Review queue

Atlas and axis (C1 and C2) · Clinical 4 · presentation

…An increased atlantodental interval on lateral films suggests instability.

Why flagged: normal ADI limits — about 3 mm adults, 5 mm children

Greater occipital nerve · Anatomy · course

…uberance, and ascends with the occipital artery over the back of the scalp.

Why flagged: exact emergence point varies between individuals

Spinal cord · Anatomy · location

…medullaris at about the L1–L2 disc in adults (lower, about L3, in newborns).

Why flagged: newborn level quoted as L2–L3 or L3

Spinal cord · Anatomy · bloodSupply

…usually on the left between about T9 and T12, supplying the lower cord.

Why flagged: level range T8–L1 is also quoted

Vertebral artery · Clinical 2 · presentation

…arms (commonly more than 15–20 mmHg) and a weaker pulse on the affected side.

Why flagged: BP difference thresholds vary

Vertebral column · Clinical 1 · presentation

…is used for moderate curves in growing children; large curves may need surgery.

Why flagged: bracing and surgical thresholds

Vertebral column · Exam · specialTests · 1 · positive

An increase of less than about 5 cm.

Vertebral column · Anatomy · notes

…rspace; the dimples over the posterior superior iliac spines mark S2.

Why flagged: surface landmark levels vary between individuals

Aortic valve · Anatomy · location

…o the left side of the sternum at about the level of the 3rd intercostal space.

Azygos vein · Anatomy · formation

…tering the thorax through the aortic hiatus or the right crus of the diaphragm.

Cardiac conduction system · Anatomy · bloodSupply

…nterior two-thirds of the septum) and of the posterior interventricular artery.

Why flagged: quoted percentages vary between sources

Cardiac conduction system · Anatomy · innervation

…e right vagus predominantly affects the SA node and the left vagus the AV node.

Why flagged: side-specific vagal dominance is a simplification

Diaphragm · Imaging · xray

…effusion or volume loss. Blunting of the costophrenic angle suggests effusion.

Why flagged: normal dome position varies with inspiration and body habitus

Diaphragm · Exam · landmarks

…the 5th intercostal space in expiration; excursion is roughly 3–5 cm in adults.

Esophagus · Anatomy · parts · 3

…n bronchus, about 25 cm), diaphragmatic (esophageal hiatus, about 40 cm).

Why flagged: distances from the incisors vary between sources

Heart · Exam · landmarks

…left intercostal space to the apex (5th intercostal space, midclavicular line).

Why flagged: surface projection points vary slightly between texts

Internal thoracic artery · Imaging · ultrasound

…y the vessel before procedures; also used to assess its suitability as a graft.

Left coronary artery · Clinical 1 · presentation

…ificant left main disease is an indication for revascularization (CABG or PCI).

Why flagged: ECG pattern is suggestive, not specific

Left coronary artery · Anatomy · course

…2 cm) passing between the left auricle and the pulmonary trunk before dividing.

Why flagged: length quoted variably

Lungs · Anatomy · notes

…lower lobes lie mostly posteriorly and the right middle lobe anteriorly.

Why flagged: surface projections vary between texts

Main bronchi · Anatomy · bloodSupply

…usually one right, two left; from the thoracic aorta or an intercostal artery).

Mitral valve · Anatomy · location

…, posterior to the sternum at about the level of the left 4th costal cartilage.

Pectoralis major · Anatomy · innervation

…al pectoral nerves (clavicular head mainly C5–C6; sternocostal head C7, C8, T1)

Pericardium · Imaging · ct

…about 4 mm suggests constriction), calcification, and effusion characteristics.

Pericardium · Exam · landmarks

…ard the left shoulder at about 30–45° to the skin, ideally under echo guidance.

Why flagged: angle and direction vary between protocols; echo-guided apical and parasternal approaches are also used

Pleural cavity · Imaging · xray

…lateral film detects smaller volumes than a PA film (roughly 50 mL vs 200 mL).

Why flagged: quoted detection volumes vary

Pleural cavity · Anatomy · notes

…ribs at the same lines. The gap between them is the costodiaphragmatic recess.

Why flagged: textbooks differ by one rib level for some of these markings

Pulmonary valve · Anatomy · location

…superior of the valves, behind the left 3rd costal cartilage near the sternum.

Ribs · Clinical 2 · mechanism

…r more adjacent ribs in two or more places, creating a free-floating segment.

Why flagged: definitions range from two to three adjacent ribs

Right coronary artery · Anatomy · notes

…ant (from the circumflex-artery) in a minority, and codominant in the rest.

Right coronary artery · Anatomy · supplies

…ragmatic) LV wall (in right dominance), and the posteromedial papillary muscle.

Why flagged: dominance and nodal supply percentages vary between sources

Sternum · Exam · landmarks

…about 5 cm below the notch), body, and xiphoid process in the epigastric angle.

Why flagged: vertebral level of the jugular notch differs slightly between sources

Sternum · Anatomy · notes

…and the point where the azygos-vein arches into the superior-vena-cava.

Why flagged: the exact levels of the carina and pulmonary trunk bifurcation vary with posture and respiration

Superior vena cava · Clinical 2 · presentation

…lies below it). Always check for pneumothorax after IJ or subclavian placement.

Why flagged: ideal tip position recommendations differ between guidelines

Superior vena cava · Anatomy · course

…the right atrium at about the level of the right 3rd costal cartilage.

Thoracic aorta · Imaging · xray

…on: rib notching, "figure 3" contour. A normal CXR does not exclude dissection.

Why flagged: widening thresholds (e.g. >8 cm on supine AP) vary

Thoracic duct · Anatomy · notes

…ck. There it arches laterally (at about C7) to open into the left venous angle.

Why flagged: exact crossing level varies between texts and individuals

Thymus · Clinical 1 · mechanism

…common in MG. Other associations: pure red cell aplasia, hypogammaglobulinemia.

Why flagged: commonly quoted: ~30–50% of thymomas with MG; ~10–15% of MG patients with thymoma

Trachea · Clinical 2 · presentation

…t left breath sounds. Confirm with end-tidal CO₂, auscultation and chest X-ray.

Why flagged: target tip position is usually quoted as about 3–5 cm above the carina in adults

Tricuspid valve · Anatomy · location

…ventricle, behind the sternum at about the level of the 4th intercostal space.

Anterior abdominal wall · Anatomy · notes

…from the umbilicus to the pubis) marks where the posterior rectus sheath ends.

Why flagged: vertebral levels vary with body habitus and posture

Colon · Imaging · xray

…is at risk of perforation). Coffee bean sign in sigmoid volvulus. Free air.

Why flagged: cecal diameter threshold varies

Gallbladder and biliary tree · Imaging · xray

…ble). Pneumobilia with gallstone ileus. Porcelain gallbladder (calcified wall).

Why flagged: percentage of radiopaque stones

Gallbladder and biliary tree · Imaging · ultrasound

…han about 6 mm, higher after cholecystectomy or with age) suggests obstruction.

Why flagged: CBD diameter thresholds vary with age

Inferior epigastric artery · Clinical 2 · presentation

…nd superior to the ASIS, ideally with ultrasound guidance to avoid the vessels.

Why flagged: preferred site descriptions vary between protocols

Inferior vena cava · Imaging · ultrasound

…id status (limited reliability in ventilated patients). Doppler for thrombosis.

Why flagged: IVC-based volume assessment has significant limitations

Inguinal canal · Exam · testing

…ct is unreliable on exam; the distinction is made surgically or on imaging.

Kidney · Imaging · ultrasound

…tones in pregnancy or children. Normal adult kidney length is roughly 10–12 cm.

Why flagged: normal size ranges vary

Liver · Exam · landmarks

…er span by percussion in the right midclavicular line is roughly 6–12 cm.

Why flagged: normal span values vary with body size and technique

Liver · Anatomy · bloodSupply

…er (about 25%; oxygenated) from the common hepatic artery (celiac-trunk).

Why flagged: commonly quoted 75/25 split

Small intestine (jejunum and ileum) · Imaging · xray

…s in a step-ladder pattern and little colonic gas. Free air with perforation.

Why flagged: diameter thresholds vary

Spermatic cord · Clinical 1 · mechanism

…e into the left renal vein, which can be compressed between the aorta and SMA).

Why flagged: quoted left-sided proportion

Spermatic cord · Imaging · ultrasound

…Valsalva in varicocele; an anechoic collection around the testis in hydrocele.

Why flagged: vein-diameter thresholds vary

Spleen · Imaging · ultrasound

…splenic length; roughly more than 12–13 cm suggests splenomegaly in adults.

Why flagged: size cut-offs vary

Stomach · Imaging · ultrasound

…esholds around 3–4 mm muscle thickness and about 15 mm or more channel length).

Why flagged: thresholds vary between sources

Vermiform appendix · Imaging · ct

…ancement, periappendiceal fat stranding, appendicolith, abscess or perforation.

Why flagged: diameter thresholds vary

Bony pelvis · Imaging · xray

…about 2.5 cm suggests disruption of the pelvic floor and sacroiliac ligaments.

Why flagged: threshold for symphyseal diastasis in APC injuries

Bony pelvis · Anatomy · features · 5

…clinically (about 12.5 cm). The obstetric conjugate is about 1.5–2 cm shorter.

Why flagged: typical values vary slightly between obstetric texts

Hip bone · Anatomy · ossification

…Y-shaped triradiate cartilage that fuses around puberty (about 15–17 years)

Why flagged: age of triradiate fusion varies between sources

Internal iliac artery · Anatomy · relations

…rona mortis") and can bleed during hernia repair or pelvic fracture fixation.

Why flagged: prevalence estimates vary widely

Ovary · Exam · palpation

…woman needs evaluation, because the ovaries normally atrophy after menopause.

Ovary · Anatomy · innervation

…pain is referred to the periumbilical region and lower abdomen (about T10–T11)

Pelvic and inguinal lymph drainage · Imaging · ct

…odes (short-axis size criteria, about 1 cm for most pelvic groups) for staging.

Why flagged: node size thresholds vary by site

Pelvic autonomic nerves · Anatomy · sensory

…e sigmoid colon is an exception, sending pain with the parasympathetic fibers.)

Why flagged: exceptions to the pelvic pain line

Pelvic diaphragm · Anatomy · innervation

…and perineal branches of the pudendal-nerve. Coccygeus: S3–S4 ventral rami.

Why flagged: the pudendal contribution to levator ani is described differently between sources

Penis · Clinical 3 · presentation

…rgical repair; up to about 1 in 5 have a urethral injury (blood at the meatus).

Pubic symphysis · Imaging · xray

…views can show dynamic instability (a vertical shift of more than about 2 mm)

Why flagged: flamingo view instability threshold

Pubic symphysis · Anatomy · innervation

Branches of the iliohypogastric, ilioinguinal and pudendal nerves

Pubic symphysis · Anatomy · bloodSupply

…the obturator, inferior epigastric and internal and external pudendal arteries

Rectouterine pouch · Anatomy · boundaries · floor

…from the posterior vaginal fornix onto the rectum, about 5–6 cm above the anus

Sacroiliac joint · Exam · specialTests · 2 · significance

…ts. Several positive provocation tests together make SI joint pain more likely.

Why flagged: diagnostic accuracy of provocation-test clusters

Sacroiliac joint · Anatomy · innervation

…rami of about L5–S3 posteriorly, with anterior contributions from ventral rami

Why flagged: reported innervation varies (L2/L4–S3)

Uterine artery · Anatomy · notes

…order of 500–750 mL/min, which is why postpartum hemorrhage can be torrential.

Why flagged: term uterine blood flow estimate

Uterine tubes · Anatomy · innervation

…terovaginal) plexuses; visceral pain with sympathetic afferents to about T10–L1

Axillary nerve · Exam · landmarks

…oid about at the level of the surgical neck, roughly 5–6 cm below the acromion.

Why flagged: landmark distance quoted differently between sources

Brachial plexus · Exam · specialTests · 1 · technique

…ends the neck, rotates the head toward the tested side and takes a deep breath.

Why flagged: head rotation direction differs between sources (toward vs away from the tested side)

Clavicle · Anatomy · classification

…cribed as lacking a true medullary cavity (spongy bone within a compact shell).

Clavicle · Anatomy · ossification

…medial (sternal) epiphysis is among the last to fuse, in the early-to-mid 20s.

Why flagged: exact timing of medial epiphyseal fusion varies between sources

Deltoid · Clinical 2 · presentation

…art of the middle deltoid, about 2–3 fingerbreadths (≈5 cm) below the acromion.

Why flagged: landmark recommendations differ slightly between guidelines

Deltoid · Anatomy · bloodSupply

…humeral artery (principal) and the deltoid branch of the thoracoacromial artery

Elbow joint · Anatomy · movements · 2

…carrying angle (cubitus valgus) of about 5–15°, typically greater in females

Glenohumeral joint · Anatomy · movements · 1

…pulothoracic motion (scapulohumeral rhythm, about 2:1 glenohumeral to scapular)

Infraspinatus · Anatomy · bloodSupply

Suprascapular and circumflex scapular arteries

Long thoracic nerve · Imaging · ultrasound

…e on the superficial surface of serratus anterior along the lateral chest wall.

Why flagged: whether this is routine practice varies by institution

Median nerve · Clinical 2 · mechanism

…st often injured in extension-type fractures), or with compression or neuritis.

Why flagged: some older texts name the radial nerve as most commonly injured in supracondylar fractures

Median nerve · Imaging · ultrasound

…s-sectional area at the tunnel inlet (pisiform level) supports the diagnosis.

Why flagged: diagnostic cut-offs vary between studies, roughly 9–12 mm²

Median nerve · Anatomy · roots

C6, C7, C8, T1 (± C5)

Why flagged: some texts include C5 via the lateral root. Check which your atlas uses.

Pronator teres · Exam · specialTests · 0 · significance

Suggests pronator syndrome.

Pronator teres · Anatomy · bloodSupply

…ulnar-artery (including the anterior ulnar recurrent) and radial-artery

Radial artery · Exam · specialTests · 0 · positive

…too long to return to the palm. Thresholds of roughly 5–10 seconds are quoted.

Why flagged: normal-return threshold varies between sources

Radial nerve · Anatomy · motor

…s longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis.

Why flagged: whether ECRB is supplied by the deep branch or the superficial branch varies between sources

Radius · Clinical 3 · mechanism

…the hand). The anular ligament slips over the radial head. Typically ages 1–4.

Why flagged: quoted peak age range varies

Radius · Imaging · xray

…ghly: radial inclination ~22°, radial height ~11–12 mm and volar tilt ~11°.

Why flagged: normal values differ slightly between sources

Scaphoid · Clinical 3 · presentation

…akness. On PA radiograph, a widened scapholunate gap ("Terry Thomas" sign).

Why flagged: >3 mm is the commonly quoted threshold

Scapula · Anatomy · location

Posterolateral thoracic wall, overlying ribs 2–7.

Why flagged: some sources give ribs 2–8

Scapula · Anatomy · relations

…trapezius, the rhomboids and levator scapulae. Seventeen muscles attach to it.

Why flagged: the count of attaching muscles varies with how muscles are counted

Serratus anterior · Anatomy · origin

…surfaces of the lateral parts of the upper 8–9 ribs by fleshy digitations.

Why flagged: textbooks give ribs 1–8 or 1–9

Serratus anterior · Anatomy · bloodSupply

Lateral thoracic and thoracodorsal arteries

Subscapularis · Anatomy · innervation

Upper and lower subscapular nerves from the posterior cord (C5, C6)

Why flagged: some texts list C5–C7

Subscapularis · Anatomy · bloodSupply

Subscapular artery and its branches

Supraspinatus · Imaging · xray

…ve tears the humeral head rides up and the acromiohumeral interval narrows.

Why flagged: a threshold of <7 mm is commonly quoted

Supraspinatus · Anatomy · innervation

Suprascapular nerve (C5, C6)

Why flagged: some texts include C4

Supraspinatus · Anatomy · bloodSupply

Suprascapular artery

Teres minor · Anatomy · bloodSupply

Circumflex scapular and posterior circumflex humeral arteries

Triceps brachii · Exam · specialTests · 0 · significance

Suggests complete triceps tendon rupture.

Triceps brachii · Anatomy · bloodSupply

Profunda brachii (deep brachial) artery

Why flagged: additional supply from the posterior circumflex humeral and ulnar collateral arteries

Ulnar artery · Imaging · keyViews · 1

…(tortuous "corkscrew" ulnar artery is described in hypothenar hammer syndrome)

Ulnar artery · Anatomy · termination

…arch lies at about the level of the distal border of the fully extended thumb.

Wrist joint · Exam · specialTests · 1 · significance

Suggests a TFCC foveal tear or ulnotriquetral ligament injury.

Ankle joint · Imaging · xray

…over about 4 mm suggests deltoid/syndesmotic injury) and tibiofibular overlap.

Why flagged: medial clear space threshold

Bones of the foot · Imaging · ultrasound

Thickened plantar fascia (over about 4 mm) in plantar fasciitis.

Why flagged: thickness threshold

Femur · Anatomy · ossification

…fuse in late adolescence; the distal epiphysis fuses last (about 18–20 years).

Why flagged: fusion ages vary by sex and source

Menisci of the knee · Exam · specialTests · 1 · significance

Meniscal tear.

Why flagged: reported accuracy varies widely between studies

Piriformis · Clinical 1 · presentation

…oot signs. Treat with stretching and physical therapy; injection if refractory.

Why flagged: diagnostic criteria are debated

Deep neck spaces · Imaging · xray

…an half the vertebral body width) in children suggests retropharyngeal abscess.

Why flagged: pediatric cutoff values

Deep neck spaces · Anatomy · contents · 0

…pper mediastinum); contains retropharyngeal nodes (prominent in young children)

Why flagged: inferior extent T1–T2 vs T4 varies between sources

Eyeball · Clinical 1 · presentation

…molol, pilocarpine, apraclonidine, IV/oral acetazolamide, then laser iridotomy.

Why flagged: IOP value

Internal jugular vein · Clinical 1 · presentation

…P rises with inspiration (constrictive pericarditis). Hepatojugular reflux.

Why flagged: normal JVP cutoff varies by source (3 vs 4 cm)

Larynx · Clinical 4 · presentation

…Needle cricothyrotomy is preferred in young children (under about 10–12 years).

Why flagged: pediatric age cutoff varies by source

Larynx · Anatomy · parts · 2

…airway. In infants the narrowest part is the subglottis at the cricoid level.

Why flagged: pediatric narrowest point is debated

Middle meningeal artery · Imaging · xray

…f the middle meningeal artery is also used to treat chronic subdural hematomas.

Paranasal sinuses · Anatomy · notes

…the frontal sinus appears around age 5–7 and develops through adolescence.

Why flagged: ages of sinus development

Recurrent laryngeal nerve · Anatomy · notes

…n a small minority of people, usually with an aberrant right subclavian artery.

Why flagged: prevalence ~0.5–1%

Skull · Anatomy · ossification

…8–24 months, the posterior fontanelle (triangular) by about 2 months.

Why flagged: typical fontanelle closure ages

Submandibular gland · Clinical 1 · mechanism

…saliva is more mucous and alkaline and its duct is long and runs upward.

Temporomandibular joint · Exam · testing

…' breadth); observe deviation of the jaw on opening (toward the affected side).

Thyroid gland · Clinical 1 · mechanism

…odules, adenomas); about 5–10% are malignant (papillary carcinoma most common).

Why flagged: malignancy rate

Circle of Willis · Anatomy · anastomoses

…ircle is present in only a minority of people, so collateral capacity varies.

Why flagged: proportion with a complete circle varies widely between studies

Ventricular system and CSF · Anatomy · notes

…l opening pressure on lumbar puncture is about 6–20 cm H₂O (lateral decubitus).

Why flagged: upper limit quoted as 20 or 25 cm H₂O