RAN 100. Radiographic Anatomy 100 Radiografiese Anatomie 100

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1 Copyright reserved/ Kopiereg voorbehou FACULTY OF HEALTH SCIENCES/ FAKULTEIT GESONDHEIDSWETENSKAPPE SCHOOL OF MEDICINE DEPARTMENT OF ANATOMY SKOOL VIR GENEESKUNDE DEPARTEMENT ANATOMIE BRad I RAN 100 Radiographic Anatomy 100 Radiografiese Anatomie 100 Second Examination (November 2009) Tweede Eksamen (November 2009) Date / Datum: 18 November 2009 Internal examiner(s) / Interne eksaminator(e): Mrs / Mev N Keough Dr EN L Abbé Time / Tyd: 3 hours / ure External examiner(s) / Eksterne eksaminator(e): Mrs / Mev E Smith (UP) TOTAL: 100 marks / TOTAAL: 100 punte GENERAL INSTRUCTIONS / ALGEMENE INSTRUKSIES No cell phones, books or study material may be brought into the examination venue. Geen selfone, boeke of studiemateriaal mag die eksamenlokaal binnegebring word nie. SPECIAL INSTRUCTIONS / SPESIALE INSTRUKSIES Answer all the questions. Answer Section A in a separate book. The paper consists of SEVEN (7) pages. Mark allocation: ½ mark per fact unless indicated otherwise. Question 1 / Vraag 1 SECTION A / AFDELING A Beantwoord al die vrae. Beantwoord Afdeling A in n aparte boek. Die vraestel bestaan uit SEWE (7) bladsye. Puntetoekenning: ½ punt per feit, tensy anders aangedui. A female toddler was taken to a paediatrician because the bruises on her legs would not heal properly. The doctor diagnosed her with haemophilia; a recessive X-linked trait that prevents the clotting of blood. n Dogtertjie word na die pediater geneem omdat kneusplekke op haar bene nie behoorlik gesond wil word nie. Die dokter diagnoseer hemofilie; n resessiewe X-gekoppelde kenmerk wat bloedstolling verhinder. Provide one reason for cells to undergo cell division. Voorsien een rede waarom selle selverdeling ondergaan. (½) List the stages of the second phase of meiosis in the correct order. Noem die fases van die tweede fase van meiose in die korrekte volgorde. (2)

2 What is a Barr body? Wat is n Barr-liggaampie? (1) (d) Classify the type of epithelium that is found on the epidermis of the skin. Klassifiseer die tipe epitel in die epidermis van die vel. (1½) (5) Question 2 / Vraag 2 A 20-year-old female was taken to the Steve Biko Academic Hospital with injuries to her intervertebral discs and a compound fracture to her left femur. n 20-Jarige vrou word na die Steve Biko Akademiese Hospitaal geneem met beserings aan haar intervertebrale diski en n saamgestelde fraktuur van haar linker femur. Match the terminology in column A with the correct definition in column B. Some definitions may be used once, more than once, or not at all. Pas die terme in kolom A met die korrekte definisie in kolom B. Definisies kan een of meer keer of selfs glad nie gebruik word nie. (3) Column A / Kolom A Column B / Kolom B (1) Interstitial lamella Surrounds the outer surface of bone and contains Interstisiële lamellae regular dense connective tissue Omring die buitenste oppervlak van been en bevat reëlmatig digte bindweefsel (2) Osteocytes Responsible for the resorption of bone Osteosiete Verantwoordelik vir die resorpsie van been (3) Periosteum Forms the bony matrix Periosteum Vorm die beenmatriks (4) Osteoclasts (d) Parts of remodelled Haversian systems Osteoklaste Dele van gehermoduleerde Haverse sisteme (5) Lamellae (e) Mature osteoblasts trapped within lacunae Volwasse osteoblaste binne lacunae (6) Osteoblasts (f) Osteoblaste Concentric cylinders of bone material that fits into one another Konsentriese silinders been wat binne mekaar pas (g) Has a spongy appearance and has an irregular distribution of lamella and Haversian systems Het n sponsagtige voorkoms en onreëlmatige verspreiding van lamellae en Haverse sisteme Explain the histological morphology of fibrous cartilage. Verduidelik die histologiese bou van fibreuse kraakbeen. (2) (5) Subtotal / Subtotaal: (10) 2

3 SECTION B / AFDELING B Question 3 / Vraag 3 A 25-year-old woman was shot through her shoulder during a bank robbery. The bullet fractured her scapula through the glenoid fossa. Tydens n bankroof is n 25-jarige vrou in haar skouer geskiet. Die koeël het n fraktuur van haar skapula deur die glenoid fossa veroorsaak. Draw and label a diagram of the costal surface of the scapula. Teken n benoemde diagram van die kostale oppervlak van die skapula. (4) Name the static stabilizers of the glenohumeral joint. Noem die statiese stabiliseerders van die glenohumerale gewrig. (2½) (6½) Question 4 / Vraag 4 Vertebral osteophytes result from an age degenerative process. The cervical and lumbar vertebrae are more commonly affected by vertebral osteophytes than the thoracic. Complete the following table regarding the morphological differences between the vertebrae in your answer book. Vertebrale osteofiete is n degeneratiewe proses as gevolg van veroudering. Die servikale en lumbale werwels word meer algemeen as die torakale werwels aangetas. Aangande die morfologiese verskille tussen die verskeie werwels, voltooi die volgende tabel in u antwoord boek. (4) Body Liggaam Articular processes Artikulasie prosesse Pedicles Pedikels Spinous processes Spineuse prosesse Transverse processes Transverse prosesse Cervical 3-6 Thoracic 2-8 Lumbar 1-4 Moderate, heart-shaped, ½ facets ribs Middelmatig en hartvormig, ½ fasette - ribbes Large and kidney shaped Groot en niervormig Upper faces medially; lower faces laterally Boonste mediaalwaarts, onderste sywaarts Small and round Klein en rond Short and bifid Kort en gevurk (d) Long, prismatic and sloping; ends in knob Lank, prismaties en skuins; eindig in knop (f) (g) (h) Flattened from top to bottom Afgeplat van bo na onder (e) 3

4 Question 5 / Vraag 5 You study PA chest radiographs of a patient with pneumothorax. There is a shift in the mediastinum to the right. U bestudeer PA radiografiese opnames van die borskas van n persoon met pneumotoraks. Daar is n verskuiwing van die mediastinum na regs. Describe the borders and name the contents of the inferior mediastinum. Beskryf die grense en noem die inhoud van die inferior mediastinum. (5½) Briefly discuss the right atrium of the heart with regard to openings, valves and the structure of the walls. Bespreek kortliks die regte atrium van die hart met betrekking tot die openinge, kleppe en die struktuur van die wande. (4) (9½) Subtotal / Subtotaal: (20) SECTION C / AFDELING C Question 6 / Vraag 6 A 15-year-old girl complains that her upper arm is sore after a hockey match. Radiographs show that she has a fracture of the humerus. Na n hokkiewedstryd kla n 15-jarige meisie dat haar bo-arm seer is. Radiografiese opnames toon n fraktuur van die humerus. Briefly discuss the osteology of the proximal end of the humerus. Beskryf kortliks die osteologie van die proksimale einde van die humerus. (3½) Which nerve can be in danger with a fracture of the distal end of the humerus? Watter senuwee sou in gevaar wees met n fraktuur van die distale einde van die humerus? (½) Describe the origin, insertion and innervation of biceps brachii. Beskryf die oorsprong, inplanting en senuweevoorsiening van m. biceps brachii. (3) (7) Question 7 / Vraag 7 A mother lifted her three-year-old boy by his hand when she tried to cross a busy street quickly. Afterwards the boy did not want to use his arm. Further examination confirmed that the boy had a dislocation of the proximal end of the radius. Terwyl sy n besige straat vinnig probeer kruis het, het n ma haar 3-jaar-oue seuntjie aan sy hand opgetel. Daarna wou die seuntjie nie sy arm gebruik nie. Verdere ondersoek het bevestig dat die seun n dislokasie van die proksimale einde van die radius het. Draw and label a diagram of the proximal end of the radius. Teken n benoemde diagram van die proksimale einde van die radius. (1½) 4

5 The tendon of biceps brachii forms one of the components of the cubital fossa and has an insertion point on the proximal radius. Name the structures forming the borders of the cubital fossa, specifying which structure forms which border. Die pees van m. biceps brachii vorm een van die komponente van die fossa cubitalis en het n aanhegtingspunt op die proksimale radius. Noem die strukture wat die grense van die fossa cubitalis vorm en spesifiseer watter struktuur watter grens vorm. (3) Explain the difference between pronation and supination in anatomical terms. Verduidelik die verskil tussen pronasie en supinasie in anatomiese terme. (4) (8½) Question 8 / Vraag 8 A 15-year-old girl falls on her extended arm during an ice-skating exhibition. Radiographs of the wrist joint indicate a fracture of one of her carpal bones. n 15-jarige meisie val tydens n ysskaatsvertoning op haar uitgestrekte hand. Radiografiese opnames van die polsgewrig toon n fraktuur van een van haar karpale bene. List the proximal row of carpal bone in sequence from lateral to medial. Noem die proksimale ry karpale bene in volgorde van lateraal na mediaal. (2) What is the clinical importance of the most lateral carpal bone in question? Wat is die kliniese belang van die mees laterale karpale been in vraag? (½) List the contents of the anatomical snuffbox. Noem die inhoud van die anatomiese snuifdoos. (2) (4½) Question 9 / Vraag 9 A 24-year-old girl fell and twisted her ankle. Radiographs of her ankle showed a fracture of the distal end of the tibia. n 24-Jarige meisie het geval en haar enkel geswik. Radiografiese opnames van die enkel toon n fraktuur van die distale einde van die tibia. Discuss the osteology of the distal end of the tibia. Bespreek die osteologie van die distale einde van die tibia. (4) Describe the ankle joint under the following headings: Beskryf die enkelgewrig onder die volgende opskrifte: (i) Classification / Klassifikasie (1) (ii) Bony elements / Benige elemente (1½) (iii) Ligaments / Ligamente (3) Name the muscles found in the anterior compartment of the leg and mention the nerve that innervates this compartment. Noem die spiere wat in die anterior kompartement van die been gevind word en noem die senuwee wat hierdie kompartement voorsien. (3) (12½) 5

6 Question 10 / Vraag 10 A 28-year-old man injures his right foot by dropping a 20 kg weight on his foot at the gym. n 28-Jarige man beseer sy regter voet toe hy n 20 kg gewig op sy voet laat val in die gimnasium. Describe the lateral longitudinal arch with regard to bony elements and support structures. Beskryf die lateraal longitudinale voetboog met betrekking tot die benige elemente en ondersteuende strukture. (3½) Discuss the origin, insertion and innervation of fibularis brevis. Bespreek die oorsprong, inplanting en senuweevoorsiening van m. fibularis brevis. (2) Name the muscles found in the second muscle layer of the foot. Noem die spiere wat in die tweede spierlaag van die voet gevind word. (1) (6½) Subtotal / Subtotaal: (39) SECTION D / AFDELING D Question 11 / Vraag 11 An infection of the vertebral discs in the vicinity of the posterior abdominal wall muscles may spread in an anterolateral direction into the psoas muscle sheath. In this case, radiographs may indicate a mass just below the inguinal ligament. n Infeksie van die vertebrale diskusse in die omgewing van die spiere van die posterior abdominale wand mag in n anterolaterale rigting beweeg tot in die psoas spierskede. In hierdie geval, sou radiografiese opnames n massa net onder die inguinale ligament aantoon. Describe the origin and insertion of the psoas major and iliacus muscles. Bespreek die oorsprong en inplanting van m. psoas major en m. iliacus. (4) Name four structures that can be found on the transpyloric line. Noem vier strukture wat op die transpiloriese lyn gevind kan word. (2) (6) Question 12 / Vraag 12 You study a pelvic radiograph of a victim of a motorcar accident. It shows fractures through the pelvic inlet. U bestudeer n radiografiese opname van die bekken van n persoon wat in n motorongeluk betrokke was. Dit toon n fraktuur deur die bekkeningang. Distinguish between the pelvic inlet and outlet. Onderskei tussen die bekkeningang en uitgang. (6) Describe the true anatomical orientation of the pelvis. Beskryf die ware anatomiese oriëntasie van die bekken. (3) (9) Subtotal / Subtotaal: (15) 6

7 SECTION E / AFDELING E Question 13 / Vraag 13 During a boxing fight, Mike Tyson broke his opponent s orbital rim and jaw with a hook punch. Tydens n boksgeveg breek Mike Tyson sy opponent se oogrand en sy kakebeen met n haakhou. List the bones that make up the neurocranium. Noem die bene wat die neurokranium vorm. (3) Name the foramina found in relation to the bony orbits, and in each case, mention the bone associated with the foramen. Noem die foramina wat in verhouding met die benige orbita gevind word en noem in elke geval met watter been die foramina geassossieer word. (3) Briefly describe the osteology of the internal surface of the mandible. Beskryf kortliks die interne oppervlak van die mandibula. (4) (10) Question 14 / Vraag 14 A 29-year-old woman is attacked at an automatic bank teller. During the attack she is hit several times on the back of the head with a blunt object. Radiographs indicate a fracture of the occipital bone. n 29-Jarige vrou word by n outomatiese bankteller aangeval. Tydens die aanval is sy verskeie kere met n stomp voorwerp oor die agterkant van die kop geslaan. Radiografiese opnames toon n fraktuur van die oksipitale been. Draw and label a diagram of the external surface of the occipital bone. Teken n benoemde diagram van die eksterne oppervlak van die okspitale been. (4) Tabulate two differences between male and female skulls. Tabuleer twee verskille tussen die manlike en vroulike skedel. (2) (6) Subtotal / Subtotaal: (16) TOTAL / TOTAAL: (100) 7