First FRCR Anatomy Questions and Answers

First FRCR Anatomy Questions and Answers

First FRCR Anatomy Questions and Answers Usman Shaikh Interventional Radiology Fellow, Royal Liverpool University Hospital, Liverpool, UK John Curtis Consultant Radiologist, University Hospital Aintree, Liverpool, UK Rebecca Hanlon Consultant Radiologist, University Hospital Aintree, Liverpool, UK David White Consultant Radiologist, University Hospital Aintree, Liverpool, UK Andrew Dunn Consultant Radiologist, Royal Liverpool University Hospital, Liverpool, UK Andrew Healey Consultant Paediatric Interventional Radiologist, Alder Hey Children s Hospital, Liverpool, UK Jane Belfield Consultant Radiologist, Royal Liverpool University Hospital, Liverpool, UK Elizabeth Kneale Radiology Registrar, University Hospital Aintree, Liverpool, UK Peter Dangerfield University of Liverpool, Liverpool, UK Hilary Fewins Consultant Radiologist, Liverpool Heart and Chest Hospital, Liverpool, UK

CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi, Mexico City Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York Information on this title: /9781107679498 # U. Shaikh, J. Curtis, R. Hanlon, D. White, A. Dunn, A. Healey, J. Belfield, E. Kneale, P. Dangerfield and H. Fewins 2012 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2012 Printed in the United Kingdom at the University Press, Cambridge A catalogue record for this publication is available from the British Library Library of Congress Cataloging-in-Publication Data First FRCR anatomy : questions and answers / John Curtis... [et al.]. p. ; cm. Includes index. ISBN 978-1-107-67949-8 (Paperback) I. Curtis, John, 1963 [DNLM: 1. Anatomy Case Reports. 2. Anatomy Examination Questions. 3. Radiology Case Reports. 4. Radiology Examination Questions. QS 18.2] 616.07 0 57076 dc23 2011034134 ISBN 978-1-107-67949-8 Paperback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Contents Foreword Preface page vii ix Introduction 1 Examination 1: Questions 3 Examination 1: Answers 23 Examination 2: Questions 31 Examination 2: Answers 51 Examination 3: Questions 58 Examination 3: Answers 78 Examination 4: Questions 85 Examination 4: Answers 105 Examination 5: Questions 113 Examination 5: Answers 133 Examination 6: Questions 141 Examination 6: Answers 161 Examination 7: Questions 167 Examination 7: Answers 187 Examination 8: Questions 193 Examination 8: Answers 213 v

Foreword Knowledge and understanding of human anatomy is a key element of medical training, whether it is at an undergraduate or at a postgraduate level. This is particularly so in interpreting radiological images. A good radiologist requires many different skills and competences, but right up there at the top of the list is a detailed knowledge of anatomy relevant to radiology. Over recent years it has become apparent that the knowledge of anatomy acquired at medical school and in specialties prior to entry to radiology training is variable and the Royal College of Radiologists has made it one of its priorities to set the standard of radiological anatomical knowledge that all radiologists should achieve. Theoretically, knowledge of anatomy should be possible to acquire as a radiology trainee passes through the modular training, but many involved in training have realized that this on its own is not sufficient. A curriculum and an appropriate form of assessment are required to ensure consistency, and there is good evidence that the need to pass an exam drives learning. The recently introduced anatomy curriculum and the First Part FRCR anatomy examination are intended to achieve this end. Radiological images, particularly cross-sectional images, are also an excellent way of teaching anatomy to medical students, and more and more medical schools are taking advantage of this facility, as are specialties where anatomy is essential for practice within that particular area of medicine. The exciting developments in molecular and functional imaging mean that it is now even more important to be able to localize a particular function to a particular anatomical structure, and this is only possible with an excellent understanding and knowledge of anatomy. A key element of a modern curriculum is that students should undertake regular formative assessment to allow them to evaluate their own progress and identify their training needs and that part of this should be self-assessment. There are a number of resources available to achieve this and amongst them are books produced specifically for this purpose, web-based material and the radiology integrated training initiative (R-ITI) e-learning database (e-ld). Dr David RM Lindsell FRCR vii

Preface The reintroduction of an anatomy section heralded a welcome return to the part 1 FRCR examination. Anatomy is the main cornerstone on which radiology rests and without a good grounding, being an effective radiologist is impossible. Clinicians often call upon radiologists to guide them with anatomy in addition to steering them towards better diagnosis and management of their patients. Our aim with this book was much more than a simple pre-examination selfassessment text. From its inception, we wanted to write a text that would prove equally as useful after the part 1 FRCR examination and therefore endeavoured to include radiological pearls that would serve the radiologist well throughout his or her career. Similarly a non-radiologist reading the text would derive significant benefit in their particular field. The authors have chosen these clinical pearls, from within their own susbspecialties, rather than purely didactic information that might be obtained in other standard textbooks. The cases in this book very closely match the standard type of cases likely to be encountered in the actual anatomy section of the examination. Self-assessment gives immediate feedback to the reader which is often lacking in larger texts. Furthermore it gives a framework for further reading in the various subspecialties. We also believe that this text will be invaluable to medical students, foundation doctors and specialist trainees in surgery and medicine. We would like to thank all of the contributing authors for their hard work in diligently putting questions together and for their shared wisdom. Usman Shaikh John Curtis June 2011 ix