Anatomy for the Royal College of Radiologists Fellowship. Malcolm Sperrin

interest in radiation medicine, especially Nuclear Medicine and Radiotherapy. He also plays a significant role in radiation protection and contingency planning. In parallel to his conventional hospital duties, Malcolm also spends a lot of time teaching and lecturing with organisations including Oxford Postgraduate Medical School, The Open University and various Royal Colleges not to mention lectureships at Guildford and the University of the West of England.

      Malcolm was made a visiting professor at Reading, Guildford and Open Universities and visiting academic at Oxford University and plays a role on the national stage with the Institute of Physics, Royal Institution, Science Media Centre and the British Association for the Advancement of Science. Malcolm also feeds into activities centred on science and health policy at the DoH.

      Malcolm’s down-to-earth approach to Medical Science has led to him being frequently sought by the media for comment on mobile phone use, WiFi safety and even the risks from the Fukushima reactor. He is very active in developing innovation whether operational or scientific and has recently been involved in initiatives with Microsoft and other multi-national companies with a drive to improve patient outcomes.

      Malcolm is a keen adventure sports enthusiast and likes to climb, cave and canoe and has been known to parachute. He has a partner, Nicki (who is not sure about the parachuting), an 9-year-old son and a spaniel called Harvey.

      Ian Francis

      Dr Ian Francis MA (Clin Ed), FRCR, FRCS, BDS (Hons) is a consultant radiologist working across both the NHS and private sectors. He is also a co-founder and a director at Medical Imaging Partnership, a clinico-radiological business supporting radiologists and imaging departments in developing strategy and service redesign of their imaging services with fully integrated back office services. Ian Is also a leader in educational development across the radiology spectrum and was the Education Development Lead for the Royal College of Radiologists, driving programmes of radiology educational delivery throughout the UK.

      IOP Publishing

      Anatomy for the Royal College of Radiologists Fellowship

      Illustrated questions and answers

      Andrew G Murchison, Mitchell Chen, Thomas Frederick Barge, Shyamal Saujani, Christopher Sparks, Radoslaw Adam Rippel, Malcolm Sperrin and Ian Francis

      Chapter 1

      Head and neck

      Andrew G Murchison and Mohammed Khoshkoo

Q1.1 3D reconstruction of a paediatric skull CT

      1 Name the anatomical variant.

      2 Name the arrowed structure.

      3 Name the arrowed structure.

      4 Name the arrowed structure.

      5 Name the arrowed structure.

       Answers

      1 Metopic suture.

      2 Left frontozygomatic suture.

      3 Left coronoid process of the mandible.

      4 Right superior orbital fissure.

      5 Right pterion.

       Comments:

      The frontal bone of the skull is separated from the two parietal bones by the coronal suture. The parietal bones meet at the sagittal suture, which forms a ‘T-junction’ with the coronal suture at a point called the bregma. The point at which the sagittal suture meets the lambdoid suture, separating the parietal bones from the occipital bone, is known as the lambda.

      The temporal bones join the parietal bones at the squamous sutures. The junction where the coronal and squamous sutures, and the frontal, parietal, temporal and sphenoid bones converge is known as the pterion.

       Exam tips:

       A metopic suture, which is found most commonly in infants but which may persist into adulthood, is an exam favourite. If the question asks for an anatomical variant, and the image presented is of the skull, there’s a good chance that you’ll find a metopic suture.

       Remember to be specific if the arrows are clearly pointing to a specific part of a larger structure (e.g. the coronoid process of the mandible).

Q1.2 Lateral radiograph of the facial bones of a child

      1 Name the arrowed structure.

      2 Name the arrowed structure.

      3 Name the arrowed structure.

      4 Name the arrowed structure.

      5 Name the arrowed structure.

       Answers

      1 Hyoid bone.

      2 Nasal bone.

      3 Soft palate.

      4 Middle nasal turbinate.

      5 Posterior clinoid process.

       Comments:

      The nasal turbinates (or conchae) are ledges of bone which arise from the lateral walls of the nasal cavity. The inferior meatus is the nasal passage below the inferior turbinate, the middle meatus lies between the inferior and middle turbinates, and the superior meatus lies between the superior and middle turbinates.

      The hard palate is a bony structure which forms the superior border of the oral cavity and the inferior border of the nasal cavity. Posterior to this is the soft palate, a soft tissue structure containing several muscles involved in swallowing. Projecting from the posterior border of the soft palate is protuberance called the uvula.

       Exam tip:

       The inferior nasal turbinate can be readily identified because it is the largest of the turbinates.

Q1.3 Coronal bony reconstruction from a CT petrous bones study

      1 Name the arrowed structure.

      2 Name the arrowed structure.

      3 Name the arrowed structure.

      4 Name the arrowed structure.

      5 Name the arrowed structure.

       Answers

      1 Left cochlea.

      2 Left atlantooccipital joint.

      3 Odontoid process of C2 (dens).

      4 Right head of malleus.

      5 Right tegmen tympani.

       Comments:

      The inner ear and structure of the petrous part of the temporal bone are complex but could legitimately pop up in the exam.