Case 1
Question 3 – Calvarial sutures
List five (5) common or important variants of the calvarial sutures. (5 marks)
• Accessory parietal suture
• Mendosal suture – accessory occiptal suture, closes by 6 years of age
• Persistent metopic suture – frontal suture generally closes between 3 months of age to 7 years of age
• Persistent occipital suture – normally closes by 4 years
• Wormian bones – additional intrastural bones
Case 2
Question 3 – Paranasal sinus
a. Name five (5) common or important variants of the paranasal sinuses. (5 marks)
• Paradoxical curvature of the middle turbinate – convexity is directed laterally instead of medially (toward the nasal septum)
• Conch bullosa – pneumatisation of the middle turbinate
• Pneumatisation of the unicinate process
• Haller cells – pneumatised infraorbital ethmoid cells
• Posterior nasal septal air cell – seen in posterosuperior portion of nasal septum and can communicate with sphenoid sinus
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698895/
Case 3
Question 3 – Conus Medullaris & Artery of Adamkiewicz
a) List the vertebral levels of the conus medullaris in the fetus, neonate and adult. (3)
• Neonate: L5 and sacrum
• Feotus (term): L2
• Adult: L1 – L2
b) Which side and level does the artery of Adamkiewicz most commonly arise? (2)
• Most commonly arises on the left (80%)
• Most commonly arises at the 9th – 12th intercostal artery (70%)
Case 4
Question 3 – Coronary arteries
Name five (5) common or important variants of the coronary arteries (5 marks).
• Left dominant variant, large left circumflex supplies posterior interventricular artery
• Left coronary artery supplying SA nodal branch (40%)
• LCx supplying AV node
• Coronary artery arising from non-coronary sinus
• Co-dominance of the arteries
• Ramus intermedius – an additional artery arising at the bifurcation of the left main artery
Case 5
Question 3 – Pancreatic ducts
Name five (5) common or important variants of the pancreatic ducts. (5 marks)
• Double accessory pancreatic duct (Santorini)
• Double main pancreatic duct (Wirsung)
• Anastomosis between ducts
• Crossing or double-crossing of ducts
• No communication between ducts
Case 6
Question 3 – Ureters
Name five (5) common or important variants of the ureters. (5 marks)
• duplex collecting system
• bifid ureter
• ectopic ureter
• ureterocele
• retrocaval ureter
Case 7
Question 3 – Arterial supply of the hand
Name five (5) common or important variants of the arterial supply of the hand. (5 marks)
• Brachioradial artery – high origin from brachial artery (~9%)
• High origin from axillary artery
• Cubital crossover – anastomosis between brachioradial artery and normal brachial artery in cubital fossa
• Contribution of radial or brachioradial artery to formation of the superficial palmar arch
• Persistent median artery
Case 8
Question 3
Name five (5) anatomical variants of popliteal artery branching (5 marks).
• popliteal artery arising off a persistent sciatic artery
• trifurcation (no tibioperoneal trunk)
• high bifurcation (above popliteus)
• high origin of anterior tibial artery ~2.5% (range 0.5-4.5%)
• high origin of posterior tibial artery ~1%
• peroneal artery arising off the anterior tibial artery