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Ростовский Государственный Медицинский Университет

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22. On Figure 10.22, axial oblique MRI of hip, post-arthrogram, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

23. On Figure 10.24, coronal MRI of hip, post-arthrogram, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

180

24. On Figure 10.45, axial MRI of distal femur, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

25. On Figure 10.57, axial MRI of right knee, label the following structures.

a. ___________________________________

b. ___________________________________

c. ___________________________________

d. ___________________________________

181

26. On Figure 10.64, axial MRI of knee with tibioﬁbular articulation, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

27. On Figure 10.67, axial MRI of ankle with malleoli, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

182

28. On Figure 10.87, sagittal MRI of knee, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

29. On Figure 10.96, axial MRI of knee, label the following structures.

a. ___________________________________

b. ___________________________________

c. ___________________________________

d. ___________________________________

183

30. On Figure 10.118C, 3D CT of foot, lateral view, label the following structures.

a. __________________________________

b. __________________________________

c. __________________________________

d. __________________________________

31. On Figure 10.144, axial MRI of ankle, label the following structures.

a. _____________________________________

b. _____________________________________

c. _____________________________________

d. _____________________________________

e. _____________________________________

32. On Figure 10.162, coronal MRI of metatarsals, label the following structures.

a. ___________________________________

b. ___________________________________

c. ___________________________________

d. ___________________________________

184

CASE STUDIES

Case Study 1

A 17-year-old male soccer player experienced tingling and burning along the medial side of the ankle and along the bottom of the foot. After a clinical examination and electrodiagnostic studies were completed, the patient was diagnosed with tarsal tunnel syndrome.

1. What is the tarsal tunnel?

2. What structures pass through the tarsal tunnel?

Case Study 2

A 14-year-old female was playing soccer when she heard an audible pop and felt her knee lock up. She complained of severe pain, and her knee swelled signiﬁcantly. An MRI conﬁrmed that she had a large meniscal tear that would require arthroscopic surgery for repair.

1. Which meniscus is most mobile?

2. What two ligaments arise from the posterior horn of the lateral meniscus?

185

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Answers

CHAPTER 1: INTRODUCTION TO SECTIONAL ANATOMY

MATCHING

Directional Terminology

1. d

2. k

3. e

4. l

5. n

6. f

7. q

8. m

9. b

10. o

FILL IN THE TABLE (see Table 1.3)

Internal Landmarks

Landmark Location

Aortic arch 2.5 cm below jugular notch

Aortic bifurcation L4–L5

Carina T4–T5, sternal angle

Carotid bifurcation Upper border of thyroid cartilage

11. c

12. r

13. p

14. a

15. h

16. i

17. j

18. s

19. g

Regional Terminology

1. e

2. l

3. f

4. b

5. c

6. j

7. d

8. i

9. a

10. h

11. k

12. g

Celiac trunk 4 cm above transpyloric plane

Circle of Willis Suprasellar cistern

Common iliac vein bifurcation Upper margin of sacroiliac joint

Conus medullaris T12 to L1, L2

Heart: apex Fifth intercostal space, left midclavicular line

Heart: base Level of second and third costal cartilages behind sternum

Inferior mesenteric artery 4 cm above bifurcation of abdominal aorta

Portal vein Posterior to pancreatic neck

Renal arteries Anterior to L1, inferior to superior mesenteric artery

187

Landmark Location

Superior mesenteric artery 2 cm above transpyloric plane

Thyroid gland Thyroid cartilage

Vocal cords Midway between superior and inferior border of thyroid cartilage

SHORT ANSWER

1. Sagittal—a vertical plane that passes through the body, dividing it into right and left portions

Coronal—a vertical plane that passes through the

body, dividing it into anterior and posterior portions

Axial—a horizontal plane that passes through the

body, dividing it into superior and inferior portions

Oblique—a plane that passes diagonally between the

axes of two other planes

2. The two main body cavities are the dorsal and ventral cavities. The dorsal cavity includes the cranial and spinal cavities, and the ventral cavity is subdivided into the thoracic and abdominopelvic cavities.

3. Any three of the following: right lobe of the liver, gallbladder, right kidney, portions of the stomach, small and large intestines

4. Any six of the following: right hypochondrium, epigastrium, left hypochondrium, right lateral, umbilical, left lateral, right inguinal, hypogastrium, left inguinal

5. It represents the attenuating properties or density of each tissue.

6. Any CT number above zero will represent tissue denser than water and will appear in progressively lighter shades of gray to white.

7. In MRI, the gray scale represents the speciﬁc tissue relaxation properties of T1, T2, and proton density.

8. A ray from the camera’s viewpoint is directed to stop at the maximum voxel value. With this method, only the brightest voxels will be mapped into the ﬁnal image.

9. In volume rendering, the contributions of each voxel are summed along the course of the ray from the camera’s viewpoint. The process is repeated numerous times to determine each pixel value that will be displayed in the ﬁnal image.

10. The two commonly used horizontal planes are the transpyloric and transtubercular planes, and the two sagittal planes are the two midclavicular.

TRUE/FALSE

1. False—The largest immovable facial bone is the maxilla.

2. True

3. False—The maxillary sinuses drain into the middle nasal meatus.

4. False—The sphenoid sinuses are typically paired and separated by a septum.

5. True

6. True

7. False—The vestibule is a part of the inner ear, but it is involved with balance and equilibrium.

8. False—The bony orbit is composed of the frontal, sphenoid, and ethmoid bones of the cranium and the lacrimal, palatine, maxillary, and zygoma of the facial bones.

9. False—The lacrimal gland is located in the superior lateral portion of the orbit.

10. True

FILL IN THE BLANKS

1. Round window

2. Foramen magnum

3. Clivus

4. Temporal

5. Sphenoid

6. Masseter

7. Vomer

8. Articular eminence

9. Cribriform plate

10. Tuberculum sellae

11. Ethmoid bulla

12. Rotundum, ovale, and spinosum

13. Collateral ligaments

CHAPTER 2: CRANIUM AND FACIAL BONES

MATCHING

1. f

2. d

3. c

188

4. b

5. a

6. e

FILL IN THE TABLE (see Table 2.3)

Paranasal sinus drainage location

Sinus Drainage Location

Ethmoid: anterior Middle nasal meatus

Ethmoid: posterior Superior nasal meatus

Maxillary Middle nasal meatus

Sphenoid Sphenoethmoidal recess

Frontal Middle nasal meatus

Foramina and Fissures of the Skull (see Table 2.2)

Bone Foramen/Fissure Major Structures Using Passageway

Frontal Supraorbital foramen (or notch)

Frontal foramen (or notch)

Supraorbital nerve and artery Frontal artery and nerve

Ethmoid Cribriform plate Olfactory nerve (I)

Sphenoid Foramen rotundum

Foramen ovale Foramen spinosum Pterygoid canal Optic canal Superior orbital ﬁssure

Maxillary branch of trigeminal nerve (V) Mandibular branch of trigeminal nerve (V) Middle meningeal artery Petrosal nerve Optic nerve and ophthalmic artery Ophthalmic vein, Oculomotor nerve (III), trochlear

nerve (IV), ophthalmic branch of trigeminal nerve (V), abducens nerve (VI)

Sphenoid and

Inferior orbital ﬁssure Maxillary branch of trigeminal nerve (V)

maxillary bones

Occipital Foramen magnum

Hypoglossal canal

Temporal Carotid canal

External auditory meatus Internal auditory canal Stylomastoid foramen and facial

Medulla oblongata and accessory nerve (XI) Hypoglossal nerve (XII)

Internal carotid artery Air in canal conducts sound to tympanic membrane Vestibulocochlear nerve (VIII) and facial nerve (VII) Facial nerve (VII)

nerve canal

Temporal and

occipital bones

Jugular foramen Internal jugular vein, glossopharyngeal nerve (IX),

vagus nerve (X), and accessory nerve (XI)

Temporal, sphenoid,

and occipital bones

Foramen lacerum Fibrocartilage, internal carotid artery as it leaves

carotid canal to enter cranium, nerve of pterygoid canal, and a meningeal branch from the ascending pharyngeal artery

Maxillary Infraorbital foramen Infraorbital nerve and maxillary branch of trigeminal

nerve (V)

Lacrimal with

maxilla

Lacrimal groove, nasolacrimal

canal

Lacrimal sac and nasolacrimal duct

Mandible Mental foramen Mental artery and nerve

189

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