic CLOG

(a) The anterior wall of the internal auditory canal is shorter than the posterior.

(a) False - the opposite is true

(a) The dorsum sellae is the anterior boundary of the pituitary fossa.

(a) False - this forms the posterior boundary.

(a) The umbilical artery anastomoses with the inferior epigastric artery in the adult.

(a) False - this is the first branch of the internal iliac artery in the fetus which persists as the medial umbilical ligament. This may be recognized in the presence of pneumoperitoneum.

(a) The frontal sinuses are present at birth.

(a) False - traces of sphenoid and maxillary sinus are present in the neonate. All other sinuses become evident at about 7 or 8 years.

(a) The right subclavian artery arises directly from the arch of the aorta.

(a) False - usually from the brachiocephalic trunk which divides into the right subclavian and right common carotid arteries. The left subclavian arises directly from the arch of the aorta.

a) The pulmonary valve is anterior and to the right of the aortic root.

(a) False anterior and to the left of the aortic root.

(a) The anterior cardiac veins empty into the coronary sinus.

(a) False the anterior cardiac veins drain the anterior surface of the right ventricle and open directly into the right atrium. The venae cordis minimae are minute vessels in the myocardium which also drain into the chambers, mainly the atria.

(a) The left atrial auricular appendage contributes to the normal left cardiac border.

(a) False the left atrium does not contribute to the normal cardiac outline.

26. The superior vena cava: (a) lies posterior to the right main-stem bronchus.

(a) False-SVC is anterior to the right main bronchus.

(a) The pretracheal space is bounded anteriorly by the anterior junctional line.

(a) False-anteriorly the SVC or right brachiocephalic veins, ascending aorta with its enveloping superior pericardial sinus and posteriorly the trachea or carina.

(a) The left bronchial artery arises from the right bronchial artery.

(a) False-bronchial arteries are variable. Usually the right bronchial artery arises from the third posterior intercostal artery or from the upper left bronchial artery The left bronchial arteries are two in number and arise from the thoracic aorta.

(a) Air in the oesophagus on axial CT usually indicates a dilated abnormal oesophagus.

(a) False-in 80 % of normal individuals the oesophagus contains a small amount of air.

(a) Complete fissures may be crossed by small bronchovascular structures seen on HRCT

(a) False-incomplete fissures have parenchymal fusion and small bronchovascular structures.

(a) The posterior intercostal arteries supply the 11 intercostal spaces

(a) False-there are usually nine pairs of posterior arteries from the postero-lateral margin of the thoracic aorta distributed to the lower nine intercostal spaces. The first and second spaces are supplied by the superiorintercostal artery branches of the costocervical trunk from the subclavian artery

fa) Most of the external surface of the left ventricle is anterolateral.

(a) False-though the left ventricle forms most of the left heart border on the frontal radiograph, most of its external portion is postero-lateral.

(a) The aortic root and pulmonary trunk are covered with parietal pericardium.

(a) True

(a) The azygos vein at the level of the fourth thoracic vertebra arches over the root of the right lung to end in the superior vena cava (SVC)

(a) True

(a) The bronchovascular bundle of the secondary pulmonary lobule is demonstrated as a rounded density about 1 cm away from the pleural border on axial CT

(a) True

(a) The facet joints of the thoracic spine up to T10 are in the coronal plane and resist anterior translation.

(a) True

(a) The retromandibular vein drains into the external jugular vein.

(a) True

(a) The three major aortic branches from right to left are the innominate, left common carotid and left subclavian arteries. approximately 0.5 % f the population

(a) True

(a) The tracheobronchial groove appears on the ventral aspect of the caudal end of the pharynx

(a) True

(a) Bone maturation and development are assessed on a single view of the non-dominant hand and wrist.

(a) True - centred over the head of the third metacarpal, the images may be analysed by two different methods.

(a) The femur is strongly reflective at 10 weeks. (b) The distal femoral epiphyses is seen at 36 weeks.

(a) True - ossifies at 6 to 12 weeks. (b) True - the upper and lower femoral epiphyses appear later in the third trimester. The presence of a distal epiphysis in utero on a plain radiograph at 36 weeks signified maturity of the fetus. This is not practised any more.

(a) The lower two-thirds of the rectum drains into the internal iliac nodes.

(a) True - the lymphatic drainage follows vascular supply. The upper two-thirds drains into the inferior mesenteric nodes.

(a) CT arthrography is of value in the assessment of the glenoid labrum.

(a) True - the prone oblique position provides more information about the posterior aspect of the glenoid labrum and the capsular attachments, which are important in patients with posterior dislocations.

(a) Wormian bones are small bony elements seen in suture lines and suture junctions.

(a) True - these are usually normal variants but may be pathological when multiple in conditions such as cleidocranial dysostosis, osteogenesis imperfecta and hypophosphatasia.

(a) The urachal remnant forms the median umbilical ligament passing from the apex of the bladder to the umbilicus.

(a) True - this is extraperitoneal.

(a) The azygos fissure results from failure of normal migration of the azygos vein from the chest wall through the lung.

(a) True almost always on the right, rarely an analogous fissure may be seen on the left with the accessory hemiazygos or left superior intercostal vein.

(a) The parietal pleura is continuous with the visceral pleura at the hilum

(a) True and in the inferior pulmonary ligament.

7. Regarding the secondary pulmonary lobule: (a) It consists of approximately ten acini.

(a) True-acini are 8-20 mm in diameter and consists of respiratory bronchioles, alveolar ducts and alveoli.

(a) The thymus is usually inferior to the left brachiocephalic vein.

(a) True-and superior to the level of the horizontal portion of the right pulmonary artery

(a) The primitive heart is formed by fusion of two parallel tubes.

(a) True-soon this grooves to demarcate the sinus venosus, atrium, ventricle and bulbus cordis from behind forward.

(b) The circle of Willis is complete in the majority of individuals.

(b) False

(b) The hypoplastic anterior communicating artery may occur in 15-20% of individuals.

(b) False - 3%.

(b) The upper limit of normal in the short axis for retrocrural nodes is 10 mm.

(b) False - 6 mm, para-aortic and subcarinal nodes may be up to 12 mm.

(b) Congenital tarsal coalitions are best visualized using oblique

(b) False - CT, particularly in the coronal plane, is the best way of looking at the subtalar joint.

(b) A low puncture is ideal as it decreases the chances of a retroperitoneal haematoma

(b) False - a high puncture placed above the inguinal ligament may result in retroperitoneal haematoma as the artery is difficult to compress without the support of the femoral head. A low puncture may cause a pseudoaneurysm formation or arteriovenous fistula if the profunda femoris is punctured.

(b) The right gastric artery is a branch of the superior mesenteric artery.

(b) False - arises from the proper or left hepatic arteries in about equal proportions. It supplies the pylorus and courses along the lesser curve to anastomose with the left gastic artery.

(b) The thickness of the normal pyloric muscle should not exceed 3 mm.

(b) False - dimensions vary depending on size of the child. However upper limits in the longitudinal section are as follows: 3 mm thickness of pyloric muscle, and 17 mm in length for the pyloric canal. With measurements above these figures pyloric stenosis has to be suspected.

(b) Following administration of intravenous iodinated contrast medium, the spinal cord and nerve roots enhance.

(b) False - following contrast, the spinal cord, nerve roots and intervertebral discs do not enhance. The spinal meninges, dorsal root ganglia and blood vessels enhance.

(b) The duodenal junction is held by the ligament of Treitz, a peritoneal fold that ascends to the left crus of the diaphragm.

(b) False - it ascends to the right crus of the diaphragm. An abnormal position of this ligament indicates mal-rotation.

(b) The skull vault has a high signal on T1-weighted MR images.

(b) False - on MRI the subcutaneous fat is of high signal, superficial to a signal void of the skull vault.

(b) The outline of both psoas muscles is seen in the majority of plain radiographs.

(b) False - only seen in 48% of normal radiographs.

(b) The pectoralis major muscle divides the axillary artery into three parts.

(b) False - pectoralis minor divides it into three parts.

(b) The superficial femoral artery passes lateral to and behind the lower shaft of the femur.

(b) False - posterior and medial to the femur, through the adductor hiatus.

(b) The first labyrinthine segment of the facial nerve extends anteromedially from the internal auditory meatus.

(b) False - the first segment of the facial nerve extends anterolaterally from the internal auditory meatus.

(b) The deltoid ligament is responsible for about 85% of all ankle ligament injuries.

(b) False - the lateral collateral ligament complex is responsible for about 80% of all ankle ligament injuries.

(b) The medial femoral condyle projects more anteriorly compared to the lateral femoral condyle.

(b) False - the lateral femoral condyle projects more anteriorly and tends to prevent lateral dislocation.

(b) A line joining the parietal eminence on each side forms the smallest transverse diameter of the skull.

(b) False - the line joining each parietal eminence forms the greatest transverse diameter of the skull.

(b) The lobular vein follows the branches of the bronchioles.

(b) False - the lobular artery follows the branches of the bronchioles. Peripheral veins drain the lobule and run along the interlobular septum.

(b) The left lobe is usually larger than the right.

(b) False - the opposite is true. The right lobe is more vascular than the left and tends to enlarge more in diffuse disorders.

(b) The infratemporal fossa communicates with the nasal cavity through the sphenopalatine foramen.

(b) False - the pterygopalatine fossa opens into the nasal cavity through the sphenopalatine foramen.

(b) The cortical compact bone is the weight-bearing component of the body of the vertebra.

(b) False - the vertebral body consists of a mass of cancellous bone surrounded by a cortical rim of compact bone. The cancellous bone has vertical (weight- bearing) and horizontal trabeculae.

(b) The piriformis passes out of the pelvis through the lesser sciatic foramen.

(b) False - through the greater sciatic foramen.

(b) The right hepatic artery usually crosses the common hepatic duct anteriorly.

(b) False - usually posteriorly.

(b) The aortopulmonary window is above the aortic arch.

(b) False -above the pulmonary artery under the aortic arch

(b) About 10% of the population have an azygos lobe.

(b) False -in 1% of the population, the azygos vein traverses the lung before entering the SVC resulting in the azygos fissure. The azygos lobe' is not a true segment

b) On a PA radiograph the pleura is seen in the costophrenic sulcus.

(b) False -the visceral pleura can be seen on a plain radiograph only where it invaginates the lung to form fissures and at the junctional lines.

(b) On T2-W MRI the oesophagus shows similar intensity to skeletal muscle.

(b) False On T2-W MRI esophagus reveals higher intensity than muscle. The signal intensity on T1 W MRI is similar to that of muscle.

(b) The oblique fissure separates the upper and lower lobes from the middle lobe on the right.

(b) False the oblique fissure separates the upper and middle lobes from the lower lobe on the right.

(b The left atrium is posterior to the oesophagus.

(b) False-is related posteriorly to the oesophagus and left lower lobe bronchus.

(b) The posterior junctional line is anterior to the oesophagus

(b) False-the lungs almost touch each other posterior to the oesophagus to form the posterior junction line.

(b) The inferior pulmonary veins draining the lower lobes are more vertical than the lower lobe arteries.

(b) False-the opposite is true.

(b) At the level of the diaphragm, IVC is separated from the aorta by the right crus of the diaphragm and oesophagus.

(b) True

(b) Gracilis, sartorius and semitendinosus insert into the medial condyle of the tibia.

(b) True

(b) The bicipital aponeurosis separates the superficial median cubital vein from the deeper brachial artery.

(b) True

(b) The internal thoracic artery arises from the subclavian artery and supplies the upper six intercostal spaces

(b) True

(b) The left colic artery anastomosis with the middle colic artery.

(b) True

(b) The left main bronchus is about twice as long as the right.

(b) True

(b) The subclavian artery lies posterior to the subclavian vein.

(b) True - and scalenus anterior muscle and ends at the lateral border of the first rib, where it continues as the axillary artery.

(b) The posterior limb of the internal capsule myelinates before the anterior limb of the internal capsule.

(b) True - at term the posterior limb is myelinated. At 4 months the anterior limb starts to myelinate.

(b) Hypoplasia of maxillary sinus may be seen in up to 10% of normal population, and is seen as high density on plain radiographs

(b) True - not to be confusd with inflammation when seen on a plain radiograph.

(b) Disruption of Harris' ring indicates a fracture on a lateral cervical spine radiograph.

(b) True - on a lateral cervical spine radiograph, it is formed anteriorly by the pedicle and anterior body of axis; posteriorly by the vertebral body; superiorly by the upper margin of the superior articular facet; inferiorly by the inferior border of foramen transversarium.

(b) gives rise to the dorsal pancreatic artery.

(b) True - or it arises from the SMA's first jejunal branch.

(b) The heart tube kinks to form a U-shaped loop

(b) True - the caudal end (sinus venosus) receiving venous blood, comes to lie behind the cephalic end (which gives rise to truncus arteriosus). In the fully developed heart, the atria and great vein lie posterior to the ventricles and to the roots of the great arteries.

(b) The 'collar of the Scotty dog' on an oblique radiograph of the lumbar spine is the pars interarticularis.

(b) True - the head is the transverse process, eye the pedicle, the ear is the superior articular process and the front limb of the 'dog' is the inferior articular facet, all of which belong to one vertebra.

(b) Axial sections, which correlate with axial sections of computerized tomography, are obtained at the level of the basal cisterns.

(b) True - using the pterion (just above and behind the pinna of the ear) as the acoustic window.

(b) The deep bronchial veins may end in the left atrium.

(b) True the deep bronchial veins communicate freely with the pulmonary veins , end in a pulmonary vein or left atrium. The superficial bronchial veins drain extrapulmonary bronchi, visceral pleura and hilar lymph nodes, and end on the right side into the azygos vein and on the left into the left superior intercostal vein or the accessory hemiazygos vein.

(b) MRI demonstrates thymic tissue better than CT

(b) True-after puberty, the density gradually decreases owing to fatty replacement. In older patients the thymus may be indistinguishable from mediastinal fat. On T2 - W MRI the signal intensity is similar or sometimes higher than fat and does not change with age. On T 1- W MRI, the intensity of normal thymic tissue is similar or slightly higher than that of muscle.

(b) The ascending lumbar veins and the lower three posterior intercostal veins are the tributaries hemiazygos vein.

(b) True-and subcostal veins of the left side, some mediastinal and oesophageal veins.

(b) The inferior accessory fissure separates the medial basal segment from the rest of the right lower lobe.

(b) True-runs upward and medially towards the hilum, from the medial aspect of the diaphragm.

(b) In approximately 0.5 % f the population the right subclavian artery arises distal to the left subclavian artery

(b) True-the aberrant right subclavian artery runs posterior to the oesophagus from left to right

(b) The primary bronchial buds develop from the tracheobronchial diverticulum

(b) True-the bronchial buds differentiate into bronchi in each lung

(c) False - above the foramen of Magendie the dorsal surface becomes the floor of the fourth ventricle, which opens into the cerebellopontine angle on each side through the foramen of Luschka around the inferior cerebellar peduncle

(c) False - anterosuperior to the seminal vesicle. The ureter is usually lateral to the IVC - except in a retrocaval ureter.

(c) False - drains into the splenic vein in 40%, into the confluence of the SMV and splenic vein in 30% and into the SMV in 30%.

(c) The external jugular vein drains into the internal jugular vein. (d) The retromandibular vein is joined by the occipital vein to form the external jugular vein. (e) The internal jugular vein has no valves.

(c) False - drains into the subclavian vein. (d) False - retromandibular vein is joined by the posterior auricular vein to form the external jugular vein. The occipital vein drains into the internal jugular vein. (e) False - it has valves just above the inferior bulb, which may prove difficult to pass with a guidewire.

(c) The sacroiliac joint does not have a synovial component. (d) The intersosseous sacroiliac ligament is a strong ligament.

(c) False - has a synovial component. The sacral surface is lined by fibrocartilage and the iliac surface by hyaline cartilage. (d) True, it provides the main strength of the joint.

(c) False - in cortical scarring, the loss of cortex overlies a calyx. In fetal lobulation the divisions lie between calyces.

(c) False - in the cervical region, they usually arise from branches of vertebral, deep cervical arteries, costocervical trunk or rarely from the thyrocervical branch of the subclavian. In the thoracic region they are branches of the supreme intercostal arteries and the aortic intercostal arteries.

(c) False - in the prone position the oesophagus is distended well and strictures which may be missed in the upright position are best seen.

(c) False - most of the flow is directed to the right transverse sinus. From the deep venous system blood flows into the left transverse sinus.

(c) False - orientated anterolaterally at 45° to the sagittal plane and is thus demonstrated using an oblique radiographic projection. In the thoracic and lumbar regions they are orientated laterally, and lateral radiographs are appropriate to demonstrate them.

(c) Intravenous digital subtraction angiography usually requires less iodinated contrast medium than the intra-arterial technique.

(b) The profunda brachi artery runs in the radial groove.

(c) False - tendons are echobright. Echopoor areas in the tendon may be due to tendonitis and a gap in the tendon is diagnostic of a tear.

(c) False - the aponeurosis of the oblique and transverse muscles of the anterior abdominal wall form the rectus sheath within which the rectus abdominis muscle is enclosed.

(c) False - the fossa of Rosenmuller (the site of origin of up to 50% of nasopharyngeal carcinomas) is posterior and medial to the opening of the auditory tube.

(c) The middle trunk lies beneath the scalenus anterior muscle. (d) The five nerve roots eventually give rise to five nerves. (e) The cords of the brachial plexus form above and behind the pectoralis minor muscle.

(c) False - the middle trunk is formed by the seventh cervical root. The eighth cervical and first thoracic roots unite behind scalenus anterior to form the lower trunk. (d) True (e) True - and surround the axillary artery, run between the clavicle and first rib to enter the axilla, where they divide into their terminal branches.

(c) False - the mucosa of the first part of the duodenum is smooth. The rest of the small bowel is broken into the 'plica circularis'.

(c) False - the posterior longitudinal ligament is firmly attached to the discs and is separated from the vertebral bodies by the emerging basivertebral vein and epidural venous plexuses. The anterior longitudinal ligament is attached firmly to the vertebral bodies and less firmly to the discs.

(c) False - the radius carries the hand.The lower extremity of the radius expands to form the articular surface for the wrist joint and the ulna.

(c) False - the sacrospinous ligament and the sacrotuberous ligament form the superior and postero-inferior borders of the lesser sciatic foramen, respectively. The internal pudendal artery and pudendal nerve exit the pelvis through the greater sciatic foramen and enter the perineum through the lesser sciatic foramen.

(c) False - the thyroid appears relatively homogeneous in texture and relatively hyperechoic to the superficial sternocleidomastoid muscles.

(c) False - though the oesophagus enters the thorax in the midline it deviates to the left of the midline. In the upper thorax, the left subclavian artery, aortic arch and upper part of descending aorta lie on its left. Esophagus is posterior to the right subclavian artery.

(c) False -during embryonic life the alveoli is lined by cuboidal epithelium that lines the rest of the respiratory tract. When respiration commences at birth the transfer to the flattened pavement epithelium of the alveoli is accomplished.

(c) False after 6 to 20 divisions the segmental bronchi no longer contain cartilage in their walls and become bronchioles

(e) The parietal pleura is supplied by the pulmonary circulation.

(c) False the parietal pleura is supplied by the systemic circulation, and the visceral pleura is supplied by the pulmonary and bronchial circulation of visceral

(c) False-currently MRI is a poor technique for showing lung detail. It allows visualisation of the chest wall, heart, mediastinal and hilar structures.

(c) False-superior accessory fissure separates the superior segment the lower lobe from the basal segments and is inferior to the minor fissure on the frontal radiograph

(c) False-the left pulmonary artery is higher than the right and arches over the left main bronchus and descends posterior to it.

(c) False-the oblique fissures follow a gently curving plane. The upper portion faces forward and laterally and the lower portion forwards and medially.

(c) The extra-hepatic portal vein lies posterior to the CBD. The CBD is to the right and hepatic artery lies to the left, both anterior to portal vein.

(c) True - from left to right posteriorly are the fourth part of duodenum, aorta, IVC, right gonadal vessels, the right ureter and psoas muscle.

(c) True - one in the centrum; one for each half of the neural arch. There are two ossification centres in the centrum, which fuse. Failure of one-half of this ossification centre to develop results in a hemivertebra.

(c) True - persists as the fibrous medial umbilical ligament, which may be recognized in a plain abdominal film in the presence of a pneumoperitoneum.

(c) True - these are three narrow bands present on the outer wall of the colon, they converge on the appendix proximally and the rectum distally.

(c) True - this is the first 2 cm of the duodenum which is slightly conical in shape and is between the folds of the greater and lesser omentum.

(c) True-commonest variant of the major vessels (27 % ). The left vertebral may arise directly from the arch (2.5 % ) and lie between the left common carotid and subclavian arteries.

(c) True-the upper few centimetres are usually straight or concave towards the lung. A convex shape suggests a subcarinal mass adults: however this may be normal feature in children.

(d) 99mTc pertechnetate imaging provides functional data on the thyroid gland.

(d) False - 99mTc is not metabolized in the thyroid. However, 123I is both trapped and organified, and functional data can be obtained. 99mTc provides morphological information and will reveal the presence of ectopic thyroid tissue.

(d) Corticomedullary differentiation is appreciated on a DMSA scan.

(d) False - Dimercaptosuccinic acid (DMSA) scintigrams give information on renal scarring and renal function. DTPA (diethylene triamine pentacetic acid) or mercaptocetyl triglycine (MAG3) scans quantify renal function and provide structural information, e.g. reflux of urine from the bladder into the ureter. MAG 3 gives eRPF. DTPA gives GFR.

(d) The thalamostriate arteries are branches of the middle cerebral artery that supply the majority of the thalamus.

(d) False - branches of the posterior cerebral artery.

(d) has a lumbar expansion at the level of L1 to L5 vertebra.

(d) False - from T10 to L1 vertebral levels the nerve roots emerge.

(d) Transverse process arises from the lateral aspect of the vertebral bodies.

(d) False - from the junction of the pedicle and the lamina. The articular processes project superiorly and inferiorly from the junction of the pedicle and lamina.

(d) The coeliac axis supplies the gut from the upper oeosphagus to the superior half of the duodenum.

(d) False - from the lower oesophagus.

(d) The submandibular gland has a similar attenuation to the parotid on CT.

(d) False - higher than that of parotid gland.

(d) Dolan's three lines are useful to identify facial symmetry in the Cauldwell (occiptofrontal) view.

(d) False - in the Water's view

(d) in the female passes just superior to the uterine artery.

(d) False - inferior and here it is in danger during a hysterectomy.

(d) The supraspinous ligament joins the tips of adjacent spinous processes from C1 to the sacrum

(d) False - it extends from C7 to the sacrum. Above C7 it continues as ligamentum nuchae and inserts into the external occipital protuberance.

(d) The obturator nerve runs lateral to the psoas in the pelvis.

(d) False - it runs medial to the psoas, and then along the lateral pelvic wall, lies posteromedial to the common iliac vein to enter the obturator canal.

(d) The greater wing separates the frontal lobe of the brain from the infra temporal fossa below.

(d) False - it separates the temporal lobe of the brain from the infratemporal fossa below.

(d) The inferior orbital fissure transmits a branch of the maxillary division of the fifth cranial nerve from the middle cranial fossa.

(d) False - it transmits this nerve after it has passed from the middle cranial fossa into the pterygopalatine fossa via the foramen rotundum.

(d) on the right is anterior to the IVC.

(d) False - posterior to the IVC and right lobe of the liver.

(d) The internal iliac artery is anterior to the ovary.

(d) False - posterior to the ovary.

(d) The intrahepatic bile ducts are usually clearly seen parallel to the portal vein.

(d) False - the 'shotgun' sign when the bile ducts are of similar calibre and parallel to the portal vein indicates that there is intrahepatic biliary duct dilatation. However this sign may be seen in portal hypertension when there is compensatory enlargement of the branches of the hepatic artery, alongside those of the portal vein. Colour doppler will distinguish ducts from vessels.

(d) The pre-communicating (P1) segment of the posterior cerebral artery extends from the basilar bifurcation to the origin of the inferior temporal artery.

(d) False - the P1 segment extends from the basilar bifurcation to the origin of the posterior communicating artery. The thalamic perforating arteries, which arise from both the P1 segments and the posterior communicating artery, give extensive supply to the thalamus, hypothalamus, the third nerve and the fourth nerve and to the internal capsule.

(d) The right portal vein supplies the caudate lobe.

(d) False - the caudate lobe is supplied by the left portal vein.

(d) After gadolinium DTPA the ovarian follicles exhibit increased signal intensity.

(d) False - the follicles are low signal foci in surrounding high signal stroma, which enhances after intravenous gadolinium.

(d) The outer and inner layer of the dura give rise to the falx and tentorium

(d) False - the inner layer of the dura covers the brain and gives rise to the falx and tentorium. The outer layer of the dura is the periosteum of the inner table of skull.

(d) The lamina cribrosa is at the medial end of the internal auditory meatus.

(d) False - the lamina cribrosa is at the lateral end of the internal auditory meatus through which the facial nerve passes to enter the facial canal and the vestibulocochlear nerve which gives branches to the cochlea and vestibule.

(d) The lateral two-thirds of the external auditory meatus is cartilaginous.

(d) False - the lateral one-third is cartilaginous and the medial two-thirds are osseous.

(d) The musculus submucosa ani has a high signal intensity compared to fat and submucosa on T1-weighted MRI. (e) The subcutaneous fibres of the external sphincter have a high signal on T1-weighted MRI.

(d) False - the musculus submucosa ani is a fascial extension of the longitudinal muscle coat of the rectum which inserts into the mucocutaneous junction (the Hilton's white line). This has a low signal intensity compared to the high signal fat and submucosa on T1-W MRI. (e) False

(d) the obturator foramen is bounded inferiorly by the sacro-spinous ligaments.

(d) False - the obturator foramen is bounded by the bodies and rami of the pubis and ischium. The sacrospinous ligament defines the inferior limit of the greater sciatic foramen.

(d) The paraglottic space terminates below the cricoid cartilage.

(d) False - the paraglottic spaces lie deep to the false and true cords. They contain fat and terminate at the upper border of the cricoid cartilage. Therefore there is no soft tissue within the cricoid ring.

(d) The IVC lies directly behind the first part of the duodenum.

(d) False - the portal vein lies between the first part of the duodenum and the IVC posteriorly.

(d) The colon has sacculations due to the mucosal folds

(d) False - the taeniae are shorter than the colon. Therefore the colon is thrown into sacculations which give the appearance of haustra on radiographs.

(d) The dens of the axis develops entirely from two primary ossification centres.

(d) False - the tip of the dens develops from secondary centres at 3 years and fuses at 12 years. The dens unites with the rest of the body of the axis at 3 years.

Lymphography is the method of choice to visualize the internal iliac, hepatic and pre-aortic nodes

(d) False - these group of nodes are not visualized on lymphography. High quality CT has almost completely replaced this technique.

(d) The internal cerebral veins are located in the quadrigeminal plate cistern

(d) False - they are in the cistern of the velum interpositum.

(d) In anterior dislocation of the shoulder, cortical defects may occur in the anterior aspect of the head of the humerus.

(d) False - they occur in the posterior aspect of the head of the humerus (Hill-Sachs lesion), which are best shown by a Striker's view (patient supine, humerus 90° to the table with a cephald beam at 25°).

(d) The descending genicular artery is a branch of the popliteal artery supplying the knee.

(d) False - this is a branch of the superficial femoral artery, prior to entering the adductor hiatus. The medial and lateral superior and inferior genicular arteries are given off in the popliteal fossa.

(d) The white matter above the lateral ventricle is known as the corona radiata.

(d) False - this is the centrum semiovale.

(d) The iliofemoral ligament is a thickening of the posterior capsule.

(d) False - this is the ischio-femoral ligament. The ilio-femoral ligament is attached to the anterior inferior iliac spine and to the inter-rochanteric line, and is anterior to the femoral neck.

(d) Gas exchange takes place in the terminal bronchioles and acini.

(d) False -the terminal bronchiole is the last of the purely conducting airways beyond which are the gas-exchange units of the lung- the acini.

(d )The left atrium lies to the right of the aortic root.

(d) False it is posterior.

(d) A left minor fissure is seen in 10 % of frontal radiographs.

(d) False left minor fissure seen in 10% of individuals is hardly seen on frontal or lateral radiographs. It separates the lingular segments from the rest of the upper lobe.

(d) Lobules are best demonstrated nearer to the hilum of the lung on CT.

(d) False lobules are surrounded by connective tissue septa which contain veins and lymphatic vessels, in the lung periphery. Therefore they are best demonstrated in the periphery of the lung.

(d) The right paravertebral stripe is thicker than that on the left due to the azygos vein.

(d) False the left paravertebral stripe is usually wider than the right.

(d) The major fissures appear as a soft tissue linear density from the hilum to the chest wall on standard 10 mm thick CT sections.

(d) False the most common appearance is a curvilinear avascular band extending from the hilum to the chest wall, reflecting the lack of vessels in the subcortical zone of the lung. On HRCT, the major fissure appears as a line or a band.

(d) The oesophageal hiatus lies posterior to the aortic hiatus.

(d) False, the oesophageal hiatus lies anterior to aortic hiatus.

(d) A persistent tracheo-oesophageal fistula (TOF) is commonly associated with an atresia of the duodenum.

(d) False-TOF indicates the close developmental relationship between the foregut and the respiratory passages. It is usually associated with an atresia of the oesophagus and the fistula is situated below the atretic segment.

(d) The internal thoracic veins empty into the corresponding subclavian

(d) False-into the corresponding brachiocephalic veins

(d) The thoracic duct is mostly a single structure as it runs from the cisterna chyli.

(d) False-it may consist of up to eight separate channels.

(d) The foramen secundum is a defect in the septum secundum.

(d) False-the foramen secundum is a defect the septum primum.

(d) The lower lobe pulmonary veins are vertical as they approach the heart.

(d) False-they run horizontally

Bronchography is the technique of choice to visualize the bronchial tree

(d) False-this invasive technique has largely been superseded by HRCT

(d) In a frontal chest radiograph the artery and bronchus of the anterior segment of the upper lobes are frequently seen end-on.

(d) True

(d) The azygo-oesophageal recess lies behind the subcarinal space

(d) True

(d) The intercostal spaces are drained by two anterior veins and a single posterior intercostal vein.

(d) True

(d) The mandibular fossa is part of the squamous portion of the temporal bone.

(d) True

(d) The right upper lobe pulmonary artery is anterior to the right upper lobe bronchus.

(d) True

(d) Innervation of the dura is primarily from the trigeminal nerve.

(d) True - and also from the lower cranial nerves and the first three cervical segments. This may be the reason for cervical pain in cranial subarachnoid haemorrhage.

(d) The medullary pyramids of the neonatal kidney are more hypoechoic than older children.

(d) True - and larger.

(d) The phrenicocolic ligament is continuous with the splenorenal ligament.

(d) True - and the transverse mesocolon (see question 6 (e)).

(d) The periosteum is invested externally and internally.

(d) True - both externally (pericranium) and internally (endosteum).

(d) The ureters lie anterior to the common iliac arteries.

(d) True - common iliac veins, lumbosacral trunk, obturator nerve, iliolumbar artery and the sympathetic trunk lie posterior to the common iliac trunk.

(d) The normal indentations of the oesophagus are seen anteriorly and to the left.

(d) True - from above downwards these are as follows; where the pharynx joins the oesophagus, aortic arch, left main bronchus and where the oesophagus passes through the diaphragm.

(d) The diaphysis of ulna and radius extend to the same level at the wrist.

(d) True - important relationship, as many bony anomalies foreshorten the distal radius.

(d) The lesser omentum forms the anterior surface of the lesser sac.

(d) True - its free edge extends to the porta hepatis as the hepatoduodenal ligament.

(d) The left gastro-epiploic artery arises from the terminal portion of the main splenic artery.

(d) True - or from one of its terminal branches. It descends along the greater curvature of the stomach to form the 'arcus arteriosus ventriculi inferior of Hyrtl' with the right gastro-epiploic artery.

(d) The neurocentral joints (synchondroses) between the centrum and each half of the neural arch fuse by 7 years of age.

(d) True - the arches unite first in the lumbar region and last in the cervical. The centrum unites first with the arch in the cervical region and in the lumbar region last.

(d) The spinal dura mater is a continuation of the inner layer of the cerebral dura.

(d) True - the epidural (extradural) space is between the periosteum of the vertebrae (which represents the outer periosteal layer of the dura) and the spinal dura mater.

(d) On T2-W MRI the testis is either equal to or greater than that of fat.

(d) True - the fibrous tunica albuginea is of low signal on all sequences. On T1-W images the testis is of uniformly medium signal less than that of fat.

(d) The lower third drains into the portal system.

(d) True - the left gastric vein drains the lower third into the portal system. The middle third drains into the azygos, therefore there is an important anastomosis between the azygos and portal system via the left gastric vein. The upper third drains into the brachiocephalic veins.

(d) The rectum is supplied by branches of the internal iliac artery.

(d) True - the superior rectal (branch of inferior mesenteric), middle rectal (branch of internal iliac), inferior rectal (branch of internal pudendal) and median sacral artery (continuation of the aorta) supply the rectum.

(d) The flexor retinaculum is attached to the pisiform, hook of hamate, scaphoid tubercle and ridge of the trapezium.

(d) True - this forms the carpal tunnel which contains tendons of flexor pollicis longus, flexor digitorum profundus and superficialis and the median nerve. The tendon of flexor carpiradialis lies in a separate compartment of the carpal tunnel

(d) The second, third and fourth intercostal spaces on the right, drain via the right superior intercostal vein into the azygos vein.

(d) True-hemiazygos, accessory hemiazygos, oesophageal, mediastinal, pericardial and right bronchial veins drain into the azygos system.

(e) Segments III, IVb, V, VI are below the portal vein in a clockwise fashion on axial CT.

(e) False

(e) The dura is not seen on T2 gradient echo images.

(e) False

(e) The peritoneum is reflected on the prostate.

(e) False

(e) 99m Technetium-labelled colloid is used to detect Meckel's diverticulum.

(e) False - Meckel's diverticulum containing gastric mucosa is detected using 99mTechnetium pertechnetate. Occult bleeding in the small bowel is detected using 99mTc labelled with colloid or red cells. Active bleeding at a rate of more than 0.5 ml per minute is required to enable detection at angiography.

(e) There is a decreased incidence of malignancy with the P2 and DY patterns described by Wolfe.

(e) False - Wolfe graded the amount and distribution of fibroglandular tissue within a breast into four categories. N1 = normal largely adipose tissue; P1 = adipose breast with parenchymal thickening anteriorly, less than on quarter of the breast volume; P2 as P1 but involving greater than one quarter of the breast volume; DY = generalized increased density of the fibroglandular pattern, without a recognizable ductal or nodular appearance. There is an increased risk of malignancy with the P2 and DY patterns.

(e) The pre-epiglottic space lies between the base of the tongue and the epiglottis.

(e) False - between the epiglottis and hyoid bone.

(e) The lateral pterygoid muscle lies inferior and lateral to the medial pterygoid.

(e) False - bulk of lateral pterygoid is cranial to the medial pterygoid. Therefore, on axial images the lateral and medial pterygoid appear to be at the same level.

(e) The duodenum is predominantly supplied by the coeliac axis.

(e) False - dual supply from SMA and coeliac axis - hence the difficulty in controlling bleeding from an eroding duodenal ulcer.

(e) A left-sided IVC drains into the coronary sinus.

(e) False - due to a persistent left sacrocardinal vein, cross-over to the right IVC occurs at the level of the left renal vein. Crossover occurs anterior to aorta and drains into the right IVC and into right atrium.

(e) Failure of fusion of the neural arches with the centrum results in spina bifida

(e) False - failure of fusion of the neural arches posteriorly results in spina bifida . Up to 20% of the population have defects in the lumbosacral region.

(e) The carotid sheath receives contribution from only the middle layer of the deep cervical fascia

(e) False - from all three layers of the deep cervical fascia.

(e) The collecting system of the kidney is derived from endoderm.

(e) False - from mesoderm.

(e) In approximately 25% of individuals the entire hepatic arterial supply arises from the superior mesenteric artery (SMA).

(e) False - in 20% of individuals all or part of the hepatic arterial supply arises from the SMA, of these 10-12% will be replaced by right hepatic artery from the SMA, 4-6% from an accessory right hepatic artery from the coeliac axis. In 2.5% the entire hepatic arterial supply arises from the SMA.

(e) The infratemporal fossa is inferior to the lesser wing of sphenoid.

(e) False - inferior to greater wing of sphenoid and behind the maxilla.

(e) Tensor fascia lata arises from the anterior superior iliac spine and inserts into the lateral condyle of the femur.

(e) False - inserts into the iliotibial tract - a strong thickened band of deep fascia of the lateral aspect of the thigh (fascia lata) which is attached to the lateral condyle of the tibia.

(e) In a duplex kidney the ureter of the lower moiety enters the bladder below to that of the upper moiety.

(e) False - it enters at the normal orifice: the ureter of the upper moiety enters at an ectopic site lower than the normal orifice.

(e) The superficial temporal artery grooves the inner table of the temporal and parietal bones

(e) False - it grooves the outer table of the temporal and parietal bones.

(e) The cisterna chyli extends from the bifurcation of the aorta to just below the diaphragm.

(e) False - it is 6 cm long anterior to L1 and L2 posterior to the right crus of the diaphragm. It passes through the retrocrural space with the aorta to become the thoracic duct.

(e) The blood supply to the optic chiasm is through the basilar artery.

(e) False - it is through the anterior cerebral and internal carotid artery. The posterior cerebral artery gives branches to the lateral geniculate body, lower fibres of optic radiation and visual cortex. The middle cerebral artery gives branches to the upper fibres of optic radiations and inconsistently to the occipital poles.

(e) The coeliac axis is inferior to the lesser omentum.

(e) False - it lies above the pancreas and splenic veins, below the left lobe of the liver, on its left is the cardia of the stomach and in front is the lesser omentum.

(e) The abducent nerve lies inferior to the maxillary nerve in the cavernous sinus.

(e) False - it lies free within the sinus applied to the lateral wall of the internal carotid artery.

(e) The hippocampus lies in the roof of the temporal horn of the lateral ventricles.

(e) False - it lies in the floor of the temporal horn of the lateral ventricles.

(e) The pericallosal artery runs in the cistern of the lamina terminalis.

(e) False - it runs in the callosal cistern and the anterior communicating artery runs in the cistern of the lamina terminalis.

(e) Translumbar aortography is used nowadays

(e) False - largely abandoned nowadays, and replaced by the aortogram through the transfemoral approach.

(e) The lateral surfaces of the frontal lobes are supplied by the anterior cerebral artery.

(e) False - most of the lateral surfaces of the hemispheres are supplied by the frontal, parietal, angular, superior temporal branches of the middle cerebral arteries from which they arise in the insular.

(e) The biceps femoris attaches to the lateral condyle of the femur.

(e) False - originates from the ischial tuberosity (long head) and the linea aspera (short head) and inserts into the head of the fibula.

(e) On ultrasound colonic peristalsis is seen in the second trimester.

(e) False - small bowel peristalsis is commonly seen in the third trimester and colonic peristalsis is not seen in utero.

(e) The Von Rosen's view is useful in the assessment of femoral capital epiphyses in children.

(e) False - the Frog's lateral view is used for this - the Von Rosen's view is used in the assessment of congenital dislocation of the hip. Judet's views of the acetabulum and femoral head give information on the anterior and posterior columns of the acetabulum.

(e) The cervical vertebral bodies are supplied by segmental branches from the aorta.

(e) False - the atlas and axis vertebrae are supplied by the ascending pharyngeal and occipital arteries. The other cervical vertebrae are supplied by segmental branches from the costocervical, thyrocervical trunks and vertebral arteries. The thoracic and lumbar parts of the vertebral column are supplied by segmental aortic branches.

(e) The inferior orbital fissure extends from the middle cranial fossa into the orbit.

(e) False - the inferior orbital fissure anteriorly forms an opening between the orbital cavity and the infra temporal fossa. More posteriorly it forms an opening between the orbit and the pterygopalatine fossa.

(e) The oesophagogastric junction is the 'B' ring or Schatzki ring.

(e) False - the lower end of the oesophagus is dilated to form the vestibule, just above the oesophagogastric junction (mucosal junction between the oeosphagus and stomach - the 'Z' line). The upper limit of the vestibule is the 'A' ring and the lower limit as the 'B' ring or Schatzki ring which is usually below the diaphragm.

(e) The majority of the blood supply to the pancreas is derived from the dorsal pancreatic artery.

(e) False - the majority of the blood supply is from the splenic artery.

(e) The intercavernous sinuses are situated on either side of the pituitary fossa.

(e) False - the paired cavernous sinuses are situated in the side of the pituitary fossa and they connect with each other through the intercavernous sinuses.

(e) The testicular vein drains into the pampiniform plexus of veins.

(e) False - the pampiniform plexus of veins above and behind the testis become one single testicular vein as they approach the inguinal ring. The right testicular vein drains into the IVC and the left testicular vein drains into the left renal vein.

(e) On TRUS the seminal vesicles are very echogenic.

(e) False - the seminal vesicles appear as convoluted tubules containing transonic fluid - hence they are of lower echogenicity than the prostate.

(e) The left ureter runs in the apex of the sigmoid mesocolon.

(e) False - the sigmoid and superior rectal vessels run between the layers of the sigmoid mesocolon and the left ureter runs behind its apex into the pelvis.

(e) There is a portosystemic anastomosis between the middle and inferior rectal veins.

(e) False - the superior rectal (a tributary of the inferior mesenteric which drains into the portal vein) forms an important portosystemic anastomosis with the middle rectal vein and inferior rectal vein (branches of internal iliac and internal pudendal veins).

(e) The upper oesophagus has lymphatic drainage to the mediastinal lymph nodes

(e) False - the upper oesophagus has lymphatic drainage into the deep cervical nodes, the middle to the posterior mediastinal nodes of the coeliac group.

(e) The venous angle is where the great cerebral vein joins the inferior sagittal and straight sinuses.

(e) False - the venous angle is the confluence of the thalamostriate and septal veins behind the interventricular foramen of Munro to form the internal cerebral vein.

(e) The appendices epiploicae are sparse in the sigmoid colon.

(e) False - they are sparse in the caecum and rectum and most numerous in the sigmoid colon. Herniation of mucous membrane through the appendices apiplocae leads to formation of diverticula.

(e) The thoracic duct crosses from the left to the right at the level of T4.

(e) False-at T 6, it crosses from right to left of the spine and ascends along the lateral aspect of the oesophagus and arches forward across the left subclavian artery and inserts into a large central vein within 1 cm of the junction of the left internal jugular and subclavian veins.

(e) The oesophagus is anteromedial to the descending aorta throughout its course.

(e) False-in its upper portion the oesophagus lies to the right of the aorta.

(e) The superior rectal artery supplies the upper half of the anal canal.

(e) True - the inferior rectal artery supplies the lower half.

(e) In congenital absence of IVC the azygos vein enlarges.

(e) True-in the azygous continuation of the IVC, the azygos is a large structure, but otherwise the anatomy is unaltered. This may be confused with a mediastinal mass.

(e) The first posterior intercostal vein may drain into the corresponding vertebral vein.

(e) True-or the corresponding brachiocephalic vein.

entrance doses for radiographs

AP lumbar spine, AP abdominal x-ray, AP pelvic x-ray, 10 mGy PA chest x-ray 0.3 mGy PA skull x-ray 5 mGy

Dorsalis pedis artery is a continuation of

Anterior tibial artery

CIs to bronchography

Asthma..should use steroids and inhalers pre-op..not a CI Acute chest infection. CI Recent bronchoscope..not a CI

BOLT 0.04

B. Bladder O. oesophagus L. liver T. thyroid

Barium density

Ba250% w/v double contrast barium meal Ba125% w/v double contrast barium enema Ba 100% w/v barium follow through 15% w/v single contrast barium enema

Prostate has upper surface called........

Base

thyroid gland vertebral level

C2- C4

common carotid artery bifurcates at

trachea vertebral levels

C6 to T5

posterior relations of pancreas

CBD portal and splenic veins IVC and aorta SMA origin left psoas muscle left adrenal and kidney hilus of spleen

CSF

CSF is actively secreted by choroid plexus, flows cranial from basal cisterns, and posterior to spinal cord. Flows caudal anterior to spinal cord. Formed at a rate of 600 ml per sec.

CXR IVU Barium meal Barium enema CT abdomen

CXR 0.02mSv IVU 5mSv Barium meal 5mSv Barium enema 9mSv CT abdomen 8mSv

Largest tarsal bone

Calcaneus

Spleen, tail of pancreas, first part of duodenum lymphatic drainage

Celiac nodes

What is colloid shift?

Colloid shift is abnormal distribution of isotope into the spleen signifying portal HTN or diffuse liver disease.

Internal auditory canal lies in which plane

Coronal

Routine MRI ankle sequence include

Coronal T1, STIR, axial T1, sagittal GE

Changes in Doppler venous flow signal

Decrease in inspiration and increases in expiration

Hyoglossus has lingual artery running........ to it

Deep

Contrast media for bronchography

Dionosil is no longer made Iotrolan is a new non-ionic dimer made for bronchography

Radial nerve is ..... to humerus

Dorsolateral

Olfactory epithelium is

Ectodermal

Cervix drains to , gland penis drains to,

External and internal iliac LNDS, deep inguinal LNDS,

30 In the radiological investigation of the biliary tree: Ipodate leaves no radio-opaque residue in the gut

FALSE

Calcaneum articulates with cuneiforms

False

In abdominal US, adrenals are reliably imaged than with CT.

False

aorta bifurcates at level of L5

False L4

Post myelogram CT should be delayed for 24 hours after myelogram in order to reduce the contrast density by dilution

False a delay is not needed unless it is for syringomyelia, in which case, a delay of 24 hours is essential to show the syrinx.

Shoulder arthrography Single contrast technique is usually recommended

False a double contrast study is usually performed using 10 ml positive contrast and 10 ml of air

A full bladder is encouraged fro Meckel's scan

False a full bladder will obscure Meckel's diverticulum

Acromioclavicular joint is a typical synovial joint

False atypical synovial joint

Rectus femoris is in contact with greater trochanter of femur

False head of femur

pancreas lies anterior to lesser sac

False posterior

Tectum or quadrigeminal plate is anterior to cerebral aqueduct

False posterior to cerebral aqueduct

Pancreatic examination left lateral position is good for examination

False right lateral decubitus position is good

The recesses sacciformis is a pouch anterior to the proximal radioulnar joint

False the distal radioulnar joint

Effective dose limit for a member of the public is 50mSv per year

False the effective dose limit for a member of the public is 1 mSv per year.

Portal flow rates increase with exercise and inspiration

False they decrease

Liver and spleen may be seen in a normal bone scan

False this Amy be seen in reduced Tc tin oxide impurity.

Choroid plexus is usually seen in the occipital horn

False usually no choroid plexus in occipital horn

IVC is seen related to caudate lobe of liver at L1

False, IVC is free of liver at L1

Sustentaculum tali is a projection on the medial side of talus

False, on the medial side of calcaneum

Occipital horn of lateral ventricle are well developed in 90% subjects

Falsely in 12%

Lateral semicircular canal forms a prominence on posterior wall of middle ear

Fasle on medial wall, so does the bony canal of facial nerve

Maximum AP diameter of pancreatic head and body?

Head 25 mm Body 15 mm

Gd DTPA is protein bound and taken up by .....

Hepatocytes

GAstrografin is .....osmolality water soluble?

High osmolality..avoid in neonates

What to do to improve visualization of duct ?

Inject second dose of contrast 3-4 hours before the study

Half life Krypton 81 m Xenon 133 Xenon 127 Indium 113 m Indium 111m

Krypton 81 m..13 seconds Xenon 133..5 days Xenon 127..36 days Indium 113 m..1000 seconds..17 mins Indium 111m..2.8 days

Level of first part of duodenum

transpyloric plane is at

Filum terminale

Lower lumbar, sacral and coccygeal nerves together make filum terminale

Medial geniculate body and inferior colliculus is attached to auditory tract ..mnemonic?

MIA..

Heel pad thickness

Males 23 mm , females 21 mm

Pterygopalatine fossa contains........division of trigeminal nerve

Maxillary

Third ventricle is in the diencephalon

Midbrain

CIs for ureteric compression

Neonates Abdominal mass Renal trauma Renal obstruction

Jugular foramen

Ninth, tenth and eleventh

Caudal angulation is required in which

Occipitofrontal 20 degree and TMJ

Lateral elbow

Over lateral epicondyle

Angiography infusion rates

Renal , IMA and carotid hand injection 3-4 ml per second

Following patients should receive LOCM rather than conventional HOCM?

Renal failure, elderly and infants, poorly hydrated patients, patients with myelomatosis and patients with a strong history of allergy

Cranial angulation of tube in

Reverse Towne's view, SMV, AP SIJ 15 degree

Right lymphatic duct is...... cm long and total thoracic duct is..... cm long

Right is 1 cm long and total is 45 cm long

Doppler of portal vein approach

Right lateral intercostal approach is used as the beam angle for Doppler should be no greater than 60 degree. Anterior approach is optimal for imaging.

SGS pes ansinerus

Sartorius Gracilis Semitendinousus

Static renal scintigraphy can show false positive during UTI

So avoid DMSA for 3 months following a UTI

Pterygopalatine fossa communicates medically with nasal cavity through

Sphenopalatine foramen

Thickness of stomach, small bowel and large vowel

Stomach 10 mm Small bowel 3mm Colon 5mm

CI for direct cervical puncture

Suspected mass lesion in upper cervical canal Cerebellum tonsillar herniation Suspected lumbar spinal dysraphism Spinal deformities leading to loss of C1/C2 interspace

Subtraction films should be obtained where there is prosthesis

TRUE-Because of the difficulty in distinguishing contrast from the radio-opaque cement.

sources of radiation in the environement

Terrestrial gamma rays: 350ùSv per year Cosmic gamma rays: 320ùSv per year flying 4ùSv per hour so 0.048 mSv for 12 hours radon: 1.3 mSv per year in UK eating food: 270 ùSv per year natural sources: 2.2 mSv per year Cornwall natural source radiation: 7mSv medical exposure: 370 ùSv per year nuclear weapon fallout 4 ùSv per year smoke detectors 0.1 ùSv per year occupational exposures 6ùSv per year

Enteroclysis catheter is advanced through pylorus so turn the patient to left side

True

Facial nerve can be seen in parotid gland in T1 W images

True

Imaging renal tract,cross kidney film is centered on lower costal margin and done in arrested expiration with 35 degree posterior oblique projection, and 25-40 degree angular swing,

True

In CT of spine, dorsal root ganglion may be seen

True

Optic canal transmits optic nerve and ophthalmic artery

True

Oral barium will effect the result of bone densitometry

True

Parapharyangeal space is triangular in shape

True

Peripheral zone of prostate is high on T2

True

Pituitary gland stalk is composed of nerve fibers whose cell bodies are in third ventricle

True

Popliteal artery is deep to tibial nerve

True

Portal vein drains the entire gut from lower esophagus to upper anal canal

True

Posterior division of retromandibular vein joins posterior auricular vein to form external jugular vein

True

Potassium perchlorate blocks thyroid gland and salivary glands.

True

Profunda brachial vessels lie lateral to the humerus

True

The anterior surface of heart is formed by right ventricle

True

The ascending colon has a mesenteric in 10% of cases

True

The cavity of the right auricle lies to the left of the superior vena canal orifice

True

The common carotid artery arises from brachiocephalic artery in 25-30%

True

The descending colon lies on the lateral aspect of left kidney

True

The distal phalanges have roughened tuberosities on the palmar aspect of their distal ends

True

Thyroid imaging, Tc99 m image after15 min, and I- 123 image after 2-3 hours

True

Diagnostic angiography complications include: Retroperitoneal hemorrhage following transfemoral puncture

True by hematoma in femoral sheath, subperitoneal and intraperitoneal spaces , scrotum and fascial planes of thigh

Filling defects in SVC are seen in the normal patient during contrast enhancement

True due to incomplete mixing of pacified and unopacified blood

In pelvic and fetal US, cavitation echo is seen in midline of non-pregnant uterus.

True echo is produced by the contact of endometrial surfaces.

The zygomatic arches are clearly seen in A. A lateral skull B. A submento-vertical projection C. An occipito-mental projection with 30 degrees of caudal angulation D. A fronto-occipital projection with 30 degrees of caudal angulation (Towne's view) E. An occipito-frontal projection with 20 degrees of caudal angulation

True for B, C and D A submento-vertical projection A occipito-mental projection with 30 degrees of caudal angulation A fronto-occipital projection with 30 degrees of caudal angulation (Towne's view)

The ossification center for distal femur is present at birth

True for proximal femur ossification center is present at 1 year

Intrinsic muscles of tongue include all except genioglossus

True hyoglossus, palatoglossus, styloglossus.

Gastrografin may be used in treatment of meconeum ileus

True hypertonic gastrografin draws water into the bowel helping to dislodge the meconium. A dx barium enema should be done first.

Krypton ventilation study can be performed simultaneously with the perfusion study

True if dual energy data acquisition is performed. Krypton emits gamma rays with an energy of 190 keV and Tc 99m emits gamma rays with an energy 140 keV.

In pedal lymphography, left chain of LNDs extends higher than the right.

True in 51% it extends higher than the right or mid chain. Right reaches higher level in 17%.

A prominent longitudinal fold is present in 2nd part of duodenum?

True in 90% patients

Valsalva maneuver is used to demonstrate swallowed foreign body lodged in the neck

True in lateral valsalva film, thyroid cartilage moves anteriorly and a foreign body will be unchnaged.

Metoclopramide is CI in pheochromocytoma

True it causes acute hypertensive response.

In chest X-ray, posterior wall of bronchus intermediums can usually be seen on a lateral film.

True it forms a radiodense strip, 0.5-3 mm wide between the air in the bronchus and the lungs in the azygoesophageal recess . Can be seen in most lateral films and seen in 55% mostly. Well seen in CT.

In chest radiograph, only posterior portion of left hemidiaphragm is seen on the lateral projection.

True, this is one of the signs used to differentiate the leaves of the diaphragm on the lateral film.

fetus of a pregnant employee should not receive more than 1mSv over the declared term of pregnancy.

True, this limit applies to declared term, from when the employee informs her employer that she is pregnant until delivery of her child.

IVU coned bladder view

Tube is angled 15 caudad 5cm above pubic symphysis

Intravenous contrast injection has ........ times more contrast reactions

Two times more

First part of subclavian artery branches

Vertebral and internal mammary

cataract threshold

between 2 and 6 Gy.

anterior relations of ureter

duodenum terminal ileum right colic and ileocolic vessels right gonadal vessels root of small bowel mesentery

vallecula are paired lateral structures

false paired anterior recesses which lie in the larynx

spinal cord ends at upper limit of L3 vertebrae

false upper limit of L1 vertebrae

cavum septum pellucidum can be visulaized in 95% of infants

false visualized in 50% of full term infants and 15-20% of 6 month babies

long saphenous vein drains into

femoral vein passes anterior to medial malleolus

what is not seen on submentovertical view of skull?

foramen rotundum

anterior to 1st part of duodenum

gallbladder quadrate lobe of liver

the whole body fatal dose threshold is 1 Gy

it is 2-5 Gy

tributaries of portal vein

left gastric , right gastric and splenic vein, SMV, cystic vein, paraumbilical vein

venous drainage of ovaries

left.... left renal vein right....IVC

anterior to gallbladder are

liver anterior abdominal wall

infratemporal fossa contains the ............ nerve

mandibular nerve

motor supply of diaphragm

phrenic nerve

barium enema best sigmoid view is

prone with 45 degree caudal angulation

posterior relations of ureter

right psoas muscle bifurcation of right ocmmon iliac artery

pterygopalatine fossa communicates with nasal cavity through

sphenopalatine foramen

carotid areteriography

transfemoral approach is preferred

Artery of Adamkiewicz arises from vertebral level T8-T12

true

CSF flows caudally in front of the spinal cord and cephalad posterior to it.

true

Centering point for PA chest is T8.

true

Contrast between gray and white matter is superior on MRI of the brain

true

Dural sac finishes at S2 but pia mater in the form of filum terminale is attached to 1st coccygeal segment

true

ECA has anastomotic branches with ICA

true

ERCP will affect the result of ultrasound

true

Equivalent dose is absorbed dose multiplied by RWF

true

GM tube is more efficient in detecting lower energy as opposed to higher energy beta particles

true

Glucagon has a longer lasting effect than buscopan?

true

HRCT shows normal interlobular septa

true

fetal BPD of 25mm at 13 weeks is normal

true

sigmoid colon view RAO?

true. RAO view

lung window level should be

-600 to + 1000

Lymphoscintigraphy contrast dose for Tc 99m nanocolloid

0.1-0.3 ml subcutaneously

Size of sulphur colloid particles

0.1-1 micronmeters

sensitivity of TLD

0.1. to 0.2 mSv

stomach and breast tissue weighting factor

0.12

PA chest film AP abdomen Lateral lumbar spine absorbed dose

0.15 mGy 5 mGy Lateral lumbar spine 12 mGy 0.015 mSv is typical effective dose of PA chest film. absorbed fetal dose of barium enema in pregnant patient is 5mGy. Absorbed fetal dose of a CT pelvis is 10-30 mGy.

Adrenaline dose

0.5-5 ml 1 in 10,000 IV for anaphylaxis 0.5 ml of 1 in 1000 subcutaneous for angioedema

Fluoroscopy with under-couch tube has drapes which should have a lead equivalence of .....

0.5mm

digital imaging

1 micro gray per frame

Facet joint arthrography technique

1 ml contrast in facet joint , steroid and anesthetic injection generates useful information, L5/S1 facet joint needs caudal angulation

the efficiency of detection of gamma rays by GM tube is...

1%. This can be increased to 5% by the use of a lead cylinder as a cathode.

PA chest x-ray effective dose

0.015mSv

Gonads TWF

0.08

cine radiography dose rate

0.1 micro gray per frame

body aprons lead equivalence

0.35 mm

leakage rate from x-ray tube

1 mGy in 1 hour time at 1 meter

Incidence of cervical ribs is .............

1-2%

Superior mesenteric angiography technique includes

1. Patient nil by mouth for 4 hrs 2. Arterial phase 2-3 frames per second for 3-5 seconds. 3. Venous phase 1 frame per second for 20 seconds is appropriate

ON ultrasound , 1. cystic duct is seen in approximately 50% 2. right adrenal is more commonly visualized than the left

1. True 2. True

Inguinal, nodes how many vessels enter?

10-15

Splenic pulp pressure is

10-15 mm of water not Hg

Angle of the longitudinal arch of the foot is normally

130-170 degree

medical investigation contribution to average annual total effective dose

14%

Standard arterial angiographic needle for adults

18 G

Max width of portal vein is

2 cm

Apparent thickness of diaphragm when air is in the peritoneum is

2-3 mm

Pericardial sac has .... ml of serous fluid

25 ml

33 The percutaneous extraction of retained biliary calculi E. Antibiotic cover is necessary

33 TRUE-A brond-spectrum antibiotic is given 24 hours before and 2-3 days after, the procedure. Reference

33 the percutaneous extraction of retained biliary calculi B. The catheter is manipulated to a point distal to a stone in the common bile duct.

33B TRUE-The extraction device can then be advanced to the catheter tip. The catheter is then withdrawn to permit capture of the stone .

Oblique view of kidney

35 degrees posterior oblique

38 In lymphography B. The injection is made at a rate of about 15 ml per hour.

381 FALSE The maximum desirable rate is 10 ml per hour. Faster injection rates than this will cause extravasation, Reference,

threshold dose for hair loss

3Gy

what dose causes testes sterility?

4Sv to the testes causes sterility

the annual equivalent dose limit to the eyes for a trainee aged less than 18 years is

50 mSv

Coronary sinus drain.......of heart

60%

carina forms an angle of .... in adults carinal forms an angle of ...... in children carina lies at level of

65 degrees 120 degrees T4/T5

Shoulder CT arthrogrpahy

1-3 ml of contrast and4-8 ml of air are used

I131 half life

8 days

Barium transit through bowel increases with A. Warm saline. B. Buscopan

A. False, cold saline B. False. Anti-cholinergic

Recurs abdominis attachment, adherence and costal attachment

Attaches to front of pubic bone, adheres to anterior rectus sheath and 5, 6 and 7 costal cartilage attachment.

full bowel preparation for barium enema should be avoided in all of the following conditions except:

Avoid full bowel preparation in hirschsprung's disease, colonic obstruction, acute UC exacerbation and Suspected bowel perforation. Full bowel preparation can be done in irritable bowel syndrome.

Tube angulation Axial calcaneus. Tunnel view knee AP cervical spine Submentovertex

Axial calcaneus: 30 cephalad Tunnel view knee: 90-110 angulation to shaft of tibia AP cervical spine: 15 cephalad Submentovertex: 5 cephalad

MRI air hip

Axial or coronal T1, T2 and STIR images are used. Only sagittal for symptomatic hip

Site of Porto-systemic anastomosis

Bare area of liver , lower esophagus, peri umbilical, lower part of anal canal

Median cubical vein connects the cephalic to the....... veins

Basilic veins

Why is sedation not advisable in micturating cystogram?

Because sedation increases the risk of bladder rupture from overfilling

Properitoneal fat line

Between anterior abdominal wall and peritoneum, absent in 18% of cases

PA wrist

Between radial and ulnar styloid

External acoustic canal

Bone in medial 2/3 rd and cartilage in lateral 1/3rd

BC BLS 0.12

Bone marrow Colon Breast Lung Stomach

BS BS 0.01

Bone surface Skin Brain Salivary gland

Meglumine predisposes to ?

Bronchospasm, rigors

IVU contrast media is CI in all except one MM Sickle cell anemia RTA previous allergic rexc to contrast Bronchial asthma

CI in all except sickle cell anemia

Regarding the cerebellum, a CT of the upper cerebellum contains cerebellum posteriorly and occipital lobes anterolaterally

CT of the upper cerebellum contains the cerebellum anteriorly and occipital lobes posteriorly. This is because superior surface of the cerebellum slopes upwards from posterior to anterior

typical effective doses CXR BARIUM ENEMA IVU NUCLEAR MEDICINE CARDIAC IMAGING NUCLEAR MEDICINE LUNG VENTILATION

CXR 0.1 mSv BARIUM ENEMA 9mSv IVU 5mSv NUCLEAR MEDICINE CARDIAC IMAGING 6mSv NUCLEAR MEDICINE LUNG VENTILATION 0.1mSv

Cavum septum pallucidum can be visualized in about 95% of full term infants

Cavum septum pellucidum can be visualized in about 50% of full term term infants. By 6 months of age it's incidence is similar to that reported in adults 15-20%.

Centering point Lateral toes Lateral foot Lateral calcaneus

Centering point Lateral toes..head of 1st metatarsal Lateral foot..cubonavicular joint Lateral calcaneus..talocalcaneal joint

Barium formulation EZM HD ?

Comes as a powder, mixed with 60 mls water to form a 250 w/v. Baritop is a suspension in 300 ml can.

CRL 27 mm pregnancy duration

Compatible with 9 weeks 3 days

Myelography contrast is injected with x-ray table tilted 15 degree head down

Contrast is injected with 15 degree foot down to ensure pooling of contrast in lumbar subarachnoid space.

AP shoulder . Centering point

Coracoid process

Shoulder MRI routine sequences

Coronal oblique along supraspinatus tendon are done Sagittal perpendicular to coronal oblique.

Pigtail catheters have side holes in the straight portion. If in curved portion, it is .......

Drainage catheter

Anterior relations of right kidney include:

Duodenum, ascending colon, ascending branch of right colic artery

Tympanic antrum is ecto or endodermal?

Endodermal

Cavernosography indications

Erectile dysfunction Priapism Penile trauma Peyronie's disease

Intraperitoneal barium has a mortality rate of 50%

Even with treatment there is still a 50% mortality rate if barium leaks into peritoneal cavity.

Which structures lie dorsal to the wrist joint?

Extensor retinaculum, radial artery, anterior interrosseous artery curves does ally at wrist to anastomose with posterior interroseous artery ,adductor pollicis longus tendon

Thyroid scintigraphy, following are causes of an absent gland

Extravasation, lipiodol lymphangiogram in previous year,ectopic thyroid, amiodarone therapy

27 Oral cholecystographic contrast media lipid C. Have peak concentrations in the bile ducts at 10-14 hours after administration

FALSE As far as ipodate is concerned, the peak concentration in the ducts occuts at about 3 hours. Maximum levels in the gall bladder occur at 14-19 hours depending on the particultar contrast medium

35 ln arthrogrnphy of the knee D. Intra-articular injection of contrast usually causes some pain

FALSE The injection is painless. If the patient complains of pain, an extra-articular injection should be suspected in which case, the contrast medium will remain around the needle tip.

32 Endoscopic retrograde cholangiopancreatography (ERCP) D. Requires 8-12 ml to fill the normal pancreatic duct.

FALSE--2-5 ml are required. Reference S, p. 88.

38 In lymphography D. A 24 gauge needle is used to cannulate the lymphatics.

FALSE-27-30 gauge needles are used. Reference J, p. 280.

27 Oral cholecystographic contrast media E. Are removed from the blood by passive diffusion.

FALSE-An active mechanism is used. It is rate limited. Reference S, p. 62.

36 In hip arthrography C. The anterior (vertical) approach is favoured when there is a hip prosthesis

FALSE-An anterolateral approach is preferred because the prosthesis obscures the metallic needle. Reference

39 In lymphography. The contrast medium should be seen as globules on a radiograph of the calf.

FALSE-Globulation occurs when Lipiodol is injected intravenously.This has been described as the caviare sign". Reference

40 In lymphography A. 'The procedure may be performed if the patient is receiving a course of raiotherapy to the chest.

FALSE-It is unsafe in this situation because of the risk of cerebral oil embolus.

E. Contrast containing 350 mg iodine per 100 ml is used at cholangiography PTC

FALSE-The contrast (e.g.hypaque 25%). The contrast preferred is one containing 150 mg per 100 ml . Too high concentration of iodine will obscure Small stones. Reference S, p. 76.

C. 15 ml of contrast should be injected before any films are exposed at operative cholangiograplhy

FALSE-The first film should be taken after the injection of alout 3 ml because the terminal portion of the bile duct may otherwise be obscured by contrast in the duodenum. A sntisfactory seuence is to take films when 3, 5-8, and 12 ml have been injected. Reference

30 In the radiological investigation of the biliary tree: A. Oral cholecystographic contrast media give good results during acute cholecystitis

FALSE-The gall bladder frequently fails to opacify. This has been action of bacteria which deconjugate the contrast and permit its reabsorption by the gall bladder itself. Reference

40 In lymphography C. The injection is stopped when the cisterna chyli is seen

FALSE-The injection is stopped when the contrast medium has reached the level of L4.

31 In the examination of the biliary tree: A. It is abnornmal for the intramural segment of the bile duct to appear as a gap on T-tube cholangiograplhy.

FALSE-The intramural segment normally has a narrow lumen or appears as a gap on a T-tube or operative cholangingraphy. It should not be interpreted as abnormal. Reference

24-hour films are taken to demonstrate the lymphatic vessels.

FALSE-The lymphatic vessels are devoid of contrast at 24 hours. The films at this time show the nodes.

B. Reflux of contrast along the pancreatic duct during T-tube cholangiography indicates ductal obstruction

FALSE-This is a common finding in the normal examination

A small amount of contrast enters the narrow zone of lucency that surrounds the normal prosthesis

FALSE-This suggests that loosening of the prosthesis has occurred

branches of subclavian artery VITCO

FIRST PART Vertebral artery Internal thoracic artery Thyrocervical trunk SECOND PART Costocervical trunk THIRD PART no branches from third part

In abdominal US, free blood can be distinguished from ascitis.

False

In chest, radiograph, lower lobe disease is best seen in the lordotic position.

False

Lignocaine interacts adversely with propranolol and antidepressants

False

Motion artifact adjacent to the heart is eliminated in HRCT

False

PICA is a branch of the basilar artery

False

Popliteus tendon separates the popliteal artery from posterior surface of the femur.

False

Prolonged prothrombin time is a CI for ERCP

False

The C1 vertebra has a bifid spinous process

False

The following are features of air gap technique for chest radiography, good definition of soft pulmonary shadows

False

annual equivalent dose limit for the lens of the eye for an employee is 150 mSv.

False

Lymphangiography Internal iliac lymph nodes are well demonstrated

False Internal iliac, mesenteric, retrocrural, splenic and renal hilar nodes are not seen in this investigation.

Sodium iothalamte does not cross the BBB?

False The normal BBB is deficient. Lolli's theory. so it crosses the BBB.

MR cholangiopancreatography Cannot demonstrate ductal anatomy proximal to an occlusion Special resolution is less than with ERCP

False True

annual background radiation exposure per caput of UK population is about 1.5mSv

False , 2.5mSv

The annual equivalent dose limit for the skin of a member of the public is 150mSv.

False , annual equivalent dose limit for the skin of a member of the public is 50 mSv.

Regarding percutaneous cholangiography, active cholangiography is an absolute CI

False , relative CI

Portal vein formed by union of inferior mesenteric and splenic veins

False , superior mesenteric and splenic veins

Right adrenal gland and segment 2 of liver are seen at L1

False , they are seen at T10 and T11

LPO 25 degree to show right glenohumeral joint

False , this is good for left glenohumeral joint.

Sodium salt causes peripheral neuropathy, salivary gland enlargement and is bound to plasma protein

False , true, false less than 1% is bound to plasma protein

Endoscopy upper GI perforation rate is 0.1%

False 0.018%

For bronchography atropine dose is 6mg

False 0.6 - 1.2 mg

Post rectal space should not exceed 2 cm

False 1 cm

Barium enema perforation as a complication occurs in 1 in 1000

False 1 in 12000

leakage of radiation at a distance of 1 m from the focus must not total more than 10 mGy.

False 1 mGy

T tube cholangiography is done 21 days post op

False 10 days post op

Average carpal angle is 150-170

False 135-140

In a single dose technique cholecystographic agent is taken one hour before visualizing GB.

False 14 hours before visualizing gall bladder.

In technetium brain scan, 2-3 mCi of pertechnetate is used

False 15 mCi

Retrograde pyelography 340 mg/ml contrast media is used

False 150-200 mg iodine per ml is used so that smaller lesions are not obscured

Dacryocystography, 16 gauge cannula used

False 18 gauge

Ureters have a course of 5mm through bladder wall

False 2 cm

broad ligament contains 4 layers of peritoneum

False 2 layers of peritoneum

For gallium breastfeeding should be stopped for 2 days

False 2 weeks

Nasal cycle alternates every 20-30 minutes

False 2-3 hours

In bladder ureteral openings are 5 cm apart

False 2.5 cm apart

AP elbow beam is 2.5 cm proximal to episcondyles

False 2.5 cm distal to epicondyles

natural background radiation contributes 5mSv to the annual whole body dose per person in the UK

False 2.5 mSv

Pancreatic duct diameter upper limit is 3.5 mm

False 2.5 mm

Intrapancreatic duct transducers have a frequency of 7.5-12 Hz.

False 20 - 30 Hz

ERCP 150 mg/ ml should be used to visualize pancreatic duct

False 240 mg/ml is used for pancreatic duct. Bile duct 150 mg/ml

Esophagus is 40 cm long, inclines left at neck and reaches midline at.......

False 25 cm long, T5

Normal maximum diameter of abdominal aorta is 4cm

False 3 cm

Prostate has 2 lobes

False 3 lobes left , right and median

Double contrast knee arthrography, 15 ml of positive contrast medium is recommended.

False 3 ml of positive contrast medium and 50 ml of air

Normal venous pressure of pulmonary vessels is 10 mm of mercury

False 3 mm of Hg

kidney length is normally four and a half vertebrae

False 3 vertebrae

Phrygian cap deformity is seen in 20%

False 4 %

The range of movement of f diaphragm on deep inspiration / expiration is 2cm

False 4 cm

Anal canal is 10 cm long

False 4 cm long

Optic nerve is 4 mm thick and has three parts

False 4 mm thick but 4 parts intraocular, intraorbital, intracanalicular and intracranial

There are 5 pairs of strap muscles in neck

False 4 pairs. Omohyoid, thyrohyoid , sternohyoid, sternothyriod,

Average increase in attenuation value of hepatic parenchyma is 80 HU.

False 45 HU

Cervical oblique X-ray is done with 60 degree head turn

False 45 degree

portal phase imaging in contrast enhanced CT of liver is achieved in 30-40s after injection

False 49 - 73 s after injection

Lymphoid follicles In rectum measure up to 6mm

False 4mm

Left main bronchus is 2cm long

False 5 cm long

Ureteric compression should be applied 15 minutes after the contrast media injection

False 5 mins after the contrast media injection

For brain scan, 3.5 MHz linear array transducer is preferred.

False 5-7.5 Hz sector transducer is used

Oral cholecystography, minor side effects are experienced in 15%

False 50 %

When using krypton lateral oblique views of the lung should be avoided due to overlap of two lungs

False 6 views necessary RPO, LPO, right lateral and left lateral, anterior and posterior.

Internal auditory canal transmits caroticotympanic nerve

False 7 and 8 CN

Duran sinuses opacity 10-14 s after ICA injection

False 7 s

Lower limb lymphangiography 7ml lipiodol ultrafluid should be used for each lower limb at an injection rate of 1 ml/min

False 7ml lipiodol ultrafluid per lower limb should be injected over 45 mins by a pump injector approximately 0.2 ml per min.

Inferior accessory fissure is seen in 1% of PA chest xrays Superior accessory fissure 5% Minor fissure 50% Left transverse fissure 8%..not seen on chest xray Azygos fissure 0.4%

False 8% True True True

Aorta gives off 6 pairs of intercostal arteries

False 9 pairs

Bronchial arteries arise from thoracic aorta in 50 % of cases, at T5/6

False 90% cases

when deciding on whether an examination is justified, the ALARP principle should be taken into account

False ALARP is for optimisation

ARSAC certificates are issued to a set group of clinicians within an x-ray department.

False ARSAC certificate is issued to an individual clinician.

Duplex scanning combine B mode and color Doppler

False B mode and pulse doppler

Scalenus anterior is attached superiorly to the anterior tubercles of lower three cervical vertebrae

False C3- C6

Chiba needle in PTC is inserted via anterior approach

False Chiba needle 22G inserted in mid axillary line in right 7th or 8th intercostal space. Inserted parallel to the plane of table and advanced in suspended respiration through the right lobe of liver

High resolution computed tomography (HRCT) uses a slice thickness of 4-6 mm to identify mass lesions in the lung.

False HRCT uses 1-2 mm slice thickness and a high resolution computer algorithm to show fine detail of the lung parenchyma, pleura and tracheobronchial tree. It is not used to delineate masses in the lung.

Tc 99 m pertechnetate can be used to assess thyroid function

False I 123 can be used. 60 MBq of Tc99 m is routinely used

IRR 99 aims to minimize harmful ionizing radiation to patients

False IRR 99 relates to safety of employees at work. IR (ME) R relates to patients.

IV contrast enhancement is mandatory for CT scan of orbit

False IV contrast enhancement is given to show space occupying lesions in better detail or when there is suspicion of intracranial involvement by a lesion. Not necessary in thyroid eye disease or trauma.

A supine patient position is optimal for demonstrating the fundus of stomach

False It demonstrates the antrum and body of stomach

Azygos vein may arise from right renal vein

False May arise from IVC, ascending lumbar veins, or subcostal veins

AP knee for patella

False PA knee so patella is close to film. To reduce magnification and blur. Short FFD used to blur femoral condyles.

RPA is responsible for day-to-day management of radiation protection

False RPS is responsible for day-to-day management of radiation protection

Equivalent dose is measured in mGy

False Sv

In trans lumbar aortography, high puncture is at L1-2.

False T 12

Artery of Adamkiewicz is from T4 to T8

False T8 to L4

MRA, TOF technique is more sensitive to slow flow than the phase contrast technique

False TOF MRA uses a GE sequence with a flip angle of 30-60 degree to maximize flow related enhancement of vessels that occurs due to the entry phenomenon. Thus in-phase flow will produce less signal so that TOF techniques are less sensitive to slow flow within the imaging plane.

For endoscopic US scan of esophagus, patient preparation includes drinking at least 1 liter of fluid

False US probe is attached to a rubber bag containing water so that acoustic contact can be maintained between esophageal wall and probe.

A soft tissue algorithm is used

False a bony algorithm is used in HRCT.

Metacarpal index of greater than 7.4 suggests arachnodactyly

False a metacarpal index of greater than 8.4 suggests arachnodactyly

Regarding perfusion isotope lung imaging It should be performed after a ventilation scan for pulmonary embolism

False a normal perfusion scan excludes pulmonary embolism. So perfusion scan should be done first. Ventilation scan only done if perfusion scan is abnormal.

GB may be silent in a HIDA scan in fasting subject

False a silent GB is seen in acute cholecystitis.

Gall bladder is absent in 0.5% cases, double in 1% cases

False absent in 0.05% of cases, false double in 0.025% cases

Oral cholecystography is useful in diagnosis of acute cholecystitis

False acute cholecytsitis is a CI to oral cholecystography as GB will not opacify. Other CIs are hepatorenal failure, dehydration, IV cholangiography in the previous week and previous cholecystectomy.

Air in biliary tree is always abnormal

False after Whipple or instrumentation it is normal

CBD should never be more than 1 cm

False after cholecystectomy it can be

Annual effective dose limit for hands of an employee is 500 mSv.

False annual equivalent dose limits for hands of an employee is 500 mSv

ICA lies posterior to middle ear

False anterior

Phrenic nerve lies posterior to scalenus anterior

False anterior

Portal vein lies posterior to epiploic foramen

False anterior

The posterior end of hippocampus has a paw appearance called peshippocampi

False anterior end is called peshippocampi

Os supratalare is seen posterior to talus

False anterior to talus on its superior aspect

The vertebral artery in foramen transversarium passes posterior to the ventral rami of spinal nerves

False anterior to ventral rami of spinal nerves

Pelvic kidney is well demonstrated by posterior view

False anterior view

Median umbilical ligament is attached to bladder base

False apex

The deep lobe of submandibular gland is wound around the lateral border of mylohyoid

False around the posterior border of mylohyoid

A gap in lumbar trunk on right is abnormal.

False associated with right lower lumbar bypass vessel at L3/L4 level. Left lumbar chain is always continuous.

Ossification center for femoral head is present at birth

False at 1 year

Secondary ossification center at sternal end of clavicle appears at 6 years

False at 15 years

Distal ulnar epiphyses is present at birth

False at 5-6 years of age

CBD joins pancreatic duct at angle of 90 degrees

False at 60 degrees

Thoracic duct Pierce's T.H. diaphragm at T10

False at T12

A complete ring of cartilage is seen at the supraglottic level

False at glottic level

Anterior median fissure begins at lower border of medulla

False at lower edge of pons

The basilar artery when deviating from midline, deviates to the side that forms the dominant vertebral artery

False away from the dominant vertebral artery side

There's minor supplied by sub scapular is nerve

False axillary nerve

At shoulder, axillary vein is lateral to axillary artery

False axillary vein is medial to axillary artery

60% w/v is used as a positive bowel contrast agent

False barium is used as a negative bowel contrast agent by shortening T2 and therefore appearing black on T2 weighted spin echo images. Gadolinium and fatty oils are used as positive bowel contrast agents.

A single injection will normally opacity the anterior spinal artery

False because radicomedullary branches are segmental, multiple injections are required.

Radial artery lies on brachioradialis in upper forearm

False below brachioradilis

Coccygeal lies above piriformis

False below piriformis

Saccule lies in cochlea and utricle lies in vestibule

False both saccule and cochlea lie within the vestibule

Brachial artery lies in contact with humerus

False brachial artery lies medial to the humerus on brachialis and triceps muscles.

During arterial pornographers liver enhances by 40 HU

False by 150 to 190 HU

Popliteal artery is separated from femur by facsia

False by loose fatty layer

Ovaries attach to the uterus by suspensory ligament of uterus

False by suspensory ligament of ovary

Optic canal is entirely formed by the greater wing of sphenoid

False by the lesser wing of sphenoid, optic canal does not transmit superior ophthalmic vein- passes through superior orbital fissure

Tc 99m MAG 3 is excreted by glomerular filtration

False by tubular secretion

Temporal lobe is separated into 3 gyri by two vertical sulci

False by two horizontal sulci

Gastrografin is indicated to see TOF in infant

False cause pneumonitis and pulmonary edema if as

In cervical spine radiography, no tube angulation is needed in AP view provided that the canthomeatal line is at 90 degree to the film

False cephalad angulation by 5 to 10 degree is needed. CML is above horizontal and. Superimposes mandible and occiput.

Trachea is lined by stratified sq epithelium

False ciliated columnar epithelium

For embolization always use coaxial technique

False coaxial is done only for super selected small vessels

Hexadecanoic acid, potassium 43 and thallium 201 is taken up by infarcts heart muscle

False cold spot is produced as it is taken up by normal muscle and not infarcted heart muscle.

Largest white matter association fiber is corpus callosum

False commissural fibers

Managing adverse reaction to contrast media IV metoclopramide for nausea IV chlorpheniramine for urticaria

False confident reassurance is adequate True

Diastolic flow reversal is seen in the common carotid artery

False continuous forward flow is seen in the common carotid artery

Sinogrphy, maximum 20 ml contrast medium is injected

False contrast is injected until either reflux occurs or the fistula is shown

In dacryocystography, an occipitofrontal 20 control film is taken

False control film is occipitomental

Transrectal prostate biopsy , at least 6 fine needle aspirate should be taken

False core biopsies are done with 18 G needle

Knee arthrography, correct sitting of needle tip should be confirmed by aspiration of synovial fluid

False correct sitting of needle tip is confirmed by test injection of small volume of contrast media under fluoroscopic control .

The study of ascending venography is complete when the deep femoral vein has been demonstrated

False deep femoral vein is demonstrated in about 50% of cases when there is a loop connection with the superficial femoral vein

Superficial palmar arch is proximal to deep palmar arch

False deep is proximal to superficial palmar arch

Dentate nucleus is related to the posterior limb of the internal capsule

False dentate nucleus is a part of cerebellum

development of leukemia in childhood has a threshold of 4Sv to the bone marrow

False development of cancer as a result of radiation is a stochastic effect.

measurements of air kerma may be undertaken to represent absorbed dose in tissue.

False dosimeters are calibrated in terms of air kerma.

Sigmoid colon drains to para aortic LNDs and measures usually less than 45 cm

False drains to inferior mesenteric nodes, True

Internal biliary drainage is indicated if ductal calculi are seen

False ductal calculi are a CI to endoprosthesis insertion.

Lymphangiography beading is due to valves in the lymph channels

False due to intravenous injection

Embolization proximal vessels first

False embolize distal vessels first

Department of the environment is responsible for enforcing the IRR99

False enforcing the IRR99 is the responsibility of the Secretary of State for Health who uses the appropriate HSE- health and safety executive.

Entrance dose for a PA chest x-ray is greater than that of an abdominal x-ray.

False entrance dose for a PA chest x-ray is 0.3 mGy and for AP abdomen is 10 mGy.

Posterior relation of left bronchus is esophagus and IVC

False esophagus and descending aorta

In bronchography, some contrast is seen in bronchi for 3 weeks

False expectorated in 2 days

Oblique fissure extends from T6

False extends from T4/5

Anterior jugular vein enters the internal jugular vein

False external jugular vein

The right and left subphrenic spaces are divided by the coronary ligament

False falciform ligament

Vertebral artery arises from second part of subclavian artery

False first part

Flagella is seen in 5% adults

False flabella is seen in 20% adults

Posterior process of talus is grooved by peroneus longus tendon

False flexor hallucis longus tendon

LPO 25 degree for right glenohumeral

False for left glenohumeral

Cervical ribs are found in 10-20% of subjects

False found in 1-2% of subjects

The articulate process of vertebrae project superiorly and inferiorly from each pedicle

False from each lamina

Pericardium receives blood supply from branches of pulmonary arteries

False from internal mammary arteries

Uterus develops from Wolffian ducts

False from mullerian ducts

Glenoid labrum is deficient inferiorly

False glenoid labrum is a continuous ring

MRI is poor for paranasal sinuses

False good since bony septa have no signals outlined by high signal mucosa

Lateral aspect of ankle joint has 2 separate ligaments

False has 3 separate ligaments.

hepatic veins follow the structures of the portal triad

False hepatic arteriole follows the structures of portal triad

Transitional zone of prostate is hyperechioc

False hypoechoic

The hypoglossal canal lies posterior to the occipital condyle

False hypoglossal canal lies anterior and above the occipital condyle

Lumbar nodes may normally extend laterally beyond the tips of the transverse processes.

False if they do they are displaced.

Arthrography TMJ joint, upper lower spaces are visualized by one injection. Puncture the superior joint space first

False if visualized, disc rupture suspected. False, puncture the inferior joint space first. Lateral flexion of head is done to stop overlap of the two TMJ joints. Needle is advanced in posterosuperior aspect of condyle.

DMSA imaging should be performed immediately

False imaging should not be performed before 1.5 hours in order to allow free technetium to clear from the urinary tract.

Splenunculi are found in 25% adults

False in 10% adults

Pneumothorax will be detectable on X-ray in approximately 60% cases

False in 15-25% cases.

Right vertebral artery is bigger in majority of cases

False in 20% of cases

Left renal vein is retroaortic in 1% cases, LRV splits to surround aorta in 7 %

False in 3.5% , true

Facial nerve can be demonstrated in parotid gland in 50% cases

False in 30% cases

Reaction to urographic contrast media occurs in 90% of patients with history of previous reaction?

False in 35%

Left vertebral originated from aortic arch in 20%

False in 5%

A sesamoid bone is seen in the IP joint in 10% cases

False in 73% cases

Nephrogram is produced by contrast in renal arterioloes

False in PCT

CT abdomen adrenals are seen in only 10% of patients

False in all

Crucial easy ligaments insert into tibial spines

False in front of and behind the tibial spines

Bony thoracic anomalies are more common in lower ribs

False in the upper ribs

Indirect portal venography is performed via transsplenic approach

False indirect portography results from injecting contrast into coeliac or SMA and obtaining delayed films of the portal vein

In the normal pedal lymphangiography A. The cisterna chyli is usually demonstrated as a distinct sac at the level of L2

False intermittently demonstrated and as a plexus of vessels

HRCT contiguous 1 mm thick sections are obtained

False interval 1 mm thick sections are obtained

Accessory hemiazygous vein drains into left brachiocephalic vein

False into Azygos vein

Dorsal and ventral roots unite 2cm beyond the intervertebral foramina to form spinal nerve.

False invite at the intervertebral foramen

Sacrospinous ligament becomes broader laterally

False it becomes narrower laterally

Atlas ha no foramen transversarium

False it does have

Direct radionuclide micturating cystogram gives 10 fold lower dose than a radiographic micturating cystogram

False it gives 20 fold lower dose

The uterine body has four distinct zones on T2 W MRI

False it has three distinct zone High signal endometrium Low signal transitional zone due to compressed myometrium Intermediate signal myometrium

Long saphenous vein has no valves above the knee

False it has, more below the knee, less above the knee.

TB radiation dose from sulphur colloid is 1-2 rad

False it is 0.03-0.06 rad.

threshold dose for harming a fetus is 0.1-0.5 mGy

False it is 0.1-0.5 Gy.

Vagina measures 20 cm in length

False it is 10 cm

Thoracic inlet is 15 cm wide and AP 5 cm

False it is 10 cm wide

The five consecutive years dose limit for the skin of a member of public is 50mSv.

False it is 100 mS

Krypton 81m has half life of 5.5 days, is taken up by normal liver, radiation energy 191 keV, is derived from thallium,

False it is 13 seconds. Xe 133 has half life of 5.5 days, false , false, false obtained from rubidium81 .

Pneumothorax complication in lung biopsy is 50%

False it is 15-35%

Ascending aorta is 10 cm long

False it is 5 cm long

CT larynx, asymmetry of valley lake is abnormal

False it is a normal variant

in percutaneous cholangiography, active cholangitis is an absolute contraindication.

False it is a relative contraindication.

Adrenaline is not added to contrast medium for arthrography

False it is added 0.1 ml of a 1 in 1000 solution. It's added to delay the absorption from joint space.

Appendix has a collateral arterial supply

False it is an end artery

Sacroiliac joint is a primary cartilaginous joint

False it is atypical synovial joint

Thyroid gland lies anterior to pretracheal fascia

False it is enclosed within pretracheal fascia

Recommendations of ICRP introduced 3 basic principles of radiation protection: justification, optimization and diagnostic reference levels

False it is from IRMER

Annulus fibrosus of intervertebral disc contains elastic tissue.

False it is made of concentric sheets of collagen fibers

Intracranial portion of optic nerve is lateral to internal carotid artery

False it is medial to internal carotid artery

Iothalamate 320 is suitable contrast agent for introduction use in parotid

False it is too dense and liable to produce artifacts. Low iodine concentration 5-7% is required.

Subacromial bursa communicates with shoulder joint

False it normally doesn't. Subcross x never.

Lung biopsy hemolysis occurs in 1%

False it occurs in 2-5%

Ligamentum flavum passes from posterior surface of one lamina to the anterior surface of the lamina below

False it passes from anterior surface of lamina to posterior surface of lamina below

Window level of a CT scan should be 100 for scans of mediastinum

False it should be at zero.

Fossa oval is is in the upper part of the interatrial septum

False it's in the lower part of the interatrial septum

Catheter should be inserted to a maximum distance of 3 cm into the sinus track

False it's inserted as far as possible into the sinus track until a resistance is felt

Posterior pararenal space communicates across the midline

False it's limited by gerota's fascia. Anterior does communicate across midline

Regarding the right atrium, it's anterior wall is smooth into which the great veins drain

False it's posterior wall is smooth into which the great veins drain

The left kidney may be normally up to 17 cm in length

False kidneys are normally 11-15 cm in length.

Magnetic iron oxide particles are taken up by hepatocytes.

False kupffer cells

Dorsalis pedis is medial to extensor hallucinate long is

False lateral

Groove on medial femoral condyle is by popliteus tendon

False lateral femoral condyle

37 In hysterosalpingography: D. The scar of previous caesarian section is demonstrated on frontal films

False lateral fims

Right phrenic nerve enters thorax medial to brachiocephalic vein

False lateral to BC vein

Leakage of contrast around the catheter should be avoided when filling the bladder at cystography

False leakage is a sign that adequate filling has occurred such that child is likely to continue to micturating. Flexing toes is a useful sign too.

Middle and right hepatic veins often join prior to entering IVC

False left and middle

Diagonal branches are from left circumflex artery

False left anterior descending artery

US of appendix, sector transducer is used

False linear transducer

Spleen is more echogenic than liver in adults

False liver is more echogenic than spleen

Short T2 high signal

False long T2 high signal

The short process of incus articulates with stapes

False long process of incus articulates with stapes

Hepatic oil embolism following lymphography may occur when nodes are normal

False lymphaticovenous connections open up when lymphatic are obstructed.

Floor of maxillary sinus is higher than floor of nose

False maxillary floor is lower than that of nasal cavity

Sternocelidomastoid has one head attached to the medial half of clavicle

False medial one third of clavicle

Medial pterygoid is attached to the head of mandible

False medial surface of ramus and angle of mandible

Right vagus nerve passes lateral to Azygos vein

False medial to Azygos vein

Meglumine salts compared to sodium slats are preferred for IV urography

False meglumine are diuretic so sodium salts are preferred

Metoclopramide increase small bowel transit time

False metoclopramide increases gastric peristalsis thus reducing small bowel transit time

Ascending urethrography is exam of choice to demonstrate posterior urethral valves

False micturating cystourethrography Ascending urethrography is Exam of choice for suspected urethral trauma and urethral stricture

middle and right hepatic veins often join prior to entering IVC

False middle and left hepatic veins join prior to entering IVC in 60% cases

Respiratory depression as a result of lignocaine overdose may be reversed by naloxone

False naloxone reverses respiratory depression caused by opioid analgesics.

Flax cerebral is narrower at its posterior attachment

False narrow at its anterior attachment, sickle shaped

CT larynx, canthomeatal line is at 90 degrees to the horizontal

False neck extended 25-30 degrees to make larynx parallel and vocal cords perpendicular to the table top as possible.

Pelvic peritoneum is in contact with pelvic floor on its lateral margin

False never in contact with pelvic floor

Acetabular angle in 6mo child is 40 degree

False no more than 34 degree in a child between 3 to 12 months. Used in congenital dislocation of hip.

In MRI diffusion study is done with contrast

False no need for contrast

When using transoceanic approach, a larger volume of contrast medium is required in patients with splenomegaly

False no need to increase contrast for splenomegaly. However, an increase volume of contrast is necessary in splenomegaly for indirect portography.w with 70 ml LOCM 370 mg iodine per ml at 8 ml per second.

CT neck suspended respiration is required

False no need. Patient should be told not to swallow during the exposure

CT pneumocolon , rectal contrast is advised

False no positive contrast is needed

for persons of reproductive capacity gonad shields must always be used

False not always

Adrenaline should always be added to lignocaine to prolong its local anesthetic effect

False not always especially in digits or appendages, can cause ischemic necrosis

A female member of staff must not receive an annual dose of more than 13 mSv.

False not more than 13 mSv in a consecutive 3 month period.

Frontal sinus visible by age 2 yrs

False not seen unti 2 yrs baby

Vocal cords are attached to the inner surface of cricoid cartilage

False of thyroid cartilage

Apices can be seen on PA film of chest?

False on PA films apices are obscured by ribs or clavicle

On the right the costocervical trunk is formed medial to scalenus anterior muscle

False on left On right made behind scalenus anterior muscle

Area gastricae are usually best seen on erect film

False on supine film

Stomach May be supplied by a branch of SMA

False only by celiac

Oesophageal plexus of nerves is formed by both phrenic and vagus nerves

False only by vagus nerves

Major fissures appear as thin white lines in majority of cases

False only in 10-20% cases

In majority of subjects, nutrient arteries enter the scaphoid in its distal half only

False only in 13 %

Superior and inferior extensor retinacula are attached to calcaneus

False only inferior extensor retinacual is attached to calcaneus. Superior is attached to only distal end of tibia and fibula.

The left phrenic nerve accompanies IVC at the canal opening

False only right phrenic nerve accompanies

The pre-pyloric vein of Mayo drains the first and second parts of the duodenum

False only the first 2.5 cm of duodenum

Autotomography is employed in lateral oblique view of TMJ

False open and closed mouth views of TMJ do not employ patient movement

Lordotic AP projection of chest is useful in evaluating, carina, pleural effusion

False over penetration film or CT used, false effusion seen in lateral decubitus

Angioplasty heparin should not be given

False patient should be anticoagulated during angioplasty using 3000-5000 units of heparin

Regarding internal biliary drainage, Hilary structures are best treated endoscopically

False percutaneously

Patients on MAOIs, can be given pethidine

False pethidine effect is increased by MAOI causing respiratory depression, restlessness and coma.

In OF20 pet roux ridges should be projected at or near the superior orbital margin

False petrous ridges should be projected onto the inferior orbital margins leaving an unobstructed view of the bony orbits

The left parabolic gutter communicates with the left subphrenic space

False phrenicocolic ligament separates left subphrenic space from left paracolic gutter

Fibular spurs are below head of the fibula pointing cranially

False point caudally

Popliteal vein is superficial to tibial nerve

False popliteal vein is deep to tibial nerve

For TIPS stents is inserted at the portal vein bifurcation

False portal vein is extraheaptic in 75% cases and puncture leads to fatal hemoperitoneum

Right main bronchus is anterior to ascending aorta

False posterior

Short saphenous vein is anterior to lateral malleolus

False posterior

Superior auricular artery is a branch of ECA

False posterior auricular artery

Floor of interpeduncular fossa is anterior perforated substance

False posterior perforated substance

Anterior and posterior commissaries are thin in abduction of vocal cord

False posterior thin anterior is very thin

Iliohypogastric nerve lies anterior to left kidney

False posterior to left kidney

Psoas major muscle is related anteriorly to lumbar arteries

False posteriorly

The profunda femoris artery arises from posteromedial aspect of superficial femoral artery

False profunda femoris artery arises from posterolateral aspect of superficial femoral artery

TOF investigation, patient is supine

False prone

Small bowel follow through serial supine abdominal radiographs are taken after barium has been ingested

False prone films should be taken because compression of abdomen helps to separate the loops of small bowel

The ejaculatory ducts opens into membranuos urethra

False prostatic urethra, prostatic urethra is 15 cm long

Voter forms anterosuperior part of nasal septum

False psoteroinferior

Articulate surface of glenoid is half that of humeral head

False quarter

CVS radionuclide imaging Red cells are labelled with chromium ions

False red cells are labelled with Tc99m pertechnetate but before this they are primed with stannous ions . Stannous ions reduce the pertechnetate and allow it to bind to the RBCs.

Intravenous urography, patients with renal failure require half the standard amount of iodine

False require twice the standard amount of iodine 600 mg iodine per kg

Intravasation of contrast is harmless in hysterosalpingogram

False risk of contrast media reaction

Pelvic peritoneum forms floor of retro pubic space

False roof

Foramen rotundum third division of fifth CN

False second maxillary

parotid gland drains into the mouth opposite the second lower molar

False second upper molar

In pulmonary angiography Catheter tip should be situated at the bifurcation of the pulmonary artery

False should be 1-3 cm above the pulmonary valves I.e below the bifurcation of the pulmonary artery

Lymphangiography should not be performed within 6 months of radiotherapy

False should not be performed within 3 weeks of radiotherapy as disruption of the lymph node architecture may allow oily contrast medium to pass into the systemic circulation.

Regarding erect AXR, patient should be standing erect

False sitting down

For CT portography splenic vein is catheterized

False splenic artery is catheterized

Radionuclide bone scan anterior oblique views are taken to separate sternum and ribs

False sternum and spine

Area gastricae are approx 5 mm nodules in stomach body

False stomach antrum

Dartos muscle is deep to superficial fascia

False superficial

Psoas bursa lies between ilifemoral ligament and the capsule

False superficial to iliofemoral ligament and joint capsule

Inferior ophthalmic vein passes through inferior ophthalmic fissure

False superior ophthalmic fissure

Towne's view 30 requires cranial angulation of central ray

False taken with patient supine, tube angled 30 degree caudally and beam centered on foramen magnum

The window level of a CT scan refers to the range of attenuation values on the grayscale.

False that is window width. Midpoint on the grey scale is window level.

effective dose should never be higher than the diagnostic reference level for the examination

False the DRLs are for audit purposes and are given for a standard patient.

Optically stimulated luminescence (OSL) personal dosimeters use filters to prolong their useful life

False the doses behind the different filters are used to estimate deep and shallow personal dose equivalent.

Concerning deterministic effects of radiation: The effect will only occasionally occur below the threshold dose.

False the effect will not occur below the threshold dose.

The employee has to consult a radiation protection supervisor to ensure compliance with the regulations.

False the employer

Ileal reflux of barium is minimized if air insufflation is performed with the patient supine

False the ileocecal valve is most commonly on the posteromedial wall of cecum and is therefore dependent in the supine position making reflux of barium into the ileum likely

Hepatic oil embolism following lymphography tends to occur in left lobe with right lobe sparing.

False the left lobe is spared. Heavy oil gravitates to inferiority placed right portal vein.

The left renal vein is retroaortic in 10% of cases

False the left renal vein is retroaortic in 3.5% of cases

The referrer is responsible for justification of a medical exposure

False the practitioner is responsible for justification of a medical exposure

In angiocardiography, the right heat is studied via a catheter passed retrogradely from the femoral artery

False the right heart is studied via a catheter passed antegradely into a peripheral vein. In adults, the left heart is studied via a catheter passed retrogradely from the femoral artery.

The left hepatic artery arises from superior mesenteric artery in 10%

False the right hepatic artery arises from superior mesenteric artery in 10%

risk of inducing a fatal cancer when exposing an adult to effective dose of 10 mSv is 1 in 20 000.

False the risk is 5% per Sv or 1 in 20 000 per mSv. An effective dose of 10 mSv carries a risk of 1 in 2000.

Stress incontinence erect lateral views coned to the bladder should be taken at rest, straining and micturition

False these lateral views include sacrum and pubic symphysis

True vocal cords are addicted during gentle respiration

False they are abducted during gentle respiration

Ovaries are readily identified on pelvis CT

False they are difficult to identify

Seminal vesicles are highly echogenic

False they are echopoor with fine internal echoes

In technetium brain scan, cerebral secondaries are seen as areas of increased uptake on a dynamic scan.

False they are usually silent at this stage. They produce areas of increased uptake on a static scan at a later stage.

Posterior cranial fossa scanning artifacts can be reduced by increasing slice thickness

False thinner and more frequent sections will reduce bone artifacts and improve scan quality when scanning the posterior cranial fossa

The ratio of head circumference to abdominal circumference gives an accurate assessment of gestational age in the second trimester

False third trimester

Risk of fatal cancer in adults is 1 in 33 000 per mSv.

False this is the risk of childhood cancer following irradiation in utero. In adults it is 1 in 20 000 per mSv.

The thoracic duct arches at the level of the C7 over the left lung approximately 3-4 cm below the clavicle

False thoracic duct arches over the left lung 3-4 cm above the clavicle

Bare area of liver drains to celiac nodes

False to para aortic nodes

Internal auditory canal opens medically to middle cranial fossa

False to posterior cranial fossa

Pubofemoral ligament passes to superior part of the capsule

False to the inferior part of capsule

Azygos vein lies posterior to abdominal aorta

False to the right of abdominal aorta

Viscosity of contrast media at 20 C is half that at 37

False twice

A bicollis uterus has two uterine horns

False two cervices, Bicornuate has two horns

In technetium brain scan ventricles are normally seen

False unless perchlorate has been omitted from the patient's preparation.

Posterior rectal space may measure up to 2cm at S4 level

False up to 1.5 cm in length at S4 level

Sheath of meninges around optic nerve extends up to the optic canal

False up to the sclera

Conus elastics is attached to lower border of cricoid cartilage

False upper border

using 25 mm of aluminum beam filtration for general radiography reduces patient dose

False using 2.5mm of aluminium reduces patient dose

Dorsal part of scapula gives attachment to subscapularis

False ventral part

Barium enema examination, do not do the procedure within 4 weeks of full thickness rectal biopsy

False within 1 week or 7 days

Ductography involves injection of 5ml of water soluble contrast into a dilated duct

False, 0.5 to 1ml of water soluble contrast medium should be injected into a duct slowly and injection terminated when the patient is experiencing pain

annual effective dose limit for a member of the public is 3mSv

False, 1 mSv

In middle ear, the lateral and medial walls curve inwards and are about 6mm apart in its middle aspect

False, 2 mm apart at the middle, 6 mm apart at the roof.

A standard dose of contrast supplies 40 g iodine in 70 kg man?

False, 300 mg iodine per kg...21 g in 70 kg man

Gallium citrate scans are acquired at 6 and 24 hours

False, 48-72 hours

Isotope renography, hippuran is excreted largely by glomerular filtration

False, 80% of dose is eliminated by tubular secretion.

In using contrast in CT, an infusion of IV contrast is required for maximal enhancement of vascular structures

False, A bolus is required.

Following myelography, CT of the spine should be delayed at least 8 hours

False, CT is not delayed unless it is for Syringomyelia in which case it is delayed for 24 hours.

Urethrography males, Knutson clamp is used for phimosis?

False, Foley with balloon in navicular fossa is used for phimosis. Knutson can only be used with retracted prepuce.

Inferior mesenteric angiography film is in RPO

False, LPO to open out artery

barium swallow initial position is AP

False, RAO

Superior orbital fissure transmits first two divisions of fifth cranial nerve and third, fourth and sixth cranial nerve

False, Superior orbital fissure transmits first division of fifth cranial nerve and third, fourth and sixth cranial nerve

Tc 99m labeled DTPA is used for lacrimal scintillography

False, Tc labeled sulphur colloid is used.

When using Xe 127 the ventilation study must be performed prior to the perfusion study

False, Xe 127 has higher energy than Xe133 and Tc99m and so can be used to perform a ventilation study after a perfusion scan.

In cerebral angiography, direct vertebral puncture is best performed with a short bevel needle.

False, a needle with a blocked tip and side hole is preferred because of the small lumen of the vertebral arteries.

CT pulmonary angiogram should start at the level of the arch of aorta

False, below the level of the left atrium and moves cephalad. Upwards so that if patient is breathless and breathes it is above T.H. eleven of hula and does not cause respiratory artifact.

Pyrophosphate Tc 99m is used to detect infarcted heart muscle within 6 hours of infarction

False, between 12-36 hours.

Filling of duodenal cap with barium occurs reliably with glucagon than buscopan?

False, buscopan causes relaxation of pyloric so cap is seen better.

Perivenous injection detected by swelling at injection site?

False, by persistent arm pain

Dental amalgams create artifacts that preclude the examination of facial structures

False, dental amalgams require that the plane of cut be changed.

In pelvimetry, central beam is directed at symphysis pubis in the AP view.

False, directed 2cm above the symphysis pubis.

Epiglottis normally calcifies in adult

False, does not calcify normally

Filum terminale is attached to the second sacral vertebrae

False, first coccygeal segment

Central ray is angled 30 degree caudally in standard occipitomental view

False, for basic occipitomental the central ray is not angled. For OM 30, it is angled 30 degree caudally

In cervical spine radiography, IV foramina near the film are seen in AP oblique projection. In PA oblique, foramina near tube are seen? In AO foramina near film are seen? In PO foramina near tube are seen?

False, foramina near tube are seen. False in PA foramina near film are seen peecha. True different for anterior oblique and posterior oblique

Intraosseous phlebography or venography requires local anesthesia?cause bone infarction in 5-10% cases?

False, general anesthesia, very painful. False, no bone infarction.

Sulphur colloid is used for blood background subrptraction

False, human serum albumin is used

In bronchography, catheter for right lung is placed in right main bronchus

False, intermediate bronchus.

PA chest x-ray centering point is T4

False, it can be T4, T5, T6 or T7.

In US of ovarian follicles, the size prior to ovulation is 22-28 mm

False, it is 18-24 mm at ovulation with mean of 20.2 mm.

The tissue weighting factor is expressed in mGy/kg.

False, it is a factor so has no units. Organs are divided into low, medium and high risk and the total adds up to 1.0.

Ct head, skin dose is 5 rad

False, it is about 1 rad with maximum of 1.6 rad.

Ct brain, IV contrast is given in cases of suspected cerebral infarction

False, it results in deterioration of the patient's condition.

Ioxaglate is preferred for dacryocystography

False, lipiodol is preferred

CT larynx, scans are made during suspended inspiration.

False, made during slow inspiration effort, during phonation.

Inferior vena cava drains the median sacral veins

False, median sacral veins unite and drain into the left common iliac vein

The average background population dose in the UK is around 5mSv/year.

False, more like 2.2 mSv in a year. This varies depending on county area and local prevalence. In Cornwall, it is more than twice the national average at 7mSv per year.

Normal functioning hepatocyte return to their normal attenuation values by 6 hours following IV contrast media

False, normally functioning hepatocytes remain hyper dense at 6 hours post contrast so a delayed scan can detect metastasis which washes out of contrast early within 6 hours

Zygomatic arches are best demonstrated on lateral view

False, occipitomental projections

In bronchography, water soluble contrast gives better filling of small bronchi than oily contrast.

False, oily gives better peripheral filling.

Obturator artery passes through obturator canal below obturator membrane

False, passes above obturator membrane

The left adrenal vein is more difficult to catheterize than right adrenal vein?

False, right is difficult because of variable origin from IVC and small diameter.

Only radiologists and radiographers are allowed to take the role of a practitioner under IRMER

False, role of practitioner can be performed by any health care professional who has adequate training and is entitled by the employer to be able to carry out his duty. Practitioners may include radiologists, radiographers, cardiologists and dentists.

In abdominal US, spleen is seen with a scan through anterior abdominal wall .

False, scan through lower intercostal spaces . Lie patient on right side . Normal spleen is 12 cm.

Absolute or relative CIs of barium follow through: suspected small bowel obstruction.

False, small intestine secretes fluid which dilutes the barium so there is danger of impact ion. Barium is good as it has high density and fewer side effects.

Deterministic effects have a long latent period

False, stochastic have a long latent period.

For varicography a superficial vein is punctured. Patient is initially supine.

False, superficial varicose vein is punctured. False, initially erect.

In perfusion lung scan, scintillation detectors are pure sodium iodide.

False, thallium is added.

The base of the heart is formed by the left ventricle

False, the base of the heart is formed by the left atrium and its four pulmonary veins

CT larynx, laryngeal ventricle can be usually seen separating the true and false vocal cords.

False, the laryngeal ventricle is seen in this way in only 10% of scans. This is a weakness of CT scan and it's difficult to ascertain the spread of tumor from false to true vocal cords.

Absolute or relative CIs of barium follow through: percutaneous transhepatic cholangiography in a patient with cholestatic jaundice.

False, the procedure makes a distinction between cholestatic jaundice and extrahepstic obstruction.

In pediatric radiology, enema reduction of an intussception is performed with a hydrostatic pressure of 4-5 ft. (1.22-1.53m) and enema reduction is done in the presence of plain film evidence of small bowel obstruction

False, the reduction should be attempted with the barium column no more than 1m above the table. False it is CI in small bowel obstruction , in shock or in peritonitis.

For TIPS, transfemoral approach is used. A stent is placed between portal vein and IVC.

False, trans jugular approach is used. False, stent is placed between portal vein and hepatic vein.

Regarding tenography, needle is inserted under screening

False, under palpation

RPA needs to be consulted whenever an employer plans to use a radioactive substance.

False, where the concentration of activity is low enough the RPA does not need to be consulted.

Lymphangiography thoracic duct should be seen within 24 hours, Maximum reduction in T CO is seen in 12 hours

False, within 2 hours. False, within 36 hours

In fetal US, 4 chamber view of heart is obtained with a scan at 60 degrees to the long axis of the fetus.

False,it is achieved with a transverse scan of the thorax.

Lymphatic do not crossover between the lumbar trunks

False. Crossover occurs in 45% of lymphangiograms. Crossover from right to left occurs twice as commonly as in the reverse direction. So right tumor Mets to left lymph nodes can be seen.

b. Local rules might include Identification of who can refer a patient for X-ray

False. Identification of the referrer is a part of the IRMER

It is mandatory to monitor the dose of all staff members who work with radiation

False. The IRR99 makes it mandatory to monitor the dose of classified workers only. In practice, the employer monitors the majority of staff working in a controlled area to monitor and keep dose limits within acceptable limits.

Notifying the authority if the wrong patient is radiated

False. This is covered under the IRMER.

Workers must be designated as classified if their annual dose limit exceeds 20 mSv

False. Workers are designated as classified if their annual dose limit exceeds 6 mSv. The effective dose limit for classified workers is 20 mSv.

barium enema can be used in suspicious rectovaginal fistula

False. it will cause adhesions if used. Use water soluble contrast gastrografin.

Non ionic contrast media have a greater mass of iodine per unit volume

False. low osmolality. Their use will reduce the number of deaths due to reactions to IV contrast media.

Pubis ossified in membrane

Falsely in cartilage

IVO compression is routinely used in neonates

Fasle never used in infants

Angular ligament is attached to neck of radius

Fasle not attached only passes around it

Anterior arch of fauces in oral cavity contains palatopharyngeus muscle

Fasle palatoglossus

Tc labelled HIDA scan Phenobarbitals reduces hepatic excretion of isotope Morphine increases Gb visualization Indicated in bile leaks

Fasle phenobarbital is given to infants 3-5 days prior to the scan to enhance hepatic excretion. True True

Palmar digital arteries are branches of deep palmar arch

Fasle superficial palmar arch

For small bowel enema pass tube through nasopharynx with head flexed

Fasle with head extended

Angiographic unit must have a

Floating table top, high speed rotating anode, focal spot 0.3-12 mm sq. Tilting table top is desirable.

Focal spot to skin distance

Focal spot to skin distance should never be less than 30cm. Not less than 45cm when stationary equipment is used For chest radiography, distance should not be less than 60cm.

Ct orbit prone patient position is essential when obtaining direct coronal sections

For direct coronal: 1. the patient lies prone with chin elevated. 2. The patient lies supine with neck hyperextended

Umbilical arteries

Form the superior vesical arteries and the medial umbilical ligament

Osteomeatal complex

Frontal, maxillary and anterior ethmoidal

best MRI sequence tp detect hemorrhage is

GRE or T2* W

In direct region to hip joint are

Gluteus minimums, obturator externus, rectus femoris, pectineus, piriformis

MAG 3

Good for renal scarring, 80% secreted, 20% actively filtered., cannot estimate GFR, images taken from 0-30 mins

NIH catheters for pulmonary angiography,

Have no end hole, have side holes, inserted through a sheath via the common femoral vein, are specifically for pulmonary angiography

Silk tubes

Have no end hole. Tungsten tip, inject contrast without removing tip, accepts bladder syringe

Magic angle phenomenon

Healthy tendons acquire abnormally high signal on short TE sequences if oriented at 55 degree to the static magnetic field

ERCP complications

Hyperamylasemia 70% Pancreatitis 7.4 %

CI of cavernosography

Hypersensitivity to contrast media

If thyroid takes up Tc99m pertechnetate in same way as salivary gland, it is.........

Hypothyroidism

MIBG scan

I-123 MIBG imaged at 24 and 48 hours. I-131 MIBG imaged at 4 and 24 hours. False negative given by reserpine, phenyephrine, TCAs, beta blockers

normal calcification is seen in

ICA, lens of eye, basal ganglia and choroid plexus

Health protection agency enforces IRR99

IRR99 are enforced by the HSE.

Nerve supply of LL muscles

Iliacus, Vastus lateralis...femoral nerve Gracilis..obturator Gluteus minimums, tensor fascia lata.. superior gluteal nerve

Lordotic AP projection of chest is useful in evaluating, fluid in oblique fissure

In AP projection, the fissure is less of oblique to X-ray in this projection

When is petroleum ridge seen projected within the orbit

In occipital frontal view where beam emerges from glabella

Metoclopramide

Increases gastric and small bowel motility

In HRCT, mA are usually increased compared with conventional chest CT

Increasing mA reduces the visible image noise and improves scan quality

Injection site for shoulder arthrography

Injection site lies about 2 cm inferior and lateral to the tip of the coracoid process.

Glucagon is CI in

Insulinima , pheochromocytoma

Ga 67 scanning

Intense uptake in bowel. So should be scanned 72 hours after giving dose. Laxative should be given for 2 days following isotope injection

Aptibialis anterior ....... the foot

Inverts

27 Oral cholecystographic contrast media, which is most lipid soluble?

Iopanoic acid

Long axis of talus in children is more horizontal or vertical?

It is more vertical in children under 5

equivalent dose

It is the absorbed dose multiplied by a radiation weighting factor defined for each type of ionizing radiation. measured in Sv

Conus lies at ..... at birth

conus medullaris lies at

Double contrast barium

LAO for spleen Sigmoid colon caudal angulation 30 degree prone

Bronchography LOA or RPO.........lung True lateral.....lung

LAO or RPO left lung True lateral is for right lung ..RL Right lung...lateral and frontal view is done Right lung is imaged first before left to avoid superimposition of left lung

branches of external carotid artery

LASS MOP F Lingual Ascending pharyngeal Superficial temporal Superior thyroid Maxillary Occipital Posterior auricular Facial

Ossification of laryngeal cartilages is more easily seen on the frontal radiograph than the lateral radiograph

Laryngeal cartilage ossification is best seen on the lateral radiograph which avoids superimposition of cartilage over spine.

Base of maxillary antrum forms

Lateral wall of nasal cavity

Ascending aorta, LAD

Left anterior oblique

Left circumflex, LAD

Left lateral

Negative D dimer DVT

Less than 5% patients have it

Sodium salt of diatrizoic acid is more or less viscous than meglumine?

Less viscous. Meglumine more viscous.

Left gastric artery branch of celiac supplies

Lesser curvy and antrum, right gastric also supplies antrum

Psoas major inserts into....... trochanter

Lesser trochanter

Hypertrophied column of Bertin

Lies at the junction of upper and middle thirds of kidney With maximum diameter less than 3cm

Gallium citrate scans subtraction studies are done for renal and colloid scan is done for.......

Liver and spleen

Ingesting magnetic iron oxide particles makes bowel .........signal on both T1 and T2

Low

High viscosity low density barium should be used in double contrast barium meal examinations

Low viscosity and high density should be used

Aorta begins at

Lower border of third rib costal cartilage T 3 behind RVOT

Maleolar fossa of fibula is seen on anterior medial aspect of lateral malleolus of tibia

Maleolar fossa of fibula is seen on postero medial aspect of medial malleolus of tibia

RPO lumbar spine centering point

Midclavicular line at lower costal margin on raised side

Frog lateral hips centering

Midline at level of femoral pulse

Mediastinal structures are best demonstrated with a narrow window width

Narrow window width 3000HU and soft tissue level 30-50 HU are optimal.

DMSA can be used to estimate GFR or determine urinary tract obstruction?

No it just gives information about functional cortical tissue.

Is it normal to see injected contrast media in lymph vessels at 24 hours?

No it should be intranodal in 24 hours

Technique for IVC filter insertion

No need to use sheath as IVC filter has a sheath IVC diameter should be 2.5 - 3.5 cm.

Is previous severe reaction to contrast, severe HTN with diastolic greater than 120, oral anticoagulants tc and abnormal clotting , A CI to angiography?

No only 15% patients with history of severe contrast reactions develop second severe reaction. Use steroid. For abnormal clotting use 4 F catheter and FFPs. Discontinue oral anticoagulants. Only sepsis is CI.

branches of internal carotid artery

OASIC PAM SP Ophthalmic Anterior choroidal Superior hypophyseal Inferior hypophyseal Caroticotympanic PCOM Anterior cerebral artery Middle cerebral arteyr striate Pterygiod

Endoscopic US is done with

Oblique view linear array scope with rigid end

RPO view of lumbar spine will demonstrate the oft pars interarticularis

Oblique views of lumbar spine show the pars interarticularis on the side to which patient is turned. RPO shows the right pars

The intervertebral discs are wedge shaped in cervical and lumbar region because

Of lordosis

Tomographic midpoint of kidneys

One third the distance from table top to the anterior abdominal wall at inferior costal margin

Accessory bones of foot

Os trigonometry. On posterior surface of talus Os peroneum. Multi centric, seen proximal to base of 5th metatarsal near cuboid Os Vesalianum. Base of 5th metatarsal Os tibiale externum. Fused to navicular

Hard palate is formed by

Palatine process of maxilla and horizontal plate of palatine bones

Pectineus, femoral ........, femoral.......

Pectineus, femoral vein, femoral artery

The reflective peripheral zone constitutes the major part of the normal gland

Peripheral zone constitutes 70% of the normal gland

CIs to reduction of intussusception

Peritonitis, perforation, intestinal obstruction

PTC CIs

Platelet count less than 100 x 109 per liter is CI Elevated prothrombin time Hydatid dx Severe cardiopulmonary disease

centering point for frog lateral view of hips

Point of maximum femoral pulse

Left renal vein is ........... to body of pancreas and SMA

Posterior to

Pterygopalatine fossa communicates superiority with orbit through ...... part of inferior orbital fissure

Posteriro

Patient preperation for angiography includes

Premedication, written consent, blood glucose for DM, ECG monitoring for cardiac disease patients, nil by mouth for 4 hours and fluid 2 hr before procedure

Parotid sialography probe and rate?

Probe is advanced 1cm into the parotid duct and contrast is injected at rate of 0.2 ml per min.

Procaine is recommended in order to anesthetize the pharynx prior to passage of the tube during enteroclysis

Procaine, a local anesthetic is poorly absorbed from mucous membranes. Lignocaine spray is well absorbed

Left ventriculogram position

RAO

Barium meal double contrast

RAO supine, semi-erect - antrum and duodenal cap Erect view of antrum is single contrast

RCA LCA arteriography

RCA requires 3-8 ml vol by hand injection LCA requires 5-10 ml volume by hand injection

new xray equipment RPA or RPS?

RPA

personal protective equipment RPA or RPS

RPS

Lateral wrist

Radial styloid

Breaches of IR(MER) can be dealt with under criminal law.

Radiation protection is rightly taken seriously.

Townes view 30 degree occipitofrontal

Radiographic baseline is at 90 degree to cassette, tube angulated caudally, Dortmund stellar projected through foramen magnum, zygomatic arches and coronal suture not visible.

Radiographic baseline Anthropological baseline

Radiographic: orbitomeatal outer canthus of eye to center of external auditory meatus...radiouter Anthropology: infraorbital to upper border of external auditory meatus..infrapology These two lines are at angle of 10 degrees to each other

best MRI sequence to detect subtle soft tissue or marrow is

STIR..short tau inversion recovery

SVC begins behind and ends at

SVC begins at T1 or first costal cartilage and ends at T3 or behind the third right costal cartilage in the right atrium

To view SVC AND IVC bilateral puncture is required

SVC.. bilateral medial anterior cubical fossa vein IVC bilateral femoral vein

Routine MRI of the knee includes

Sagittal oblique along the plane of ACL. Each knee needs a separate coil.

Achilles' tendon MRI

Sagittal views T2 and STIR used . Also axial T1 . Coronal views are not helpful as Achilles tension is also in coronal plane.

Prominent anterior fat pad

Seen in 15% of individuals

Ligament of stuthers

Seen in less than 1% of individuals

Ultrasound of pylorus in infants

Should be less than 15 mm in length and less than 3 mm in thickness

Wrist arthrography

Single contrast 2-4 ml required with injection at radiocarpal joint . Early views required to detect leakage into the mid carpal joint.

Prepubertal uterus is

Smaller than neonatal uterus, endometrium should not be visible, and cervix occupies 2/3 rd of uterus

Branches of axillary artery

Some Times Life Seems A Pain 1st part S. Superior thoracic 2nd part T. Thoracoacromial L. Lateral thoracic 3rd part S. Subscapular A. Anterior circumflex humeral P. Posterior circumflex humeral

Stomach views in barium meal

Spot exposures of the stomach (lying): (a) RAO—to demonstrate the antrum and greater curve (b) Supine—to demonstrate the antrum and body (c) LAO—to demonstrate the lesser curve en face (d) Left lateral tilted, head up 45 degrees—to demonstrate the fundus

Vascular guide wires

Standard adult size is 0.035 and pediatric size is 0.025. Standard interventional wire is 0.038 inch.

Abdominal compression is useful when imaging abdominal vessels

Subtraction errors due to bowel gas movements may be reduced by abdominal compression and IV buscopan

Isotopes used in small bowel studies Sulphur colloid and tagged RBC Pertechnetate Labeled leukocytes

Sulphur colloid and tagged RBC..bleeding Pertechnetate..meckel's diverticula and ectopic gastric mucosa Labelled leukocytes. Inflammatory bowel Disease

Lymphatic drainage of pancreas is to

Superior mesenteric and celiac nodes

Medial and fibular collateral ligament are best viewed on

T1 coronal sequences

All of the following has medial relation with both lungs except

T1 nerve root

Triangular fibrocartilaginous complex best seen on which sequence?

TFCC seen on T1 or T2* coronal . Sagittal not good.

sensitivity TLD, film, optically stimulated luminescent dosimeters electronic dosimeters

TLD sensitivity is same as film 0.1 OSLD has sensitivity to 0.01mSv electronic dosimeter measures down to 1 microsievert

Severe reactions to urographic contrast media. C. May produce a prolonged nephrogram.

TRUE-A persistently dense nephrogram and poor pelvicalyceal opacification will be found if the patient is profoundly hypotensive which may occur as part of a severe reaction to contrast.

40 In lymphography B. Severe emphysema is a contra-indication to the procedure

TRUE-Because there is depression of lung function after the injection of contrast. as the oil is filtered by the pulmonary capillaries of lung

27 Oral cholecystographic contrast media A. Differ from water-soluble contrast media in that the carbon-5 position in the benzene ring is unsubstituted.

TRUE-This causes them to be bound to plasma protein, reducing their glomerular filtration and leading to their preferential excretion by the liver. Rcference S, p. 60

28 In oral clolecystography: A. The contrast agents are uricosuric

TRUE-This may account for the occasional nephrotoxicity of the contrast agents. A good fluid intake should be encouraged and does not interfere with the activity of the media.

E. Stasis of contrast on a post-operative intravenous cholangiogram indicates existing obstruction.

TRUE-distension and over-filling of the hepatic radicles also suggests obstruction.

When does talus ossify ?

Talus ossifies in 7th fetal month

Which radioisotope is used for esophageal studies?

Tc 99 m sulphur colloid

Stomach radionuclide studies

Tc 99m is the isotope of choice, cannot be used to investigate ulceration, used for gastric emptying studies,

Brain imaging radionuclides

Tc99m DTPA, Tc 99m pertechnetate, Tc 9m glucoheptonate

radionuclide effective doses

Tc99m MAA 1 mSv Gallium 67 18 mSv Tc99m MAG3 1 mSv Kr 81 m gas 0.1 mSv Tc99m phosphonate 5 mSv

Testes blood supply

Testicular artery and cremasteric branch of inferior epigastric artery

buscopan contraindications

This drug should not be used under the following circumstances: Glaucoma Muscle weakeness e.g. Myasthenia Gravis Paralytic ileus Dilated colon (Megacolon) Fructose intolerance Pyloric stenosis Porphyria

Regarding the cerebellum, the deepest fissure is the primary fissure at the superior surface

Though the primary fissure divides the superior surface, the deepest fissure is the horizontal fissure

Parathyroid imaging

Tl 201 is taken up by thyroid and parathyroid tissue. Tc 99m is taken up by only thyroid. So parathyroid images are taken by subtracting Tc99m from Tl.

Shoulder arthrography is done with forearm supineated. Why?

To rotate long head of biceps away from path of needle and also glenoid will face anteriorly avoiding damage to labrum

120 mm of concrete provides approximately equal protective power against X-rays as 1 mm of lead

True

ARSAC certificates are issued by the department of health

True

Accessory hemidiaphragm is more common on right side

True

All muscles of mastication are supplied by trigeminal nerve

True

Amygdaloid body is part of caudate nucleus

True

An overexposure of greater than 1.5 times the intended dose of a barium swallow due to a fault in the AEC system is a notifiable incident.

True

Annulus fibrosis has no elastic tissue and has no motor nerve supply

True

Arthrography delayed films are useful for investigation of loose body

True

Arthrography of knee: images are obtained in prone position

True

Articulate facets face posteriorly on superior facets and anteriorly on inferior facets

True

At carotid bifurcation, external carotid artery lies posterolateral to ICA

True

Auditory tube opens via anterior wall of middle ear

True

Axillary tail of breast drains to posterior axillary nodes

True

Barium infusion technique for small bowel, uses 75 ml per minute total 1200 ml

True

Barium particle is small 0.6-1.4 micronmeter, they are coated to provide plasticity and rapid flow

True

Barium swallow is done with the patient prone when assessing esophageal motility

True

Bladder volume calculated by product of 3 planes into 0.7

True

Buscopan is CI in angina pectoris and glaucoma

True

CBD is 8 am long

True

CT larynx, piriform sinuses are filled out by Valhalla maneuver

True

Capsule of knee joint includes head of fibula

True

Caudate lobe segment 1 Quadrate lobe segment 4

True

Centering point Lateral skull 2.5 cm superior to EAM Pituitary fossa 2.5 cm superior and anterior to EAM PA skull nasion PA 20 skull nasion OM 20 midway between the infraorbital margin

True

Common peroneal nerve is lateral to tibial nerve

True

Conus meddullaris lies at level of L3 at birth

True

Cricopharyngeal region is approximately 15 cm from incisors

True

Deltoid cause flexion of arm

True

Diagnostic angiography procedures are performed with 4 F or 5 F catheters

True

Each typical vertebral has 3 primary and 5 secondary ossification centers.

True

Elbow joint communicates with proximal radioulnar joint

True

First metacarpal has a styloid process at on its dorsal aspect

True

For oblique view of lumbosacral junction, the patient is rotated approximately 45 degree

True

Foramen rotundum transmits the maxillary nerve

True

Glucagon is produced from islets of langerhans an acts in 1 min

True

Hepatic vessels have low signal on T1 and T2

True

Horizontal fissure on right is at level of 4th costal cartilage and is absent in 10 % of subjects

True

ICA enters subarachnoid space medial to the anterior clinked process

True

In bronchography, propyliodone is the contrast of choice

True

In most medical applications, the equivalent dose is numerically equal to the absorbed dose in tissues

True

In obstetric patient: the CRL at 10 weeks is 33mm.

True

In plain abdominal X-ray, injecting 50 ml air from NG tube assists in diagnosing perforation.

True

In popliteal fossa, plantaris tendon lies deep to the medial head of gastrocnemius

True

Inferior epigastric artery arises from external iliac artery just above the inguinal ligament

True

Inferior mesenteric artery supplies anal canal

True

Insertion of nephrostomy tube, hemorrhage can be treated by increasing the nephrostomy tube size

True

Intravenous pyelogram Nephrogram is due to contrast in PCT

True

Iodine 125 labelled fibrinogen is taken up into developing thrombus

True

Isthmus and inferior thyroid vein are anterior to trachea in the cervical region

True

Kidneys may move as much as 5cm with respiration

True

LAO is best for demonstrating left ureter in IVP

True

Lateral tubercle is the most posterior part of talus

True

Lateral wall of vestibule opens into the middle ear at round and oval window

True

Less dilution of contrast occurs if contrast flows cephalad than caudad in spinal canal

True

Limits for employees between 16-18 are set at 1 /3rd the normal adult limit, hence equivalent limits of 45 mSv year-1 for lens of eye, 150 mSv year-1 for extremities, and 6 mSv effective annual dose

True

Lymphoscintigraphy Static images acquired in 3 hours Complete blockage represented by absent limbo-sacral uptake in 24 hours Ischiorectal injections demonstrate iliopelvic lymph nodes Rib periosteal injections can be used to demonstrate internal mammary chain of LNDs

True

MIBI is excreted via hepatobiliary route

True

Majority of female urethra is embedded in vaginal wall

True

Maxillary sinus seen a few weeks after birth

True

Meglumine deglumine more diuretic than sodium salts..so sodium salts produce denser pyelograms

True

Minor fissure is seen 1 cm below the hilar point

True

Nasolacriaml duct drains into the middle meatus

True

Normal bladder wall thickness when empty is 0.3-0.5 cm.

True

On AP radiograph, tibial tubercle is seen as lucent area

True

On transcranial US cerebellum tonsils are not well demonstrated

True

PA Chest X-ray is T4 AP chest X-ray sternal notch PA hand is head of third metacarpal

True

PTC anterior subcostal approach, left subhepatic is best cannulated

True

Pain is more common with water soluble contrast

True

Pancreas has transverse mesoocolon attached to its anterior surface

True

Popliteal artery ends as it passes the fibrous arch of popliteal muscle

True

Prostate is anterior to seminal vesicles

True

Radial head is fused at 17 years

True

Radius and ulna are supplied by anterior interosseous artery

True

Regarding internal biliary drainage, plastic stents are more prone to migration than metallic stents

True

Regarding internal biliary drainage, trasnhepatic tract is larger for plastic stents than metallic stents

True

Rhomboid fossa is seen in inferomedial aspect of clavicle

True

Right vagus gives right RLN which hooks right subclavian artery

True

Round window in ear is closed by a fibrous disc

True

SMA has the inferior pancreaticoduodenal artery as it's first branch

True

Seminal vehicle are posterior to bladder in male

True

Small bowel enema incurs higher radiation dose than small bowel follow through

True

Spleen decreases in size with age

True

Spring ligament is attached to the inferior margin of navicular

True

Superior orbital foramen is at junction of medial one third and lateral two- third of supraorbital margin

True

TMJ is more stable with close mouth

True

TMJ upper compartment gliding movement and lower compartment hinge movement

True

Tc 99m HMPAO preferentially labels granulocytes

True

Tensor tympani tendon is attached to handle of malleus

True

The annual effective dose for a member of the public is 1 mSv, and for an employee is 20 mSv. The equivalent dose limit for the lens of an eye in an employee is 150 mSv and 15 mSv for the public. The threshold dose for cataracts of the lens developing is 5 Gy. The equivalent dose for the extremities is 500 mSv in an employee and 50 mSv in a member of the public.

True

The facial vein lies posterior to facial artery

True

The internal thoracic artery gives anterior intercostal artery to upper six spaces

True

The left brachiocephalic vein is anterior relation of trachea

True

The left superior intercostal vein passes anterior to aorta towards the brachiocephalic vein

True

The medial aspects of the kidneys are slightly more anterior than the lateral aspects

True

The right subphrenic space is bounded posteriorly by the coronary ligament

True

The sup and middle concha are part of ethmoid bone

True

The valves of the internal jugular vein are closely applied to the inferior bulb

True

Transrectal prostatic US, no bowel preparation is needed

True

Transverse arytenoid muscle is unpaired muscle seen in midline

True

Vagina has a blood supply from vaginal and uterine arteries.

True

Valsalva maneuver may improve pancreas visualization

True

Visceral pericardium is also known as epicardium

True

Visceral peritoneum is attached to posterior fornix of vagina

True

absorbed dose is measured inn mGy

True

annual effective dose limit for a member of the public is 1mSv

True

annual equivalent dose limit for hands of a member of the public is 50 mSv

True

azygous vein ends at the level T4

True

cervical rib is seen at C6

True

department of health should always be informed of equipment failures

True

deterministic effects occur due to radiation induced cell death

True

left oblique fissure forms an angle of 60 degrees and is more vertically oriented

True

overexposure by more than 1.5 times the intended dose of IR, radiographic and fluoroscopic procedures involving. contrast agents, CT examinations or high dose nuclear medicine products are all notifiable.

True

particles with high LET are more hazardous than low LET

True

typical absorbed dose fro 3 mins of fluoroscopy can be upto 150 mGy.

True

typical absorbed dose of a lateral lumbar spine is 12 mGy

True

Annual dose limit for lens of eye is 150 mSv.

True Cataract threshold dose is 5 Sv.

Barium swallow double contrast: Right side fro reflux AP views mandatory Lateral view is mandatory

True False False Mandatory projections are RAO, LAO erect and LPO prone

Anterior oblique foramina near film seen , 15 degree cranial angulation Posterior oblique foramina near tube seen, 15 degree caudal angulation

True True

Urodynamic investigation Rectal pressure transducer records abdominal pressure A vesicles pressure transducer records deter us or pressure

True False

Regarding hand: The distal phalanges ossify before the middle and proximal phalanges Secondary ossification centers appear at the heads of proximal phalanges

True False base

Valsalva maneuver facilitates superior vena cavography Catheterization of both subclavian veins is rarely necessary to obtain good opacification

True True

Renal agenesis is more common than renal ectopia, renal agenesis is more common on left

True , true

The following are features of air gap technique for chest radiography, wide exposure latitude

True , true wide exposure latitude is necessary because of wide range of density between mediastinum and lung.

In sialography, reservoir of contrast has to be raised 70cm above the patient's head

True . Secreting pressure of gland is from 54 to 76 cm of water so 70 cm is appropriate to exceed this.

In mammography, the total permanent filtration should never be less than 0.03 mm molybdenum

True 0.03 mm molybdenum is equal to 0.5 mm aluminium

Gastrografin is added to barium to reduce small bowel transit time

True 10 ml gastrografin is added to achieve this effect.

CT brain, 15 contiguous 10 mm thick axial sections

True 10 mm continuous sections from posterior arch of the atlas to the vertex

CT pelvimetry has a much lower radiation dose than conventional pelvimetry

True CT pelvimetry measurements are accurate and reproducible

Hysterosalpingogram is CI if there is a history of untreated salpingitis during preceding 6 months

True HSG is CI until a course of antibiotics has been given and there is evidence of successful treatment

Normal interlobular septa may be visible

True Normal centrilobular arteries may also be visible. The centrilobular bronchioles is not normally seen.

A torniquet applied above the ankle may occlude the normal anterior tibial vein

True The absence of anterior tibial vein filing by contrast is not therefore always indicative of venous thrombosis.

The equivalent dose and absorbed dose are numerically identical for x-rays.

True The sievert and gray are the special names for equivalent and absorbed doses and both are used instead of J/Kg.

Dimeglumine gadopentate produces a transient increase in serum iron levels following intravenous injection

True Therefore the serum iron estimations may be inaccurate in the 24 hours following intravenous injection

Perfusion isotope lung imaging Respiratory failure may be induced in patients with pulmonary hypertension

True a slow injection is given in patients with pulmonary hypertension. And microspheres should be used whenever possible. Perfusion scanning is CI in patients with right to left cardiac shunts due to the possibility of systemic emboli.

Infraorbital meatal line is aligned parallel to the slice plane in scanning of the paranasal sinuses

True additional scans may be performed in the coronal plane

SPECT is mandatory when Tc99m HMPAO is used

True anatomical detail is better displayed using SPECT at any time from 2 mins to 8 hours after injection

Peak of renogram occurs at 3-5 mins

True and it takes 10-15 mins for the activity to drop to half its peak value I.e the clearance half time

GP has a lower signal than surrounding brain in MRI

True as it has high iron content

IVDSA Basilic vein is preferred to cephalic vein as a site of access

True as it is more difficult to negotiate a catheter through the cephalic vein in the region of clavipectoral fascia.

Absolute or relative CIs of barium follow through: IV cholangiography when oral cholecystography has failed 24 hours previously.

True as there is a greater incidence of both major and minor reactions plus poor visualization of the ducts.

Percutaneous lung biopsy, previous contralateral pneumonectomy is a CI to the procedure

True because a pneumothorax would be poorly visualized.

The head of the epididymis is of similar reflectivity to the testicular tissue

True but the rest of epididymis is less reflective than testicular tissue

Glucagon improves visualization of CBD

True by contraction of sphincter of Oddi, followed by relaxation, increased choleresis and increased hepatic blood flow

Lordotic AP projection of chest is useful in evaluating, middle lobe

True longest axis of middle lobe takes up a position more in line with X-ray.

Patient movement during an exposure is usefully employed in the AP cervical spine

True mandible will be blurred when pat opens and closes his mouth during prolonged exposure.

In brain scanning Tc 99m DTPA can be used.

True no patient prep needed and reduced radiation exposure.

Small bowel enema anesthetize nostril and avoid anesthetizing throat

True nostril for nasal intubation and avoid throat as there is risk for aspiration

Tachycardia is a recognized side effect of buscopan

True other anti-cholinergic side effects are blurry vision, dry mouth and urinary retention. buscopan is opposite to cholinergic. It is anti-cholinergic.

Prophylactic intravenous antibiotics are recommended prior to transrectal guided biopsy of the prostate gland

True prophylactic antibiotics should be given immediately before and subsequently orally for 3 days post biopsy

Cricoid lamina a medullary center

True situated within a dense cortical rim.

TCAs should be stopped before MIBG scan for pheochromocytoma

True so does reserpine, labetalol and cocaine. The thyroid should be blocked before MIBG scanning with potassium perchlorate or lugol's iodine.

In sialography, sublingual ducts May open into the submaxillary duct.

True so it can be injected in error.

The right atrium is preferred to the SVC as a central site for the catheter tip

True the right atrium is optimal site for contrast as it produces good mixing of blood from SVC and IVC.

At low doses, alpha particles have the same radiation effect for 5% of the absorbed dose of xrays.

True the weighting factor for calculating the equivalent dose of alpha particles is 20.

If small bowel barium examination and double contrast barium examination have to be done, do small bowel first

True then the barium goes to colon and is washed off during preparation of enema.

Normal velocity waveform of CCA shows continuos forward flow in diastole

True this is characteristic of a low resistance arterial flow pattern

Normal waveform of ECA shows reversal in diastole

True this is characteristic of high resistance arterial flow pattern

Lymphangiography Hepatic oil embolism is a recognized complication

True this occurs when there is lymphatic obstruction and lymphaticoportal venous communication.

Delayed films are useful in sialography

True to assess clearing of contrast from the gland

Vascular sheaths have side arms, side holes

True to flush catheters with saline, heparin or for drug infusion False,

DMSA renal scintigraphy is indicated in child with urinary incontinence

True to look for duplex kidney with ectopic insertion

In cervical spine radiography, a long FFD is required

True to reduce magnification and loss of definition.

Orbital cavit Roof by frontal bone and lesser wing of sphenoid Lateral wall by greater wing of sphenoid

True true

Cavernosography Venous thrombosis is a recognized compliaction

True venous thrombosis can lead to priapism with impotence

Human error resulting in serious patient over-exposure should be investigated by the Department of Health

True, If the over-exposure is greater than 3 times the dose intended, the equipment should be withdrawn. Nevertheless, all faults should be investigated and rectified.

Bladder supplied by obturator artery in its lower part, veins draining bladder form plexus around bladder neck

True, True

Myelography, A LP within the preceding week is a CI

True, a small amount of CSF leaks into subdural or extradural space after LP, and if a second LP is done within a week of first, the pool of leaked CSF may be tapped inside of subarachnoid space.

Urethrography is stopped if intravasation occurs?

True, bleeding may accompany. Recent instrumentation predisposes to it.

The right suprarenal gland has a peritoneal covering on it slower half , middle suprarenal artery is multiple in 5% of caes

True, false in greater than 30% of cases

In abdominal US, intrahepatic branches of hepatic artery cannot be seen but hepatic artery can be seen.

True, hepatic artery is seen with splenic artery arising from coeliac axis in a seagull pattern.

Retrograde urography ARF is a complication?

True, rarely

A PA chest radiograph has the same effective dose as a 5 hour transatlantic flight.

True, the effective dose of a PA chest x-ray is 0.01-0.025 mSv. Air flight has an effective dose of approximately 0.04 mSv per hour.

Maxillary antra are best shown on occipitomental OM view

True, together with frontal sinuses and anterior ethmoids

Carotid Doppler examination Maximum peak systolic velocity of common carotid artery is 1-1.2 m/s. 60-70 degree is angle of interrogation

True, true

Inferior canaliculus has a vertical and horizontal component

True, vertical 2mm, horizontal 7mm.

Use LOCM in tracheosophageal fistula and perforated ulcer

True. In perforation, HOCm is an absolute contraindication.

meniscus is poorly visualized

True. Only outer 1/3rd of menisci are vascularized by perimeniscal plexus from medial and lateral geniculate arteries

In bronchography, 1 ml contrast per year of age per side is required in children of normal size.

True. With additional 1-3ml for bronchiectasis.

Elevating arm relieves pain from injection site

Tue, pain due to stasis of contrast is relieved..more with sodium salts.

Median umbilical ligament is a remnant of ..............

Urachus

Radionuclide bone scan isotopes used and dose?

Uses Tc99m and MDP , uses dose of 500-600 MBq

mnemonic for subclavian arteyr

VIT C D

water soluble contrast is indicated in suspected perforation suspected leakage meconium ileus CT abdomen All of the above

Water soluble contrast is indicated in all of the above

Trickle artifact in ERCP is seen

When injecting contrast into a dilated biliary tree

when do employees need to be classified?

When the effective dose is likely to exceed 6mSv or 3/10 s of any equivalent dose. To be classified an employee has to be over the age of 18, and be certified as medically fit to be classified.

ideal characteristic of a radiopharmaceutical agent is:

a lower limit of gamma ray emission energies above 100 keV

all are hypointense on T1 except subacute hemorrhage chronic hemorrhage fibrous tissue air cortical bone

all are hypo-intense except subacute hemorrhage which is hyper-intense. also metHb is hyper-intense.

embolization can be performed using the following materials gelatin sponge absolute alcohol autologous blood clot sucralfate cyanoacrylate

all can be used except cyanoacrylate

radiation weighting factor for alpha radiation is ..... and x-ray is....

alpha 20 xray 1

scaphoid views are centered at

anatomical snuffbox

anterior cardiac veins, small veins and vena cordis minimae drain into

anterior cardiac veins..right atrium small veins and venae cordis minimae ( Thebesian veins) drain into chambers of the heart mostly on the right side

cerebral peduncle and colliculi of midbrain. Which lies anterior and posterior?

anterior cerebral peduncle posterior colliculi

tributaries of EJV

anterior jugular vein posterior division of retromandibular vein posterior auricular vein posterior EJV transverse cervical vein suprascapular vein

branches of vertebral artery

anterior spinal artery meningeal branches vertebras and disc branches posterior inferior cerebellar artery

aortic opening transmits T12

aorta, thoracic duct, azygous vein..AAT

accessory hemiazygous vein drains into

azygous vein

pancreas body and head vertebral level

body. L1 head. L3

what is anterior to scalenus anterior?

brachial plexus

arch aortography catheter should be:

catheter should be end and side hole type

odontoid or peg view is view of odontoid process. x-ray is centered at:

centre of open mouth

interpeduncular cistern or cisterna interpeduncularis is between:

cerebral peduncles of midbrain and dorsum sellae

employers are responsible for the patients treated under the Act

clinicians are responsible for the patients treated under the act

von rosen's view is useful in assessment of

congenital dislocation of hip

pericallosal cistern contents?

contains branches of anterior cerebral artery

IMA angiography shoulde be performed before SMA and Celiac so that

contrast in bladder cannot obscure the branches of IMA

controlled area supervised area

controlled area 6mSv supervised area greater than 1mSv

controlled area supervised area

controlled area..exposure dose rate is greater than 7.5 micro sievert supervised area..exposure dose rate is 2.5-7.5 microSv per hour.

upper esophagus has lymphatic driangae to

deep cervical lNDs

cervix lymphatic drainage

external iliac, internal iliac and sacral nodes

tributaries of internal jugular vein

facial vein inferior petrosal sinus lingual vein pharyngeal veins superior and middle thyroid veins

contents of broad ligament of uterus

fallopian tube ovarian and uterine vessels round ligament of ovary and uterus

IVC on axial CT is circular on inspiration

false

in children, ECA may bifurcate from CCA at higher level than in adults

false

increasing frame rate in fluoroscopy decreases patient dose

false

olfactory nerve passes through spheno-ethmoid foramen

false

pituitary gland enhances poorly with intravenous gadolinium

false

porta hepatic nodes drain directly into celiac nodes

false

pterygopalatine fossa lies above the apex of the orbit

false

radicular arteries are branches of posterolateral spinal arteries

false

right pars interarticularis of a lumbar vertebrae is shown in a right oblique projection

false

right renal vein is posterior to superior mesenteric artery

false

short saphenous vein passes anterior to lateral malleolus

false

sinography requires local anesthesia in majority of cases

false

superior hemiazygous vein arches over the left pulmonary artery

false

the anterior horns of lateral ventricles deviate medially towards the midline

false

the housing and support plate have a lead equivalence of 2.5 mm

false

to see orbital foramen, baseline is at 30 degree to the film

false

glucagon dose should be 10 mg for adult

false 1 mg IM

housing and supporting plates of an x-ray image intensifier should provide shielding equivalent of at least 1mm lead for 100 kV

false 2mm lead for 100 kV

paratracheal stripe may measure 5mm

false 3mm

Trainees under 18 years of age must not receive an effective dose of more than 6Sv

false 6 mSv

sacral foramina are 8

false 7

CSF is absorbed by dura matter

false CSF is in subarachnoid space

DAP can be converted to absorbed dose using a conversion factor

false DAP can be converted to the effective dose using the conversion factor

IRR sets out rules for referrer, practitioner and operator

false IRMER set out the roles of referrer, practitioner and operator

IRMER requires dose limits to be defined for different procedures

false IRR

AP knee is used for optimal frontal demonstration of patella

false PA knee is used I think

horizontal fissure is absent in 30% of normal subjects

false absent in 10% of subjects

neck of the ribs is th emost posterior part

false angle of the rib is the most posterior part

pancreas lies posterior to CBD

false anterior

gastrografin is the contrast of choice in bronchography

false barium is the contrast of choice in bronchography

cingulate gyrus lies above the cingulate sulcus

false below the cingulate sulcus

liver is supplied by phrenic nerve

false by celiac plexus and splanchnic nerves

GB has a spiral valve made of smooth muscle

false concentric folds of mucosa

employer has to consult RPS to ensure compliance with the regulations

false consult RPA

relation of medial end of clavicle to the posterior ribs on the film is used to detect rotation on PA film

false distance of clavicles from sternum

records regarding radiation equipment used within a controlled area must be kept for a minimum of 5 years

false for a minimum of 2 years

sustentaculum tali arises from the lateral aspect of the calcaneus

false from anteromedial aspect of calcaneus

lingular lobe bronchus arises from lower lobe

false from upper lobe

complex calyces are more commonly seen in the lower pole of kidney

false in the upper pole

risk of stochatic effect increases exponentially with dose

false increases linearly with dose .. this is linear no threshold theory.

using air gap decreases patient dose

false increases patient dose

nasolacrimal duct opens into the middle meatus

false inferior meatus

lacrimal sac lies inferolaterally

false inferomedially

fallout from nuclear weapon tests contributes a higher proportion of radiation to the public than medical exposure

false it contributes a lower proportion of radiation to the public than medical exposure

thoracic duct drains into the confluence of right IJV and Subclavian vein

false it crosses from right to left at T4 and drains into left brachiocephalic vein

vertebral artery has no branch in cervical portion

false it has ascending pharyngeal and deep cervical

sacrum has four pairs of anterior foramina?

false it has four pairs of sacral foramina anteriorly

thyroid gland is derived from 3rd snd 4th pharyngeal pouches

false it is derived from 1st and 2nd pharyngeal pouches

vagina is seen as a stripe of decreased echogenicity on longitudinal images

false it is of increased echogenicity

midline sagittal brain MRI will show hippocampus?

false its not a midline structure

gluteus medius and minimus has a posterior relation

false lateral relation

quadrate lobe is supplied by right hepatic artery

false left hepatic artery and vein

psoas major inserts into the greater trochanter of femur

false lesser trochanter

water soluble contrast is used in lymphangiography

false lipiodol lipid soluble is used

fossa ovalis is an oval depression in the upper part of interatrial septum

false lower part of interatrial septum

the upper lobe pulmonary artery lies lateral to pulmonary vein

false medial to pulmonary vein

in adrenal venography, more contrast is needed for right adrenal than left

false more needed for left than right as left adrenal is bigger. In humans, the right adrenal gland is pyramidal in shape, whereas the left is semilunar or crescent shaped and somewhat larger. The adrenal glands measure approximately 3 cm in width, 5.0 cm in length, and up to 1.0 cm in thickness.

Most stochastic effects have repair mechanisms, an exception being cataract development of the lens

false most deterministic effects have repair mechanisms except cataract development of the lens

exposure to the pregnant employee must ensure a dose of less than 0.1 mSv to the fetus for the remainder of the pregnancy

false must be less than 1 mSv for the remainder of the pregnancy

regarding arthrography, 1. it is vital that the needle enters horizontally to avoid extrareticular injury 2. At least four images are acquired in each quadrant and valgus strain should be obtained

false needle should enter vertically true

air in portal vein during enema indicates bad prognosis

false no mortality

cavernosography is contraindicated in the presence of proven UTI.

false not CI

all gadolinium chelates are ionic

false not all

abdominal aorta is related to cisterna chyli on its left

false on its right

ejaculatory ducts open into membranous urethra

false open into utricle in prostatic urethra

outer 2/3 of menisci are avascular

false outer 1/3 rd is vascularized

peri-renal spaces show free communication across midline

false pararenal spaces communicate across midline

anococcygeal body separates the lower vagina from the anal canal

false perineal body

concerning diaphragm, it has a sensory supply from the intercostal nerve

false phrenic nerve

arachnoid matter is closely applied to spinal cord

false pia mater

right main bronchus lies anterior to SVC

false posterior

superior and inferior colliculus lies on the anterior surface

false posterior surface of midbrain

right adrenal lies anterior to IVC

false posterior to IVC

anterior tibial artery passes anterior to medial malleolus

false posterior to medial malleolus

os trigonum is found anterior to talus

false posterior to talus

extensor retinaculum is anterior to the wrist joint

false posterior to the wrist joint

brachial plexus lies in the anterior triangle

false posterior triangle

foramen rotundum is best seen on occipitofrontal view when no angulation of primary beam is used

false primary beam is angulated 15-20 degree caldwell view

portal vein is assessed via anterior approach

false right lateral intercostal approach

In ERCP, use of an end viewing endoscope is mandatory

false side viewing endoscope should be used

subscapularis muscle inserts into the greater tuberosity

false subscapularis inserts into the lesser tuberosity

The head of pancreas receives its main BD from splenic artery

false superior and inferior pancreaticoduodenal arteries

broad ligament of uterus has a lower free edge

false superior free edge

rhomboid fossa are seen at inferolateral aspect of clavicles

false superolateral

thalamus forms the floor of the third ventricle

false thalamus form lateral wall of third ventricle

the posterior cord of brachial plexus is closely related to axillary vein

false the anterior cord is closely related to axillary vein

dose to the patient should not exceed a certain limit

false the dose to the patient should be as low as reasonably possible in order to make sure the patient receives maximum benefit with minimum risk .

The dose limit for a member of staff who is pregnant is 13 mSv over the declared term of her pregnancy.

false the mother should not receive more than 1 mSv to the fetus for the remainder of her pregnancy.

At the elbow joint, fat pads lie outside the joint capsule

false they lie inside the joint capsule

IRMER regulates that patient information detailing the risks associated with ionizing radiation must be given to all patients undergoing a significant medical exposure

false to all patients undergoing treatment or diagnosis with radioactive medicinal products

employer is responding to employ a medical physics expert

false to have expert advice and ensure that an MPE is involved with medical exposure is a part of the IRMER.

ulnar styloid is distal to the radial styloid

false ulnar styloid is proximal to the radial styloid

normal heel pad thickness in males is 23 mm

false upto 21 mm

venous drainage of quadrate lobe is distinct from rest of the liver

false venous drainage from all lobes of liver is to IVC through hepatic veins except caudate lobe which is distinct and drains to IVC directly through cystic veins

warmaian duct is of submandibular gland

false warton duct is of SM gland

Radiation protection is considered appropriate if exposure is kept within required limits.

false, doses still need to be kept as low as reasonably possible.

annual effective dose limit for a visitor can never exceed 1mSv

false, if a person is exposed to ionizing radiation resulting from the medical exposure of another, the limit on effective dose for any such person shall be 5mSv in any period of 5 consecutive calendar years, which may be greater than 1 mSv per year.

In skull radiography, a fine secondary radiation grid is desirable

false, it is needed

ascending aorta lies anterior to main pulmonary artery

false, main pulmonary artery lies anterior to ascending aorta

IR (MER) provides no indication as to the training required by a practitioner or operator prior to medical exposure

false, schedule 2 of IRMER lists relevant subjects for training.

according to IRMER 2000 regulations the employer must justify each radiation exposure

false, the practitioner must justify each radiation exposure.

Caudal angulation 25 degree on AP view will help demonstrate the calcification in the rotator cuff muscle.

false. neutral rotation or internal rotation for subscapularis and infraspinatus

in sialography, success of procedure depends on rapid injection of 2-3 ml of contrast

fasle

The left margin of lesser sac opens into the greater sac

fasle, the right margin opens into lesser sac

white matter

fornix, anterior commissure

great cardiac vein and middle cardiac vein run in which groove

great cardiac vein runs in anterior interventricular groove middle cardiac vein runs in posterior interventricular groove

all of the cerebral veins are paired except

great cerebral vein of Galen ..it is a single vein

inferior sagittal sinus drains to

great cerebral vein of Galen to become straight sinus to left transverse sinus

spleen indents

greater curvature of stomach

supraspinatus muscle is attached to ....

greater tubercle of humerus

PA view of the hand has centering point at

head of 3rd metacarpal

centering point for axial view of shoulder is

head of humerus or glenohumeral joint

For IV urography, LOCM are received in preference to HOCM in all except: DM SLE SCD CHF MM

in all except SLE. SLE takes HOCM. DM, SCD, CHF and MM should receive LOCM.

arterial supply of diaphragm

inferior phrenic and intercostal arteries

pituitary fossa is

inferior to optic chiasm, hypothalamus appears empty on CT of patient with normal pituitary function floor of pituitary fossa forms roof of sphenoid sinuses

azygous vein 1 cm diameter becomes smaller on

inspiration, valsalva maneuver, standing , exercise

paraortic nodes

kidneys adrenals testis ovaries uterine fundus fallopian tubes deep lymph vessles of abdominal wall common iliac nodes

ureter lies ............ to IVC

lateral

infratemporal fossa is bounded medially by

lateral pterygoid plate

lead apron thickness for fluoroscopy and IR

lead apron thickness of 0.35 mm of lead or lead equivalent is common

posterior to first part of duodenum

lesser sac GD artery PV IVC CBD

spleen receives its blood supply via the

lienorenal ligament

right ureter relations

lies posterior to ileocolic vessels lies posterior to gonadal artery and vein enters the bladder lateral to right vas deferens is in a direct posterior relation of the renal vein at the renal hilum

for US of testes, linear array or sector array transducer is used

linear array sector array is to cover large view of field

vagina lymph drainage and venous drainage ?

lymph drainage is to iliac nodes and superficial inguinal nodes venous drainage is to internal iliac veins

inferior alveolar artery is a branch of

maxillary artery

paranasal sinuses age of appearance

maxillary within few weeks of birth frontal 2 years of age sphenoidal 3 years of age adult sinus configuration seen at 14 years of age

atlantoaxial 35M

medial 35M 3mm adults 5mm children lateral 23L 2 mm adults 3mm children

diaphragm originates from

medial arcuate ligament lateral arcuate ligament slips from lower 6 costal cartilages slips from posterior xiphisternum surfaces central tendon

MIA SLRV

medial geniculate body, inferior colliculus and auditory superior colliculus, lateral geniculate body, red nucleus vision

lenticulostriate arteries are branches of:

middle cerebral artery

In a lordotic position, chest x-ray shows:

middle lobe disease

monomer contrast and dimer

monomer diatrizoate, metrizoate, iothalamate iopramide, iomeprol, ioversol, iohexol dimer meglumine, iothalamate. iotrolan, iodixanol.

denser nephrogram is obtained by

more rapid injection of a given concentration and volume of contrast

membranous urethra points

narrowest external voluntary sphincter located here

body aprons with a protective equivalent of

not less than 0.25 mm lead for x-rays up to 100 kV not less than 0.25 mm lead for x-rays up to 150 kV. not less than 0.3 mm lead for x-rays over 100kV

the skull base consists of following bones

occipital sphenoid frontal temporal

petrous temporal bone could be seen in all of the following views except

occipitomental 30 degrees

superior orbital fissure transmitts?

oculomotor nerve trochlear nerve ophthalmic division of trigeminal nerve abducens nerve ophthalmic veins

esophageal opening transmits T10. esoVagus

oesophagus vagus trunks left gastric artery, vein and lymphatics

suprasellar cistern contents?

optic chiasm , optic nerve, anterior part of Circle of Willis

gadolinium properties

paramagnetic contrast agent shortens T1 relaxation time excreted by kidneys increase serum iron transiently following IV injection has severe adverse effects

caldwell view gives better view of

paranasal and frontal sinuses

tangential knee projection demonstrates

patellofemoral articulation

petrosal sinuses

petrosal sinuses drain the cavernous sinus superior petrosal sinus drains to transverse sinus inferior petrosal sinus to the internal jugular vein

which bursa communicate with knee joint?

popliteal bursa semi membranous supra-patellar

short saphenous vein drains into

popliteal vein SS passes posterior to lateral malleolus

superior meatus which ethmoid air cells open?

posterior ethmoidal air cells

inferior orbital fissure communicates with ?

pterygopalatine fossa and infratemporal fossa superior orbital fissure does not communicate

acute complication of femoral artery catheterization?

retroperitoneal hemorrhage

right bronchus and left bronchus angle to vertical

right is 20 degree left is 40 degree

RALS

right main pulmonary artery anterior to right bronchus left main pulmonary artery is superior to left bronchus. Initially superior then posterior.

lordotic view of chest is for

right middle lobe

IVC is derived from:

right supracardinal vein right subcardinal vein right vitelline vein

superior sagittal sinus drains to

right transverse sinus

what is not visible in Towne's view?

sagittal suture

CT pelvis at the level of obturator foramen

sciatic nerve lies on the anterior surface of the gluteus maximus pudendal canals may be identified on the lateral walls of the ischiorectal fossae femoral vein lies medial to femoral artery long saphenous vein is normally seen empty vagina is H shaped with anterior and posterior walls in contact

threshold doses for deterministic effects

skin erythema and sterility, 2-5 Gy sterility 2-3 Gy fetal abnormalities 0.1-0.5Gy cataracts 5Gy

rete testis

small intratesticular tubular strand which is adjacent to epididymis

effective dose

sum of the effective dose to each organ multiplied by a tissue weighting factor for each organ. measured in mGy.

the lymph drainage of uterus includes all except

superficial inguinal, internal iliac, external iliac, para-aortic and deep inguinal ..all except deep inguinal

thyroid gland venous supply

superior and middle thyroid vein drain to internal jugular vein inferior thyroid vein drains to left brachiocephalic vein

superior and inferior to first part of duodenum

superior epiploic foramen inferior head of pancreas

superior meatus middle meatus inferior meatus

superior meatus. posterior ethmoidal air cells middle meatus.osteomeatal complex. frontal, maxillary and anterior ethmoid air cells inferior meatus. sphenoethmoidal recess nasolacrimal duct

thyroid gland arterial supply

superior thyroid artery ECA inferior thyroid artery branch of thyrocervical trunk thyroidea ima artery ..branch of arch of aorta

ulnar groove in elbow joint is best demonstrated by which view:

superoinferior elbow view

all of the following are in medial relation to middle ear excpet

tegmen tympani

gray matter

thalamus, claustrum, cerebellar cortex

the following structures are seen on an axial CT scan at the level of third ventricle

thalmaus, internal capsule, sylvian fissure, septum pellucidum NOT PONS

posterior to gallbladder

transverse colon first and 2nd parts of duodenum

psoas major inserts into lesser trochanter of femur and originates from :

transverse processes of the lumbar vertebrae L1 to L5

1 mm of lead is equivalent to 120 mm of concrete and 12 mm of barium plaster

true

12 mm of barium plaster is equal to 1 mm lead equivalence

true

2.5 mm lead equivalence is satisfactory for use in the walls, doors and windows of an x-ray room

true

2.7% have a common origin of the left common carotid and subclavian as a left brachiocephalic artery

true

80 % undescended testis lie in the inguinal canal in first year of life

true

AP coccyx central ray is 10 degree caudad

true

AP view of C3-C7 , tube is angled 15 degree cephalad

true

AP view of hip is centered to femoral pulse

true

AP view of the hip is taken with leg in internal rotation

true

An empty bladder is required before IVP

true

IV gadolinium is not seen in CT scan after MRI

true

IV iodinated contrast of CT scan is not seen in MRI

true

IVC is left sided in 0.5% of cases

true

IVC lies posterior to epiploic foramen

true

In 0.5% an aberrant right subclavian artery arises distal to the left subclavian artery and passes to the right, posterior to the oesophagus.

true

In 2.5% the left common carotid arises from the brachiocephalic artery.

true

In 5% of subjects the left vertebral artery arises directly from the arch of the aorta, between the origins of the left common carotid and left subclavian arteries.

true

In CT scan coronal section gives best view of ethmoid

true

In IV urography, pyelotubular opacification or papillary blush is more frequently seen with non-ionic than ionic contrast media

true

In SMV view, the radiographic baseline IOMLN is parallel to the film

true

In endoscopic US of esophagus, all layers of esophageal wall can be identified

true

MRCP IS equivalent to ERCP in determining level of obstruction

true

MRI myelography can be done without gadolinium

true

MV is placed in left lower anterior aspect of left atrium

true

Permanent folds or Houston valves are lateral crescentic, semilunar transverse folds or transverse rectal folds which consist of mucosa and submucosa

true

Radioactive substances act introduced a system of licensed disposal sources

true

SMA anastomoses with IMA at splenic flexure

true

SVC derives from the right anterior cardinal vein in utero

true

SVC if present on left drains into right atrium through coronary sinus

true

SVC occurs on the left in 0.3% cases

true

SVC receives azygous vein behind the 2nd costal cartilage

true

Skin ulceration, sterility, erythema, hair loss, and cataracts are all deterministic effects.

true

Stryker's view in shoulder is used in suspected recurrent shoulder recurrent dislocation.

true

The diaphragmatic crura can be mistaken for enlarged lymph nodes

true

The left limb of sigmoid mesocolon is attached medially to left psoas muscle.

true

a slit towne's view demonstrates the TMJ joint well

true

accessory lobe of parotid gland is oftan found lying above parotid stenson duct

true

accessory parotid gland lies above the origin of the parotid duct

true

adrenal on right is posterior to IVC

true

all cervical vertebral bodies have two lateral synovial joints

true

an abdominal x-ray to a pregnant employee can expose the fetus to as much as 4mGy

true

annual effective dose for a trainee under 18 years of age is 6mSv

true

anterior cruciate ligament courses anterolaterally to the posterior cruciate ligament

true

anterior pararenal space contains dudodenum, pancreas and part of the colon

true

anterior perirenal space is bounded posteriorly by gerota's fascia

true

arytenoid cartilages are located on the upper border of the cricoid cartilage

true

ascending urethrography should not be performed within 2 weeks of urethral instrumentation

true

at pulmonary hilum right superior pulmonary vein is antero inferior to the right pulmonary artery

true

at the pterion the frontal bone articulates with the parietal bone

true

at venography, femoral puncture is made easier by Valsalva maneuver

true

average dose from all natural sources is roughly 3 times higher in Cornwall than across the UK

true

barium meal, a single contrast study should only be used in partial obstruction

true

capsule of knee joint includes head of fibula

true

caudate lobe has veins - caudate lobe veins - which drain directly to IVC

true

caudate process is superior to epiploic foramen

true

centering point for lateral cervical spine x-ray is below mastoid process at level of thyroid cartilage

true

cervix pierces the anterior wall of vagina

true

chest CT, mediastinal structures are best demonstrated with a narrow window width

true

chlorpheniramine is used with caution in patients with BPF

true

classification of persons is required under the IRR

true

claustrum lies lateral to external capsule

true

clearly seen fat lines on plain film of abdomen indicate edema

true

collateral ligaments of the knee are evaluated by coronal plane

true

coning decreases patient dose

true

coronary sinus opens between fossa ovalis and tricuspid valve

true

cystic artery arises from right hepatic artery in majority of cases

true

cystic duct usually lies to right of common hepatic duct

true

deep perineal space communicates with ischiorectal fossa

true

descending aorta is related to the posterior basal segment of the left lung

true

descending genicular artery is a branch of superficial femoral artery prior to entering adductor hiatus

true

deviation of trachea to right in children is normal

true

during barium meal, caudal angulation of the x-ray beam. is done in A PA projection overlapping loops of sigmoid colon

true

end plates of cervical vertebrae are well seen on AP view

true

epiphyseal plate is the site of anastomosis between epiphyseal and metaphyseal vessels

true

equivalent dose is numerically equal to absorbed dose

true

external capsule lies lateral to putamen

true

external carotid artery is crossed laterally by the posterior belly of digastric

true

femoral epiphysis can be seen radiologically at 4 months

true

femoral head ossification center appears at 3-6 mo

true

femoral nerve supplies iliacus

true

fluoroscopy dose rate at input phosphor 1 micro gray per second

true

for elbow radiography, beam is centered 2.5 cm distal to the epicondyles in AP view

true

foramen ovale is in the sphenoid bone

true

fourth ventricle communicates with the pontine cistern

true

gastrografin is indicated in suspected perforation

true

genitofemoral nerve passes posterior to ureter

true

greater trochanter appears at 2 to 4 years

true

haustra are basent in appendix, rectum and cecum

true

haustra are more clearly defined in the ascending colon than the descending colon

true

if a worker is exposed to an effective dose greater than 20 mSv in a year the executive needs to be notified.

true

in myelogrpahy, if there is direct cervical puncture, fluoroscopy may be needed.

true

in parotid sialogrpahy, injection of contrast is continued until the patient indicates that it causes pain

true

in transfemoral aortogrpahy, intimal dissection is a more serious complication during an antegrade than a retrograde study of the femoral artery

true

internal auditory meatus is well seen on SMV view

true

intraperitoneal barium leak has a mortality of 50%

true

ionic contrast causes rash in 5% patients

true

ionic contrast media with meglumine cause 4 times for anaphylactic reaction than sodium.

true

lateral epiphyseal artery supplies mainly the medial part of femoral epiphysis

true

lateral skull radiograph should be performed with a horizontal projection

true

lateral view of calcaneum is talocalcaneal articulation

true

lateral view of cervical spine, elevate chin

true

lateral view of the hip is taken with leg in external rotation

true

left ankle arthrography, anterior approach is used

true

left common carotid artery arise from brachiocephalic artery in upto 7% of people

true

left ventriculogram is used before selective coronary catheterization

true

lesser trochanter 10 yrs

true

ligamentum arteriosum derives from ductus arteriosus

true

ligamentum flavum connects the lamina and fuses with the facet joint capsule

true

ligamentum nuchae is large median ligament composed of tendons and fascia located between the posterior muscles of the neck and extends from spine of C7 to occiput.

true

lignocaine is contraindicated for acute porphyria

true

lignocaine toxicity increases with cimetidine

true

liver interlobar fissure contains ligamnetum venosum and teres

true

local sepsis is absolute C/I for angiography

true

long FFD is required for lateral cervical spine view

true

lower limb venography is carried out with 30 degree of head up table tilt

true

lumbar myelography can cause papilledema

true

lymphoid follicles in the rectum are upto 1cm in diameter

true

major fissure runs parallel to the 5th rib

true

maldescended pituitary is found as a soft tissue mass expanding the infundibulum

true

mediastinum is better seen with high kV

true

oblique fissure passes through hilum

true

occipital bone forms part os central skill base

true

occipitofrontal 20 is centered so that central ray emerges through glabella

true

oesophagus is related to the apical segment of the upper lobe of the left lung

true

on plain X-ray we cannot see the antrum of stomach

true

opening of TT and ET tube is in the anterior wall

true

orthopantomography after contrast injection demonstrates the parotid gland well

true

ovaries receive blood supply from aorta through ovarian vein

true

pancreas decreases in size with age

true

pancreas has splenic vein running along its inferior border

true

parasternally left lung normally extends no more inferiorly than the fourth rib

true

parotid gland contains facial nerve lateral to external carotid artery

true

patella ossification center at 5 yrs

true

peri-renal, anterior and posterior para-renal spaces communicate superiorly.

true

piriformis is posterior to hip joint

true

placing the patient prone alleviates dependent or gravitational edema seen posteriorly in the normal patient during sequential axial scanning

true

post op menisci are evaluated by knee arthrography

true

posterior para renal space is bounded posteriorly by transversalis fascia

true

posterior pararenal space is boounded posteriorly by transversalis fascia

true

psoas bursa occasionally communicates with the hip joint

true

radial artery passes between the first and second metacarpals in part of its course

true

radial head 5 yrs

true

rectum is filled by air during a double contrast barium enema when the patient lies prone

true

regarding complications of diagnostic angiography, encephalitis is not a complication

true

retrograde popliteal artery puncture is useful for angioplasty of superficial femoral artery

true

right brachiocephalic vein lies anterolateral to its artery

true

right hepatic artery crosses dorsal to the portal vein in 10% of cases

true

sacroiliac joint is best shown on 25-30 degree posterior oblique projection

true

scrotum has dartos muscle superficial to superficial fascia

true

sixth rib articulates with 5th and 6th thoracic vertebrae

true

skyline view for suspected subluxation of patella requires projection in various degrees of flexion

true

spheno-occipital synchondroses fuses at puberty

true

sterility is a deterministic effect

true

sternal angle is at T4/T5

true

subscapularis muscle is evaluated by axial scan

true

superior metaphyseal artery supplies mainly the lateral part of femoral epiphysis

true

superior radioulnar joint is continuous with the elbow joint

true

the left heart border is commonly related to both the inferior and superior segments of the lingula

true

the osmolality of conventional ionic water soluble contrast media is 4-7 times the osmolality of blood

true

third part of the duodenum lies posterior to the superior mesenteric vessels

true

to evaluate rotator cuff, coronal oblique should be done

true

to show subacromial calcification, the 25 AP view of shoulder is centered to acromion

true

total filtration in dental should not be less than 1.5 mm of aluminum.

true

towne's view is best for visualization of occipital bone

true

transverse genicukate ligament is seen in 12% of lateral plain films

true

transverse geniculate ligament is visible in 12% of lateral plain film of the knee

true

transverse process of L5 arise from the junction of body and the other pedicle.

true

vagina is seen as echogenic on US images

true

vagus nerve on the left passes in front of oesophagus

true

valvulae connivantes are 1 mm thick in the middle and distal rectum

true

vertebral artery arises directly from aortic arch in left side in 5%

true

vertebral artery arises from left SC artery in 74%

true

vertebral artery is crossed over by the inferior thyroid artery

true

perirenal space is enclosed by Gerota's fascia contains IVC

true true

gradient echo can be used for differentiation of gray and white matter?

true Gradient echo T2 weighted MR can best differentiate gray and white matter

in parotid gland facial nerve is lateral and ECA is medial

true MELF

fronto-occipital towne's view 30 degree caudad angulation shows internal auditory meatus

true and beam emerges through vertex of skull. 30 degree caudad tube angulation is needed for Towne's view

head of epididymis is of similar reflectivity to testicular tissue

true and the rest of the epididymis is hyperechoic to the testis

food and drink contribute 300 micro sievert to the total per caput annual dose

true controlled area and supervised area

appendix is seen in barium enema?

true in 70% cases appendix is seen

left testes often hangs lower than the right

true left testes hangs at a lower level than the right in an upright position

natural background radiation contributes 2.2 mSv of the total per caput annual dose

true natural background radiation contributes 85% of total background exposure 50% thoron and radon, 12% food and drink 13% gamma rays 10% cosmic rays artificial exposure 15% of which diagnostic medical radiation is largest artificial source 14% occupational exposure 0.3% total per caput annual dose is 2.6 mSv

mediastinum cross section at T3 shows aortic arch, azygous vein, trachea and thoracic duct but not pulmonary trunk.

true pulmonary trunk starts to appear at T5

when diaphragm contracts intrathoracic volume increase

true when diaphragm contracts, it descends and intra-thoracic volume increases

female radiation workers are not obliged to inform their employer if they become pregnant

true, radiation workers are themselves responsible and obliged to use available protective equipment

fetal derivatives

umbilical vein-ligamentum teres ductus venosus-ligamentum venosum ductus arteriosus..obliterated in few hours of first breath

weighert-meyer rule

upper moiety ureter inserts inferior to that of lower moiety ureter.

vena cava opening T8 transmits.. vena Pava

vena cava vena Pava right phrenic nerve

quadrigeminal cistern contents

venous confluence of straight sinus and inferior sagittal sinus to form great cerebral vein of Galen

foramen magnum transmitts?

vertebral arteries anterior spinal artery posterior spinal artery spinal parts of accessory nerves medulla oblongata meninges tectorial membrane apical ligament of dens meningeal branches of upper cervical nerves

anterior inferior cerebellar artery is a brach of

vertebral artery

cisterna magna contents ?

vertebral artery posterior inferior cerebellar artery

tributaries of brachiocephalic vein

vertebral vein inferior thyroid vein internal thoracic vein thoracic duct

radiation weighting factors x-rays, gamma rays, electrons Protons Alpha particles Neutrons

x-rays, gamma rays and electrons 1 Protons 5 Alpha particles 20 Neutrons 5-20 (energy dependent)

statements regarding ileopsoas muscle on US

1. produce tubular low reflective echoes medial and posterior to the kidney 2. must have high reflectivity linear echoes within. These are muscle fibers. 3. psoas minor muscle is not identified separately medially and inferiorly 4. high reflectivity structure posteriorly and medially represents femoral nerve sheath 5. low reflective structure in area of psoas muscle is due to distal shadowing of the iliac wing.

RPA is consulted for :

1. requirements of controlled areas 2. ,Risk aservicing and correct use of equipment

direct coronal section of orbits can be obtained by

1. supine position hyperextended neck 2. prone position flexion of the neck

peritoneal spaces 1. right paracolic gutter communicates directly with right subhepatic space 2. left paracolic gutter does not communicate directly with left subphrenic space

1. true 2. true

dental radiography less than 70 keV requirement for aluminium

1.5 mm of aluminium

Radionuclide for lung perfusion

10 - 100 micrometer particles used. Tech eggs containing carbon particles are used for ventilation studies.

100% lethal dose for humans?

10 Sv or more is 100% lethal to humans

AP projection of coccyx , central beam is angled at

10 degree caudad

IMA angiography

10 ml of 300 mg per ml contrast, do before SMA or celiac, hand injection, LPO 30 views for sigmoid.

how much dose CT abdomen gives to the fetus?

10-20 mGy. The deterministic threshold for fetal abnormalities is not less than 100mGy and is possibly higher.

Perfusion lung scan

100 MBq maximum dose Uses Tc 99 m MAA particles Shake syringe before injecting to avoid particles settling 200-400 MBq is appropriate dose for Meckel's scan..imaging done on 5 mins

CCA arteriography rate

12 ml volume LOCM with iodine of not more than 300 mg/ml iodine not 350 mg/ml

Small bowel enema technique

1200 ml of 50% w/v barium required

I 123 half life

13 hours

medial oblique position of the ankle for mortise joint requires the leg to be rotated

15 degree internally

percutaneous nephrostomy, 16 french catheters are usedz

18 french

annual equivalent dose limit for members of the public or visitors is...........

1mSv

Renal length increase by....... per week in fetus

1mm

maximum diameter of pancreatic duct of Wirsung

2-3 mm

AP elbow centering point

2.5 cm above elbow crease

Right main bronchus is

2.5 cm long and 1.5 cm wide

centering point for lateral view of cervical spine

2.5 cm posterior to the angle of the mandible

for most exposures aluminum thickness is

2.5 mm

swimmer view lateral view of cervical spine centering point is

2.5cm above jugular notch at level of T1

24 deciduous teeth normally

20 deciduous teeth

Annual effective dose is

20 mSv for staff 18 years of age and over

Frequency of post myelographic headaches

20-30% , 10% will have prolonged headaches particularly females

Approximately 1000 ml of gas should be produced in stomach for a satisfactory double contrast study

200-400 ml is adequate volume of gas

annual effective dose limit for a radiation worker 18 years and over is ......... and that for a member of the public is.......

20mSv 1mSv

Percutaneous transhepatic cholangiography, bile duct cannulation is done by

22 or 23 G Chiba needle

dose limit of pregnant abdomen

2mSv for mom and less than 1 mSv to the fetus over the term of the pregnancy

Us can detect lymph nodes of size........

2mm or greater

Myelography technique

3 grams iodine used max, with ct done in 2-3 hours and headache occurs in 30-40% patients.

Ossification centers for patella appear at :

3 years of age

Volume of barium for child

3-4 ml/kg

Needles used for lymphangiography and sialography

30 gauge McCarthy needle for lymphangiography 30 gauge Rabinov needle for sialography

staff who are likely to exceed ........% of any annual dose limit for workers need to be designated as classified

30%

SMA angiography technique

30-45 ml contrast injected through femoral-visceral side winder cobra or femoral renal catheter. Injection is with a pump. Buscopan is used to stop the bowel movement and stops subtraction artifact.

Coronary angiogram cine film freq

30-60 frames per second

Gd BOPTA is protein bound and taken up by hepatocytes and optimally imaged at ........

30-60 mins

Percutaneous transhepatic cholangiography D. Erect films are useful

30. TRUE-They may give the best demonstration of the comumon bile duct of any films taken. Reference S, p. 81.

32 Endoscopic retrograde cholangiopancreatography (ERCP) A. Is indicated in the investigation of pancreatic pseudocyst.

32 FALSE-This is a contra-indication to the procedure. If discovered during the procedure it should not be fully opacified. Antibioties are given and surgical drainage within 24 hours consicered.

35 ln arthrography of the knee lesions C. Double-contrast is the method of choice for evaluating radio opaque loose bodies

35C FALSE-Negative-contrast is best in this situation because positive contrast will obscure the loose body. Negative-contrast arthrography gives poor film contrast and detail of internal joint structures. Reference K,p. 57

39 In lymphograplhy D. Cerebral oil embolus is a rare but usually fatal complication.

39 FALSE-In a series of 10000, two cases of cerebral oil emboli were recorded. Both patients recovered completely, Reference

Pulmonary angiography contrast rate, films required

45 ml in 1.5 sec, AP only, May be oblique, lateral is of no value due to superimposition.

which dose causes cataracts?

5 Sv

Lateral lumbar spine view is centered ........ cm anterior to L3 spinous process.

5 cm anterior

collimator field size is

5 x 5 cm

Hepatic artery variable origin

5% Common hepatic artery arising from SMA 25% Some portion of hepatic artery arising from SMA

50 ml contrast to delineate pelvicalyceal system

5-10 ml

Transparencies portography contrast

50 ml 370 mg of iodine per ml is injected in 5 seconds

Pulmonary arteriography rate

50 ml volume rate of 20-25 ml per sec

Antegrade pyelogram macroscopic hematocrit is seen in .... % of cases

50%

Incidence of bilateral cervical ribs is........

50%

Lateral thoracic spine view is centered ........ cm anterior to T6 spinous process.

5cm

portal vein is .......cm long, runs posterior to first part of duodenum, lies behind neck of pancreas, and formed by confluence of splenic vein and superior mesenteric vein.

5cm

AP sacroiliac joint centre

5cm below ASIS and above pubic symphysis

Oblique view of hand and ball catchers hand centering point

5th metacarpal head

Retrocrural space measures ........... mm

6 mm

26 In percutaneous splenoportography (PSP) : A. The puncture is made in the anterior axillary line if the spleen is impalpable B. The inferior mesenteric vein is seen in the normal examination C. The left gastric vein is better demonstrated than by the venous phase of a coeliac angiogram in the normal patient D. The normal pulp pressure is less than 20 mm Hg. E. Gelfoam is used to reduce bleeding.

A posterior axillary line B false C false D less than 11 mm of Hg E true

A solution of 150 ml of gastrografin in one liter of a flavored drink is recommended to opacity the bowel prior to a CT examination

A solution of 15 ml of gastrografin in one liter is recommended. This dilution minimizes artefacts arising from the contrast medium.

Internal iliac artery A. Divides into medial and lateral branches B. Gives off obturator artery near its origin C. Lies posterior to the internal iliac vein

A. False anterior and posterior branches B. False obturator is branch of anterior division C. False the internal iliac artery lies anterior to internal iliac vein

Regarding biopsy of liver, A.. Paracentesis should be done before percutaneous liver biopsy B.. a transvenous large cutting needle biopsy is CI if there is a bleeding diaphyis C.. a plugged biopsy requires direct visualization of the liver capsule

A.. True B.. false it is method of choice in severe clotting disorders. C. Fasle

relations of ureter

ANTERIOR right colic and ileocolic vessels duodenum terminal ileum right gonadal arteries root of small bowel mesentery POSTERIOR Psoas muscle Bifurcation of right common iliac artery

relations of thoracic trachea

ANTERIOR arch of aorta sternum thymus left CCA left BC artery and vein POSTERIOR esophagus left recurrent laryngeal nerve RIGHT Azygous vein right vagus nerve pleura LEFT arch of aorta left CCA left SC artery left vagus and phrenic nerves pleura

anterior and posterior to cervical trachea

ANTERIOR isthmus of thyroid inferior thyroid vein sternohyoid and sternothyriod POSTERIOR RLN esophagus

Centering point AP hips AP pelvis Lateral ankle AP ankle AP foot

AP hips.. 2.5 cm above PS AP pelvis..5cm above PS Lateral ankle..medial malleolus AP ankle..midway between medial and lateral malleolus AP foot..middle cuneiform

Cenetering point AP knee Lateral knee

AP knee. 2.5 cm below inferior border patella Lateral knee 2.5 cm below and behind inferior border of patella

which projection demonstrates pisiform free of superimposition?

AP oblique lateral wrist with 20 degree supination carpal tunnel view

Prostate lie ......... the levator ani complex

Above

All doses sequence and definition

Absorbed dose Gy Equivalent dose is absorbed dose multiplied by RWF. measured in mSv. Effective dose is sum of equivalent dose multiplied by TWF. also mSv.

Axial shoulder

Acromion

ERCP CIs

Acute pancreatitis, pseudocyst, cardio respiratory disease.

Peroral pneumocolon technique

Air rectally, contrast oral 300 ml, introduce air when contrast has reached mid transverse colon, used for terminal ileum and caecum

Structures involved in lambic system are

Amygdala, hippocampus, parahippocampal gyrus, piriform cortex, fornix, hypothalamus, septal nuclei, paraterminal gyrus, cingulate gyrus

Catheters Aortography Bronchial angiography

Aortography..pigtail or straight Bronchial angiography..cobra are for viscera Mani catheters are multi- purpose

triphasic liver CT

Arterial 22 to 27 s Portal venous 49 to 73 Delayed 8 to 10 mins

Radionuclide bone imaging

Arterial phase 2s images taken for 1 min after contrast Blood pool phase image taken 5 min after injection Delayed phase image taken 2-4 hours later

Final

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