Tomorrow I have anatomy practical bone viva. So, give me... Important viva questions and answers related to different bones that are included in the first year bone viva practical syllabus. Okay.
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first year MBBS anatomy bone viva practical questions answers important 2024
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First Year MBBS Anatomy Bone Viva - Important Q&A
Here is a bone-by-bone breakdown covering the standard first-year MBBS practical syllabus. These are the most commonly asked viva questions.
GENERAL OSTEOLOGY (Asked for ANY bone)
Q: How do you identify the side of a bone?
A: Look for landmarks that indicate medial/lateral or anterior/posterior surfaces. For long bones, identify the head, nutrient foramen direction, and muscle attachments to determine side.
Q: What is the direction of the nutrient foramen?
A: The nutrient foramen faces away from the growing end (the end that contributes most to growth - "to the knee I grow, from the elbow I go").
Q: What are the parts of a long bone?
A: Diaphysis (shaft), epiphysis (ends), metaphysis (flared end of diaphysis), articular cartilage, periosteum, medullary cavity, endosteum.
Q: What is ossification? Types?
A: Formation of bone. Types: (1) Intramembranous - directly from mesenchyme (e.g., flat bones of skull, clavicle); (2) Endochondral - from cartilage model (most long bones).
Q: What is a primary vs secondary ossification center?
A: Primary center appears in the diaphysis (in fetal life). Secondary centers appear in the epiphyses (after birth, except lower end of femur and upper end of tibia which appear just before birth).
HUMERUS
Q: How do you identify the side of the humerus?
A: Head is medially placed, greater tubercle is lateral, lesser tubercle is anterior, the spiral groove (for radial nerve) runs postero-laterally, and the medial epicondyle is more prominent.
Q: Name the parts of the humerus.
A: Upper end: head, anatomical neck, surgical neck, greater & lesser tubercles, intertubercular sulcus. Shaft: deltoid tuberosity, spiral groove. Lower end: capitulum, trochlea, medial & lateral epicondyles, olecranon fossa, coronoid fossa, radial fossa.
Q: Which nerve is related to the surgical neck of the humerus?
A: Axillary nerve (circumflex nerve) - injured in fracture of surgical neck.
Q: Which nerve is related to the spiral groove (radial groove)?
A: Radial nerve - injured in mid-shaft fractures (Saturday night palsy / wrist drop).
Q: Which nerve is related to the medial epicondyle?
A: Ulnar nerve - injured in fracture of medial epicondyle (funny bone injury - cubitus valgus).
Q: What is carried in the intertubercular sulcus (bicipital groove)?
A: Tendon of the long head of biceps brachii.
Q: Ossification of humerus?
A: Primary center in shaft (8th week intrauterine). Secondary centers (mnemonic: CRITOE for elbow region):
- Capitulum - 1 year
- Radial head - 3 years
- Internal (medial) epicondyle - 5 years
- Trochlea - 7 years
- Olecranon - 9 years
- External (lateral) epicondyle - 11 years Upper end: Head (6 months), Greater tuberosity (7-10 months), Lesser tuberosity (~5 years) - all fuse together and with shaft at ~20 years.
Q: What is a supracondylar process?
A: A rare bony outgrowth just above the medial epicondyle on the anteromedial surface. It is an atavistic structure (vestigial). If present, a fibrous band (Struthers' ligament) connects it to the medial epicondyle and may entrap the median nerve.
Q: What is a supratrochlear foramen?
A: A rare variant where the olecranon fossa and coronoid fossa communicate through an opening, weakening the bone.
RADIUS & ULNA
Q: How do you identify the radius?
A: Head is disc-shaped (upper end), radial tuberosity is medial on the upper shaft, the lower end is wider and has a styloid process laterally.
Q: How do you identify the ulna?
A: Olecranon is the large posterior prominence at the upper end, coronoid process is anterior, trochlear notch articulates with the humerus. Styloid process is at the lower end medially. The shaft is triangular.
Q: Name the articulations of the radius.
A: (1) Head with capitulum of humerus; (2) Head with radial notch of ulna (superior radioulnar joint); (3) Lower end with scaphoid & lunate (radiocarpal joint); (4) Lower end with ulna at the ulnar notch (inferior radioulnar joint).
Q: Where does the brachialis insert?
A: Coronoid process and tuberosity of ulna.
Q: Where does the biceps brachii insert?
A: Radial tuberosity (and bicipital aponeurosis into deep fascia of forearm).
Q: The two bones forming the forearm - what connects them?
A: Superior radioulnar joint (pivot), interosseous membrane (fibrous joint), and inferior radioulnar joint (pivot).
Q: Carpal bones - proximal row?
A: Scaphoid, Lunate, Triquetrum, Pisiform (mnemonic: She Looks Too Pretty).
Q: Carpal bones - distal row?
A: Trapezium, Trapezoid, Capitate, Hamate (mnemonic: Though The Carpal Has).
Q: Most commonly fractured carpal bone?
A: Scaphoid (in fall on outstretched hand). Risks avascular necrosis because blood supply enters distally.
FEMUR
Q: How do you identify the side of the femur?
A: Head is medially directed, greater trochanter is lateral, lesser trochanter is posteromedial, linea aspera is on the posterior surface.
Q: Name the features of the upper end of femur.
A: Head (articular, 2/3 of sphere), fovea capitis (for ligamentum teres), neck, greater trochanter, lesser trochanter, intertrochanteric line (anterior), intertrochanteric crest (posterior), quadrate tubercle on the crest.
Q: What is the angle of inclination (neck-shaft angle)?
A: Normally 126° (± 5°). >126° = coxa valga, <126° = coxa vara.
Q: What is the angle of anteversion?
A: Normally 10-15°. The femoral neck is twisted anteriorly relative to the shaft. Increased = in-toeing gait.
Q: What is the linea aspera?
A: A rough longitudinal ridge on the posterior surface of the femoral shaft. It has medial and lateral lips. Distally it divides into medial and lateral supracondylar lines, enclosing the popliteal surface.
Q: Which is the adductor hiatus?
A: A gap in the tendon of adductor magnus at the lower end of the linea aspera through which the femoral vessels pass to become popliteal vessels.
Q: Ossification of femur?
A: Primary center: shaft (7th week intrauterine). Secondary centers: lower end of femur appears just before birth (Spalding's sign used in forensics - present at 36 weeks, useful for determining viability of a fetus). Upper end: head (6 months after birth), greater trochanter (4 years), lesser trochanter (13 years).
Q: Why is the lower end ossification center of femur clinically important?
A: It appears just before birth (~36 weeks gestation) and is used to determine fetal maturity at autopsy (Beclard's nucleus).
TIBIA & FIBULA
Q: How do you identify the side of the tibia?
A: Tibial tuberosity is on the anterior surface superiorly, the medial surface is subcutaneous (flat and smooth), the soleal line runs obliquely on the posterior surface, the medial malleolus is at the lower end.
Q: What is the tibial tuberosity?
A: A bony prominence on the anterior surface of the upper tibia for attachment of the ligamentum patellae (quadriceps tendon). In adolescents, avulsion of this can cause Osgood-Schlatter disease.
Q: Which structures form the knee joint?
A: Lower end of femur (medial and lateral condyles), upper end of tibia (medial and lateral condyles with menisci), and the patella.
Q: What is Gerdy's tubercle?
A: A tubercle on the anterolateral surface of the lateral tibial condyle for the insertion of the iliotibial tract.
Q: Name the fibula features used in side identification.
A: Lateral malleolus is more pointed and extends more inferiorly than the medial. The interosseous border (medial) faces the tibia. The head is at the upper end and does NOT form the knee joint.
Q: Does fibula bear weight?
A: Only about 1/6 of the leg's body weight. The tibia bears the majority.
SCAPULA
Q: How do you identify the side of scapula?
A: Costal (anterior) surface is concave (subscapular fossa), glenoid cavity faces laterally, coracoid process is anterior and superior, spine is on the posterior surface.
Q: What are the borders of the scapula?
A: Superior border (shortest, with suprascapular notch), medial/vertebral border, lateral/axillary border.
Q: What passes through the suprascapular notch?
A: Suprascapular nerve passes through (below the superior transverse scapular ligament); suprascapular vessels pass over the ligament. Mnemonic: "Armies go under the bridge; navies over."
Q: What forms the coracoacromial arch?
A: Coracoid process + coracoacromial ligament + acromion. The supraspinatus and subacromial bursa pass beneath this arch - impingement can occur here.
CLAVICLE
Q: How do you identify the side of clavicle?
A: Sternal end is rounded (medial), acromial end is flat (lateral), the shaft is S-shaped (medial 2/3 convex forward, lateral 1/3 concave forward), subclavian groove is on the inferior surface.
Q: What type of ossification does clavicle have?
A: Both intramembranous AND endochondral - the only long bone to ossify by intramembranous ossification (primary center). This is a high-yield MCQ point.
Q: What is the first bone to ossify?
A: Clavicle (5th-6th week intrauterine).
Q: Most commonly fractured bone?
A: Clavicle. Most commonly at the junction of the medial 2/3 and lateral 1/3 (weakest point). After fracture, medial fragment is elevated by sternocleidomastoid; lateral fragment drops due to weight of upper limb.
HIP BONE (Os Coxae)
Q: What are the three bones forming the hip bone?
A: Ilium, ischium, and pubis. They meet at the acetabulum.
Q: At what age do they fuse?
A: All three fuse at the acetabulum at about 16-18 years (in the Y-shaped triradiate cartilage).
Q: What is the acetabular notch? What passes through it?
A: A notch in the inferior margin of the acetabulum. Bridged by the transverse acetabular ligament, through which the acetabular branch of the obturator artery passes (supplies the head of femur via ligamentum teres).
Q: What is the obturator foramen?
A: Large foramen between the pubis and ischium. Mostly closed by the obturator membrane. The obturator nerve and vessels pass through the obturator canal (a gap in the superior part of the membrane).
Q: Identify the greater sciatic notch and what passes through it.
A: The piriformis muscle passes through it, dividing it into above and below piriformis. Structures above: superior gluteal nerve/vessels. Structures below: inferior gluteal nerve/vessels, sciatic nerve, pudendal nerve, nerve to obturator internus, posterior cutaneous nerve of thigh.
SKULL BONES (High Yield)
Q: What is the pterion?
A: The H-shaped sutural junction of four bones: frontal, parietal, temporal, and greater wing of sphenoid. It is the thinnest part of the skull. Deep to it runs the anterior branch of the middle meningeal artery - rupture causes extradural (epidural) hematoma.
Q: What is the asterion?
A: The junction of the parietal, occipital, and temporal (mastoid part) bones. Overlies the junction of the transverse and sigmoid sinuses.
Q: What is the foramen magnum? What passes through it?
A: Large opening in the occipital bone. Transmits: medulla oblongata (becoming spinal cord), vertebral arteries, anterior and posterior spinal arteries, accessory nerve (spinal root, ascending to join cranial root).
Q: Name the foramina of the middle cranial fossa and what passes through them.
A:
- Foramen ovale: mandibular nerve (V3), accessory meningeal artery, lesser petrosal nerve
- Foramen rotundum: maxillary nerve (V2)
- Foramen spinosum: middle meningeal artery and vein, meningeal branch of V3
- Foramen lacerum: internal carotid artery (passes over it, not through), greater petrosal nerve
Q: What is Wormian bone?
A: Sutural or Wormian bones are small, irregular bones found within the sutures of the skull. Associated with osteogenesis imperfecta, cleidocranial dysostosis.
VERTEBRAE
Q: How do you identify a cervical vertebra?
A: Small body, bifid spinous process (C3-C6), triangular vertebral foramen (larger than thoracic), transverse foramina (for vertebral artery), anterior and posterior tubercles on transverse processes.
Q: What is special about C1 (Atlas)?
A: No body, no spinous process. Has anterior and posterior arches with lateral masses. Articulates with occipital condyles (atlanto-occipital joint = nodding "yes").
Q: What is special about C2 (Axis)?
A: Has the dens (odontoid process) - a tooth-like projection that is actually the body of C1 incorporated into C2. This is the pivot for the atlanto-axial joint (rotation = "no" movement).
Q: What is special about C7 (Vertebra Prominens)?
A: Long, non-bifid spinous process that is visible and palpable at the root of the neck. Used as a clinical landmark.
Q: How do you identify a thoracic vertebra?
A: Heart-shaped body, circular vertebral foramen (smallest), costal facets (on body and transverse process for rib articulation), long downward-sloping spinous processes.
Q: How do you identify a lumbar vertebra?
A: Large kidney-shaped body, triangular vertebral foramen, short broad spinous process (hatchet-shaped), no costal facets, no transverse foramina. Largest vertebrae overall.
Q: What is the sacrum?
A: Formed by fusion of 5 sacral vertebrae. Features: sacral promontory (anterosuperior edge of S1 body, important in obstetrics), anterior and posterior sacral foramina (4 pairs each), sacral hiatus (for caudal epidural injection), sacral cornua.
HIGH-YIELD ONE-LINERS FOR VIVA
| Question | Answer |
|---|---|
| Longest bone | Femur |
| Smallest bone | Stapes (middle ear) |
| Strongest bone | Femur |
| Sesamoid bone (largest) | Patella |
| Only bone with no muscle attachment | Hyoid |
| First bone to ossify | Clavicle |
| Last bone to ossify | Medial clavicle epiphysis (22-25 years) |
| Bone to ossify intramembranously (long bone) | Clavicle |
| Most common fracture | Clavicle |
| Most commonly fractured carpal bone | Scaphoid |
| Bone at risk in posterior dislocation of shoulder | Posterior glenoid lip |
| Nutrient artery of femur | Branches of profunda femoris |
| Pre-birth ossification centers | Lower end of femur (Beclard's), upper end of tibia, head of humerus (distal) |
TIPS FOR THE VIVA TABLE
- Always pick up the bone correctly - hold it in anatomical position first before describing.
- Identify side first, then describe features systematically: upper end → shaft → lower end.
- Know one clinical/applied point for every bone - examiners love applied anatomy.
- Ossification centers are almost always asked - memorize the CRITOE mnemonic for the elbow.
- For any groove/notch, know what nerve/vessel passes through it.
- For any foramen, know what passes through it.
Good luck tomorrow! You've got this.
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