First FRCR Anatomy - Practice Cases

417 Pages·2016·26.86 MB·English

by  Constantinos Tingerides

First FRCR Anatomy
Practice Cases

First FRCR Anatomy
Practice Cases
Constantinos Tingerides MBBS BSc MRCS
Radiology Registrar,
Leeds Radiology Academy, UK
Ashley Uttley MBBS BSc
Radiology Registrar,
Leeds Radiology Academy, UK
David Minks MBBS BSc
Radiology Registrar,
Leeds Radiology Academy, UK
Claire Exley MBBS FRCR
Consultant Radiologist
Mid Yorkshire Hospitals NHS Trust, UK
London • St Louis • Panama City • New Delhi
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ISBN: 978-1-907816-37-6
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Preface
In 2010, the Royal College of Radiologists introduced the radiological anatomy module into the
First FRCR exam. The module is designed to test a candidate’s knowledge of radiological anatomy,
as demonstrated in various different modalities and planes. This book is specifically designed as a
tool to help candidates revising for it. The book is a compilation of over 200 images, which provide
an excellent demonstration of human anatomy, using a wide range of different radiological
investigations. Each case is followed by descriptive text discussing the salient points that can
be taken from the case, as well as hints and tips to improve exam success. Where appropriate,
artworks are included to help explain the anatomy that is being demonstrated.
The images are presented in a similar format to those in the exam, allowing readers to become
familiar with the exam structure. Each chapter focuses on a single anatomical area matched to
the syllabus, allowing readers to consolidate knowledge as they progress through the book.
Once the main chapters have been worked through, there are two practice papers at the end for
self-assessment. Each of these papers comprises 20 cases to be answered within 75 minutes, with
further explanatory answers and references to the main chapters. These practice papers allow
readers to test knowledge and practise timings before the real exam.
This book is an excellent revision tool to help trainees develop confidence and improve
technique for the First FRCR Anatomy module. It provides a wide variety of images and a thorough
grounding for candidates preparing to sit the exam.
Constantinos Tingerides
Ashley Uttley
David Minks
Claire Exley
May 2012
v

Contents
Preface v
Exam revision hints and tips ix
Chapter 1 Head and neck 1
Brain 2
Face and neck 21
Skull 55
Answers 64
Chapter 2 Chest 109
Cardiac and vascular 110
Bronchopulmonary 128
Chest wall and diaphragm 135
Breast 142
Answers 143
Chapter 3 Abdomen and pelvis 165
Bowel 166
Upper abdominal viscera 180
Abdominal wall 187
Spaces and planes 193
Genitourinary 198
Gynaecology 206
Vascular supply and lymph node groups 213
Answers 224
Chapter 4 Musculoskeletal system 265
Lower limb 266
Spine 284
Upper limb 297
Answers 311
Chapter 5 Practice Paper 1 341
Cases 342
Answers 362
vii
Contents
Chapter 6 Practice Paper 2 369
Cases 370
Answers 390
Index 397
viii
Exam revision hints and tips
The exam
The First FRCR anatomy module comprises 20 cases, with five questions presented in each case.
The exam lasts for 75 minutes. The cases are viewed on an individual computer work station, with
a mouse to navigate between the cases and a question booklet to record answers. Details of the
viewing software and sample cases can be found on the Royal College’s website (http://www.rcr.
ac.uk).
What can you do to prepare?
One of the most important methods to prepare for the anatomy module is to gain a breadth of
experience of normal images. An understanding of normal anatomy as seen in different modalities
and in different planes is essential. Testing yourself during normal day-to-day practice is a good
way to develop knowledge and understanding.
There are various ‘classic’ images that can be found in anatomy atlases and are important when
studying for the exam. It is worthwhile learning the details of these anatomical sections, since
they demonstrate the relationship between structures and are likely to appear in the exam.
An understanding of anatomical relationships is the first step in learning radiological anatomy.
However, knowledge of the imaging acquisition process will help to build on this and will greatly
enhance the understanding of how anatomy is demonstrated radiologically. It is important not
only to understand the relationship between anatomical structures and their surroundings, but
also how they appear on different modalities and how they enhance. This background knowledge
can be invaluable in the exam. For example, recognising whether an image has been acquired in
the arterial or venous phase, or whether an image is T1 or T2 weighted can be very helpful when
defining anatomy. When comparing the appearance of structures on different modalities, it is also
worthwhile learning how the density, signal and echogenicity compare between neighbouring
structures, for example that the liver typically appears slightly more dense than the spleen, or that
it is usually more echogenic than the neighbouring renal cortex.
To prepare for the exam, it can also be helpful to attend a revision course specifically designed
for this exam. Courses can consolidate learning and offer a simulated exam environment to
practise timings and technique. It is important to practise mock exams before the real one, since
they provide an idea of how long is needed to complete the exam and will help you to manage
time appropriately. If you perform well in a simulated exam environment, it will improve your
confidence when sitting the real exam.
In the exam
Make sure you read the questions accurately and identify the labels properly. Do not assume that
the labels A to E will be placed in the same order on each case. Sometimes they will go clockwise
around the image and on other occasions they go anticlockwise – it is not worth losing marks
by putting the right answer in the wrong place in your answer booklet. There may be extra
information on the image, for example side markers – pay attention to these, since they can
provide extra detail.
ix