Radiology 3rd semester ka course hai ospe ko chor ka mujhe 100 mcqs bana kr do 4 option Wala explanation na ho lakin correct option ho zarur Kuch scenario based banao Kuch simple lakin concept guma kar S.No Weeks Contents Learning Outcome Domain MIT's Time/ Hours Assessment No of Items C P A TOPIC:THORACIC WALL 2 Week-1 Thoracic wall, sternum, ribs, costal cartilage, intercostal muscles, thoracic openings Describe the structure of thoracic wall in detail C2 Interactive Lecture/SDG 2 MCQs 3 Explain the anatomy of sternum,costal cartilage and ribs C2 Discuss the anatomy of thoracic openings C2 4 Explain the origin,insertion and action of muscles of thoracic wall C3 7 Demonstrate the radiographic appearance of all thoracic bones P4 Demo 1 OSPE 8 Identify anterior and posterior ribs independently on PA-chest radiograph A4 Role Play TOPIC:THORACIC WALL 11 Week-2 Intercostal nerves,daiphragm,blood supply of thoracic wall, Discuss intercostal nerves and its major branches C2 Interactive Lecture/SDG 2 MCQs 12 Explain the structure of daiphragm in detail C3 13 Discuss the blood supply of thoracic wall C3 Explain the structure of supraplueral membrane and endothoracic fascia C3 14 Identify different parts of diaphragm and lungs on standard chest radiographs P4 Demo 1 OSPE 15 Adopt how to care and handle radiographs A4 Role Play TOPIC: THORACIC CAVITY 16 Week-3 Mediastinum,pleurae, respiratory tree,lungs, bronchopulmonary segment Describe mediastinum and the structures related to superior and inferior mediastinum C3 Interactive Lecture/SDG 2 MCQs 17 Discuss the pleurae and it's types C2 Describe the respiratory tree in detail C3 Discuss the lobes and fissures of lungs C2 18 Explain bronchopulmonary segment as a functional unit of lung C3 24 Demonstrate all the joints of thoracic wall P4 Demo 1 OSPE 25 Identify basic radiographic opacities independently A4 Role Play TOPIC: THORACIC CAVITY 32 Week-4 Percardium,heart,arterial supply, thymus Explain the anatomy of esophagus and it's realtions with other structures C3 Interactive Lecture/SDG 2 MCQs 33 Explain the pericardium and structure of heart in detail C3 Describe heart arterial supply C2 34 Explain the structure and function of thymus C2 36 Demonstrate the measurement of CTR P4 Demo 1 OSPE 37 Identity the boundaries,chambers of heart PA-chest radiograph A4 Role Play TOPIC: THORACIC CAVITY 37 Week-5 Thoracic arteries,veins & Radiographic anatomy Describe the large thoracic arteries and veins in detail C2 Interactive Lecture/SDG 3 MCQs/SEQs Explain radiograph and radiographic opacities C2 38 Discuss different radiographic projections used for chest imaging C2 Explain bronchography,contrast study of esophagus and coronary angiography C3 39 Discuss the quality assessment of radiograph in detail C3 41 Interpretation of normal chest x-ray P4 Demo 1 OSPE TOPIC: ABDOMINAL WALL 44 Week-6 Osteology, abdominal wall layers, anterior abdominal muscles Discuss the osteology of abdominal wall C2 Interactive Lecture/SDG 2 MCQs Explain the layers of abdominal wall in detail C3 Explain the origin, insertion and action of abdominal muscles C3 45 Explain rectus sheath, transversalis fascia in detail C3 46 Discuss extra peritoneal fat and parietal peritoneum C1 47 Demonstrate abdominal lines and planes on human models/charts P4 Demo 1 OSPE 48 Identify surface landmarks of abdominal wall effectively A4 Role Play TOPIC: ABDOMINAL WALL 49 Week-7 Anterolateral abdominal wall arteries and veins, inguinal canal, posterolateral wall muscles Discuss all the arteries of abdominal wall C2 Interactive Lecture/SDG 2 MCQs 50 Explain the inguinal canal and mechanics related to prevention of inguinal hernia C3 60 Explain the origin, insertion and action of posterolateral abdominal wall muscles C3 62 Demonstrate abdominal organs on different radiographic projections P4 Demo 1 OSPE 63 Adopt how to care and handle human skeletal models/radiographs A4 Role Play TOPIC: ABDOMINAL CAVITY 64 Week-8 Peritoneum,recesses,esophagus,stomach, small intestine Discuss peritoneum and it's arrangements C2 Interactive Lecture/SDG 2 MCQs Discuss the intraperitoneal and extraperitoneal organs C1 Explain peritoneal ligament,omenta, mesenteries,recesses and function of peritoneum C3 Discuss the structure and function of esophagus and gastroesophgeal sphincter C3 65 Explain the structure and function of stomach and it's blood supply C3 66 Discuss the structure of duodenum and blood supply in detail C3 68 Demonstrate steps of contrast study used for abdominal organs P4 Demo 1 OSPE 69 Identify contrast filled abdominal structures on standard abdominal radiographs independently A4 Role Play TOPIC: ABDOMINAL CAVITY 70 Week-9 Large intestine,liver, biliary tree Describe different parts of large intestine and their functions C2 Interactive Lecture/SDG 2 MCQs/SEQs 71 Discuss the difference between large and small intestine C4 Discuss the anatomy of liver and associated ligaments in detail C2 Explain the function and blood supply of liver C3 72 Discuss the structure and function of each part of biliary tree C2 73 Identify the location and features of small and large intestine on radiographs P4 TOPIC: ABDOMINAL CAVITY 77 Week-10 Pancreas,spleen, kidneys, ureter Discuss the anatomy of pancreas and its blood supply C2 Interactive Lecture/SDG 2 MCQs/SEQs 78 Explain the location,red and white pulp, function and blood supply of spleen C2 Discuss retroperitoneal space C1 79 Describe the gross anatomy of kidneys and ureter C3 82 Demonstrate the abdominal quadrants on charts/models P4 Demo 1 OSPE 83 A4 Role Play TOPIC: ABDOMINAL CAVITY 84 Week -11 suprarenal glands,blood supply of GIT, Posterior abdominal wall blood supply Describe the structure of supra renal glands C1 Interactive Lecture/SDG 2 MCQs/SEQs 85 Explain the blood supply of GIT in detail C3 86 Explain the blood supply of posterior abdominal wall C2 93 Demonstrate all abdominal arteries on human charts P4 Demo 2 OSPE 94 Adopt how to care and handle radiographs A4 Role Play TOPIC: ABDOMINAL CAVITY 95 Week-12 Posterior abdominal wall venous supply,lumbar plexus, radiographic anatomy Discuss the veins of posterior abdominal wall C1 Interactive Lecture/SDG 2 MCQs/SEQs 96 Describe lumbar plexus and their branches C2 Discuss different radiographic projections used for abdomen C2 Discuss the normal findings on abdominal radiographs in detail C2 Explain the contrast study of GIT,biliary tree and urinary tract C3 97 Interpretation of normal abdominal radiographs P4 TOPIC:PELVIC WALL 102 Week-13 Pelvic bones, Pelvic wall, muscles, pelvic diaphragm, Describe the boney framework of pelvis in detail C2 Interactive Lecture/SDG 2 MCQs/SEQs 103 Discuss the differences between true and false pelvis C2 Explain anterior, posterior and lateral pelvic wall in detail C3 Discuss pelvic diaphragm C1 104 Explain the actions of pelvic wall muscles C3 108 Identify pelvic joints from human Models and charts independently A4 Role Play 1 TOPIC: PELVIC WALL 109 Week-14 Pelvic fascia,nerves , arteries and veins Discuss pelvic fascia C1 Interactive Lecture/SDG 2 MCQs/SEQs 110 Explain the lumbar and sacral plexus C2 Explain the Plevic arteries C1 111 Demonstrate the features of pelvic bones on human chart/models P4 TOPIC: PELVIC CAVITY 114 Week-15 & 16 Rectum,urinary tract,male and female genital organs,Blood supply, radiographic anatomy Describe the structure, function and blood supply of sigmoid colon, rectum C2 Interactive Lecture/SDG 4 MCQs/SEQs 115 Describe the gross anatomy of urinary bladder C2 Explain the structure and function of male genital tract in detail C3 Explain the structure and function of female genital tract in detail C3 Discuss the basic radiographic projections for pelvis C2 Explain different radiographic lines of pelvis C3 116 Discuss the contrast study of female genital tract C2 Demonstrate all pelvic bones along with different views on radiographs P4 117 Identify difference between male and female pelvis on radiographs P4 Demo 2 OSPE 118 Adopt how to care and handle human models and charts A4 Role Play
Here are 100 MCQs for Radiology 3rd Semester (OSPE excluded) — mix of simple concept-based and scenario-based questions, covering all weeks of the syllabus.
RADIOLOGY 3RD SEMESTER — 100 MCQs
THORACIC WALL (Weeks 1–2)
1. How many pairs of ribs are present in the human body?
- A) 10
- B) 11
- C) 12
- D) 14
✓ C) 12
2. Which ribs are called "floating ribs"?
- A) 1–2
- B) 6–10
- C) 8–10
- D) 11–12
✓ D) 11–12
3. The manubriosternal joint (sternal angle / angle of Louis) lies at the level of which rib?
- A) 1st rib
- B) 2nd rib
- C) 3rd rib
- D) 4th rib
✓ B) 2nd rib
4. Which part of the sternum articulates with the clavicle?
- A) Body
- B) Xiphoid process
- C) Manubrium
- D) Costal notch
✓ C) Manubrium
5. A 25-year-old male sustains trauma to the chest wall. The neurovascular bundle of the intercostal space travels in which plane?
- A) Superior border of the rib above
- B) Middle of the intercostal space
- C) Inferior border of the rib above
- D) Superior border of the rib below
✓ C) Inferior border of the rib above
6. Which muscle forms the innermost layer of the intercostal muscles?
- A) External intercostal
- B) Internal intercostal
- C) Innermost intercostal
- D) Subcostalis
✓ C) Innermost intercostal
7. The superior thoracic aperture (thoracic inlet) is bounded anteriorly by:
- A) T1 vertebra
- B) Manubrium sterni
- C) Body of sternum
- D) 1st costal cartilage
✓ B) Manubrium sterni
8. Which ribs are classified as "true ribs"?
- A) 1–5
- B) 1–7
- C) 1–10
- D) 8–10
✓ B) 1–7
9. On a PA chest radiograph, posterior ribs appear:
- A) More horizontal than anterior ribs
- B) More vertical and broader posteriorly
- C) At the same angle as anterior ribs
- D) Only visible in lateral projection
✓ B) More vertical and broader posteriorly
10. The scalene muscles attach to which rib?
- A) 2nd rib
- B) 3rd rib
- C) 1st rib
- D) 4th rib
✓ C) 1st rib
11. During inspiration, the external intercostal muscles:
- A) Depress the ribs
- B) Elevate the ribs
- C) Have no role
- D) Compress the thorax
✓ B) Elevate the ribs
12. The costal groove is located on the:
- A) Superior border of each rib
- B) Anterior surface of each rib
- C) Inferior border of each rib
- D) Posterior surface of each rib
✓ C) Inferior border of each rib
13. A radiographer performing thoracentesis should insert the needle:
- A) Above the upper border of the selected rib
- B) Below the lower border of the rib above
- C) Just above the lower rib of the intercostal space
- D) In the middle of the intercostal space
✓ C) Just above the lower rib of the intercostal space
14. Which of the following is NOT a content of the thoracic inlet?
- A) Trachea
- B) Esophagus
- C) Subclavian artery
- D) Ascending aorta
✓ D) Ascending aorta
15. The diaphragm receives motor innervation from:
- A) Vagus nerve
- B) Intercostal nerves
- C) Phrenic nerve
- D) Sympathetic trunk
✓ C) Phrenic nerve
16. The phrenic nerve arises from which cervical levels?
- A) C2, C3, C4
- B) C3, C4, C5
- C) C4, C5, C6
- D) C5, C6, C7
✓ B) C3, C4, C5
17. Which opening in the diaphragm transmits the inferior vena cava?
- A) Aortic hiatus at T12
- B) Esophageal hiatus at T10
- C) Caval opening at T8
- D) Caval opening at T10
✓ C) Caval opening at T8
18. The aortic hiatus of the diaphragm is located at the level of:
- A) T8
- B) T10
- C) T12
- D) L1
✓ C) T12
19. The internal thoracic artery is a branch of:
- A) Subclavian artery
- B) Axillary artery
- C) Thoracoacromial trunk
- D) Aorta
✓ A) Subclavian artery
20. Endothoracic fascia lies between which two layers?
- A) Parietal and visceral pleura
- B) Innermost intercostal muscles and parietal pleura
- C) External and internal intercostal muscles
- D) Visceral pleura and lung surface
✓ B) Innermost intercostal muscles and parietal pleura
THORACIC CAVITY (Week 3)
21. The mediastinum is divided into superior and inferior parts by an imaginary plane passing through:
- A) Sternal angle and T4–T5 intervertebral disc
- B) Manubrium and T1
- C) Xiphoid process and T8
- D) 2nd rib and T2
✓ A) Sternal angle and T4–T5 intervertebral disc
22. Which of the following is located in the superior mediastinum?
- A) Heart
- B) Thymus
- C) Esophagus lower part
- D) Pericardium
✓ B) Thymus
23. The pleural cavity is located between:
- A) Two layers of parietal pleura
- B) Parietal and visceral pleura
- C) Visceral pleura and lung parenchyma
- D) Endothoracic fascia and parietal pleura
✓ B) Parietal and visceral pleura
24. The costodiaphragmatic recess is the most dependent part of the pleural cavity and is located between:
- A) Costal and mediastinal pleura
- B) Costal and diaphragmatic pleura
- C) Visceral and diaphragmatic pleura
- D) Mediastinal and diaphragmatic pleura
✓ B) Costal and diaphragmatic pleura
25. The right lung has how many lobes?
- A) 2
- B) 3
- C) 4
- D) 5
✓ B) 3
26. The oblique fissure of the right lung separates which lobes?
- A) Upper and middle lobe
- B) Middle and lower lobe
- C) Upper lobe from middle and lower lobes
- D) Upper and lower lobes only
✓ C) Upper lobe from middle and lower lobes
27. A bronchopulmonary segment is defined as the lung tissue supplied by:
- A) A lobar bronchus and its artery
- B) A segmental bronchus and its artery
- C) A subsegmental bronchus only
- D) The main bronchus
✓ B) A segmental bronchus and its artery
28. How many bronchopulmonary segments does the right lung have?
- A) 8
- B) 9
- C) 10
- D) 12
✓ C) 10
29. The carina is the ridge at the bifurcation of the trachea located at the level of:
- A) T2
- B) T4
- C) T6
- D) T8
✓ B) T4
30. A patient inhales a foreign body. In which bronchus is it most likely to lodge?
- A) Left main bronchus
- B) Right main bronchus
- C) Right upper lobe bronchus
- D) Left lower lobe bronchus
✓ B) Right main bronchus
31. The horizontal fissure of the right lung runs at the level of which rib anteriorly?
- A) 2nd rib
- B) 3rd rib
- C) 4th rib
- D) 5th rib
✓ C) 4th rib
32. Which part of the mediastinum contains the heart?
- A) Superior
- B) Anterior inferior
- C) Middle inferior
- D) Posterior inferior
✓ C) Middle inferior
33. The posterior mediastinum contains all of the following EXCEPT:
- A) Thoracic aorta
- B) Esophagus
- C) Thoracic duct
- D) Thymus
✓ D) Thymus
34. On a standard PA chest X-ray, the right heart border is formed by:
- A) Right ventricle
- B) Right atrium
- C) Superior vena cava only
- D) Aorta
✓ B) Right atrium
PERICARDIUM, HEART & THYMUS (Week 4)
35. The fibrous pericardium is attached inferiorly to:
- A) Diaphragm
- B) Sternum
- C) Pleura
- D) T4 vertebra
✓ A) Diaphragm
36. The transverse sinus of the pericardium lies between:
- A) Great arteries anteriorly and great veins posteriorly
- B) Two venous structures
- C) Two arterial structures
- D) The two atria
✓ A) Great arteries anteriorly and great veins posteriorly
37. Which chamber forms most of the anterior surface of the heart?
- A) Right atrium
- B) Left ventricle
- C) Right ventricle
- D) Left atrium
✓ C) Right ventricle
38. The left border of the heart on PA chest X-ray is formed by which structure inferiorly?
- A) Aortic arch
- B) Pulmonary trunk
- C) Left atrial appendage
- D) Left ventricle
✓ D) Left ventricle
39. The right coronary artery supplies all of the following EXCEPT:
- A) SA node (in most people)
- B) AV node
- C) Left anterior interventricular septum
- D) Right ventricle
✓ C) Left anterior interventricular septum
40. The left anterior descending (LAD) artery is a branch of:
- A) Right coronary artery
- B) Left circumflex artery
- C) Left coronary artery (left main)
- D) Aorta directly
✓ C) Left coronary artery (left main)
41. Cardiothoracic ratio (CTR) is considered normal when it is:
- A) Less than 0.6
- B) Less than 0.5
- C) Less than 0.4
- D) Less than 0.7
✓ B) Less than 0.5
42. The thymus is located in which part of the mediastinum?
- A) Posterior mediastinum
- B) Middle mediastinum
- C) Anterior-superior mediastinum
- D) Inferior posterior mediastinum
✓ C) Anterior-superior mediastinum
43. A 60-year-old patient has cardiac tamponade. Which structure is filling with fluid?
- A) Pleural cavity
- B) Pericardial cavity
- C) Mediastinal space
- D) Peritoneal cavity
✓ B) Pericardial cavity
44. The oblique sinus of the pericardium is a recess behind the:
- A) Aorta
- B) Pulmonary trunk
- C) Left atrium
- D) Right ventricle
✓ C) Left atrium
45. The esophagus passes through the diaphragm at which level?
- A) T8
- B) T10
- C) T12
- D) L1
✓ B) T10
THORACIC ARTERIES, VEINS & RADIOGRAPHY (Week 5)
46. The arch of the aorta gives rise to which of the following branches from right to left?
- A) Brachiocephalic trunk, left common carotid, left subclavian
- B) Left subclavian, left common carotid, brachiocephalic trunk
- C) Left common carotid, brachiocephalic trunk, left subclavian
- D) Right subclavian, right common carotid, left subclavian
✓ A) Brachiocephalic trunk, left common carotid, left subclavian
47. The azygos vein drains into the:
- A) Inferior vena cava
- B) Superior vena cava
- C) Brachiocephalic vein
- D) Left subclavian vein
✓ B) Superior vena cava
48. On a PA chest radiograph, the patient is standing with:
- A) Back to the X-ray tube, chest to the detector
- B) Chest to the X-ray tube, back to the detector
- C) Left side to the detector
- D) Right side to the detector
✓ A) Back to the X-ray tube, chest to the detector
49. In a good quality PA chest X-ray, the medial ends of the clavicles should be:
- A) Asymmetrical
- B) Equidistant from the spinous process
- C) Overlapping the lung apex
- D) Below the level of T4
✓ B) Equidistant from the spinous process
50. Radiographic opacity seen on a chest X-ray — which tissue appears MOST white (radiopaque)?
- A) Lung parenchyma
- B) Fat
- C) Bone
- D) Air
✓ C) Bone
51. Bronchography is used to visualize:
- A) Coronary arteries
- B) Bronchial tree
- C) Pleural space
- D) Lymphatics
✓ B) Bronchial tree
52. A "silhouette sign" on chest X-ray occurs when:
- A) Two structures of different density are adjacent
- B) Two structures of the same density are adjacent, obliterating the border
- C) Air is trapped in the pleural space
- D) Fluid level is seen in the lung
✓ B) Two structures of the same density are adjacent, obliterating the border
53. The thoracic duct drains lymph into:
- A) Right subclavian vein
- B) Left brachiocephalic vein / left subclavian-jugular junction
- C) Azygos vein
- D) Superior vena cava directly
✓ B) Left brachiocephalic vein / left subclavian-jugular junction
ABDOMINAL WALL (Weeks 6–7)
54. The linea alba is formed by the fusion of aponeuroses of which muscles?
- A) Rectus abdominis only
- B) External oblique only
- C) All three flat abdominal muscles
- D) Transversus abdominis and internal oblique
✓ C) All three flat abdominal muscles
55. The arcuate line (semicircular line of Douglas) is located:
- A) At the level of umbilicus
- B) Midway between umbilicus and pubic symphysis
- C) At the level of anterior superior iliac spine
- D) At the xiphoid process
✓ B) Midway between umbilicus and pubic symphysis
56. Below the arcuate line, the posterior wall of the rectus sheath is formed by:
- A) Posterior layer of internal oblique aponeurosis
- B) Transversalis fascia only
- C) Transversus abdominis aponeurosis
- D) Peritoneum
✓ B) Transversalis fascia only
57. The deep inguinal ring is an opening in which layer?
- A) External oblique aponeurosis
- B) Internal oblique muscle
- C) Transversalis fascia
- D) Peritoneum
✓ C) Transversalis fascia
58. The inguinal ligament extends between:
- A) Anterior superior iliac spine and pubic tubercle
- B) Posterior superior iliac spine and ischial tuberosity
- C) Iliac crest and pubic symphysis
- D) Anterior superior iliac spine and ischial spine
✓ A) Anterior superior iliac spine and pubic tubercle
59. Hesselbach's triangle is bounded medially by:
- A) Inguinal ligament
- B) Inferior epigastric artery
- C) Lateral border of rectus abdominis
- D) Femoral artery
✓ C) Lateral border of rectus abdominis
60. An indirect inguinal hernia passes through:
- A) Hesselbach's triangle
- B) Femoral canal
- C) Deep inguinal ring
- D) Obturator foramen
✓ C) Deep inguinal ring
61. The quadratus lumborum muscle is part of which abdominal wall?
- A) Anterolateral wall
- B) Posterior wall
- C) Pelvic floor
- D) Anterior wall
✓ B) Posterior wall
62. The inferior epigastric artery is a branch of:
- A) Femoral artery
- B) Aorta
- C) External iliac artery
- D) Internal iliac artery
✓ C) External iliac artery
63. The transpyloric plane (L1) passes through all of the following EXCEPT:
- A) Pylorus of stomach
- B) Fundus of gallbladder
- C) Hilum of kidneys
- D) Origin of superior mesenteric artery
✓ B) Fundus of gallbladder
ABDOMINAL CAVITY — Peritoneum & GI Tract (Week 8)
64. Which of the following is a retroperitoneal organ?
- A) Stomach
- B) Jejunum
- C) Pancreas (except tail)
- D) Transverse colon
✓ C) Pancreas (except tail)
65. The greater omentum hangs from which structure?
- A) Lesser curvature of the stomach
- B) Greater curvature of the stomach
- C) Transverse colon only
- D) Duodenum
✓ B) Greater curvature of the stomach
66. The lesser omentum connects the liver to:
- A) Lesser curvature of stomach and proximal duodenum
- B) Greater curvature of stomach
- C) Gallbladder
- D) Transverse colon
✓ A) Lesser curvature of stomach and proximal duodenum
67. The blood supply of the stomach comes from branches of which artery?
- A) Superior mesenteric artery
- B) Celiac trunk
- C) Inferior mesenteric artery
- D) Splenic artery only
✓ B) Celiac trunk
68. The gastroesophageal junction is located at the level of:
- A) T8
- B) T10
- C) T12
- D) L1
✓ B) T10
69. Which part of the duodenum is entirely retroperitoneal?
- A) First (superior) part
- B) Second (descending) part
- C) Third and fourth parts
- D) All parts
✓ C) Third and fourth parts
70. The C-loop of the duodenum embraces which organ?
- A) Liver
- B) Spleen
- C) Head of pancreas
- D) Right kidney
✓ C) Head of pancreas
71. A barium swallow study is used to visualize:
- A) Large intestine
- B) Esophagus and stomach
- C) Biliary tree
- D) Urinary tract
✓ B) Esophagus and stomach
LARGE INTESTINE, LIVER, BILIARY TREE (Week 9)
72. The three taenia coli, haustra and appendices epiploicae are features of:
- A) Small intestine
- B) Large intestine
- C) Stomach
- D) Duodenum
✓ B) Large intestine
73. The ileocecal valve guards the junction between:
- A) Ileum and jejunum
- B) Cecum and ascending colon
- C) Ileum and cecum
- D) Jejunum and ileum
✓ C) Ileum and cecum
74. The liver receives blood from two sources. The portal vein supplies approximately what percentage of hepatic blood flow?
- A) 25%
- B) 50%
- C) 75%
- D) 90%
✓ C) 75%
75. The falciform ligament divides the liver into:
- A) Right and left lobes functionally
- B) Right and left lobes anatomically
- C) Caudate and quadrate lobes
- D) Segments I and II
✓ B) Right and left lobes anatomically
76. Bile is stored in the gallbladder and concentrated by absorption of:
- A) Bile salts
- B) Water and electrolytes
- C) Bilirubin
- D) Cholesterol
✓ B) Water and electrolytes
77. The common bile duct opens into the duodenum at:
- A) Duodenal bulb
- B) Major duodenal papilla (ampulla of Vater)
- C) Minor duodenal papilla
- D) Duodenojejunal flexure
✓ B) Major duodenal papilla (ampulla of Vater)
78. On abdominal X-ray, the large bowel is distinguished from small bowel by:
- A) Larger diameter and haustra
- B) Circular folds (plicae circulares)
- C) Central location
- D) Thicker walls
✓ A) Larger diameter and haustra
PANCREAS, SPLEEN, KIDNEYS, URETER (Week 10)
79. The pancreatic duct of Wirsung opens into the duodenum together with:
- A) Cystic duct
- B) Common bile duct
- C) Hepatic duct
- D) Accessory pancreatic duct
✓ B) Common bile duct
80. The spleen is located in which abdominal quadrant?
- A) Right upper quadrant
- B) Left upper quadrant
- C) Right lower quadrant
- D) Left lower quadrant
✓ B) Left upper quadrant
81. The hilum of the kidney lies at which vertebral level?
- A) T12
- B) L1
- C) L2
- D) L3
✓ B) L1
82. The ureter crosses the pelvic brim over which structure?
- A) External iliac artery
- B) Common iliac artery bifurcation
- C) Femoral artery
- D) Internal iliac artery
✓ B) Common iliac artery bifurcation
83. The right kidney is slightly lower than the left because of the:
- A) Spleen
- B) Liver
- C) Stomach
- D) Pancreas
✓ B) Liver
84. The white pulp of the spleen consists mainly of:
- A) Red blood cells
- B) Lymphoid tissue
- C) Sinusoids
- D) Connective tissue
✓ B) Lymphoid tissue
85. An intravenous urogram (IVU) is used to evaluate:
- A) Biliary tree
- B) GI tract
- C) Urinary tract
- D) Lymphatics
✓ C) Urinary tract
SUPRARENAL GLANDS & BLOOD SUPPLY (Week 11)
86. The celiac trunk divides into three branches. Which of the following is NOT a direct branch?
- A) Left gastric artery
- B) Splenic artery
- C) Common hepatic artery
- D) Superior mesenteric artery
✓ D) Superior mesenteric artery
87. The superior mesenteric artery supplies the gut from:
- A) Stomach to transverse colon (midgut)
- B) Esophagus to duodenum
- C) Distal transverse colon to rectum
- D) Entire large intestine
✓ A) Stomach to transverse colon (midgut)
88. The inferior mesenteric artery supplies:
- A) Foregut derivatives
- B) Midgut derivatives
- C) Hindgut (distal transverse colon to upper rectum)
- D) Rectum only
✓ C) Hindgut (distal transverse colon to upper rectum)
89. The suprarenal (adrenal) glands are located:
- A) Below the kidneys
- B) On the medial side of the kidneys
- C) On the superior pole of each kidney
- D) Behind the pancreas
✓ C) On the superior pole of each kidney
90. The right suprarenal vein drains directly into:
- A) Right renal vein
- B) Inferior vena cava
- C) Portal vein
- D) Azygos vein
✓ B) Inferior vena cava
POSTERIOR ABDOMINAL WALL, LUMBAR PLEXUS (Week 12)
91. The lumbar plexus is formed from the anterior rami of which spinal levels?
- A) T12–L3
- B) L1–L4
- C) L2–L5
- D) L1–L5
✓ B) L1–L4
92. The femoral nerve is the largest branch of which plexus?
- A) Sacral plexus
- B) Lumbar plexus
- C) Brachial plexus
- D) Celiac plexus
✓ B) Lumbar plexus
93. The portal vein is formed by the union of:
- A) Superior mesenteric vein and splenic vein
- B) Inferior mesenteric vein and hepatic vein
- C) Splenic vein and left renal vein
- D) Superior and inferior mesenteric veins
✓ A) Superior mesenteric vein and splenic vein
PELVIC WALL (Week 13)
94. The pelvic inlet is bounded anteriorly by which structure?
- A) Sacral promontory
- B) Pubic symphysis
- C) Iliopectineal line
- D) Ischial spine
✓ B) Pubic symphysis
95. Which muscle forms the main part of the pelvic diaphragm?
- A) Coccygeus
- B) Piriformis
- C) Levator ani
- D) Obturator internus
✓ C) Levator ani
96. The true pelvis (lesser pelvis) is located:
- A) Above the pelvic inlet
- B) Below the pelvic inlet
- C) Between the two iliac crests
- D) Above the iliac crest
✓ B) Below the pelvic inlet
97. Which of the following is a difference between the male and female pelvis?
- A) Female pelvis has a heart-shaped inlet
- B) Female pelvis has a wider subpubic angle (>90°)
- C) Male pelvis has a wider true pelvis
- D) Female sacrum is less curved
✓ B) Female pelvis has a wider subpubic angle (>90°)
PELVIC FASCIA, NERVES & ARTERIES (Week 14)
98. The internal iliac artery divides into anterior and posterior divisions. Which artery is NOT from the posterior division?
- A) Iliolumbar artery
- B) Lateral sacral artery
- C) Superior gluteal artery
- D) Obturator artery
✓ D) Obturator artery
99. The sacral plexus is formed from:
- A) L1–L4 anterior rami
- B) L4–S3 anterior rami
- C) S1–S4 only
- D) L2–S2 anterior rami
✓ B) L4–S3 anterior rami
PELVIC CAVITY (Weeks 15–16)
100. A radiologist is reviewing a hysterosalpingogram (HSG). This contrast study is used to evaluate:
- A) Urinary bladder and urethra
- B) Uterine cavity and patency of fallopian tubes
- C) Rectum and sigmoid colon
- D) Ovarian blood supply
✓ B) Uterine cavity and patency of fallopian tubes
Summary Table
| Week | Topic | MCQs |
|---|---|---|
| 1–2 | Thoracic Wall | 1–20 |
| 3 | Thoracic Cavity (mediastinum, pleura, lungs) | 21–34 |
| 4 | Pericardium, Heart, Thymus | 35–45 |
| 5 | Thoracic Arteries, Veins, Radiology | 46–53 |
| 6–7 | Abdominal Wall | 54–63 |
| 8 | Peritoneum, GI Tract | 64–71 |
| 9 | Large Intestine, Liver, Biliary | 72–78 |
| 10 | Pancreas, Spleen, Kidneys | 79–85 |
| 11 | Suprarenal, GIT Blood Supply | 86–90 |
| 12 | Posterior Abdominal Wall, Lumbar Plexus | 91–93 |
| 13 | Pelvic Wall | 94–97 |
| 14 | Pelvic Fascia, Nerves, Arteries | 98–99 |
| 15–16 | Pelvic Cavity | 100 |
Total: 100 MCQs - All 4-option format with correct answer marked. Mix of direct concept and clinical scenario-based questions covering the full 3rd semester Radiology syllabus (excluding OSPE items).
Ya thek Hain lakin thori SI 2,3line ki statement ho lakin guma kar ho lakin Kuch mcqs scenario based bhi ho 100 banao according to the criculam
Statement itni ziyada bari na ho which one off the following except or not Wala mcqs bhi ho scenario based bhi ho Thora SA banao
Here are 100 MCQs — short statements, "EXCEPT/NOT" types, and scenario-based questions, all curriculum-aligned.
RADIOLOGY 3RD SEMESTER — 100 MCQs
THORACIC WALL (Week 1)
1. Ribs 11 and 12 have no anterior attachment and are called:
- A) False ribs
- B) Vertebrochondral ribs
- C) Floating ribs
- D) True ribs
✓ C) Floating ribs
2. The sternal angle marks the articulation of the sternum with which rib?
- A) 1st
- B) 2nd
- C) 3rd
- D) 4th
✓ B) 2nd
3. All of the following are parts of the sternum EXCEPT:
- A) Manubrium
- B) Body
- C) Xiphoid process
- D) Costal groove
✓ D) Costal groove
4. The costal groove runs along which surface of the rib?
- A) Superior border
- B) Anterior surface
- C) Inferior border
- D) Posterior surface
✓ C) Inferior border
5. (Scenario) A 30-year-old patient needs thoracentesis. To avoid the neurovascular bundle, the needle is inserted:
- A) Above the upper border of the rib below
- B) At the mid-point of the intercostal space
- C) Just above the lower rib of the space
- D) Below the lower rib
✓ C) Just above the lower rib of the space
6. Which of the following is NOT a content of the thoracic inlet?
- A) Trachea
- B) Esophagus
- C) Subclavian artery
- D) Ascending aorta
✓ D) Ascending aorta
7. Ribs 1–7 are called true ribs because they attach to the sternum:
- A) Via the rib above
- B) Directly via their own costal cartilage
- C) Via a shared costal cartilage
- D) They do not attach to the sternum
✓ B) Directly via their own costal cartilage
8. External intercostal muscles act during inspiration by:
- A) Depressing the ribs
- B) Compressing the thorax
- C) Elevating the ribs
- D) Pulling ribs inward
✓ C) Elevating the ribs
9. On a PA chest X-ray, which ribs appear more horizontal and project anteriorly?
- A) Posterior ribs
- B) Anterior ribs
- C) Both appear identical
- D) Floating ribs only
✓ B) Anterior ribs
10. All of the following form the thoracic outlet EXCEPT:
- A) T12 vertebra
- B) 12th rib
- C) Xiphoid process
- D) Costal cartilages of ribs 7–10
✓ C) Xiphoid process
INTERCOSTAL NERVES, DIAPHRAGM & BLOOD SUPPLY (Week 2)
11. The phrenic nerve arises from anterior rami of:
- A) C2, C3, C4
- B) C3, C4, C5
- C) C4, C5, C6
- D) C5, C6, C7
✓ B) C3, C4, C5
12. (Scenario) A patient has right-sided diaphragmatic paralysis. Which nerve is most likely damaged?
- A) Right vagus nerve
- B) Right phrenic nerve
- C) Right intercostal nerve
- D) Right sympathetic trunk
✓ B) Right phrenic nerve
13. The IVC passes through the diaphragm at the level of:
- A) T8
- B) T10
- C) T12
- D) L1
✓ A) T8
14. The esophageal hiatus of the diaphragm is at the level of:
- A) T8
- B) T10
- C) T12
- D) L1
✓ B) T10
15. All of the following pass through the aortic hiatus EXCEPT:
- A) Descending thoracic aorta
- B) Thoracic duct
- C) Azygos vein
- D) Left phrenic nerve
✓ D) Left phrenic nerve
16. The endothoracic fascia lies between the innermost intercostals and:
- A) Visceral pleura
- B) Parietal pleura
- C) External intercostals
- D) Subcostalis muscle
✓ B) Parietal pleura
17. The internal thoracic artery is a branch of the:
- A) Axillary artery
- B) Aorta
- C) Subclavian artery
- D) Intercostal artery
✓ C) Subclavian artery
18. Intercostal nerves are anterior rami of which spinal nerves?
- A) T1–T10
- B) T1–T11
- C) T1–T12
- D) C8–T11
✓ C) T1–T12
19. (Scenario) During a rib fracture, a patient develops a pneumothorax. Air accumulates between which two layers?
- A) Visceral and parietal pleura
- B) Parietal pleura and endothoracic fascia
- C) Two layers of visceral pleura
- D) Lung parenchyma and visceral pleura
✓ A) Visceral and parietal pleura
20. The suprapleural membrane (Sibson's fascia) covers the apex of the lung and is a thickening of:
- A) Visceral pleura
- B) Endothoracic fascia
- C) Parietal pleura
- D) Innermost intercostal fascia
✓ B) Endothoracic fascia
THORACIC CAVITY — MEDIASTINUM, PLEURA, LUNGS (Week 3)
21. The mediastinum is divided by a plane through the sternal angle and the intervertebral disc of:
- A) T3–T4
- B) T4–T5
- C) T5–T6
- D) T6–T7
✓ B) T4–T5
22. All of the following are in the posterior mediastinum EXCEPT:
- A) Thoracic aorta
- B) Thoracic duct
- C) Thymus
- D) Azygos vein
✓ C) Thymus
23. The right lung has how many lobes?
- A) 2
- B) 3
- C) 4
- D) 5
✓ B) 3
24. (Scenario) A child inhales a peanut. It is most likely to lodge in the right main bronchus because it is:
- A) Longer and narrower
- B) Wider, shorter, and more vertical
- C) Located more superiorly
- D) Protected by the carina
✓ B) Wider, shorter, and more vertical
25. The horizontal fissure of the right lung is present at the level of which rib anteriorly?
- A) 3rd rib
- B) 4th rib
- C) 5th rib
- D) 6th rib
✓ B) 4th rib
26. A bronchopulmonary segment is best defined as a lung unit supplied by a:
- A) Lobar bronchus and lobar artery
- B) Segmental bronchus and segmental artery
- C) Main bronchus only
- D) Subsegmental bronchus
✓ B) Segmental bronchus and segmental artery
27. The costodiaphragmatic recess is located between:
- A) Costal and mediastinal pleura
- B) Costal and diaphragmatic pleura
- C) Visceral and parietal pleura
- D) Two folds of visceral pleura
✓ B) Costal and diaphragmatic pleura
28. Which of the following is NOT a part of the inferior mediastinum?
- A) Anterior mediastinum
- B) Middle mediastinum
- C) Posterior mediastinum
- D) Superior mediastinum
✓ D) Superior mediastinum
29. The trachea bifurcates at the carina at the level of:
- A) T2
- B) T4
- C) T6
- D) T8
✓ B) T4
30. (Scenario) On a PA chest X-ray, a radiologist notes the right heart border is obliterated. This silhouette sign indicates disease in which lobe?
- A) Right upper lobe
- B) Right lower lobe
- C) Right middle lobe
- D) Left lower lobe
✓ C) Right middle lobe
PERICARDIUM, HEART, THYMUS (Week 4)
31. The fibrous pericardium is attached inferiorly to the:
- A) Sternum
- B) Diaphragm
- C) Pleura
- D) Esophagus
✓ B) Diaphragm
32. Which chamber forms the majority of the anterior surface of the heart?
- A) Left ventricle
- B) Right atrium
- C) Right ventricle
- D) Left atrium
✓ C) Right ventricle
33. All of the following form the left border of the heart on PA X-ray EXCEPT:
- A) Aortic knuckle
- B) Pulmonary trunk
- C) Left atrial appendage
- D) Right atrium
✓ D) Right atrium
34. (Scenario) A patient presents with muffled heart sounds, raised JVP, and hypotension. Fluid has accumulated in which space?
- A) Pleural cavity
- B) Peritoneal cavity
- C) Pericardial cavity
- D) Mediastinal space
✓ C) Pericardial cavity
35. The normal cardiothoracic ratio (CTR) on a PA chest X-ray is less than:
- A) 0.4
- B) 0.5
- C) 0.6
- D) 0.7
✓ B) 0.5
36. The transverse sinus of the pericardium lies between the:
- A) Two venous structures
- B) Two atria
- C) Great arteries anteriorly and great veins posteriorly
- D) Right and left ventricles
✓ C) Great arteries anteriorly and great veins posteriorly
37. The left anterior descending artery (LAD) is a branch of the:
- A) Right coronary artery
- B) Left circumflex artery
- C) Left main coronary artery
- D) Aorta directly
✓ C) Left main coronary artery
38. The thymus involutes after puberty and is replaced by:
- A) Lymphoid tissue
- B) Fibrofatty tissue
- C) Connective tissue only
- D) Cartilage
✓ B) Fibrofatty tissue
39. (Scenario) On a chest X-ray of a neonate, a large sail-shaped opacity is seen in the anterior superior mediastinum. This most likely represents a normal:
- A) Thyroid
- B) Thymus
- C) Lymph node
- D) Aortic arch
✓ B) Thymus
40. The esophagus passes through the diaphragm at which level?
- A) T8
- B) T10
- C) T12
- D) L1
✓ B) T10
THORACIC ARTERIES, VEINS & RADIOLOGY (Week 5)
41. The arch of the aorta gives branches in which order from right to left?
- A) Left subclavian, left common carotid, brachiocephalic trunk
- B) Brachiocephalic trunk, left common carotid, left subclavian
- C) Left common carotid, brachiocephalic trunk, left subclavian
- D) Right subclavian, right carotid, left subclavian
✓ B) Brachiocephalic trunk, left common carotid, left subclavian
42. The azygos vein drains into the:
- A) Inferior vena cava
- B) Superior vena cava
- C) Brachiocephalic vein
- D) Left subclavian vein
✓ B) Superior vena cava
43. (Scenario) A radiograph shows the spinous processes are not centered between the medial clavicle ends. This indicates the patient was:
- A) Rotated during exposure
- B) Not in full inspiration
- C) Positioned too far from the detector
- D) Imaged in lateral projection
✓ A) Rotated during exposure
44. On a standard chest X-ray, which tissue appears most radiopaque (white)?
- A) Air
- B) Fat
- C) Soft tissue
- D) Bone
✓ D) Bone
45. The thoracic duct drains lymph into the:
- A) Right lymphatic duct
- B) Left subclavian-jugular venous junction
- C) Azygos vein
- D) Superior vena cava directly
✓ B) Left subclavian-jugular venous junction
46. All of the following are used in thoracic radiology EXCEPT:
- A) Bronchography
- B) Barium enema
- C) Coronary angiography
- D) PA chest X-ray
✓ B) Barium enema
47. (Scenario) On a PA chest X-ray, the right hemidiaphragm is higher than the left. This is normally explained by:
- A) Spleen pushing it up on the right
- B) Liver lying below the right hemidiaphragm
- C) Right lung being smaller
- D) Right phrenic nerve being longer
✓ B) Liver lying below the right hemidiaphragm
48. In a good quality PA chest X-ray, how many posterior ribs should be visible above the diaphragm?
- A) 4–5
- B) 6–7
- C) 8–9
- D) 10–11
✓ C) 8–9
ABDOMINAL WALL — OSTEOLOGY & MUSCLES (Week 6)
49. The linea alba is formed by the aponeuroses of all three flat muscles meeting at the:
- A) Lateral border of rectus abdominis
- B) Midline
- C) Iliac crest
- D) Inguinal ligament
✓ B) Midline
50. All of the following are flat muscles of the anterolateral abdominal wall EXCEPT:
- A) External oblique
- B) Internal oblique
- C) Transversus abdominis
- D) Rectus abdominis
✓ D) Rectus abdominis
51. The arcuate line is located midway between the umbilicus and the:
- A) Xiphoid process
- B) Anterior superior iliac spine
- C) Pubic symphysis
- D) Umbilicus
✓ C) Pubic symphysis
52. Below the arcuate line, the posterior wall of the rectus sheath is formed only by:
- A) Posterior layer of internal oblique aponeurosis
- B) Transversalis fascia
- C) Peritoneum
- D) Transversus abdominis aponeurosis
✓ B) Transversalis fascia
53. (Scenario) A surgeon notes that during laparotomy, below the arcuate line there is no posterior rectus sheath. The deepest layer protecting the rectus muscle here is the:
- A) Peritoneum
- B) Transversalis fascia
- C) Aponeurosis of external oblique
- D) Subcutaneous fat
✓ B) Transversalis fascia
54. Transversalis fascia is deep to which muscle?
- A) External oblique
- B) Internal oblique
- C) Transversus abdominis
- D) Rectus abdominis
✓ C) Transversus abdominis
55. The transpyloric plane passes through all of the following EXCEPT:
- A) Pylorus of stomach
- B) Hilum of kidneys
- C) Origin of SMA
- D) Fundus of gallbladder
✓ D) Fundus of gallbladder
INGUINAL CANAL & POSTEROLATERAL WALL (Week 7)
56. The inguinal ligament stretches from the anterior superior iliac spine to the:
- A) Ischial spine
- B) Pubic tubercle
- C) Pubic symphysis
- D) Iliac crest
✓ B) Pubic tubercle
57. The deep inguinal ring is a defect in the:
- A) External oblique aponeurosis
- B) Internal oblique muscle
- C) Transversalis fascia
- D) Peritoneum
✓ C) Transversalis fascia
58. (Scenario) A 45-year-old male presents with a groin bulge lateral to the inferior epigastric artery that passes through the deep ring. This hernia is classified as:
- A) Direct inguinal hernia
- B) Femoral hernia
- C) Indirect inguinal hernia
- D) Umbilical hernia
✓ C) Indirect inguinal hernia
59. All of the following are boundaries of Hesselbach's triangle EXCEPT:
- A) Inguinal ligament inferiorly
- B) Inferior epigastric artery laterally
- C) Lateral border of rectus abdominis medially
- D) External oblique aponeurosis posteriorly
✓ D) External oblique aponeurosis posteriorly
60. The inferior epigastric artery is a branch of the:
- A) Internal iliac artery
- B) Femoral artery
- C) External iliac artery
- D) Aorta
✓ C) External iliac artery
61. The quadratus lumborum originates from the iliolumbar ligament and inserts into:
- A) 12th rib and L1–L4 transverse processes
- B) Iliac crest only
- C) L5 vertebra
- D) Thoracolumbar fascia
✓ A) 12th rib and L1–L4 transverse processes
PERITONEUM, ESOPHAGUS, STOMACH, SMALL INTESTINE (Week 8)
62. All of the following are retroperitoneal organs EXCEPT:
- A) Kidneys
- B) Pancreas (except tail)
- C) Descending colon
- D) Jejunum
✓ D) Jejunum
63. The lesser omentum connects the liver to the:
- A) Greater curvature of stomach
- B) Lesser curvature of stomach and first part of duodenum
- C) Transverse colon
- D) Gallbladder only
✓ B) Lesser curvature of stomach and first part of duodenum
64. The greater omentum hangs from the:
- A) Lesser curvature of stomach
- B) Greater curvature of stomach
- C) Hepatoduodenal ligament
- D) Falciform ligament
✓ B) Greater curvature of stomach
65. (Scenario) A radiologist reviewing a barium meal X-ray sees the "C-loop" of contrast. This outlines which organ?
- A) Stomach
- B) Jejunum
- C) Head of pancreas within the duodenal loop
- D) Gallbladder
✓ C) Head of pancreas within the duodenal loop
66. The blood supply of the stomach is derived entirely from branches of the:
- A) Superior mesenteric artery
- B) Celiac trunk
- C) Inferior mesenteric artery
- D) Splenic artery only
✓ B) Celiac trunk
67. All of the following are parts of the duodenum EXCEPT:
- A) Superior (first) part
- B) Descending (second) part
- C) Horizontal (third) part
- D) Sigmoid part
✓ D) Sigmoid part
68. The epiploic foramen (foramen of Winslow) gives access to the:
- A) Greater sac
- B) Lesser sac (omental bursa)
- C) Pelvic peritoneal cavity
- D) Paracolic gutters
✓ B) Lesser sac (omental bursa)
LARGE INTESTINE, LIVER, BILIARY TREE (Week 9)
69. All of the following are features of the large intestine EXCEPT:
- A) Taenia coli
- B) Haustra
- C) Plicae circulares
- D) Appendices epiploicae
✓ C) Plicae circulares
70. The portal vein supplies approximately what percentage of liver blood flow?
- A) 25%
- B) 50%
- C) 75%
- D) 90%
✓ C) 75%
71. (Scenario) A 55-year-old patient has a stone impacted at the ampulla of Vater. Which two structures open here?
- A) Cystic duct and hepatic duct
- B) Common bile duct and pancreatic duct
- C) Right and left hepatic ducts
- D) Common hepatic duct and cystic duct
✓ B) Common bile duct and pancreatic duct
72. The falciform ligament divides the liver into right and left lobes and contains the:
- A) Portal vein
- B) Ligamentum teres (round ligament)
- C) Hepatic artery
- D) Bile duct
✓ B) Ligamentum teres (round ligament)
73. All of the following are parts of the biliary tree EXCEPT:
- A) Right and left hepatic ducts
- B) Common hepatic duct
- C) Common bile duct
- D) Pancreatic duct of Santorini
✓ D) Pancreatic duct of Santorini
74. On a plain abdominal X-ray, which feature distinguishes large bowel from small bowel?
- A) Small bowel has haustra
- B) Large bowel has plicae circulares
- C) Large bowel shows haustra and is peripheral
- D) Small bowel is peripheral and large
✓ C) Large bowel shows haustra and is peripheral
PANCREAS, SPLEEN, KIDNEYS, URETER (Week 10)
75. The pancreas lies at the level of:
- A) T10–T11
- B) L1–L2
- C) L3–L4
- D) T12–L1
✓ B) L1–L2
76. (Scenario) A patient presents with severe epigastric pain radiating to the back. Serum amylase is very high. The most likely diagnosis involves which organ?
- A) Liver
- B) Spleen
- C) Pancreas
- D) Gallbladder
✓ C) Pancreas
77. The spleen is located in which abdominal region?
- A) Right hypochondrium
- B) Epigastric region
- C) Left hypochondrium
- D) Left iliac fossa
✓ C) Left hypochondrium
78. All of the following are correct about the kidney EXCEPT:
- A) The right kidney is slightly lower than the left
- B) The hilum lies at the level of L1
- C) The left renal vein is longer than the right
- D) The right renal vein is longer than the left
✓ D) The right renal vein is longer than the left
79. The ureter crosses the pelvic brim at the bifurcation of the:
- A) External iliac artery
- B) Common iliac artery
- C) Internal iliac artery
- D) Femoral artery
✓ B) Common iliac artery
80. (Scenario) An IVU (intravenous urogram) is performed. It demonstrates the entire urinary tract including kidneys, ureters, and bladder using:
- A) Barium sulfate
- B) Iodine-based contrast given intravenously
- C) Gas insufflation
- D) Water-soluble oral contrast
✓ B) Iodine-based contrast given intravenously
SUPRARENAL GLANDS & BLOOD SUPPLY OF GIT (Week 11)
81. The right suprarenal vein drains directly into the:
- A) Right renal vein
- B) Inferior vena cava
- C) Portal vein
- D) Azygos vein
✓ B) Inferior vena cava
82. All of the following are direct branches of the celiac trunk EXCEPT:
- A) Left gastric artery
- B) Splenic artery
- C) Common hepatic artery
- D) Superior mesenteric artery
✓ D) Superior mesenteric artery
83. The inferior mesenteric artery supplies the gut from the:
- A) Stomach to mid-transverse colon
- B) Distal transverse colon to upper rectum
- C) Entire large intestine
- D) Ileum only
✓ B) Distal transverse colon to upper rectum
84. The suprarenal glands sit on the superior pole of the kidneys enclosed within the:
- A) Renal capsule
- B) Gerota's fascia (perirenal fascia)
- C) Transversalis fascia
- D) Endopelvic fascia
✓ B) Gerota's fascia (perirenal fascia)
85. (Scenario) A patient has a midgut volvulus. The artery most at risk of occlusion is the:
- A) Celiac trunk
- B) Inferior mesenteric artery
- C) Superior mesenteric artery
- D) Renal artery
✓ C) Superior mesenteric artery
POSTERIOR ABDOMINAL WALL VEINS & LUMBAR PLEXUS (Week 12)
86. The portal vein is formed by the union of the superior mesenteric vein and:
- A) Inferior mesenteric vein
- B) Splenic vein
- C) Left renal vein
- D) Hepatic vein
✓ B) Splenic vein
87. The lumbar plexus is formed from the anterior rami of:
- A) T12–L3
- B) L1–L4
- C) L2–L5
- D) L1–L5
✓ B) L1–L4
88. The femoral nerve exits the lumbar plexus and enters the thigh under the:
- A) Inguinal ligament lateral to femoral vessels
- B) Inguinal ligament medial to femoral artery
- C) Femoral canal
- D) Obturator foramen
✓ A) Inguinal ligament lateral to femoral vessels
89. All of the following are branches of the lumbar plexus EXCEPT:
- A) Femoral nerve
- B) Obturator nerve
- C) Iliohypogastric nerve
- D) Sciatic nerve
✓ D) Sciatic nerve
90. (Scenario) On a plain abdominal X-ray, loss of the psoas shadow on one side may suggest:
- A) Normal variation
- B) Retroperitoneal pathology such as abscess or hematoma
- C) Small bowel obstruction
- D) Ascites
✓ B) Retroperitoneal pathology such as abscess or hematoma
PELVIC WALL — BONES, MUSCLES, DIAPHRAGM (Week 13)
91. The pelvic inlet is bounded posteriorly by the:
- A) Pubic symphysis
- B) Sacral promontory
- C) Coccyx
- D) Ischial tuberosity
✓ B) Sacral promontory
92. The true pelvis is located:
- A) Above the pelvic inlet
- B) Between the iliac crests
- C) Below the pelvic inlet
- D) Above the arcuate line
✓ C) Below the pelvic inlet
93. All of the following are parts of levator ani EXCEPT:
- A) Pubococcygeus
- B) Iliococcygeus
- C) Puborectalis
- D) Piriformis
✓ D) Piriformis
94. (Scenario) A female patient has a wider subpubic angle (>90°) on her pelvic X-ray. This is a feature of which pelvis type?
- A) Android
- B) Platypelloid
- C) Gynecoid
- D) Anthropoid
✓ C) Gynecoid
95. The main muscle of the pelvic diaphragm is:
- A) Piriformis
- B) Obturator internus
- C) Levator ani
- D) Coccygeus
✓ C) Levator ani
PELVIC FASCIA, NERVES & ARTERIES (Week 14)
96. The obturator artery is a branch of the:
- A) Posterior division of the internal iliac artery
- B) Anterior division of the internal iliac artery
- C) External iliac artery
- D) Femoral artery
✓ B) Anterior division of the internal iliac artery
97. The sacral plexus is formed from the anterior rami of:
- A) L1–L4
- B) L4–S3
- C) S1–S4 only
- D) L2–S2
✓ B) L4–S3
98. All of the following are branches of the sacral plexus EXCEPT:
- A) Sciatic nerve
- B) Superior gluteal nerve
- C) Pudendal nerve
- D) Obturator nerve
✓ D) Obturator nerve
PELVIC CAVITY (Weeks 15–16)
99. (Scenario) A radiologist performs a hysterosalpingogram (HSG) on a woman with infertility. Contrast spills freely from the fallopian tubes. This confirms:
- A) Uterine fibroids
- B) Tubal patency
- C) Ovarian cysts
- D) Bladder reflux
✓ B) Tubal patency
100. The rectum receives its blood supply from all of the following EXCEPT:
- A) Superior rectal artery (IMA branch)
- B) Middle rectal artery (internal iliac branch)
- C) Inferior rectal artery (pudendal branch)
- D) Inferior mesenteric artery directly at the anal canal
✓ D) Inferior mesenteric artery directly at the anal canal
Summary
| Week | Topic | Qs |
|---|---|---|
| 1 | Thoracic wall, ribs, sternum | 1–10 |
| 2 | Intercostals, diaphragm, blood supply | 11–20 |
| 3 | Mediastinum, pleura, lungs | 21–30 |
| 4 | Pericardium, heart, thymus | 31–40 |
| 5 | Thoracic arteries, veins, radiology | 41–48 |
| 6 | Abdominal wall osteology & muscles | 49–55 |
| 7 | Inguinal canal, posterolateral wall | 56–61 |
| 8 | Peritoneum, GI tract | 62–68 |
| 9 | Large intestine, liver, biliary | 69–74 |
| 10 | Pancreas, spleen, kidneys | 75–80 |
| 11 | Suprarenal, GIT blood supply | 81–85 |
| 12 | Posterior wall veins, lumbar plexus | 86–90 |
| 13 | Pelvic wall | 91–95 |
| 14 | Pelvic fascia, nerves, arteries | 96–98 |
| 15–16 | Pelvic cavity | 99–100 |
Kmu ka jasa mcqs hote Hain wo banao
Searching the Web
KMU Khyber Medical University MCQ style anatomy radiology exam pattern
KMU style MCQs ki pehchan yeh hai:
- Short clinical vignette (age, gender, symptom/finding)
- 1-line stem phir "Which of the following is..."
- Tricky distractors jo almost sahi lagte hain
- Applied/radiological anatomy focus
- "EXCEPT" and "NOT" type bhi common
- Concept twist hota hai — ratta nahi chalta
KMU-STYLE MCQs — RADIOLOGY 3RD SEMESTER
100 Questions | Curriculum-Aligned
THORACIC WALL (Week 1)
1. A 22-year-old student is studying chest X-rays. On a PA view, the anterior ribs appear more horizontal than posterior ribs. Which of the following best explains this appearance?
- A) Anterior ribs are thicker
- B) Anterior ribs run downward and forward at a lesser angle than posterior ribs
- C) Posterior ribs are shorter
- D) Anterior ribs articulate directly with the sternum
✓ B)
2. During a practical session, a student is asked to identify the sternal angle. All of the following are true about the sternal angle EXCEPT:
- A) It marks the level of the 2nd rib
- B) It is the junction of manubrium and body of sternum
- C) It lies at the level of T4–T5 disc
- D) It is the lower limit of the superior mediastinum
✓ D)
3. A 35-year-old male sustains blunt chest trauma. The surgeon decides to insert a chest drain. To avoid injuring the neurovascular bundle, the needle should be inserted:
- A) At the center of the intercostal space
- B) Just below the upper rib
- C) Just above the lower rib of the selected intercostal space
- D) Through the costal groove
✓ C)
4. During dissection, a student traces the costal groove. The structures running in it from above downward are:
- A) Nerve, artery, vein
- B) Vein, artery, nerve
- C) Artery, vein, nerve
- D) Vein, nerve, artery
✓ B)
5. A 40-year-old patient has a stab wound at the 6th intercostal space in the midaxillary line. Which muscle layer is NOT pierced in the intercostal space?
- A) External intercostal
- B) Internal intercostal
- C) Innermost intercostal
- D) Rectus abdominis
✓ D)
6. Ribs 8, 9, and 10 are called vertebrochondral ribs because their costal cartilages articulate with:
- A) Sternum directly
- B) The costal cartilage of the rib above
- C) Each other forming a costal arch
- D) The xiphoid process
✓ B)
7. A first-year radiology student is asked about the manubrium. Which structure does NOT attach to the manubrium?
- A) Clavicle
- B) 1st costal cartilage
- C) 2nd costal cartilage (partially)
- D) 3rd costal cartilage
✓ D)
8. On a PA chest X-ray, a student counts 9 posterior ribs above the right hemidiaphragm. This indicates:
- A) Poor inspiration
- B) Good inspiratory effort
- C) Patient rotation
- D) Overexposure
✓ B)
9. Which of the following muscles is involved in FORCED expiration and is NOT a muscle of the thoracic wall?
- A) Internal intercostal
- B) Innermost intercostal
- C) Rectus abdominis
- D) Subcostalis
✓ C)
10. A radiograph shows a cervical rib in a 28-year-old woman with tingling in her arm. A cervical rib is an anomalous rib that articulates with:
- A) T1 vertebra
- B) C6 vertebra
- C) C7 vertebra
- D) Manubrium sterni
✓ C)
INTERCOSTAL NERVES, DIAPHRAGM, BLOOD SUPPLY (Week 2)
11. A 55-year-old patient has a left hemidiaphragm that is elevated on chest X-ray. The most likely nerve affected is:
- A) Left vagus
- B) Left phrenic
- C) Left intercostal T6
- D) Left sympathetic chain
✓ B)
12. The phrenic nerve arises from C3, C4, C5. A student asks why pain from the diaphragm is referred to the shoulder tip. The best explanation is:
- A) The phrenic nerve runs near the shoulder joint
- B) The diaphragm shares the same dermatome (C3, C4, C5) as the shoulder skin
- C) The vagus nerve supplies both structures
- D) The intercostal nerves cross-refer to the shoulder
✓ B)
13. The IVC passes through the diaphragm at T8. All of the following also pass through the caval opening EXCEPT:
- A) Right phrenic nerve
- B) Left phrenic nerve
- C) Terminal branches of right phrenic nerve
- D) Lymphatics
✓ B)
14. A 30-year-old patient has hiatal hernia. The esophagus herniates through the diaphragm at the esophageal hiatus. This hiatus also transmits:
- A) Thoracic duct
- B) Azygos vein
- C) Both vagus nerves
- D) Left phrenic nerve
✓ C)
15. The aortic hiatus at T12 transmits all of the following EXCEPT:
- A) Descending aorta
- B) Thoracic duct
- C) Azygos vein
- D) Left phrenic nerve
✓ D)
16. Endothoracic fascia is a layer that separates which two structures?
- A) External and internal intercostal muscles
- B) Innermost intercostal muscles and parietal pleura
- C) Visceral and parietal pleura
- D) Lung parenchyma and visceral pleura
✓ B)
17. A 50-year-old male has a posterior intercostal artery bleeding after a rib fracture. The posterior intercostal arteries (3rd–11th) arise from the:
- A) Internal thoracic artery
- B) Thoracoacromial trunk
- C) Descending thoracic aorta
- D) Subclavian artery
✓ C)
18. A hernia that occurs through the left posterior part of the diaphragm (foramen of Bochdalek) in a neonate will allow abdominal organs to enter the thorax through which opening?
- A) Esophageal hiatus
- B) Aortic hiatus
- C) Pleuroperitoneal canal (congenital defect posterolaterally)
- D) Caval foramen
✓ C)
19. The suprapleural membrane (Sibson's fascia) is important because it prevents the lung apex from:
- A) Collapsing during expiration
- B) Herniating into the neck during forced inspiration
- C) Adhering to the parietal pleura
- D) Receiving blood supply
✓ B)
20. Intercostal nerves T1–T6 supply the thoracic wall only. Which intercostal nerve is unique in having a large branch joining the brachial plexus?
- A) T1
- B) T2
- C) T3
- D) T6
✓ A)
THORACIC CAVITY — MEDIASTINUM, PLEURA, LUNGS (Week 3)
21. On a chest X-ray, a radiologist notes a right-sided opacity that obliterates the right heart border. According to the silhouette sign, the lesion is in the:
- A) Right lower lobe
- B) Right upper lobe
- C) Right middle lobe
- D) Left lower lobe
✓ C)
22. A foreign body is inhaled by a standing adult and settles in a dependent area. The most likely segment to be affected is the:
- A) Apical segment of right upper lobe
- B) Posterior basal segment of right lower lobe
- C) Anterior segment of left upper lobe
- D) Medial segment of right middle lobe
✓ B)
23. The costodiaphragmatic recess can hold approximately 200–300 mL of fluid before it appears on a standard PA chest X-ray as blunting of the costophrenic angle. Which two pleural layers form this recess?
- A) Mediastinal and diaphragmatic pleura
- B) Costal and diaphragmatic pleura
- C) Visceral and parietal pleura
- D) Costal and mediastinal pleura
✓ B)
24. A student is examining a lung specimen. She notices the left lung has only 2 lobes. Which fissure is absent in the left lung compared to the right?
- A) Oblique fissure
- B) Horizontal (transverse) fissure
- C) Accessory fissure
- D) Oblique and horizontal both
✓ B)
25. The carina is the internal ridge at the bifurcation of the trachea. On a lateral chest X-ray, this lies at the level of:
- A) T2
- B) T4
- C) T6
- D) T8
✓ B)
26. A 5-year-old boy swallowed a coin. It lodged in the right main bronchus. Which feature of the right main bronchus makes this more likely compared to the left? All EXCEPT:
- A) It is wider
- B) It is shorter
- C) It is more vertical
- D) It is longer
✓ D)
27. A student is asked about the superior mediastinum contents. All of the following are found in the superior mediastinum EXCEPT:
- A) Arch of aorta
- B) Thymus
- C) Trachea
- D) Heart
✓ D)
28. The right lung has 10 bronchopulmonary segments. A bronchopulmonary segment is surgically important because:
- A) Each segment shares a blood supply with adjacent segments
- B) Each segment can be resected individually without affecting others
- C) Segments are not separated by connective tissue septa
- D) Each segment has two segmental bronchi
✓ B)
29. During a radiology practical, a student identifies the hilar shadow on a PA chest X-ray. The main component forming the hilar shadow is:
- A) Main bronchi
- B) Pulmonary arteries and veins
- C) Lymph nodes only
- D) Trachea
✓ B)
30. The posterior mediastinum contains all of the following EXCEPT:
- A) Descending thoracic aorta
- B) Thoracic duct
- C) Esophagus
- D) Ascending aorta
✓ D)
PERICARDIUM, HEART & THYMUS (Week 4)
31. A 45-year-old man presents with hypotension, muffled heart sounds, and raised JVP (Beck's triad). An echo confirms pericardial effusion. Fluid accumulates in which space?
- A) Pleural cavity
- B) Pericardial cavity between fibrous and serous pericardium
- C) Pericardial cavity between visceral and parietal serous pericardium
- D) Mediastinal space
✓ C)
32. During cardiac surgery, a clamp is placed through the transverse sinus of the pericardium. Which structures are compressed by this maneuver?
- A) Pulmonary veins and IVC
- B) Ascending aorta and pulmonary trunk
- C) Superior and inferior vena cava
- D) Coronary arteries directly
✓ B)
33. On a PA chest X-ray, a medical student correctly identifies the right heart border. It is formed by:
- A) Right ventricle
- B) Right atrium and SVC
- C) Right ventricle and SVC
- D) Left atrium
✓ B)
34. The left border of the cardiac silhouette on a PA chest X-ray from above downward is formed by all EXCEPT:
- A) Aortic knuckle
- B) Pulmonary trunk
- C) Left atrial appendage
- D) Right atrium
✓ D)
35. A PA chest X-ray of a 60-year-old male shows the heart diameter is 16 cm and the thoracic diameter is 28 cm. The CTR is:
- A) 0.57 — normal
- B) 0.57 — cardiomegaly
- C) 0.44 — normal
- D) 0.44 — cardiomegaly
✓ B)
36. A 65-year-old patient has a myocardial infarction of the anterior wall of the left ventricle. The most likely occluded artery is:
- A) Right coronary artery
- B) Left circumflex artery
- C) Left anterior descending artery
- D) Posterior descending artery
✓ C)
37. The SA node receives its blood supply from the SA nodal artery, which in most people (60%) arises from:
- A) Left circumflex artery
- B) Left anterior descending artery
- C) Right coronary artery
- D) Left main coronary artery
✓ C)
38. On a PA chest X-ray of a 2-year-old, there is a wide anterior mediastinal shadow described as "sail-shaped." The most likely structure is:
- A) Enlarged lymph node
- B) Thyroid goiter
- C) Normal thymus
- D) Anterior mediastinal tumor
✓ C)
39. The oblique sinus of the pericardium is a blind recess behind the:
- A) Aorta and pulmonary trunk
- B) Left atrium, between the pulmonary veins
- C) Right ventricle
- D) Right atrium
✓ B)
40. All of the following are features of the fibrous pericardium EXCEPT:
- A) It is attached to the central tendon of the diaphragm
- B) It is fused with the adventitia of the great vessels
- C) It secretes pericardial fluid
- D) It is attached to the sternum by sternopericardial ligaments
✓ C)
THORACIC ARTERIES, VEINS & RADIOGRAPHIC ANATOMY (Week 5)
41. A 50-year-old hypertensive patient has aortic dissection. The first branch of the arch of the aorta that may be compromised is:
- A) Left common carotid
- B) Left subclavian
- C) Brachiocephalic trunk
- D) Right common carotid
✓ C)
42. On reviewing a PA chest X-ray, the aortic knuckle is visible. This represents the:
- A) Ascending aorta
- B) Arch of aorta (specifically the left lateral margin)
- C) Descending aorta at T4
- D) Brachiocephalic trunk
✓ B)
43. A chest X-ray is taken AP (anteroposterior) instead of PA. Which of the following changes is expected?
- A) The heart appears smaller
- B) The heart appears magnified
- C) The ribs appear more horizontal
- D) The lung fields appear blacker
✓ B)
44. On a good quality PA chest X-ray, the thoracic vertebrae should be:
- A) Completely invisible
- B) Faintly visible through the cardiac shadow
- C) Clearly bright white
- D) Only visible on lateral view
✓ B)
45. The thoracic duct begins at the cisterna chyli at the level of:
- A) T8
- B) T10
- C) T12
- D) L1–L2
✓ D)
46. A radiologist describes a "bat-wing" opacity on a chest X-ray centered on the hilum. This pattern is most associated with:
- A) Pneumothorax
- B) Pulmonary edema
- C) Pleural effusion
- D) Consolidation of a single lobe
✓ B)
47. Coronary angiography uses contrast injected into the coronary ostia. The left coronary ostium arises from the:
- A) Left sinus of Valsalva of the aorta
- B) Right sinus of Valsalva of the aorta
- C) Pulmonary trunk
- D) Aortic arch
✓ A)
48. On a PA chest X-ray, a horizontal line with air above and fluid below in the pleural space is seen. This is called:
- A) Kerley B line
- B) Air-fluid level — hydropneumothorax
- C) Silhouette sign
- D) Air bronchogram
✓ B)
ABDOMINAL WALL — OSTEOLOGY & MUSCLES (Week 6)
49. A 28-year-old patient has a surgical incision through all layers of the anterolateral abdominal wall. The correct order of layers from superficial to deep is:
- A) Skin → Camper's fascia → Scarpa's fascia → External oblique → Internal oblique → Transversus → Transversalis fascia → Extraperitoneal fat → Peritoneum
- B) Skin → Scarpa's fascia → Camper's fascia → External oblique → Internal oblique → Transversus → Peritoneum
- C) Skin → External oblique → Internal oblique → Transversalis fascia → Transversus → Peritoneum
- D) Skin → Camper's fascia → Internal oblique → External oblique → Transversus → Peritoneum
✓ A)
50. The arcuate line is significant because below it, the posterior rectus sheath is absent. This is because below the arcuate line, the aponeuroses of all three flat muscles pass:
- A) Behind the rectus abdominis
- B) In front of the rectus abdominis
- C) Both in front and behind
- D) Only the transversus passes behind
✓ B)
51. During laparotomy, a surgeon cuts through the linea alba. All of the following aponeuroses contribute to the linea alba EXCEPT:
- A) External oblique
- B) Internal oblique
- C) Transversus abdominis
- D) Rectus abdominis
✓ D)
52. A student is asked about the transpyloric plane (L1). All of the following structures lie at this level EXCEPT:
- A) Pylorus of stomach
- B) Neck of pancreas
- C) Fundus of gallbladder
- D) Origin of superior mesenteric artery
✓ C)
53. The action of the transversus abdominis muscle is to:
- A) Flex the trunk
- B) Laterally flex the trunk
- C) Compress the abdominal contents
- D) Extend the spine
✓ C)
54. The 9 regions of the abdomen are created by 2 vertical and 2 horizontal planes. The central region surrounded by all 4 planes is:
- A) Umbilical
- B) Epigastric
- C) Hypogastric
- D) Right lumbar
✓ A)
55. Parietal peritoneum differs from visceral peritoneum in that parietal peritoneum is:
- A) Insensitive to pain
- B) Sensitive to well-localized pain via somatic spinal nerves
- C) Sensitive only to stretch
- D) Supplied by autonomic nerves only
✓ B)
INGUINAL CANAL & ABDOMINAL ARTERIES (Week 7)
56. A 55-year-old male presents with a medial groin swelling that appears through Hesselbach's triangle. This is a:
- A) Indirect inguinal hernia
- B) Femoral hernia
- C) Direct inguinal hernia
- D) Obturator hernia
✓ C)
57. The superficial inguinal ring is an opening in:
- A) Transversalis fascia
- B) Internal oblique muscle
- C) External oblique aponeurosis
- D) Peritoneum
✓ C)
58. The deep inguinal ring lies lateral to the inferior epigastric vessels. The landmark for the inferior epigastric artery on a laparoscopy view is important because hernias medial to it are:
- A) Indirect
- B) Femoral
- C) Direct
- D) Obturator
✓ C)
59. All of the following are boundaries of the inguinal canal EXCEPT:
- A) Anterior wall — external oblique aponeurosis
- B) Posterior wall — transversalis fascia
- C) Floor — inguinal ligament
- D) Roof — transversus abdominis and internal oblique (arched fibers)
- (Which is NOT a boundary?)
All of the above are correct boundaries. Which of the following is NOT a content of the inguinal canal in males?
- A) Ilioinguinal nerve
- B) Vas deferens
- C) Femoral nerve
- D) Genital branch of genitofemoral nerve
✓ C)
60. The quadratus lumborum is a posterolateral abdominal wall muscle. Its lateral flexion action is important in stabilizing the 12th rib during:
- A) Swallowing
- B) Forced expiration and diaphragm contraction
- C) Hip extension
- D) Trunk rotation
✓ B)
61. The deep circumflex iliac artery is a branch of the external iliac artery. An abdominal X-ray in AP projection is taken at which standard position?
- A) Patient prone, beam from below
- B) Patient supine, beam from above (AP supine)
- C) Patient standing, beam lateral
- D) Patient sitting, beam oblique
✓ B)
PERITONEUM, GI TRACT (Week 8)
62. All of the following organs are intraperitoneal EXCEPT:
- A) Stomach
- B) Jejunum
- C) Transverse colon
- D) Duodenum (2nd, 3rd, 4th parts)
✓ D)
63. A radiologist performs a barium meal study. The "C-shaped loop" of barium outlines the duodenum. The structure filling the concavity of this C-loop is:
- A) Liver
- B) Gallbladder
- C) Head of pancreas
- D) Right kidney
✓ C)
64. The lesser sac (omental bursa) is accessed through:
- A) The right paracolic gutter
- B) The epiploic foramen (foramen of Winslow)
- C) The greater omentum directly
- D) The falciform ligament
✓ B)
65. A 60-year-old man has blood supply to the lesser curvature of the stomach compromised. Which two arteries are most likely damaged?
- A) Left and right gastroepiploic arteries
- B) Left and right gastric arteries
- C) Short gastric arteries and left gastric
- D) Gastroduodenal and splenic arteries
✓ B)
66. The gastroesophageal junction lies at the level of:
- A) T8
- B) T10
- C) T12
- D) L1
✓ B)
67. A barium swallow radiograph shows irregularity and narrowing of the esophageal lumen at the level of T4. The most anatomically relevant adjacent structure at this level is:
- A) Right main bronchus
- B) Aortic arch
- C) Diaphragm
- D) Liver
✓ B)
68. The hepatoduodenal ligament is the free right edge of the lesser omentum and contains all of the following EXCEPT:
- A) Portal vein (posterior)
- B) Hepatic artery proper (left)
- C) Common bile duct (right)
- D) Inferior vena cava
✓ D)
LARGE INTESTINE, LIVER, BILIARY TREE (Week 9)
69. A 35-year-old patient has a barium enema. Haustra are visible in the large bowel. All of the following are features of large intestine EXCEPT:
- A) Taenia coli
- B) Haustra
- C) Appendices epiploicae
- D) Plicae circulares
✓ D)
70. The portal vein is formed behind the neck of the pancreas by the union of:
- A) Superior mesenteric vein and inferior mesenteric vein
- B) Superior mesenteric vein and splenic vein
- C) Splenic vein and left renal vein
- D) Inferior mesenteric vein and splenic vein only
✓ B)
71. A stone impacted at the ampulla of Vater causes both obstructive jaundice and pancreatitis because this ampulla transmits:
- A) Right and left hepatic ducts
- B) Common bile duct and main pancreatic duct
- C) Common hepatic duct and cystic duct
- D) Accessory pancreatic duct only
✓ B)
72. On ultrasound, the normal common bile duct diameter is less than:
- A) 4 mm
- B) 6 mm
- C) 10 mm
- D) 15 mm
✓ B)
73. The Riedel's lobe is an anatomical variant of the:
- A) Left lobe of liver
- B) Caudate lobe
- C) Right lobe of liver (tongue-like inferior projection)
- D) Quadrate lobe
✓ C)
74. On a plain abdominal X-ray, gas in the large bowel is distinguished from small bowel by all of the following EXCEPT:
- A) Haustra that do not cross the full width
- B) Peripheral location
- C) Plicae circulares crossing the full width
- D) Larger caliber
✓ C) (Plicae circulares are a feature of small bowel, NOT large bowel)
PANCREAS, SPLEEN, KIDNEYS, URETER (Week 10)
75. A 40-year-old male with severe epigastric pain radiating to the back has raised serum amylase. An abdominal CT shows a swollen retroperitoneal organ at the L1–L2 level. This organ is the:
- A) Liver
- B) Spleen
- C) Pancreas
- D) Right kidney
✓ C)
76. The tail of the pancreas is the only part that is:
- A) Retroperitoneal
- B) Intraperitoneal
- C) Located in the right hypochondrium
- D) Related to the duodenum
✓ B)
77. The right kidney lies slightly lower than the left because of its relationship with the:
- A) Ascending colon
- B) Liver
- C) Right suprarenal gland
- D) Duodenum
✓ B)
78. The ureter has three anatomical constrictions where stones most commonly get stuck. All of the following are constriction sites EXCEPT:
- A) Pelviureteric junction
- B) Where ureter crosses the pelvic brim over common iliac vessels
- C) Vesicoureteric junction
- D) At the renal hilum
✓ D)
79. An IVU (intravenous urogram) at 15 minutes shows contrast in the renal collecting system. At 30 minutes, contrast should be seen in:
- A) Bladder only
- B) Ureters and bladder
- C) Renal cortex only
- D) Renal medulla only
✓ B)
80. The spleen is related to which ribs posterolaterally?
- A) 6th–8th ribs
- B) 9th–11th ribs
- C) 10th–12th ribs
- D) 7th–9th ribs
✓ B)
SUPRARENAL GLANDS & GIT BLOOD SUPPLY (Week 11)
81. The celiac trunk arises from the aorta at the level of:
- A) T12
- B) L1
- C) L2
- D) L3
✓ A)
82. A 50-year-old patient has superior mesenteric artery occlusion. The gut most likely to be infarcted extends from:
- A) Esophagus to stomach
- B) Distal duodenum to mid-transverse colon (midgut)
- C) Distal transverse colon to rectum
- D) Entire large intestine
✓ B)
83. The left suprarenal vein drains into the:
- A) Inferior vena cava
- B) Left renal vein
- C) Portal vein
- D) Left subclavian vein
✓ B)
84. All of the following arteries supply the rectum EXCEPT:
- A) Superior rectal (from IMA)
- B) Middle rectal (from internal iliac)
- C) Inferior rectal (from pudendal)
- D) Inferior mesenteric artery directly
✓ D)
85. The Waterhouse–Friderichsen syndrome involves hemorrhagic destruction of the suprarenal cortex. The suprarenal cortex has all of the following zones EXCEPT:
- A) Zona glomerulosa
- B) Zona fasciculata
- C) Zona reticularis
- D) Zona chromaffin
✓ D)
POSTERIOR WALL VEINS & LUMBAR PLEXUS (Week 12)
86. On a plain abdominal X-ray, loss of the right psoas shadow is noted. The most likely explanation is:
- A) Normal variant
- B) Retroperitoneal hematoma or abscess
- C) Small bowel obstruction
- D) Free intraperitoneal air
✓ B)
87. The genitofemoral nerve arises from L1–L2 and divides into femoral and genital branches. The genital branch in males supplies the:
- A) Femoral skin
- B) Cremaster muscle and scrotal skin
- C) Medial thigh
- D) Gluteal region
✓ B)
88. A contrast study of the GIT (barium follow-through) shows the terminal ileum. It joins the large bowel at the:
- A) Sigmoid colon
- B) Cecum at the ileocecal valve
- C) Ascending colon
- D) Hepatic flexure
✓ B)
89. All of the following are branches of the lumbar plexus EXCEPT:
- A) Iliohypogastric nerve
- B) Obturator nerve
- C) Femoral nerve
- D) Sciatic nerve
✓ D)
90. On an abdominal X-ray taken in the erect position, free intraperitoneal air is best seen:
- A) Under the left hemidiaphragm
- B) Under the right hemidiaphragm
- C) Both A and B
- D) In the paracolic gutters
✓ C)
PELVIC WALL (Week 13)
91. A female patient's pelvic X-ray shows a wide subpubic angle and a rounded inlet. This pelvis is classified as:
- A) Android
- B) Anthropoid
- C) Gynecoid
- D) Platypelloid
✓ C)
92. The true pelvis is bounded above by the pelvic inlet. All of the following form the pelvic inlet EXCEPT:
- A) Pubic symphysis anteriorly
- B) Sacral promontory posteriorly
- C) Iliopectineal line laterally
- D) Coccyx posteriorly
✓ D)
93. The levator ani muscle has 3 parts. All of the following are parts of levator ani EXCEPT:
- A) Pubococcygeus
- B) Puborectalis
- C) Iliococcygeus
- D) Piriformis
✓ D)
94. An obturator hernia passes through the obturator foramen and can compress the obturator nerve. Obturator nerve compression causes pain referred to the:
- A) Buttock
- B) Medial thigh
- C) Lateral thigh
- D) Lower leg
✓ B)
95. On a pelvic X-ray of a male, the subpubic angle is approximately:
- A) Greater than 90°
- B) Less than 90° (approximately 70–75°)
- C) Exactly 90°
- D) Greater than 110°
✓ B)
PELVIC FASCIA, NERVES & ARTERIES (Week 14)
96. The internal iliac artery divides into anterior and posterior divisions. The superior gluteal artery arises from the:
- A) Anterior division
- B) Posterior division
- C) External iliac artery
- D) Common iliac artery
✓ B)
97. The pudendal nerve arises from S2, S3, S4. It exits the pelvis through the greater sciatic foramen and re-enters through the:
- A) Obturator foramen
- B) Lesser sciatic foramen
- C) Ischiorectal fossa directly
- D) Piriformis muscle
✓ B)
98. All of the following are branches of the anterior division of the internal iliac artery EXCEPT:
- A) Superior vesical artery
- B) Obturator artery
- C) Uterine artery
- D) Superior gluteal artery
✓ D)
PELVIC CAVITY (Weeks 15–16)
99. A 32-year-old infertile woman undergoes hysterosalpingography (HSG). Contrast spills freely from the fimbriated ends of both tubes. This finding confirms:
- A) Uterine fibroids
- B) Both tubes are patent
- C) Ovarian cysts
- D) Bicornuate uterus
✓ B)
100. On a pelvic X-ray, all of the following radiographic lines are used to assess the pelvis EXCEPT:
- A) Iliopectineal line
- B) Ilioischial line
- C) Shenton's line
- D) Intercristal line
✓ D) (Intercristal line is a measurement line used for L4 level identification, not a standard pelvic assessment line on pelvic X-ray)
Summary
| Style Used | Count |
|---|---|
| Clinical vignette / scenario | ~40 |
| EXCEPT / NOT type | ~30 |
| Direct concept (short stem) | ~30 |
| Total | 100 |
KMU pattern features used: short but applied stems, tricky distractors that are anatomically close to correct, radiological anatomy integration, clinical correlation, and EXCEPT-type negative questions throughout.
Yahi mcqs dubara likho lakin Sath explanation
RADIOLOGY 3RD SEMESTER — 100 KMU-STYLE MCQs WITH EXPLANATION
THORACIC WALL (Week 1)
1. A 22-year-old student is studying chest X-rays. On a PA view, the anterior ribs appear more horizontal than posterior ribs. Which best explains this?
- A) Anterior ribs are thicker
- B) Anterior ribs run downward and forward at a lesser angle than posterior ribs
- C) Posterior ribs are shorter
- D) Anterior ribs articulate directly with the sternum
✓ B)
Explanation: Posterior ribs run steeply downward and outward, so they appear more oblique on X-ray. Anterior ribs (costal cartilages + bony ribs anteriorly) are more horizontal. This difference helps identify anterior vs posterior ribs on a PA chest X-ray.
2. During a practical session, a student is asked about the sternal angle. All of the following are true EXCEPT:
- A) It marks the level of the 2nd rib
- B) It is the junction of manubrium and body of sternum
- C) It lies at the level of T4–T5 disc
- D) It is the lower limit of the superior mediastinum
✓ D)
Explanation: The sternal angle (angle of Louis) is the UPPER limit (not lower limit) of the inferior mediastinum, and thus marks the LOWER boundary of the superior mediastinum. It lies at T4–T5 level, articulates with the 2nd rib, and is the manubriosternal junction. All other options are correct.
3. A 35-year-old male needs a chest drain. To avoid the neurovascular bundle, the needle is inserted:
- A) At the center of the intercostal space
- B) Just below the upper rib
- C) Just above the lower rib of the selected intercostal space
- D) Through the costal groove
✓ C)
Explanation: The neurovascular bundle (vein, artery, nerve — VAN from top to bottom) runs in the costal groove along the inferior border of each rib. Inserting the needle just above the lower rib avoids this bundle. Inserting near the upper rib risks hitting the vessels.
4. During dissection, a student traces the costal groove. The structures from above downward are:
- A) Nerve, artery, vein
- B) Vein, artery, nerve
- C) Artery, vein, nerve
- D) Vein, nerve, artery
✓ B)
Explanation: The mnemonic is VAN — Vein (most superior), Artery (middle), Nerve (most inferior). All three travel in the costal groove on the inferior border of each rib, protected within it.
5. A patient has a stab wound at the 6th intercostal space. Which muscle is NOT pierced in the intercostal space?
- A) External intercostal
- B) Internal intercostal
- C) Innermost intercostal
- D) Rectus abdominis
✓ D)
Explanation: The three layers of the intercostal space are external intercostal, internal intercostal, and innermost intercostal. The rectus abdominis is an anterior abdominal wall muscle and is NOT present in the intercostal spaces.
6. Ribs 8, 9, 10 attach to the sternum via the costal cartilage of the rib above. They are called:
- A) True ribs
- B) Floating ribs
- C) Vertebrochondral ribs
- D) Vertebrosternal ribs
✓ C)
Explanation: Ribs 8, 9, 10 do not directly attach to the sternum — their costal cartilages join the costal cartilage of the rib above, forming the costal arch. Hence they are called vertebrochondral. True ribs (1–7) attach directly to the sternum. Floating ribs (11–12) have no anterior attachment.
7. Which structure does NOT attach to the manubrium sterni?
- A) Clavicle
- B) 1st costal cartilage
- C) 2nd costal cartilage (partially)
- D) 3rd costal cartilage
✓ D)
Explanation: The manubrium articulates with the clavicles (sternoclavicular joints), the 1st costal cartilages directly, and the upper half of the 2nd costal cartilage (at the sternal angle). The 3rd costal cartilage articulates with the body of the sternum, not the manubrium.
8. On a PA chest X-ray, a student counts 9 posterior ribs above the right hemidiaphragm. This indicates:
- A) Poor inspiration
- B) Good inspiratory effort
- C) Patient rotation
- D) Overexposure
✓ B)
Explanation: On a good quality PA chest X-ray with adequate inspiration, 8–9 posterior ribs (or 5–6 anterior ribs) should be visible above the diaphragm. Fewer than 8 posterior ribs suggests a poor inspiratory effort, which can falsely simulate cardiomegaly or basal shadowing.
9. Which muscle involved in FORCED expiration is NOT a muscle of the thoracic wall?
- A) Internal intercostal
- B) Innermost intercostal
- C) Rectus abdominis
- D) Subcostalis
✓ C)
Explanation: Forced expiration uses the abdominal muscles (rectus abdominis, external/internal oblique, transversus abdominis) to increase intra-abdominal pressure and push the diaphragm up. Rectus abdominis is an anterior abdominal wall muscle, not a thoracic wall muscle.
10. A radiograph shows a cervical rib in a 28-year-old woman with tingling in her arm. A cervical rib articulates with:
- A) T1 vertebra
- B) C6 vertebra
- C) C7 vertebra
- D) Manubrium
✓ C)
Explanation: A cervical rib is an extra rib arising from C7 vertebra. It occurs in about 0.5–1% of the population. It can compress the lower trunk of the brachial plexus (C8, T1) or the subclavian artery, causing thoracic outlet syndrome with arm tingling and weakness.
INTERCOSTAL NERVES, DIAPHRAGM, BLOOD SUPPLY (Week 2)
11. A 55-year-old patient has an elevated left hemidiaphragm on chest X-ray. The most likely nerve affected is:
- A) Left vagus
- B) Left phrenic
- C) Left intercostal T6
- D) Left sympathetic chain
✓ B)
Explanation: The diaphragm's motor supply is exclusively from the phrenic nerve (C3, C4, C5). If the left phrenic nerve is damaged (e.g., by a lung tumor, mediastinal mass, or trauma), the left hemidiaphragm becomes paralyzed and rises. The vagus is sensory/autonomic to abdominal organs, not motor to the diaphragm.
12. Pain from the diaphragm is referred to the shoulder tip. The best explanation is:
- A) The phrenic nerve runs near the shoulder joint
- B) The diaphragm shares the same dermatome (C3, C4, C5) as the shoulder skin
- C) The vagus nerve supplies both structures
- D) The intercostal nerves cross-refer to the shoulder
✓ B)
Explanation: Referred pain occurs when visceral and somatic afferents from the same spinal level converge. The phrenic nerve (C3, C4, C5) carries sensory fibers from the diaphragm, and the skin over the shoulder tip (C4 dermatome) shares the same spinal level. So diaphragmatic irritation (e.g., blood under the diaphragm) is perceived as shoulder tip pain.
13. All of the following pass through the caval opening (T8) EXCEPT:
- A) Right phrenic nerve branches
- B) Left phrenic nerve
- C) IVC
- D) Lymphatics from liver
✓ B)
Explanation: The caval opening at T8 transmits the IVC, terminal branches of the right phrenic nerve, and lymphatics. The left phrenic nerve pierces the muscular part of the diaphragm itself (left side) separately — it does NOT pass through the caval opening. The right phrenic nerve passes through or near the caval opening.
14. A 30-year-old has a hiatal hernia. The esophageal hiatus also transmits:
- A) Thoracic duct
- B) Azygos vein
- C) Both vagus nerves
- D) Left phrenic nerve
✓ C)
Explanation: The esophageal hiatus at T10 transmits: (1) esophagus, (2) left and right vagus nerves (as anterior and posterior vagal trunks), and (3) esophageal branches of the left gastric vessels. The aortic hiatus (T12) carries the aorta, thoracic duct, and azygos vein.
15. The aortic hiatus at T12 transmits all of the following EXCEPT:
- A) Descending aorta
- B) Thoracic duct
- C) Azygos vein
- D) Left phrenic nerve
✓ D)
Explanation: The aortic hiatus carries the descending thoracic aorta, thoracic duct, and azygos vein. It is posterior to the diaphragm (between the two crura), so technically nothing "pierces" the diaphragm here. The left phrenic nerve pierces the muscular left dome of the diaphragm separately.
16. Endothoracic fascia separates which two structures?
- A) External and internal intercostal muscles
- B) Innermost intercostal muscles and parietal pleura
- C) Visceral and parietal pleura
- D) Lung parenchyma and visceral pleura
✓ B)
Explanation: The endothoracic fascia is a thin layer of connective tissue that lines the inner surface of the thoracic cage, lying between the innermost layer of muscles (innermost intercostals, subcostalis, transversus thoracis) and the parietal pleura. It is part of the deep fascia of the thoracic wall.
17. Posterior intercostal arteries 3rd–11th arise from the:
- A) Internal thoracic artery
- B) Thoracoacromial trunk
- C) Descending thoracic aorta
- D) Subclavian artery
✓ C)
Explanation: The 3rd–11th posterior intercostal arteries are direct branches of the descending thoracic aorta. The 1st and 2nd posterior intercostal arteries arise from the superior intercostal artery (a branch of the costocervical trunk of the subclavian artery). The internal thoracic artery gives anterior intercostal branches.
18. A congenital left-sided diaphragmatic hernia (Bochdalek hernia) occurs through which defect?
- A) Esophageal hiatus
- B) Aortic hiatus
- C) Posterolateral pleuroperitoneal canal (failure of closure)
- D) Caval foramen
✓ C)
Explanation: Bochdalek hernia is caused by failure of the left pleuroperitoneal canal to close during fetal development. It is the most common congenital diaphragmatic hernia (90% left-sided). Abdominal organs herniate into the thorax, compressing the developing lung and causing pulmonary hypoplasia.
19. The suprapleural membrane (Sibson's fascia) prevents:
- A) Lung collapse during expiration
- B) The lung apex from herniating into the neck during forced inspiration
- C) Adhesion of visceral to parietal pleura
- D) Blood supply to the lung apex
✓ B)
Explanation: The suprapleural membrane is a thickening of the endothoracic fascia that covers the apex of each lung like a dome. It attaches to the inner border of the 1st rib and prevents the lung apex from bulging upward into the neck during forceful inspiration.
20. Which intercostal nerve has a large branch that joins the brachial plexus?
- A) T1
- B) T2
- C) T3
- D) T6
✓ A)
Explanation: The 1st intercostal nerve (T1 anterior ramus) is unique — most of its fibers join the brachial plexus (contributing to the lower trunk, C8-T1), and only a small branch continues as the intercostal nerve. T2 contributes the intercostobrachial nerve which supplies medial arm skin, but T1 is the one with a large contribution to the brachial plexus.
THORACIC CAVITY — MEDIASTINUM, PLEURA, LUNGS (Week 3)
21. On a chest X-ray, the right heart border is obliterated. According to the silhouette sign, the lesion is in the:
- A) Right lower lobe
- B) Right upper lobe
- C) Right middle lobe
- D) Left lower lobe
✓ C)
Explanation: The silhouette sign: when two structures of the same radiodensity are in contact, their borders merge (are obliterated). The right heart border (right atrium) is in contact with the medial segment of the right middle lobe. Consolidation or collapse of the right middle lobe obliterates the right heart border.
22. A foreign body settles in a dependent area in a standing adult. The most likely segment is:
- A) Apical segment of right upper lobe
- B) Posterior basal segment of right lower lobe
- C) Anterior segment of left upper lobe
- D) Medial segment of right middle lobe
✓ B)
Explanation: In a standing patient, the most dependent segment of the lung is the posterior basal segment of the lower lobes. The right lower lobe is more commonly affected because the right main bronchus is wider, shorter, and more vertical. Foreign bodies fall by gravity to the most dependent part.
23. The costodiaphragmatic recess is formed between which two pleural layers?
- A) Mediastinal and diaphragmatic pleura
- B) Costal and diaphragmatic pleura
- C) Visceral and parietal pleura
- D) Costal and mediastinal pleura
✓ B)
Explanation: The costodiaphragmatic recess (sinus) is the lowest part of the pleural cavity, formed at the angle where the costal pleura reflects onto the diaphragmatic pleura. It can hold 200–300 mL of fluid before it becomes visible as blunting of the costophrenic angle on a PA chest X-ray.
24. A lung specimen has only 2 lobes. Which fissure is absent compared to the right lung?
- A) Oblique fissure
- B) Horizontal (transverse) fissure
- C) Accessory fissure
- D) Both oblique and horizontal
✓ B)
Explanation: The left lung has only 2 lobes (upper and lower) separated by the oblique fissure. It lacks the horizontal fissure (which separates the upper and middle lobes of the right lung). So the left lung has no middle lobe — it has a lingula (part of the upper lobe) instead.
25. The carina at the bifurcation of the trachea lies at the level of:
- A) T2
- B) T4
- C) T6
- D) T8
✓ B)
Explanation: The trachea bifurcates at the carina at the level of the sternal angle (T4–T5 disc level). This is a key anatomical landmark. On a chest X-ray, widening of the carina angle (>70°) may suggest left atrial enlargement pushing it upward.
26. A 5-year-old swallowed a coin lodging in the right main bronchus. The right main bronchus is more commonly affected because of all features EXCEPT:
- A) It is wider
- B) It is shorter
- C) It is more vertical
- D) It is longer
✓ D)
Explanation: The right main bronchus is wider, shorter, and more vertical than the left — these three features make it a "straight shot" continuation of the trachea. It is NOT longer; in fact, it is shorter (approximately 2.5 cm vs 5 cm on the left). Hence foreign bodies preferentially enter the right main bronchus.
27. All of the following are found in the superior mediastinum EXCEPT:
- A) Arch of aorta
- B) Thymus
- C) Trachea
- D) Heart
✓ D)
Explanation: The heart lies in the middle inferior mediastinum. The superior mediastinum (above the sternal angle plane) contains: trachea, esophagus, arch of aorta and its branches, brachiocephalic veins, SVC (upper part), thymus, thoracic duct, phrenic/vagus/left recurrent laryngeal nerves.
28. A bronchopulmonary segment can be resected surgically without affecting adjacent segments because:
- A) Segments share arterial supply with each other
- B) Each segment has its own segmental bronchus, artery, and is separated by connective tissue septa
- C) Segments have no venous drainage
- D) Each segment has two segmental bronchi
✓ B)
Explanation: Each bronchopulmonary segment is a functionally and anatomically independent unit supplied by a tertiary (segmental) bronchus and its accompanying segmental pulmonary artery. Intersegmental veins run in the connective tissue septa between segments, allowing surgical resection of one segment without damaging others.
29. During a radiology practical, the hilar shadow on PA chest X-ray is mainly formed by:
- A) Main bronchi
- B) Pulmonary arteries and veins
- C) Lymph nodes only
- D) Trachea
✓ B)
Explanation: The hilar shadow (hilum) on a chest X-ray is predominantly formed by the pulmonary arteries and pulmonary veins. Bronchi are air-filled and thus radiolucent. The left hilum is normally 0.5–1.5 cm higher than the right. Enlarged lymph nodes or masses can cause hilar enlargement.
30. The posterior mediastinum contains all of the following EXCEPT:
- A) Descending thoracic aorta
- B) Thoracic duct
- C) Esophagus
- D) Ascending aorta
✓ D)
Explanation: The ascending aorta lies in the middle mediastinum (within the pericardial sac). The posterior mediastinum contains: descending thoracic aorta, esophagus, thoracic duct, azygos and hemiazygos veins, sympathetic trunks, and thoracic splanchnic nerves.
PERICARDIUM, HEART & THYMUS (Week 4)
31. A 45-year-old has Beck's triad (muffled heart sounds, raised JVP, hypotension). Echo confirms pericardial effusion. Fluid is between:
- A) Pleural cavity layers
- B) Fibrous pericardium and serous pericardium
- C) Visceral and parietal layers of serous pericardium
- D) Mediastinal space
✓ C)
Explanation: The pericardial cavity is the potential space between the visceral layer (epicardium, covering the heart) and the parietal layer of serous pericardium. Fluid accumulates here. The fibrous pericardium is the tough outer layer. As little as 250 mL of rapidly accumulated fluid can cause tamponade.
32. During cardiac surgery, a clamp through the transverse sinus compresses:
- A) Pulmonary veins and IVC
- B) Ascending aorta and pulmonary trunk
- C) Superior and inferior vena cava
- D) Coronary arteries directly
✓ B)
Explanation: The transverse sinus of the pericardium lies posterior to the ascending aorta and pulmonary trunk, and anterior to the superior vena cava and pulmonary veins. A surgeon passing a finger or clamp through the transverse sinus can compress (clamp) the ascending aorta and pulmonary trunk to stop blood flow during cardiac surgery.
33. On PA chest X-ray, the right heart border is formed by:
- A) Right ventricle
- B) Right atrium and SVC (upper portion)
- C) Right ventricle and SVC
- D) Left atrium
✓ B)
Explanation: The right heart border on PA X-ray is formed by: SVC (upper part) and right atrium (lower part). The right ventricle forms the anterior surface of the heart but is NOT visible on the right border of a PA film. The left atrium forms the upper left border.
34. The left border of the cardiac silhouette from above downward — all are correct EXCEPT:
- A) Aortic knuckle
- B) Pulmonary trunk
- C) Left atrial appendage
- D) Right atrium
✓ D)
Explanation: From above downward, the left border is formed by: (1) aortic knuckle (arch of aorta), (2) pulmonary trunk, (3) left atrial appendage, (4) left ventricle. The right atrium forms the RIGHT heart border, not the left. This is a classic KMU-style trap question.
35. A PA chest X-ray shows heart diameter = 16 cm, thoracic diameter = 28 cm. The CTR is:
- A) 0.57 — normal
- B) 0.57 — cardiomegaly
- C) 0.44 — normal
- D) 0.44 — cardiomegaly
✓ B)
Explanation: CTR = heart width / thoracic width = 16/28 = 0.57. Normal CTR is less than 0.5 on a PA chest X-ray. A CTR of 0.57 indicates cardiomegaly. Note: AP films always overestimate heart size, so CTR should only be measured on PA films.
36. A 65-year-old has anterior wall MI. Most likely occluded artery is:
- A) Right coronary artery
- B) Left circumflex artery
- C) Left anterior descending artery (LAD)
- D) Posterior descending artery
✓ C)
Explanation: The LAD (left anterior descending artery) supplies the anterior wall of the left ventricle, anterior interventricular septum, and apex. It is called the "widow maker" because its occlusion causes the most devastating anterior MI. The RCA supplies the right ventricle and inferior wall. Circumflex supplies the lateral wall.
37. The SA nodal artery in most people (60%) arises from:
- A) Left circumflex artery
- B) Left anterior descending
- C) Right coronary artery
- D) Left main coronary artery
✓ C)
Explanation: In approximately 60% of people, the SA nodal artery arises from the right coronary artery (RCA). In the remaining 40%, it comes from the left circumflex. The AV nodal artery also usually arises from the RCA (~80%). This explains why RCA occlusion can cause bradyarrhythmias.
38. A PA chest X-ray of a 2-year-old shows a wide "sail-shaped" anterior mediastinal shadow. Most likely structure is:
- A) Enlarged lymph node
- B) Thyroid goiter
- C) Normal thymus
- D) Anterior mediastinal tumor
✓ C)
Explanation: In infants and young children, the thymus is a large, prominent organ in the anterior mediastinum and can appear as a wide "sail sign" or "wave sign" on chest X-ray. It is a normal finding and should not be mistaken for a pathological mass. The thymus gradually involutes after puberty.
39. The oblique sinus of the pericardium is a blind recess posterior to:
- A) Aorta and pulmonary trunk
- B) Left atrium, enclosed between the pulmonary veins
- C) Right ventricle
- D) Right atrium
✓ B)
Explanation: The oblique sinus is a cul-de-sac (blind recess) posterior to the heart, bounded by the left atrium anteriorly and the pericardium posteriorly, enclosed between the four pulmonary veins and the IVC. A surgeon's hand can slide into it from below. It is significant as fluid can collect here.
40. All of the following are features of the fibrous pericardium EXCEPT:
- A) Attached to the central tendon of diaphragm
- B) Fused with the adventitia of the great vessels
- C) Secretes pericardial fluid
- D) Attached to sternum by sternopericardial ligaments
✓ C)
Explanation: Pericardial fluid (about 15–50 mL) is secreted by the serous pericardium (mesothelial cells of the visceral serous layer / epicardium), NOT the fibrous pericardium. The fibrous pericardium is a tough, inelastic layer that anchors the heart in position via its attachments.
THORACIC ARTERIES, VEINS & RADIOGRAPHIC ANATOMY (Week 5)
41. A 50-year-old hypertensive patient has aortic dissection. The first branch of the arch that may be compromised is:
- A) Left common carotid
- B) Left subclavian
- C) Brachiocephalic trunk
- D) Right common carotid directly
✓ C)
Explanation: The branches of the arch of the aorta from right to left are: (1) brachiocephalic trunk, (2) left common carotid, (3) left subclavian. In dissection, the first branch encountered is the brachiocephalic trunk, which divides into the right common carotid and right subclavian arteries.
42. On a PA chest X-ray, the aortic knuckle represents:
- A) Ascending aorta
- B) Left lateral margin of the arch of the aorta
- C) Descending aorta at T4
- D) Brachiocephalic trunk
✓ B)
Explanation: The aortic knuckle (aortic knob) is the rounded shadow on the left upper mediastinum formed by the left lateral margin of the aortic arch. It becomes more prominent with age (aortic unfolding). It is NOT the ascending aorta (which lies in the midline/right mediastinum) or the descending aorta.
43. A chest X-ray is taken AP instead of PA. The expected change is:
- A) Heart appears smaller
- B) Heart appears magnified
- C) Ribs appear more horizontal
- D) Lung fields appear blacker
✓ B)
Explanation: In an AP film, the heart is farther from the detector (X-ray plate) and closer to the X-ray tube. Due to divergence of the X-ray beam, the heart is magnified. This is why AP films overestimate heart size and CTR cannot be reliably measured on AP films. PA is the standard for cardiac measurement.
44. On a good quality PA chest X-ray, thoracic vertebrae should be:
- A) Completely invisible
- B) Faintly visible through the cardiac shadow
- C) Clearly bright white
- D) Only visible on lateral view
✓ B)
Explanation: On a correctly exposed PA chest X-ray, the thoracic vertebrae should be just faintly visible (barely discernible) through the cardiac shadow. If they are too dark (over-penetrated), soft tissue detail is lost. If invisible (under-penetrated), the film is too white/underpenetrated. Faint vertebral visibility confirms optimal exposure.
45. The thoracic duct begins at the cisterna chyli at the level of:
- A) T8
- B) T10
- C) T12
- D) L1–L2
✓ D)
Explanation: The cisterna chyli is a dilated lymph sac at the origin of the thoracic duct, located at the level of L1–L2, just to the right of the aorta. The thoracic duct then ascends through the aortic hiatus at T12 and drains into the left subclavian-jugular venous junction. It drains lymph from all of the body EXCEPT the right upper quadrant.
46. A "bat-wing" opacity centered on the hilum on a chest X-ray is most associated with:
- A) Pneumothorax
- B) Pulmonary edema
- C) Pleural effusion
- D) Single lobe consolidation
✓ B)
Explanation: The "bat-wing" or "butterfly" pattern on chest X-ray describes bilateral perihilar opacities that spare the periphery, classically seen in pulmonary edema (both cardiogenic and non-cardiogenic). Fluid leaks from the capillaries into the perihilar alveoli first due to the lower hydrostatic pressure gradient at the periphery.
47. The left coronary ostium arises from:
- A) Left sinus of Valsalva of the aorta
- B) Right sinus of Valsalva of the aorta
- C) Pulmonary trunk
- D) Aortic arch
✓ A)
Explanation: The aortic root has three sinuses of Valsalva: right, left, and posterior (non-coronary). The left coronary artery arises from the left sinus of Valsalva, and the right coronary artery arises from the right sinus of Valsalva. The posterior sinus has no coronary artery. This is the basis of coronary angiography cannulation.
48. A horizontal line with air above and fluid below in the pleural space on chest X-ray is called:
- A) Kerley B line
- B) Hydropneumothorax with air-fluid level
- C) Silhouette sign
- D) Air bronchogram
✓ B)
Explanation: An air-fluid level in the pleural cavity indicates both air (pneumothorax) and fluid (hemothorax, effusion, pus) — called hydropneumothorax. The air rises to the top and fluid settles below, creating a sharp horizontal line. Kerley B lines are short horizontal lines at the bases due to fluid in interlobular septa (lymphedema).
ABDOMINAL WALL (Week 6)
49. The correct order of layers from superficial to deep in the anterolateral abdominal wall is:
- A) Skin → Camper's → Scarpa's → External oblique → Internal oblique → Transversus → Transversalis fascia → Extraperitoneal fat → Peritoneum
- B) Skin → Scarpa's → Camper's → External oblique → Internal oblique → Transversus → Peritoneum
- C) Skin → External oblique → Internal oblique → Transversalis fascia → Transversus → Peritoneum
- D) Skin → Camper's → Internal oblique → External oblique → Transversus → Peritoneum
✓ A)
Explanation: The 9 layers in correct order: Skin → Camper's fascia (fatty layer) → Scarpa's fascia (membranous layer) → External oblique → Internal oblique → Transversus abdominis → Transversalis fascia → Extraperitoneal fat → Parietal peritoneum. Camper's is superficial to Scarpa's — remember C (Camper) comes before S (Scarpa) alphabetically.
50. Below the arcuate line, the aponeuroses of all three flat muscles pass in front of the rectus because:
- A) There is more room anteriorly
- B) The posterior layer is absent below this line, as all aponeuroses shift anteriorly
- C) The rectus muscle disappears below the arcuate line
- D) The transversalis fascia is absent below the arcuate line
✓ B)
Explanation: Above the arcuate line, the posterior wall of the rectus sheath is formed by the posterior lamina of internal oblique + transversus abdominis. Below the arcuate line, all three aponeuroses (EO, IO, TA) pass anterior to the rectus, leaving only transversalis fascia and peritoneum behind — making this area potentially weaker.
51. All of the following contribute to the linea alba EXCEPT:
- A) External oblique aponeurosis
- B) Internal oblique aponeurosis
- C) Transversus abdominis aponeurosis
- D) Rectus abdominis
✓ D)
Explanation: The linea alba is a fibrous band running from the xiphoid to the pubic symphysis, formed by the interlacing aponeuroses of all three flat muscles: external oblique, internal oblique, and transversus abdominis. The rectus abdominis is a vertical strap muscle enclosed within the rectus sheath — it does not contribute to the linea alba.
52. All of the following structures lie at the transpyloric plane (L1) EXCEPT:
- A) Pylorus of stomach
- B) Neck of pancreas
- C) Fundus of gallbladder
- D) Origin of superior mesenteric artery
✓ C)
Explanation: The transpyloric plane (halfway between xiphoid and umbilicus, L1 level) passes through: pylorus of stomach, neck of pancreas, duodenojejunal flexure (left), hila of kidneys, origin of SMA, and hilum of spleen. The fundus of the gallbladder is slightly lower, usually at the tip of the 9th costal cartilage — NOT at L1.
53. The primary action of transversus abdominis is:
- A) Flexion of trunk
- B) Lateral flexion
- C) Compression of abdominal contents
- D) Extension of spine
✓ C)
Explanation: Transversus abdominis is the deepest flat muscle. Its fibers run transversely, so it cannot flex or extend the trunk. Its main action is to compress the abdominal contents (important for increasing intra-abdominal pressure during Valsalva, defecation, micturition, and parturition). It also plays a key role in core stability.
54. The central region of the abdomen in the 9-region system is:
- A) Umbilical region
- B) Epigastric region
- C) Hypogastric region
- D) Right lumbar region
✓ A)
Explanation: The 9 regions are created by 2 vertical (midclavicular) lines and 2 horizontal (subcostal + intertubercular) lines. The central region surrounded by all 4 planes is the umbilical region. The epigastric is above it, and the hypogastric (pubic) is below it.
55. Parietal peritoneum differs from visceral peritoneum in that it is:
- A) Insensitive to pain
- B) Sensitive to well-localized pain via somatic spinal nerves
- C) Sensitive only to stretch
- D) Supplied by autonomic nerves only
✓ B)
Explanation: Parietal peritoneum is supplied by somatic spinal nerves (intercostal and lumbar nerves), so it is sensitive to well-localized, sharp pain. Visceral peritoneum is supplied by autonomic nerves and is sensitive only to stretch and ischemia, producing poorly localized, dull, cramping pain. This distinction is clinically important in peritonitis.
INGUINAL CANAL & ABDOMINAL ARTERIES (Week 7)
56. A 55-year-old male has a medial groin swelling appearing through Hesselbach's triangle. This is:
- A) Indirect inguinal hernia
- B) Femoral hernia
- C) Direct inguinal hernia
- D) Obturator hernia
✓ C)
Explanation: A direct inguinal hernia protrudes through the posterior wall of the inguinal canal within Hesselbach's triangle (medial to the inferior epigastric artery). It does NOT pass through the deep inguinal ring. It is more common in older males due to weakening of the posterior wall. An indirect hernia passes through the deep ring (lateral to the inferior epigastric artery).
57. The superficial inguinal ring is an opening in:
- A) Transversalis fascia
- B) Internal oblique muscle
- C) External oblique aponeurosis
- D) Peritoneum
✓ C)
Explanation: The superficial inguinal ring is a triangular gap in the external oblique aponeurosis, located just above and lateral to the pubic tubercle. The deep inguinal ring is an opening in the transversalis fascia, located 1.5 cm above the midpoint of the inguinal ligament, lateral to the inferior epigastric vessels.
58. Hernias medial to the inferior epigastric artery are classified as:
- A) Indirect
- B) Femoral
- C) Direct
- D) Obturator
✓ C)
Explanation: The inferior epigastric artery is the key landmark: hernias lateral to it are indirect (passing through the deep inguinal ring), hernias medial to it are direct (passing through Hesselbach's triangle). This distinction is easily seen during laparoscopy and helps surgeons plan mesh placement.
59. Which of the following is NOT a content of the inguinal canal in males?
- A) Ilioinguinal nerve
- B) Vas deferens
- C) Femoral nerve
- D) Genital branch of genitofemoral nerve
✓ C)
Explanation: The femoral nerve does NOT pass through the inguinal canal. It exits under the inguinal ligament lateral to the femoral artery to enter the femoral triangle. Contents of the male inguinal canal include: spermatic cord (vas deferens, testicular artery, pampiniform plexus, cremasteric artery, genital branch of genitofemoral nerve) + ilioinguinal nerve.
60. The quadratus lumborum stabilizes the 12th rib during:
- A) Swallowing
- B) Forced expiration and diaphragm contraction
- C) Hip extension
- D) Trunk rotation
✓ B)
Explanation: Quadratus lumborum fixes the 12th rib to give the diaphragm a stable inferior attachment point during forced expiration and inspiration. It also performs lateral flexion of the vertebral column. It is an important posterior abdominal wall muscle arising from the iliolumbar ligament and inserting into the 12th rib and L1–L4 transverse processes.
61. An AP supine abdominal X-ray is taken with the patient:
- A) Prone, beam from below
- B) Supine, X-ray beam directed from above (AP)
- C) Standing, beam lateral
- D) Sitting, beam oblique
✓ B)
Explanation: A standard AP supine abdominal X-ray has the patient lying on their back (supine) with the X-ray beam entering anteriorly (from the front/above) and the detector behind the patient. It is used to assess bowel gas pattern, calcifications, and soft tissue masses. An erect AP is also done to look for air-fluid levels and free gas under the diaphragm.
PERITONEUM, GI TRACT (Week 8)
62. All of the following organs are intraperitoneal EXCEPT:
- A) Stomach
- B) Jejunum
- C) Transverse colon
- D) 2nd, 3rd, 4th parts of duodenum
✓ D)
Explanation: The 1st part of the duodenum (duodenal cap/bulb) is intraperitoneal, but the 2nd, 3rd, and 4th parts are retroperitoneal. Stomach, jejunum, ileum, transverse colon, sigmoid colon, and cecum (with appendix) are intraperitoneal. Remember the mnemonic: Sadp uckers — Suprarenal, Aorta/IVC, Duodenum (2–4), Pancreas, Ureters, Colon (ascending & descending), Kidneys, Rectum.
63. On a barium meal, the "C-shaped loop" of barium. The structure in the concavity is:
- A) Liver
- B) Gallbladder
- C) Head of pancreas
- D) Right kidney
✓ C)
Explanation: The C-loop of the duodenum (1st to 4th parts curving around) cradles the head of the pancreas in its concavity. This is a classic radiological sign. On a barium meal/follow-through, widening of the duodenal C-loop suggests an enlarged pancreatic head (e.g., carcinoma of head of pancreas).
64. The lesser sac (omental bursa) is accessed through:
- A) Right paracolic gutter
- B) The epiploic foramen (foramen of Winslow)
- C) The greater omentum directly
- D) The falciform ligament
✓ B)
Explanation: The lesser sac is a compartment of the peritoneal cavity posterior to the stomach and lesser omentum. It communicates with the greater sac through the epiploic foramen (foramen of Winslow), which is bounded by the hepatoduodenal ligament anteriorly (containing the portal triad) and the IVC posteriorly. Surgeons use this opening to clamp the hepatic pedicle (Pringle maneuver).
65. Blood supply to the lesser curvature of stomach is most directly from:
- A) Left and right gastroepiploic arteries
- B) Left and right gastric arteries
- C) Short gastric arteries and left gastric
- D) Gastroduodenal and splenic arteries
✓ B)
Explanation: The lesser curvature is supplied by the left gastric artery (from the celiac trunk) and the right gastric artery (from the proper hepatic artery), forming an anastomotic arcade. The greater curvature is supplied by the left and right gastroepiploic arteries. The fundus and upper greater curvature receive short gastric arteries from the splenic artery.
66. The gastroesophageal junction lies at:
- A) T8
- B) T10
- C) T12
- D) L1
✓ B)
Explanation: The gastroesophageal (GE) junction lies at T10, the same level as the esophageal hiatus of the diaphragm. The lower esophageal sphincter is at this level. T8 = IVC opening, T10 = esophagus, T12 = aorta. Mnemonic: I 8 (ate) 10 eggs at 12 (IVC at T8, Esophagus at T10, Aorta at T12).
67. A barium swallow shows esophageal irregularity at T4 level. The most anatomically relevant adjacent structure here is:
- A) Right main bronchus
- B) Arch of aorta
- C) Diaphragm
- D) Liver
✓ B)
Explanation: The esophagus has three normal constrictions: (1) at the cricopharyngeus/pharyngoesophageal junction (C6), (2) where it is crossed by the aortic arch at T4 and left main bronchus at T5, and (3) at the esophageal hiatus (T10). An aortic aneurysm or lymph node at T4 will indent/compress the esophagus here — visible on barium swallow.
68. The hepatoduodenal ligament contains all of the following EXCEPT:
- A) Portal vein (posterior)
- B) Hepatic artery proper (left/anterior)
- C) Common bile duct (right)
- D) Inferior vena cava
✓ D)
Explanation: The hepatoduodenal ligament (free right edge of the lesser omentum) contains the portal triad: portal vein (posterior), hepatic artery proper (left), and common bile duct (right/anterior). Remember: P-HAD — Portal vein, Hepatic Artery, Duct (bile). The IVC lies behind the hepatoduodenal ligament, posterior to the epiploic foramen, but NOT inside the ligament.
LARGE INTESTINE, LIVER, BILIARY TREE (Week 9)
69. All of the following are features of the large intestine EXCEPT:
- A) Taenia coli
- B) Haustra
- C) Appendices epiploicae
- D) Plicae circulares
✓ D)
Explanation: Plicae circulares (valvulae conniventes) are circular folds of mucosa and submucosa found in the small intestine (particularly jejunum), not the large intestine. The three hallmarks of the large intestine on imaging and dissection are: taenia coli (three bands of longitudinal muscle), haustra (sacculations), and appendices epiploicae (fatty appendages).
70. The portal vein is formed behind the neck of the pancreas by:
- A) SMV and IMV
- B) SMV and splenic vein
- C) Splenic vein and left renal vein
- D) IMV and splenic vein only
✓ B)
Explanation: The portal vein is formed by the union of the superior mesenteric vein (SMV) and splenic vein behind the neck of the pancreas, at the level of L2. The inferior mesenteric vein typically drains into the splenic vein (or SMV) before the formation of the portal vein — it does NOT directly form the portal vein.
71. A stone at the ampulla of Vater causes both jaundice and pancreatitis because it blocks:
- A) Right and left hepatic ducts
- B) Common bile duct AND main pancreatic duct
- C) Common hepatic duct and cystic duct
- D) Accessory pancreatic duct only
✓ B)
Explanation: The ampulla of Vater (major duodenal papilla) is where both the common bile duct and the main pancreatic duct (duct of Wirsung) open into the 2nd part of the duodenum. A gallstone impacted here blocks bile drainage (→ obstructive jaundice, dark urine, pale stool) AND pancreatic secretion drainage (→ acute pancreatitis).
72. The normal diameter of the common bile duct on ultrasound is less than:
- A) 4 mm
- B) 6 mm
- C) 10 mm
- D) 15 mm
✓ B)
Explanation: Normal CBD diameter is less than 6 mm on ultrasound (some sources allow up to 8 mm in post-cholecystectomy patients or elderly). A CBD wider than 6 mm suggests biliary obstruction. The finding of a dilated CBD prompts further investigation (MRCP, ERCP) to identify the cause (stone, stricture, carcinoma).
73. Riedel's lobe is an anatomical variant of:
- A) Left lobe
- B) Caudate lobe
- C) Right lobe of liver (tongue-like inferior projection)
- D) Quadrate lobe
✓ C)
Explanation: Riedel's lobe is a common normal variant — a tongue-like downward projection of the right lobe of the liver that can extend to the iliac fossa. It occurs more commonly in women. On clinical examination, it can be mistaken for a right-sided abdominal mass. On ultrasound, it shows normal hepatic echotexture.
74. On plain abdominal X-ray, plicae circulares are NOT a feature of the large bowel because:
- A) Large bowel has haustra instead
- B) Plicae circulares are a small intestinal feature (cross full width)
- C) Large bowel is retroperitoneal
- D) Large bowel does not appear on plain X-ray
✓ B)
Explanation: Plicae circulares (valvulae conniventes) are permanent, complete circular folds that cross the full width of the small intestine lumen, seen especially in the jejunum on X-ray. The large bowel has haustra, which are incomplete (do not cross the full lumen width) and are due to the taenia coli being shorter than the bowel. This distinction is key for identifying bowel obstruction sites on plain films.
PANCREAS, SPLEEN, KIDNEYS, URETER (Week 10)
75. A CT scan shows a swollen retroperitoneal organ at L1–L2 with raised serum amylase. This organ is:
- A) Liver
- B) Spleen
- C) Pancreas
- D) Right kidney
✓ C)
Explanation: The pancreas is a retroperitoneal organ located transversely at the L1–L2 level. It is the source of amylase and lipase. Acute pancreatitis presents with severe epigastric pain radiating to the back (because the pancreas is retroperitoneal), raised serum amylase/lipase, and is seen as a swollen pancreas on CT with peripancreatic fat stranding.
76. The tail of the pancreas differs from all other parts because it is:
- A) Retroperitoneal
- B) Intraperitoneal (within the lienorenal ligament)
- C) Located in the right hypochondrium
- D) Related to the duodenum
✓ B)
Explanation: The pancreas is almost entirely retroperitoneal EXCEPT the tail, which is intraperitoneal as it passes into the lienorenal (splenorenal) ligament to reach the hilum of the spleen. This is why the tail is the most mobile part and the only part visible within the peritoneal cavity. It is located in the left hypochondrium, not the right.
77. The right kidney lies slightly lower than the left because of:
- A) Ascending colon
- B) Liver
- C) Right suprarenal gland
- D) Duodenum
✓ B)
Explanation: The right kidney is displaced inferiorly by the large right lobe of the liver lying above it. Normally, the right kidney lies opposite T12–L3 and the left kidney lies opposite T11–L2 (the left is slightly higher). On an IVU or plain abdominal X-ray, the right kidney appears approximately half a vertebral body lower than the left.
78. All of the following are correct about the kidney EXCEPT:
- A) The right kidney is slightly lower
- B) The hilum lies at L1
- C) The left renal vein is longer than the right
- D) The right renal vein is longer than the left
✓ D)
Explanation: The LEFT renal vein is longer than the right because it has to cross the midline anterior to the aorta to reach the IVC. The right renal vein is SHORT because the IVC lies on the right side close to the right kidney. This has surgical importance — the left kidney is preferred for living donor nephrectomy because the longer left renal vein makes anastomosis easier.
79. An IVU at 30 minutes should show contrast in:
- A) Bladder only
- B) Ureters and bladder
- C) Renal cortex only
- D) Renal medulla only
✓ B)
Explanation: In a standard IVU (intravenous urogram): 1-minute film shows nephrogram (renal cortex opacification), 5-minute film shows pyelogram (collecting system), 15–20 minute film shows ureters, and 30-minute film shows bladder filling and ureter filling. Any delay in contrast reaching the ureter/bladder suggests obstruction (stone, stricture, tumor).
80. The spleen is related posterolaterally to which ribs?
- A) 6th–8th
- B) 9th–11th
- C) 10th–12th
- D) 7th–9th
✓ B)
Explanation: The spleen lies in the left hypochondrium, deep to ribs 9, 10, and 11. Its long axis follows the 10th rib. This is clinically important — left lower rib fractures (9th–11th) should always raise suspicion for splenic injury. The spleen is the most commonly injured solid organ in blunt abdominal trauma.
SUPRARENAL GLANDS & GIT BLOOD SUPPLY (Week 11)
81. The celiac trunk arises from the aorta at the level of:
- A) T12
- B) L1
- C) L2
- D) L3
✓ A)
Explanation: The celiac trunk arises from the anterior surface of the abdominal aorta at T12/L1 junction (some sources say L1, but classical anatomy teaches T12 level, just below the aortic hiatus). It immediately divides into the left gastric, splenic, and common hepatic arteries. It is the artery of the foregut.
82. A patient has SMA occlusion. The gut most likely infarcted extends from:
- A) Esophagus to stomach
- B) Distal duodenum to mid-transverse colon (midgut)
- C) Distal transverse colon to rectum
- D) Entire large intestine
✓ B)
Explanation: The superior mesenteric artery (SMA) supplies the midgut — from the 2nd part of the duodenum (at the point where the common bile duct enters) to the left colic flexure (2/3 of the transverse colon). SMA occlusion causes massive small bowel and proximal large bowel ischemia, which is a surgical emergency with very high mortality.
83. The left suprarenal vein drains into:
- A) Inferior vena cava
- B) Left renal vein
- C) Portal vein
- D) Left subclavian vein
✓ B)
Explanation: The left suprarenal (adrenal) vein drains into the left renal vein. The right suprarenal vein drains directly into the IVC (because the IVC is on the right side). This asymmetry is important in adrenal vein sampling for primary hyperaldosteronism, where the right adrenal vein is more difficult to cannulate.
84. All of the following arteries supply the rectum EXCEPT:
- A) Superior rectal (from IMA)
- B) Middle rectal (from internal iliac)
- C) Inferior rectal (from pudendal)
- D) Inferior mesenteric artery directly to anal canal
✓ D)
Explanation: The IMA's terminal branch is the superior rectal artery, which supplies the rectum above the pelvic floor. The middle rectal arteries (internal iliac) and inferior rectal arteries (from internal pudendal) supply the lower rectum and anal canal. The IMA itself does NOT directly supply the anal canal — this is the trick in the question. The terminal branch (superior rectal) does.
85. All of the following are zones of the suprarenal cortex EXCEPT:
- A) Zona glomerulosa
- B) Zona fasciculata
- C) Zona reticularis
- D) Zona chromaffin
✓ D)
Explanation: The suprarenal cortex has three zones (from outside in): GFR — Zona Glomerulosa (mineralocorticoids/aldosterone), Zona Fasciculata (glucocorticoids/cortisol), Zona Reticularis (sex hormones/androgens). The medulla (not cortex) contains chromaffin cells that secrete catecholamines (epinephrine, norepinephrine). "Zona chromaffin" does not exist.
POSTERIOR WALL VEINS & LUMBAR PLEXUS (Week 12)
86. On a plain abdominal X-ray, loss of the right psoas shadow is noted. The most likely cause is:
- A) Normal variant
- B) Retroperitoneal hematoma or abscess
- C) Small bowel obstruction
- D) Free intraperitoneal air
✓ B)
Explanation: The psoas shadow is a triangular fat shadow on either side of the lumbar vertebrae on a plain abdominal X-ray. It is lost when a retroperitoneal pathology (abscess, hematoma, tumor, or retroperitoneal lymphadenopathy) obliterates the fat plane around the psoas muscle. Loss of the psoas shadow is a classic radiological sign of retroperitoneal disease.
87. The genital branch of the genitofemoral nerve in males supplies:
- A) Femoral skin
- B) Cremaster muscle and scrotal skin
- C) Medial thigh
- D) Gluteal region
✓ B)
Explanation: The genitofemoral nerve (L1, L2) divides into: (1) femoral branch — supplies skin of the femoral triangle (lateral to femoral artery), and (2) genital branch — enters the inguinal canal via the deep ring, supplies the cremaster muscle (cremasteric reflex: L1, L2), and skin of the scrotum (or labium majus in females). The medial thigh is supplied by the obturator nerve.
88. A barium follow-through shows the terminal ileum. It joins the large bowel at:
- A) Sigmoid colon
- B) Ileocecal valve at the cecum
- C) Ascending colon
- D) Hepatic flexure
✓ B)
Explanation: The ileum ends at the ileocecal valve (also called the ileocecal junction), where it opens into the medial wall of the cecum. The ileocecal valve prevents backflow of colonic contents into the ileum. On barium follow-through, the terminal ileum and ileocecal valve are specifically evaluated as pathology here (Crohn's disease, TB) is common.
89. All of the following are branches of the lumbar plexus EXCEPT:
- A) Iliohypogastric nerve
- B) Obturator nerve
- C) Femoral nerve
- D) Sciatic nerve
✓ D)
Explanation: The lumbar plexus (L1–L4) branches: iliohypogastric, ilioinguinal, genitofemoral, lateral cutaneous nerve of the thigh, femoral nerve, and obturator nerve. The sciatic nerve (L4, L5, S1, S2, S3) is the largest branch of the SACRAL plexus, not the lumbar plexus. The lumbosacral trunk (L4, L5) connects the two plexuses.
90. On an erect abdominal X-ray, free intraperitoneal air (pneumoperitoneum) is best seen:
- A) Under the left hemidiaphragm only
- B) Under the right hemidiaphragm only
- C) Under both hemidiaphragms
- D) In the paracolic gutters as air-fluid levels
✓ C)
Explanation: Free intraperitoneal air from a perforated viscus (peptic ulcer, diverticular perforation) rises to the highest point in the abdomen. On an erect chest/abdominal X-ray, it appears as a crescent of air under both hemidiaphragms (most visible on the right, where the diaphragm contrasts against the liver). As little as 1 mL of free air can be detected on an erect film.
PELVIC WALL (Week 13)
91. A female patient's pelvic X-ray shows a wide subpubic angle and rounded inlet. The pelvis is:
- A) Android
- B) Anthropoid
- C) Gynecoid
- D) Platypelloid
✓ C)
Explanation: The gynecoid pelvis is the most common female type (~50%), with a rounded/oval inlet and subpubic angle >90°. Android pelvis (male-type) has a heart-shaped inlet and narrow subpubic angle <90°. Anthropoid has an oval inlet (AP diameter longer). Platypelloid is flattened with a wide transverse diameter. Gynecoid is most favorable for vaginal delivery.
92. All of the following form the pelvic inlet EXCEPT:
- A) Pubic symphysis anteriorly
- B) Sacral promontory posteriorly
- C) Iliopectineal line laterally
- D) Coccyx posteriorly
✓ D)
Explanation: The pelvic inlet (brim) is bounded by: pubic symphysis (anterior), iliopectineal lines (arcuate lines of ilium + pectineal line of pubis) on each side, and the sacral promontory (posterior). The coccyx is below the pelvic floor — it forms part of the pelvic outlet, not the inlet. The outlet is bounded by the pubic arch, ischial tuberosities, and coccyx.
93. All of the following are parts of levator ani EXCEPT:
- A) Pubococcygeus
- B) Puborectalis
- C) Iliococcygeus
- D) Piriformis
✓ D)
Explanation: Levator ani has three components: pubococcygeus, puborectalis, and iliococcygeus. Together they form the main part of the pelvic diaphragm. Piriformis is a posterolateral pelvic wall muscle that passes through the greater sciatic foramen to insert on the greater trochanter. Coccygeus is the smaller, posterior part of the pelvic diaphragm.
94. Obturator nerve compression causes pain referred to the:
- A) Buttock
- B) Medial thigh
- C) Lateral thigh
- D) Lower leg
✓ B)
Explanation: The obturator nerve (L2, L3, L4) exits through the obturator foramen and supplies the adductor muscles and skin of the medial thigh. An obturator hernia can compress this nerve in the obturator canal, causing pain down the medial thigh (Howship-Romberg sign), which worsens with thigh extension and is relieved by flexion. It is more common in thin elderly women.
95. The subpubic angle in a typical male pelvis is approximately:
- A) Greater than 90°
- B) Less than 90° (approximately 70–75°)
- C) Exactly 90°
- D) Greater than 110°
✓ B)
Explanation: The subpubic angle (angle between the two inferior pubic rami below the pubic symphysis) is approximately 70–75° in males and greater than 90° (often 100–110°) in females. This is one of the most reliable radiological signs for sex determination on a pelvic X-ray. A wider subpubic angle accommodates the fetal head during childbirth.
PELVIC FASCIA, NERVES & ARTERIES (Week 14)
96. The superior gluteal artery arises from the:
- A) Anterior division of internal iliac artery
- B) Posterior division of internal iliac artery
- C) External iliac artery
- D) Common iliac artery
✓ B)
Explanation: The posterior division of the internal iliac artery gives three branches: ILS — Iliolumbar artery, Lateral sacral arteries, Superior gluteal artery. The anterior division gives the remaining branches including obturator, uterine, inferior vesical, middle rectal, inferior gluteal, and internal pudendal arteries. This anterior/posterior division is a common exam distinction.
97. The pudendal nerve exits the pelvis through the greater sciatic foramen and re-enters through:
- A) Obturator foramen
- B) Lesser sciatic foramen
- C) Ischiorectal fossa directly
- D) Piriformis muscle
✓ B)
Explanation: The pudendal nerve (S2, S3, S4) exits the pelvis through the greater sciatic foramen (below piriformis), winds around the ischial spine, and re-enters the perineum through the lesser sciatic foramen to travel in the pudendal (Alcock's) canal along the lateral wall of the ischiorectal fossa. It supplies the perineum, external anal sphincter, and external urethral sphincter.
98. All of the following are branches of the ANTERIOR division of the internal iliac artery EXCEPT:
- A) Superior vesical artery
- B) Obturator artery
- C) Uterine artery
- D) Superior gluteal artery
✓ D)
Explanation: The superior gluteal artery comes from the POSTERIOR division (along with iliolumbar and lateral sacral). The anterior division supplies pelvic viscera and perineum: superior vesical (→ umbilical artery), inferior vesical, obturator, uterine (in females), vaginal, middle rectal, inferior gluteal, internal pudendal. Remembering "posterior = parietal wall supply; anterior = visceral supply" helps.
PELVIC CAVITY (Weeks 15–16)
99. A 32-year-old infertile woman undergoes HSG. Contrast spills from both fimbriated ends. This confirms:
- A) Uterine fibroids
- B) Both fallopian tubes are patent
- C) Ovarian cysts
- D) Bicornuate uterus
✓ B)
Explanation: Hysterosalpingography (HSG) involves instilling iodinated contrast through the cervix into the uterine cavity under fluoroscopy. Free spill of contrast from the fimbriated ends (lateral spillage into the peritoneal cavity) confirms tubal patency — a key investigation for infertility. Blocked tubes show no spillage and a dilated tube (hydrosalpinx) may be visible.
100. On a pelvic X-ray, all of the following are standard assessment lines EXCEPT:
- A) Iliopectineal line
- B) Ilioischial line
- C) Shenton's line
- D) Intercristal line
✓ D)
Explanation: Standard pelvic radiographic lines include: iliopectineal line (traces the anterior column of the acetabulum), ilioischial line (traces the posterior column), Shenton's line (smooth arc from the medial femoral neck to the inferior pubic ramus — disrupted in hip fracture/dislocation), acetabular teardrop, and anterior/posterior walls of the acetabulum. The intercristal line connects the iliac crests and is a surface anatomy landmark to identify L4 level — it is NOT a standard pelvic X-ray assessment line.
Complete Summary
| Week | Topic | Qs | Key Theme |
|---|---|---|---|
| 1 | Thoracic wall, ribs, sternum | 1–10 | Rib types, VAN, X-ray signs |
| 2 | Intercostals, diaphragm, blood supply | 11–20 | Phrenic nerve, hiatus levels |
| 3 | Mediastinum, pleura, lungs | 21–30 | Silhouette sign, lobes, carina |
| 4 | Pericardium, heart, thymus | 31–40 | CTR, heart borders, tamponade |
| 5 | Arteries, veins, radiology | 41–48 | AP vs PA, bat-wing, aortic knuckle |
| 6 | Abdominal wall | 49–55 | Layers, arcuate line, peritoneum |
| 7 | Inguinal canal, arteries | 56–61 | Direct vs indirect hernia |
| 8 | Peritoneum, GI tract | 62–68 | C-loop, GE junction, barium swallow |
| 9 | Liver, biliary, large intestine | 69–74 | Ampulla of Vater, CBD, portal vein |
| 10 | Pancreas, spleen, kidneys | 75–80 | IVU, rib relationship, renal veins |
| 11 | Suprarenal, GIT blood supply | 81–85 | Celiac/SMA/IMA territories |
| 12 | Lumbar plexus, posterior wall | 86–90 | Psoas shadow, sciatic vs lumbar |
| 13 | Pelvic wall | 91–95 | Pelvis types, levator ani, subpubic angle |
| 14 | Pelvic fascia, nerves, arteries | 96–98 | IIA divisions, pudendal nerve |
| 15–16 | Pelvic cavity | 99–100 | HSG, pelvic X-ray lines |
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