NMTCB Anatomy & Physiology for Nuclear Medicine 2 — Questions and Answers
Question 1: During a parathyroid scan with Tc-99m sestamibi, a parathyroid adenoma is most commonly found in which anatomical location?
- Superior mediastinum
- Inferior parathyroid glands (near inferior thyroid poles) (Correct answer)
- Anterior neck above the thyroid
- Lateral pharyngeal wall
Correct answer: Inferior parathyroid glands (near inferior thyroid poles)
Parathyroid adenomas most commonly arise from the inferior parathyroid glands located near the inferior thyroid poles, where persistent sestamibi uptake differentiates them from thyroid tissue.
Question 2: A gastric emptying study uses a radiolabeled solid meal. Which part of the stomach is primarily responsible for trituration and propulsion of solids toward the pylorus?
- Fundus
- Cardia
- Antrum (Correct answer)
- Body (corpus)
Correct answer: Antrum
The antrum grinds solid food into small particles (trituration) and propels them through the pylorus; antral dysfunction leads to delayed gastric emptying.
Question 3: In a sentinel lymph node mapping procedure for breast cancer, the primary lymph node basin targeted is located in which anatomical region?
- Inguinal region
- Axilla (Correct answer)
- Supraclavicular fossa
- Parasternal region
Correct answer: Axilla
Breast lymphatics drain predominantly to the axillary lymph nodes, which are the primary sentinel node basin mapped in breast cancer procedures.
Question 4: Which anatomical structure separates the right and left lobes of the liver and is used as a landmark in hepatic imaging?
- Falciform ligament (Correct answer)
- Coronary ligament
- Round ligament
- Triangular ligament
Correct answer: Falciform ligament
The falciform ligament is the key anatomical landmark separating the right and left hepatic lobes and is visible as a photopenic line on liver-spleen scans.
Question 5: In brain perfusion SPECT imaging, which anatomical structure shows characteristically low perfusion in Alzheimer's disease on a Tc-99m HMPAO scan?
- Occipital cortex
- Primary motor cortex
- Temporoparietal cortex (Correct answer)
- Cerebellum
Correct answer: Temporoparietal cortex
Alzheimer's disease classically shows bilateral temporoparietal hypoperfusion on brain SPECT, reflecting the distribution of neurofibrillary tangle pathology.
Question 6: During a Meckel's diverticulum scan, ectopic gastric mucosa accumulates Tc-99m pertechnetate. Meckel's diverticulum is located in which bowel segment?
- Duodenum (second portion)
- Jejunum
- Ileum (within 2 feet of ileocecal valve) (Correct answer)
- Cecum
Correct answer: Ileum (within 2 feet of ileocecal valve)
Meckel's diverticulum is a remnant of the omphalomesenteric duct located within 2 feet (60 cm) of the ileocecal valve in the ileum.
Question 7: Which bony landmark serves as the inferior boundary of the anterior pelvic ring and is frequently identified on pelvic bone scans?
- Iliac crest
- Ischial tuberosity
- Pubic symphysis (Correct answer)
- Acetabulum
Correct answer: Pubic symphysis
The pubic symphysis is the fibrocartilaginous joint at the inferior midline of the anterior pelvic ring and is a common site of stress reaction or infection seen on bone scans.
NMTCB Anatomy & Physiology for Nuclear Medicine 2
During a parathyroid scan with Tc-99m sestamibi, a parathyroid adenoma is most commonly found in which anatomical location?