Neuroanatomy and Craniofacial Imaging Anatomy — WACS Viva & Clinical Scenarios (Radiological Anatomy and Normal Imaging Variants)

Exam-style neuroanatomy and craniofacial imaging anatomy viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: Spotter / Cross-Sectional Station: Multiplanar MRI of the Brain (Axial T1-weighted, T2-weighted, and Coronal T2-weighted sequences at the level of the basal ganglia and internal capsule). Identify the structures indicated by the pointers: the head of the caudate nucleus, anterior limb of the internal capsule, genu of the internal capsule, posterior limb of the internal capsule, globus pallidus, putamen, claustrum, external capsule, and thalamus. Describe the arterial blood supply to each limb of the internal capsule.
• SCENARIO 2: Practical Cross-Sectional Station: High-Resolution Computed Tomography (HRCT) of the Temporal Bone (Axial and Coronal bone-algorithm images at 0.6 mm slice thickness). Identify the labelled structures: the internal acoustic meatus, facial nerve canal (labyrinthine, tympanic, and mastoid segments), geniculate ganglion fossa, cochlea (basal, middle, and apical turns), vestibule, lateral semicircular canal, vestibular aqueduct, tegmen tympani, scutum, Prussak space, and auditory ossicles (malleus, incus, and stapes). State the anatomical criteria for an enlarged vestibular aqueduct.
• SCENARIO 3: Written / Multi-Part Examination Prompt: Skull Base Foramina and Cranial Nerve Pathways. Provide a detailed anatomical account of the cavernous sinus and jugular foramen. Delineate the exact boundaries, compartmental divisions, and precise neurovascular contents of each space. Describe their cross-sectional appearance and signal characteristics on contrast-enhanced multiplanar MRI and high-resolution bone CT.
• SCENARIO 4: Practical / OSPE Station: Paranasal Sinuses and Anterior Skull Base CT (Coronal bone window reconstructions). Trace the normal drainage pathway of the frontal and maxillary sinuses. Identify the uncinate process, ethmoidal infundibulum, hiatus semilunaris, ethmoid bulla, middle turbinate (including ground lamella), and sphenoethmoidal recess. Define the Keros classification for the depth of the olfactory fossa and explain its clinical-radiological significance in endoscopic sinus surgery.
• SCENARIO 5: Multiplanar MRI / Sonography Station: Ventricular System, Cisternal Anatomy, and Neonatal Transfontanellar Neurosonography. Identify the anatomical components of the ventricular system on coronal and sagittal neonatal ultrasound views through the anterior fontanelle. Correlate these with standard adult axial T2-weighted and T2-FLAIR MRI sequences through the posterior fossa and suprasellar cisterns, labeling the foramina of Monro, Luschka, and Magendie, the cerebral aqueduct, prepontine cistern, ambient cistern, quadrigeminal cistern, and cisterna magna.