Thoracic, Mediastinal, and Cardiac Cross-Sectional Anatomy — WACS Viva & Clinical Scenarios (Radiological Anatomy and Normal Imaging Variants)

Exam-style thoracic, mediastinal, and cardiac cross-sectional anatomy viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: A series of axial thin-section (1 mm) high-resolution computed tomography (HRCT) thoracic images is displayed at the level of the bronchus intermedius and lower lung zones. Identify the designated central and peripheral structures of the secondary pulmonary lobule, differentiate the anatomical fissures, and delineate the segmental bronchi of the right lower lobe according to standard Boyden nomenclature.
• SCENARIO 2: Cross-Sectional Lymphatic Mapping: Axial and multiplanar reformatted contrast-enhanced thoracic CT images demonstrate the mediastinal nodal stations. Identify and define the precise anatomical borders for IASLC Station 2R, Station 4R, Station 5 (aortopulmonary window), and Station 7 (subcarinal), detailing their specific vascular, airway, and bony landmarks.
• SCENARIO 3: Mediastinal Compartment Cross-Sectional Anatomy: Compare the traditional Felson four-compartment mediastinal schema with the International Thymic Malignancy Interest Group (ITMIG) cross-sectional classification on CT. Identify the boundaries separating the prevascular, visceral, and paravertebral compartments on provided axial CT images at the level of the aortic arch and subcarinal space.
• SCENARIO 4: Cardiac and Pericardial Cross-Sectional Anatomy: On multiplanar cardiac CT and MRI reconstructions (axial, standard 4-chamber, short-axis, and left ventricular outflow tract views), identify the anatomical features of the right ventricle (including the moderator band and crista supraventricularis), the left atrium and pulmonary venous ostia, and differentiate the transverse and oblique pericardial sinuses from normal pericardial recesses.
• SCENARIO 5: Thoracoabdominal Junction, Diaphragmatic Apertures, and Chest Wall: On axial and coronal CT reconstructions, trace the diaphragmatic crura, median arcuate ligament, and the three major diaphragmatic apertures. State their respective vertebral levels, traversing neurovascular and visceral structures, and describe the anatomical course and muscular relations of the internal thoracic (mammary) arteries along the anterior chest wall.