ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 7 September 2007 am.

TOPIC: X-ray: Lateral C spine NUMBER: JL

OPENINGQUESTION

POINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

PROMPTS

Demonstrate the bony features of Cl and C2 vertebrae evident on thisXray

1 Odontoid peg (dens)

2 Bodies of Cl andC2

3 anterior and posterior arches of atlas

4 laminae and inferior articular process

5 spinous process

What are the components of the soft tissue shadow located anterior tothe upper cervical vertebrae?

1 Anterior longitudinal ligament

2 Longus colli muscle

3 Prevertebral fascia

4 Retropharyngeal space

5 Buccopharyngeal fascia

6 Pharyngeal muscle

COMMENTS

5/8 including dens topass

3/6 to pass includingretropharyngeal space

COMMENTS

JDEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VWA EXAMINATION

SUBJECT: ANATOMY FRIDAY SEPTEMBER 7 2007

TOPIC: Bone: Humerus and Scapula NUMBER: 2

OPENINGQUESTIONPOINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

Describe the bony features of the proximal humerus.

1 anatomical neck

Head

Surgical neck

2 greater and lesser tubercles

3 intertubercular groove

What factors contribute to the stability of the glenohumeraljoint?

1 Muscular- rotator cuff- TM,SS,SSp,Infsp

2 Bony structures and labrura- poor

3 Ligaments- coracoacromial ligament

4 capsule

COMMENTS

5/6 to pass

3 /4 to pass

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.1 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY Friday 7 September 2007 am

TOPIC: Ankle NUMBER: 3

OPENINGQUESTION(if needed)POINTSREQUIRED

PROMPTS

SECONDQUESTION

POINTSREQUIRED

PROMPTS

Demonstrate the structures passing behind the medialmalleolus

1)TP

2)FDL

3) Posterior tibial artery

4) Tibial nerve

5) Flexor hallucis

5

6

What is the cutaneous innervation of the tibial nerve?

1) Medial plantar nerve. . .medial sole of foot

2) lateral plantar... lateral sole of foot

3) also calcaneal branches

4

5

6

3 / 5 to pass

l/2 to pass

COMMENTS

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 7 September 2007 am

TOPIC: Photo- PELVIS NUMBER: 4

OPENINGQUESTIONPOINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

PROMPTS

Identify the structures in this photo (prompt if needed)

1 Rectum No. 27

2 Uterus No. 6/12

3 Bladder No. 5

4 Sacrum Not numbered

5 Pubic symphysis No. 25

6 Anal canal No. 1

7 Cervix and vagina No. 7 and 24

Please show the potential spaces where free fluid canaccumulate in the pelvis

1 rectouterine pouch (of Douglas) No. 26

2 vesicouterine pouch No. 34

3

4

COMMENTS

Need 5/8 to pass

Need 1 to pass

COMMENTS

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 6 September 2007 pm

TOPIC: PICTURE: CT SCAN BRAIN NUMBER: 1

OPENINGQUESTIONPOINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

THIRDQUESTION(if needed)POINTSREQUIRED

PROMPTS

Name the visible intracranial structures on this non contrast CT scan

I Lobes (frontal.parietal/temporal.occipital)

2 lateral ventricles ( anterior and posterior horns)

S.choroid plexus

4 pineal gland

5 thalamus

6 internal capsule, basa! ganglia, caudate, globus pallidus, putamen,sylvian fissure or lateral sulcus

What structures does CSF pass through to reach the base of thebrain?

1 Lateral venticles — Mntervenrricular formen

— » 3rd ventricle

— > aqueduct

— > 4 ventricle (posterior to pons/medulla)

Start at the lateral ventricle

COMMENTS

6 structures from 1st 5

Plus 1 of these forpass

3rt and 4th ventricles insequence to pass

COMMENTS

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 6 September 2007 pm.

TOPIC: Bones: Cl and C2 NUMBER: _2

OPENINGQUESTION

POINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

4

PROMPTS

THIRDQUESTION(if needed)POINTSREQUIRED

PROMPTS

Describe the features of this bone (C2)

1 odontoid peg (dens) and body

2 vertebral foramen (s.c.) transverse foramen (v.a.)

3 inferior/superior articular surfaces

4 pedicle

5 transverse process

6 lamina

7 spinous process

What ligaments stabilise the atlantoaxial joint?

1 Cruciate ligament which has two components

Transverse- between lateral masses of Cl- strong

Longitudinal- occiput to body C2- weak

2 Alar ligament- side of peg to foramen magnum

; 3 tectorial membrane- continuation of PtL from body ofC2 to internal occiput

What movement occurs at the C1/C2 joint?

Rotation of Cl onC2

COMMENTS

6/10 to pass

Identify it as C2

Cruciate and tectorialto pass i.e. 2/3

COMMENTS

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 6 September 2007 pm.

TOPIC: MODEL: ANKLE NUMBER: 3

OPENINGQUESTION(if needed)POINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

Demonstrate the attachments of the inferior extensor retinaculum

1 upper anterior surface of calcaneus

2 Y-shaped 1. medial malleolus 2. blends with plantar aponeurosis

3

Identify the structures passing beneath the IER

1 tibialis anterior

2 extensor ballads longus

3 ant tibial artery dorsalis pedis artery

4 deep fibular nerve

5 extensor digitorum longus

6 fibularis tertius

4/6 to pass

Level of ankle joint

Deep peroneal nerve

Peroneus tertius

THIRD QUESTION What is the function of the inferior extensor retinaculum?

Prevent bowstringing of extensor tendons when ankle dorsiflexed.

DEOSa Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 6 September 2007 om.

TOPIC: DISCUSSION: BRACHIAL PLEXUS NUMBER: _4

OPENINGQUESTIONPOINTSREQUIRED

Optional

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

THIRDQUESTION(if needed)POINTSREQUIRED

PROMPTS

What is the brachial plexus and how is it formed?

1 Major nerve network supplying the upper limb, extends from neckto axilla.2 Results in the formation of multisegmental peripheral nerves.

3 Initially formed by the union of the anterior rami (roots) lowercervical (C5-8) and first thoracic nerves.

4 These roots unite to form 3 trunks; superior, middle and inferior

5 Each trunk divides into anterior and posterior divisions

6 These division then form 3 cords: Anterior divisions of superiorand middle trunks for the lateral cord, anterior division of inferiortrunk forms medial cord, posterior divisions of all 3 trunks unite toform posterior cord

7 Major peripheral nerves supplying upper limb form from thesecords. Lateral cord gives rise to lateral pectoral n, musculocutaneousn and lateral root of median n. Medial cord gives rise to medial rootmedian n, medial pectoral n, medial cutaneous n of arm, medialcutaneous n of forearm and ulnar n. Posterior cord gives rise toupper subscapular n, lower subscapular n, thoracodorsal n, axillary n,and radial n.

1 . No need to describe supraclavicular branches of brachialplexus.

2. Would vou prefer to describe the formation of the brachial

COMMENTS

Start proximally todistal

Need to knowrootSjtrunkSjdivisions,cords to pass

Name at least medial andlateral roots median n,axillary n, radial n andulnar n.

COMMENTS

DE08a Anatomy Viva workshop.rtf

ACEM 2007.2 PRIMARY VIVA EXAMINATION

SUBJECT: ANATOMY 6 September 2007 pm

TOPIC: PHOTO - ABDOMEN NUMBER: _5

OPENINGQUESTIONPOINTSREQUIRED

PROMPTS

SECONDQUESTION(if needed)POINTSREQUIRED

PROMPTS

THIRDQUESTION(if needed)POINTSREQUIRED

PROMPTS

What are the unpaired visceral branches of the abdominal aorta ?

I coeliac trunk

2 superior mesenteric artery

3 inferior mesenteric artery

4

5

6

7

What are the branches of the coeliac trunk?

1 common hepatic artery

2 splenic artery

3 left gastric artery

4

5

6

Demonstrate the major venous structures in this photo

1IVC

2 right and left renal veins ( 23 and 12)

3 left adrenal vein (14)

4 left gonadal vein (6)

COMMENTS

3 for a pass

2/3 to pass

4/5 to pass

COMMENTS

DEOSa Anatomy Viva workshop.rtf