RAN 100 Radiographic Anatomy 100 Radiografiese Anatomie 100

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1 - SCHOOL OF MEDICINE DEPARTMENT OF ANATOMY BRad I RAN 100 Radiographic Anatomy 100 Radiografiese Anatomie 100 First Examination (November ) Eerste Eksamen (November 2007) SKOOL VIR GENEESKUNDE DEPARTEMENT ANATOMIE Date: 1 November 2007 Datum: 1 November 2007 Time: 3 hours Tyd: 3 ure TOTAL: 100 marks TOTAAL: 100 punte Internal examiner(s) / Interne eksaminator(e): Ms / Me AA da Silva Dr EN L Abbé External examiner(s) / Eksterne eksaminator(e): Prof MC Bosman (UP) Ms / Me YF Hartzer (UP) SPECIAL INSTRUCTIONS / SPESIALE INSTRUKSIES Answer all the questions. Answer Section A in a separate book. The paper consists of FIVE pages. Mark allocation: ½ mark per fact. Question 1 / Vraag 1 SECTION A / AFDELING A Beantwoord al die vrae. Beantwoord Afdeling A in n aparte boek. Die vraestel bestaan uit VYF bladsye. Puntetoekenning: ½ punt per feit. An obese child slips and falls in the grocery store and receives a compound fracture to his right forearm. He is rushed to a local hospital for radiographs and treatment. n Kind wat baie oorgewig is gly en val in die kruidenierswinkel en word na die plaaslike hospitaal geneem met n saamgestelde fraktuur aan sy regter voorarm. By die hospitaal word radiografiese opnames geneem en ontvang hy behandeling. Name the type of epithelium found on the skin. Noem die tipe epiteel van die vel. (1) Briefly describe the histological structure of a Haversian system. Beskryf kortliks die histologiese struktuur van n Havers-sisteem. (4) Question 2 / Vraag 2 Joints are well designed to withstand wear but heavy use over several years can cause degenerative changes. Gewrigte word ontwerp om slytasie te weerstaan, maar oormatige gebruik oor verskeie jare kan degeneratiewe veranderinge veroorsaak. Explain what a synovial joint is and aid your answer with a labelled diagram. Verduidelik wat n sinoviale gewrig is en lig u antwoord met geannoteerde sketse toe. (3) List 2 other types of joints found in the body and give an example of each. Noem 2 ander tipes gewrigte wat in die liggaam voorkom en gee n voorbeeld van elk. (2) Subtotal / Subtotaal: [10] - 1 -

2 SECTION B / AFDELING B Question 3 / Vraag 3 Radiographs of a baby born with a congential diaphragmatic hernia shows that the abdominal viscera has entered the thoracic cavity. Describe the macroscopic anatomy of the diaphragm under the following headings: Radiografiese opnames van n baba met n aangebore diafragmabreuk toon dat die abdominale vissera die torakale holte binnegedring het. Beskryf die makroskopiese anatomie van die diafragma onder die volgende opskrifte: Attachments / aanhegtings (7½) Diaphragmatic openings / diafragmatiese openinge (3) (10½) Question 4 / Vraag 4 During a rountine crown repair by a dentist, the patient accidently aspirated the crown. Radiographs show that the crown is lodged in the primary bronchus. Terwyl die tandarts n roetine kroonherstelprosedure doen, het die pasiënt per ongeluk die kroon geaspireer. Radiografiese opnames toon die kroon in die primêre brongus aan. Briefly discuss the macroscopic anatomy of the trachea. Bespreek kortliks die makroskopiese anatomie van die tragea. Describe the differences between the left and right primary bronchus in table format. Beskryf die verskil tussen die linker- en regter primêre brongus in tabelvorm. (4) (9) Question 5 / Vraag 5 A 23-year-old man was admitted into hospital after he had received a direct blow to the sternum. Draw and label a diagram of the sternum, illustrating the various parts of the sternum. n 23-Jarige man is in die hospitaal opgeneem nadat hy n vuishou direk op sy sternum gekry het. Teken en annoteer n diagram van die sternum om die verskillende dele te verduidelik. (5½) Question 6 / Vraag 6 SECTION C / AFDELING C Subtotal / Subtotaal: [25] During a boxing match, a 28-year-old man dislocated his right shoulder after punching his opponent. Radiographs confirm dislocation of the shoulder joint. Tydens n boksgeveg het n 28-jarige man sy regter skouer gedislokeer nadat hy sy opponent geslaan het. Radiografiese opnames het dislokasie van die skouergewrig bevestig. Define the bony elements involved / Omskryf die benige elemente betrokke (1) Discuss the innervation of the joint / Bespreek die senuweevoorsiening van die gewrig (1) (c) List the dynamic stabilizers of the shoulder joint. Noem die dinamiese stabiliseerders van die skouergewrig. (2) - 2 -

3 (d) Discuss two of the above-mentioned stabilizers regarding the origin and insertion. Bespreek twee van die bogenoemde stabiliseerders ten opsigte van oorsprong en implanting. (2½) (6½) Question 7 / Vraag 7 A patient, in severe shock, is given fluid by means of an intravenous line in the femoral triangle. Discuss the femoral triangle under the following headings: n Pasiënt, in n erge skoktoestand, word vloeistof toegedien deur middel van n intraveneuse lyn in die femorale driehoek. Bespreek die femorale driehoek onder die volgende opskrifte: Borders / Grense (3) Roof / Dak (1) (c) Floor / Vloer (1½) (d) Contents / Inhoud (2) (7½) Question 8 / Vraag 8 A 29-year-old woman, in her third trimester of pregnancy, complains of swelling of her hands and feet. She also has loss of sensation over her index-, middle- and half of her ring finger. Diagnosis: Carpal tunnel syndrome. Briefly discuss the anatomy of the carpal tunnel. n 29-Jarige vrou, in die derde trimester van swangerskap, kla dat haar hande en voete swel. Sy het ook verlies aan sensasie van haar wys-, middel- en helfte van haar ringvinger, veral aan die linkerkant. Diagnose: Karpaletonnel-sindroom. Bespreek die anatomie van die karpale tonnel kortliks. Question 9 / Vraag 9 A pelvic radiograph of a victim of a motorcar accident shows a dislocation of the hip joint n Radiografiese opname van die bekken van n persoon wat in n motorongeluk betrokke was toon n dislokasie van die heupgewrig. Classify the hip joint. Klassifiseer die heupgewrig. (1) Discuss the osteology of the proximal end of the femur. Bespreek die osteologie van die proksimale einde van die femur. (4) Subtotal / Subtotaal: [25] SECTION D / AFDELING D Question 10 / Vraag 10 Vertebral osteophytes result from an age degenerative process. The cervical and lumbar vertebae are more commonly affected by vertebral osteophytes than the thoracic. Discuss any 5 morphological differences in the three types of typical vertebrae in table format. Vertebrale osteofiete is n degeneratiewe proses as gevolg van veroudering. Die servikale en lumbale werwels word meer algemeen as die torakale werwels aangetas. Bespreek, in tabelvorm, enige 5 morfologiese verskille tussen die drie soorte tipiese werwels. (7½) - 3 -

4 Question 11 / Vraag 11 A 23-year-old man has severe back pain. Radiographs indicate degeneration of the intervertebral disc between T12 and L1. Write short notes on the intervertebral disc. n 23-Jarige man ondervind erge rugpyn. Radiografiese opnames toon degenerasie van die intervertebrale diskus tussen T12- L1. Beskryf kortliks die intervertebrale diskus. (4½) Subtotal / Subtotaal: [12] Question 12 / Vraag 12 SECTION E / AFDELING E Correlate the term on the left with the appropriate answer on the right. Answers in the right column may be used more than once: Korreleer die term links met die regte antwoord aan die regterkant. Antwoorde in die regter kolom mag meer as een keer gebruik word: i. Hypogastric region Hipogastrium A. Bladder Blaas ii. iii. iv. Transumbilical plane Transumbilikale vlak Rectus abdominis M. rectus abdominis Transpyloric plane Transpiloriese vlak B. Insert on pubic crest Inplanting op die crista pubica C. Medial margin of rectus sheath Mediale grense van rektusskede D. Stomach Maag v. Epigastric region Epigastrium vi. vii. viii. ix. Umbilicus Umbilikus Intertubercular plane Intertuberkulêre vlak Linea alba Bifurcation of aorta Bifurkasie van aorta x. Subcostal plane Subkostale vlak E. L3-L4 F. Neck of pancreas Nek van pankreas G. Lateral margin of rectus sheath Laterale grense van rektusskede H. Liver Lewer I. L2-L3 J. Insert on iliac crest Inplanting op die crista iliaca K. L5 L. Spleen Milt Subtotal / Subtotaal: [5] - 4 -

5 SECTION F / AFDELING F Question 13 / Vraag 13 A 25-year-old man s parachute failed to open completely. Radiographs of the pelvis reveal several fractures of pubic bone and acetabulum. n 25-Jarige man se valskerm het tydens n sprong nie volledig ontvou nie. Radiografiese opnames van die bekken toon verskeie frakture van die os pubis and asetabulum. Write short notes on the acetabulum Skryf kort aantekeninge oor die asetabulum. Briefly discuss the osteology of the pubic bone. Bespreek kortliks die osteologie van die os pubis. Subtotal / Subtotaal: [11] SECTION G / AFDELING G Question 14 / Vraag 14 An 18-year-old student presents at the Hospital with lacerations in the hairline above the nasion, glabella and supra-orbital ridges. Radiographs show no fractures of the bony orbit. n 18-Jarige student presenteer by die Hospitaal met lasserasies in die haarlyn bokant die nasion, glabella en supraorbitale riwwe. Radiografiese opname toon geen frakture van die benige orbita nie. Write short notes on each of the following terms: Skryf kort aantekeninge oor elk van die volgende terme: (i) Glabella (1) (ii) Supra-orbital ridges / Supraorbitale riwwe (½) (iii) Nasion (1) List the bones of the bony orbit. Noem die bene van die benige orbita. (3½) Question 15 / Vraag 15 A 25-year-old lady is attacked on her way home. During the attack she is hit several times on the head with a blunt object. Radiographs indicate multiple fractures of the roof of the skull. n 25-Jarige vrou word oppad huistoe aangeval. Tydens die aanval is sy verskeie kere met n stomp voorwerp oor die kop geslaan. Radiografiese opnames toon veelvuldige frakture van die skedeldak. Construct a fully labelled diagram of the roof of the skull (superior view) to illustrate the sutures and bones. Teken n volledig geannoteerde skets van die skedeldak (superior aansig) om die nate en bene te illustreer. (4½) Name 3 other bones, which have not been mention in, that form part of the neurocranium. Noem drie ander bene, wat nie in genoem word nie, wat deel van die neurokranium vorm. (1½) Subtotal / Subtotaal: [12] TOTAL / TOTAAL: [100]