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Назва наукового напрямку (модуля): Семестр: Topographical anatomy and operative surgery of regin and organ of thoracic cavity.(2c.med.Sem.Contr) Опис: Перелік питань: 1. A. B. C. D. E. * 2. A. B. C. D. E. * 3. A. B. C. * D. E. 4. A. B. C. * D. E. 5. A. B. C. * D. E. 6. A. B. C. D. * E. 7. A. B. C. The left coronary artery: Arises from the anterior surface of the aorta Ordinarily supplies the posterior interventricular branch Ordinarily supplies the diaphragmatic portion of the right ventricle All these None of these Characteristics of the left lung include which of the following? It is heavier than the right lung It is composed of three lobes The azygos vein arches over its root It has a horizontal fissure The cardiac notch is found on its superior lobe All of the following statements concerning the atrioventricular valves are true, except: The valves are attached to the anuli fibrosi The right atrioventricular (tricuspid) valve is formed by the posterior, inferior and septal cusps The left atrioventricular (mitral) valve is formed by the septal and left cusps Each cusp receives chordae tendinae from more than one papillary muscle The chordae tendinae of the mitral valve are thicker than those of the tricuspid The pericardial sinuses areof considerable interest to the cardiac surgeon. When the surgeon’s finger is in the transverse sinus, which of the following structures is not related to the sinus in the manner noted? anterior to the sinus Aorta, Pulmonary artery, anterior to the sinus Superior vena cava, anterior to the sinus Left atrium, posterior to the sinus Superior left pulmonary vein, posterior to the sinus The central part of the parietal diaphragmatic pleura is supplied by which of these nerves? Intercostals Vagus Phrenic Parasympathetics Sympathetics On the diaphragmatic surface of the heart, the posterior interventricular sulcus separates which of the following chambers? Right ventricle-right atrium Left ventricle-left atrium Left atrium-right atrium Left ventricle-right ventricle Left ventricle-right atrium The parietal pleura is described by each of the following terms except: Diaphragmatic Cervical Costal D. E. * 8. A. B. C. * D. E. 9. A. * B. C. D. E. 10. A. B. C. * D. E. 11. A. B. C. D. * E. 12. A. * B. C. D. E. 13. A. B. C. D. E. * 14. A. * B. C. D. E. Mediastinal Basal The blood supply to the anterior two-thirds of the interventricular septum is provided by the: Marginal branch of the right coronary artery Marginal branch of the left coronary artery Anterior interventricular artery Circumflex branch of the left coronary artery Posterior interventricular artery Which one of the following structures in the posterior mediastinum is found immediately posterior to the left atrium and pericardium? Esophagus Vagus nerves Azygos vein Thoracic duct Right pulmonary artery All of these statements about intercostal arteries are correct except: The upper two posterior intercostal arteries arise from the supreme intercostal artery The lower nine posterior intercostal arteries arise from the aorta The superior epigastric artery supplies anterior intercostal arteries Intercostal arteries run under the shelter of a costal groove Intercostal arteries accompany each intercostal nerve Which of the following structures is not located in the mediastinum? Heart and pericardium Trachea Vessels proceeding to and from the heart Lungs Vagus nerves Which of the following statements concerning intercostals nerves is correct? They are the ventral rami of the thoracic spinal nerves There are 11 pairs of thoracic spinal nerves The thoracic spinal nerves are commonly called subcostal nerves The ventral rami of the thoracic spinal nerves supply muscle, bone, joint, and skin of the back They supply the parietal pleura and are mainly sensory nerves Which of the following structures passes through the aortic hiatus of the diaphragm? Vagus nerve Esophagus Inferior vena cava Sympathetic trunk Azygos vein All of the following veins drain into the coronary sinus except the: Anterior cardiac veins Great cardiac vein Middle cardiac vein Oblique vein of left atrium Small cardiac vein 15. The major venous return system of the heart, the coronary sinus, empties into the: A. B. C. * D. E. 16. A. B. C. D. E. * 17. A. Inferior vena cava Left atrium Right atrium Superior vena cava Right ventricle Which of these statements is true in relation to intercostal nerves? In the intercostal space, they run between the internal and external intercostals muscles They are located in the costal groove above the artery and vein They are all confined to the thorax They are entirely cutaneous to the thoracic wall The upper six nerves terminate as anterior cutaneous branches All the following structures empty into the right atrium of the heart except the: Coronary sinus Inferior vena cava Superior vena cava Anterior cardiac veins Pulmonary veins The lateral boundary of the superior mediastinum is the: Lateral border of the sternum T-1 to T-4 vertebrae Sternal angle Mediastinal pleura T-2 to T-5 vertebrae Most of the sternocostal surface of the heart is formed by the: Right atrium Right ventricle Left ventricle Right auricle Left atrium Each of the following arteries is a branch of the internal thoracic except the: Pericardiophrenic Superior phrenic Musculophrenic Superior epigastric Anterior intercostals Which of the following structures passes posterior to the root of the right lung? Hemiazygos vein Right vagus nerve Right phrenic nerve Thoracic aorta Right recurrent laryngeal nerve Each of the following vessels empties into the coronary sinus except the: Great cardiac vein Middle cardiac vein B. C. D. E. * 18. A. B. C. D. * E. 19. A. B. * C. D. E. 20. A. B. * C. D. E. 21. A. B. * C. D. E. 22. A. B. C. * D. E. 23. A. B. * C. D. E. 24. A. B. C. * D. E. 25. A. B. C. * D. E. 26. A. B. * C. D. E. 27. A. B. C. * D. E. 28. A. B. C. D. * E. 29. A. B. C. D. * Anterior cardiac vein Small cardiac vein Posterior vein of the left ventricle Each of the following structures is found in the posterior mediastinum except the: Vagus nerve Phrenic nerve Azygos vein Descending aorta Esophagus The brachiocephalic veins receive venous blood directly from each of the following except the: Subclavian vein Internal jugular vein External jugular vein Inferior thyroid vein Internal thoracic vein Each of the following is related to the right ventricle except the: Interventricular septum Trabeculae cameae Bicuspid valve Anterior papillary muscle Septomarginal band The greater splanchnic nerve usually contains nerve fibers derived from each of the following spinal nerves except: T-5 T-10 T-9 T-7 T-8 The left coronary artery bifurcates into the circumflex branch and the: Left marginal branch Left ventricular branch Anterior interventricular branch Right marginal branch Posterior interventricular branch The posterior intercostal artery in the fifth intercostal space arises from the Musculophrenic artery Internal thoracic artery Costocervical trunk Thoracic aorta Subclavian artery All of the following can be found in the coronary sulcus (atrioventricular groove) except the Right coronary artery Circumflex branch of the left coronary artery Great cardiac vein Middle cardiac vein E. 30. A. B. * C. D. E. 31. A. B. C. D. * E. 32. A. B. C. * D. E. 33. A. B. C. D. E. * 34. A. B. C. * D. E. 35. A. * B. C. D. E. 36. A. * B. C. Coronary sinus The most anterior of the following structures in the superior mediastinum is the: Aortic arch Brachiocephalic vein Left common carotid artery Right common carotid artery Phrenic nerve Each of the following arteries is a branch of the descending thoracic aorta except the: Posterior intercostal Esophageal Bronchial Left subclavian Pericardial Within the superior mediastinum, the anterior surface of the esophagus is in contact with the: Thoracic duct Anterior longitudinal ligament of the vertebral column Trachea Thymus Arch of the aorta The thoracic duct is correctly described by each of the following except it: Is the largest lymphatic channel in the body Arises in a dilatation known as the cistema chyli within the abdomen Returns to the bloodstream lymph from all of the body below the diaphragm and from the left half of the body above the diaphragm Courses through the posterior mediastinum between the aorta and the azygos vein Diverges in the superior mediastinum to the right side of the esophagus, towards the right superior aperture of the neck Each of the following statements correctly describes the costodiaphragmatic recess except: It is an inferior extension of the pleural cavity It represents an area where the costal and diaphragmatic layers of parietal pleura can come into apposition with each other It is a sub-compartment of the thoracic cavity In quiet respiration, it is usually found deep to the eighth and ninth intercostals spaces in the midaxillary line It contains a thin film of serous fluid The most superior structure at the root of the left lung is the: Pulmonary artery Superior pulmonary vein Primary bronchus Inferior pulmonary vein Bronchiolar artery The horizontal fissure of the right lung separates the Superior and middle lobes Superior and inferior lobes Inferior and middle lobes D. E. 37. A. B. C. D. E. * 38. A. B. C. * D. E. 39. A. * B. C. D. E. 40. A. B. C. D. E. * 41. A. B. C. * D. E. 42. A. * B. C. D. E. 43. A. B. C. D. * E. 44. Superior lobe from the cardiac notch Superior lobe and lingula Each of the following is found at the horizontal plane of the sternal angle except the: Superior termination of the fibrous pericardium Intervertebral disk between the fourth and fifth thoracic vertebrae Beginning and termination of aortic arch Bifurcation of trachea Bifurcation of the brachiocephalic artery into the right subclavian and right common carotid arteries The part of the rib that articulates with the transverse process of the vertebra is the: Superior articular facet Inferior articular facet Tubercle articular facet Angle Neck The superior vena cava is formed: Deep to the right first costal cartilage Deep to the right second costal cartilage Deep to the right sternoclavicular joint Deep to the right subclavian artery Anterior to the aortic arch Deep to the fourth intercostal space on the right side of the sternum is the: Superior vena cava Right brachiocephalic vein Left brachiocephalic vein Brachiocephalic trunk Right atrium The esophageal hiatus transmits the esophagus and the: Superior phrenic artery Thoracic duct Vagal nerve trunks Greater splanchnic nerve Lesser splanchnic nerve The musculophrenic artery is a branch of which of the following arteries? Internal thoracic Inferior epigastric Superficial epigastric Superficial circumflex Deep external pudendal The aortic hiatus of the diaphragm is located at the level of which vertebra? Fourth cervical Sixth cervical Fifth thoracic 12th thoracic Fourth lumbar The mediastinum contains all the following structures except the: A. B. * C. D. E. 45. A. B. C. D. * E. 46. A. B. C. * D. E. 47. A. B. C. D. E. * 48. A. B. C. D. E. * 49. A. * B. C. D. E. 50. A. B. C. * D. E. 51. A. B. C. Heart Lungs Pulmonary arteries Trachea Esophagus Anatomically components of the proper thoracic wall include the: Pectoral muscles Serratus anterior Trapezius Intercostal muscles Latissimus dorsi The superior thoracic aperture can be described correctly by which of these statements? It is large and irregular It is bounded by the third thoracic vertebra Its plane slopes downward and forward It includes the costal arch It involves costal cartilages of the tenth rib The sternal angle is found at which of these locations? Jugular notch Xiphoid process Level with the fourth costal cartilage Level with the lower border of the sixth thoracic vertebra Manubriosternal joint Ossification of the parts of the body of the sternum usually is complete by age (in years): One Three Six 15 21 Which of the following defines true ribs? Upper seven pairs All 12 pairs Lower five pairs 10th and 11th pairs 12th pair All the following are correct statements about rib fractures except Most often they occur just anterior to the costal angle Most frequently they occur as a result of compression forces on the thorax Splinting the chest wall is essential treatment Broken rib ends tend to spring outward Fractured bone ends may injure the lungs Which of these statements correctly describes intercostal muscles? External intercostals begin anteriorly External intercostal membrane is posterior Fibers of external intercostals slant upward and backward D. * E. 52. A. B. * C. D. E. 53. A. B. C. D. E. * 54. A. B. C. * D. E. 55. A. * B. C. D. E. 56. A. B. C. D. * E. 57. A. * B. C. D. E. 58. A. B. C. * D. Fibers of internal intercostals run upward and forward Innermost intercostals are the best developed of the intercostals Innervation of the thoracic wall can be described, correctly by all the following statements except: It receives a nerve supply from spinal nerves T1-12 It receives no nerve supply from cervical nerves Cutaneous innervation of skin over paravertebral regions of the thorax is provided by dorsal rami of spinal nerves Ventral rami of T1-11 are called intercostals nerves The ventral ramus of T12 is the subcostal nerve Which of these statements is true in relation to intercostal nerves? In the intercostal space, they run between the internal and external intercostal muscles They are located in the costal groove above the artery and vein They are all confined to the thorax They are entirely cutaneous to the thoracic wall The upper six nerves terminate as anterior cutaneous branches Which of the following statements is correct regarding the blood vessels of the thoracic wall? In the intercostal space, the vessels run just below the respective intercostal nerve Branches of the vessels vary widely from those of the intercostal nerves Superficial structures of the thorax are served by intercostal vessels Posterior intercostal arteries are branches of the internal thoracic artery Branches of the descending thoracic aorta become anterior intercostal arteries All the following are true statements about the anterior thoracic artery except: It is a branch of the arch of the aorta It descends behind the subclavian vein It divides into two terminal branches It gives branches to the mediastinum The musculophrenic artery is one of its terminal branches Innervation of pleura can be described correctly by all of these statements except: Costal pleura is supplied by intercostal nerves The central portion of diaphragmatic pleura is supplied by the phrenic nerve Peripheral diaphragmatic pleura is supplied by intercostal nerves The pain of pleurisy is mediated by autonomic nerves Mediastinal pleura is supplied by the phrenic nerve Which of the following statements is correct in relation to internal anatomy of the lung? Bronchopulmonary segments are the anatomic units Arteries and veins provide the major lung framework Bronchi branch symmetrically Bronchi are hollow tubes without particular wall support Pulmonary vessels show no particular relationship to bronchial branching Which of these items is true regarding external anatomy of the lung? The upper tapered end of the lung is its base The root of the lung is located at its base Visceral pleura covers all lung surfaces Lobes are comparable to bronchopulmonary segments E. 59. A. B. C. D. E. * 60. A. * B. C. D. E. 61. A. B. * C. D. E. 62. A. B. C. D. E. * 63. A. B. C. * D. E. 64. A. B. C. D. * E. 65. A. B. * C. D. E. 66. A. Each lung has three lobes Which of these statements is correct regarding pulmonary circulation of the lung? It is the main blood supply to the bronchi It is the main blood supply to the connective tissue of the lung The pulmonary trunk goes directly to the left lung Pulmonary veins enter the right atrium of the heart The pulmonary trunk arises from the right ventricle The ligamentum arteriosum is located correctly by which of the following? Between the left pulmonary artery and the aortic arch Between the ductus arteriosus and the right pulmonary artery Between the left pulmonary vein and the aorta Between the right pulmonary vein and the pulmonary trunk Between the left bronchial artery and the aortic arch All the following are correct statements about pulmonary veins except: Two veins pass from the hilum of each lung Usually they enter the right atrium of the heart They show more variation than do the pulmonary arteries They are formed by confluence of capillaries in the lung Their primary tributaries are related to particular bronchopulmonary segments The bronchial arteries may arise from all the following except the: Descending aorta Right intercostal artery Arch of the aorta Subclavian artery Anterior thoracic artery Which of the following statements describes nerve supply of the lungs correctly? Sympathetic fibers in the pulmonary plexus are preganglionic fibers Vagal fibers in the pulmonary plexus are postganglionic fibers Visceral afferents from the lung have been demonstrated only in the vagus nerve The vagus innervates the smooth muscle in walls of pulmonary vessets Sympathetic fibers control constriction of the bronchi All of the following statements about the pericardial sac are true except: The outer layer is fibrous Epicardium completely invests the heart The pericardial sac and its contents comprise the middle mediastinum The fibrous pericardium lubricates the moving surfaces of the heart The pericardial sac is fused to the central tendon of the diaphragm Which of these items correctly describes the heart? All the great veins enter its apex Its base is made largely of the left atrium and a portion of the right atrium The apex points forward and toward the right The diaphragmatic surface is formed largely by the right ventricle and atrium The coronary sinus occupies the posterior interventricular sulcus The right atrium includes all of these structures except the: Tricuspid valve B. C. D. E. * 67. A. * B. C. D. E. 68. A. B. C. * D. E. 69. A. B. C. D. E. * 70. A. B. * C. D. E. 71. A. B. C. D. E. * 72. A. * B. C. D. E. 73. A. B. C. D. * Crista terminalis Musculi pectinati Fossa ovalis Trabeculae cameae Which of these statements correctly describes the azygos venous system? Primarily it drains blood from the body wall Normally it drains into the inferior vena cava It is located entirely on the right side of the vertebral column It receives no blood from thoracic viscera It has a number of valves All of these items correctly described the thoracic duct except: It returns lymph from the greater part of the body to the venous system It is the upward continuation of the cisterna chyli It ends at the confluence of the right subclavian and brachiocephalic veins In most of its course it lies behind the esophagus It contains valves Which of the following statements is correct in relation to thoracic splanchnic nerves? Their fibers relay in the sympathetic ganglion chain They are part of the cardiac plexus Usually they are five in number They consist of parasympathetic nerve fibers They are composed predominantly of preganglionic fibers Correct description of structure of the sternum includes which of the following statements? The jugular notch is located at the lower border of the manubrium The upper border of the body is located at the level of the costal cartilage of the second rib The sternal angle is located at the articulation of the body and the xiphoid process The body consists of five fused stemebrae The xiphoid process consists of bone thicker than that of the body Ribs may be described correctly by all the following except: Every rib articulates with the vertebral column The upper seven pairs of ribs are called vertebrosternal Ribs 8, 9, and 10 are called vertebrochondral ribs Floating ribs are the last two pairs Ribs one through 12 are called true ribs Which of these facts about ribs is not true? The typical rib takes an upward slope The sternal end of each arch lies at a lower level than the vertebral end Ribs and cartilages increase in length progressively from first to seventh rib The transverse diameter of the thorax increases progressively from first to eighth rib The ninth is the most obliquely placed rib All of the following are parts of the parietal pleura except: Costal Mediastinal Diaphragmatic Pulmonary E. 74. A. B. C. D. * E. 75. A. B. C. D. * E. 76. A. B. * C. D. E. 77. A. B. C. D. * E. 78. A. B. C. D. E. * 79. A. * B. C. D. E. 80. A. B. * C. D. E. 81. A. Cervical All of these statements describe the aortic arch correctly except: It lies in the superior mediastinum It begins at the level of the sternal angle It gives off the left common carotid artery It gives off the right subclavian artery It gives off the right and left coronary arteries Correct description of the recurrent laryngeal nerves includes which of the following? They are branches of the phrenic nerve They branch from the sympathetic trunk Their neuronal cell bodies are in the cervical spinal cord The left nerve recurs around the ligamentum arteriosum The right nerve recurs around the superior vena cava Each segmental bronchus together with the portion of lung it supplies is called: Primary segment Bronchopulmonary segment Lobar segment Epiarterial segment Alveolar segment Correct information about bronchial arteries includes all the following items except: They arise by a stem from the aorta They supply the pulmonary pleura They supply the bronchi The pressure within them is low They run through the interlobar structures Nerves of the lungs and pleura include all of these except: Branches of the vagus contribute to the pulmonary plexus Efferent vagal fibers are secretomotor Branches of the thoracic sympathetic ganglia 1 through 5 help to form the pulmonary plexus Sensory vagal fibers constitute the afferent limb of the respiratory reflex arc Visceral pleura has many afferent nerves sensitive to mechanical stimulation The tracheal bifurcation can be seen at which of these levels? T4-5 in the supine living subject T8 in the erect subject T6 during inspiration T12 during expiration T2-3 in the supine cadaver If the phrenic nerve was cut close to its origin, which of these effects could be seen? Loss of bronchoconstriction Loss of sensation in the middle diaphragm Loss of power in intercostal muscles Difficulty in expiration Loss of the respiratory reflex arc The brachiocephalic veins are formed from the union of the: External jugular and inferior vena cava B. C. D. * E. 82. A. B. C. D. E. * 83. A. B. C. D. * E. 84. A. * B. C. D. E. 85. A. B. * C. D. E. 86. A. B. C. * D. E. 87. A. B. C. * D. E. 88. A. * B. C. D. Ductus arteriosum and superior vena cava Azygos vein and the axillary vein Internal jugular and subclavian Pulmonary vein and inferior vena cava All the following structures empty into the right atrium of the heart except the: Coronary sinus Inferior vena cava Superior vena cava Anterior cardiac veins Pulmonary veins In the adult, which of the following structures is not prominent in the anterior mediastinum? Loose areolar tissue Fat Lymph vessels and nodes Thymus gland Sternopericardial ligaments The thoracic aorta gives off all of these branches except: The first pair of posterior intercostal arteries Bronchial arteries Pericardial arteries Diaphragmatic arteries One pair of subcostal arteries Which of these statements correctly describes the position of the esophagus? It passes anterior to the left principal bronchus It begins at the level of the cricoid cartilage It descends on the left of the aortic arch It runs in the anterior mediastinum It passes through the hiatus formed by the median arcuate ligament of the diaphragm Which of the following statements is true of the trachea? It descends behind the esophagus Its posterior surface is convex It ends at the level of the sternal angle During inspiration, its bifurcation ascends It contains 0-shaped bars of cartilage All of the following statements correctly describe the left vagus nerve except: It gives off the left recurrent laryngeal nerve Posterior to the left bronchus, it breaks up into the left pulmonary plexus It supplies the left side of the diaphragm It forms part of the esophageal plexus It descends from the neck posterior to the left common carotid artery Which of the following correctly describes the aortic arch? It begins posterior to the sternal angle It passes to the right of the trachea It receives the ligamentum arteriosum from the right pulmonary artery It gives off the right subclavian artery E. 89. A. B. C. D. * E. 90. A. B. * C. D. E. 91. A. * B. C. D. E. 92. A. B. C. * D. E. 93. A. B. C. D. E. * 94. A. B. C. D. E. * 95. A. B. C. D. * E. 96. A. It gives off the left brachiocephalic trunk The superior vena cava returns blood from all of these structures except the: Head Neck Upper limb Lungs Thoracic wall All of the following statements correctly describe the brachiocephalic veins except: Each is formed by the union of the internal jugular and the subclavian veins They contain valves to prevent backflow of blood They unite to form the superior vena cava Each vein receives the internal thoracic vein They arise posterior to the medial ends of the clavicle All of these structures occupy the superior mediastinum except the: Heart and pericardium Thymus Aortic arch Trachea Esophagus Which of the following statements is true regarding the coronary arteries? Sharp lines of demarcation exist between their distribution to right and left ventricles Most of the blood in these arteries returns to the left atrium They arise from the right and left aortic sinuses Variations of these arteries are uncommon They are infrequent sites of arteriosclerosis Which of these statements correctly describes sensation of the heart? Referred pain from the heart rarely occurs Heart ischemia rarely results in generation of painful stimuli Afferent pain fibers from the heart run in the vagus nerve Usually pain from the heart is felt only in the left chest The heart is insensitive to cold, heat, and touch All of the following correctly describe innervation of the heart except: Sympathetics increase rate of heart beat Parasympathetics reduce rate and force of heart beat The impulse conducting system of the heart is controlled by the autonomic nervous system The parasympathetic cardiac nerves supply three branches to each side Vagal stimulation dilates coronary arteries Which of the following is not a characteristic of the left ventricle? Its wall is much thicker than that of the right ventricle Its interior is covered by trabeculae cameae The chordae tendinae of papillary muscles are distributed to cusps of the atrioventricular valve It forms the base of the heart The aorta arises from its anterior uppermost part Characteristics of the left atrium consist of all the following except: It forms most of the base of the heart B. C. * D. E. 97. A. * B. C. D. E. 98. A. B. C. D. * E. 99. A. B. C. D. E. * 100. A. B. C. D. * E. 101. A. B. * C. D. E. 102. A. B. * C. D. E. 103. A. B. C. It contains a few musculi pectinati It receives the pulmonary arteries Much of this atrium lies posterior to the right atrium The auricle overlaps the root of the pulmonary trunk Which of the following is characteristics of the right ventricle: It gives origin to the pulmonary trunk Ussualy it has only two pappilary muscles It receives blood through the mitral valve It has internal muscular ridges, the musculi pectinaty It contains the fossa ovalis Which of the following correctly describes chambers of the heart: The coronary sulcus separates the two ventricles The right ventricle forms the right border of the heart The valve of the superior vena cava directs blood downward The superior vena cava opens into the right atrium The interventricular septum contains the fossa ovalis Which of the following statements about the pericardial sinuses is untrue? Only two major vessels, both arteries, lie anterior to an instruments in the transverse sinus The left atrium lies anterior to an instrument in the oblique sinus The superior and inferior venae cavae lie in the right wall of the obligue sinus A sharp instrument passed through the left part of the posterior wall of the transverse sinus could enter the left atrium None of these statements is true The heart may correctly be described by all the following except: An apex formed by the tip of the left ventricle A diaphragmatic surface formed by both ventricles A base formed by the atria An anterior surface formed mainly by the left atrium A location in the middle mediastinum The epicardium receives its arterial blood supply from the: Pericardiophrenic Coronary arteries Musculophrenic Superior phrenic Bronchial Which of these statements is true of the fibrous pericardium? It has no close relationship with the central tendon of the diaphragm It extends upward to the level of the sternal angle It moves freely within the thoracic cavity Its base is pierced by the aorta It has no attachment to the sternum Which of these statements correctly describes lymphatic drainage of the lungs? Usually both bronchomediastinal lymph trunks terminate in the thoracic duct Only one lymphatic plexus is involved in this drainage Little transfer of lymph drainage from side to side occurs D. * E. 104. A. * B. C. D. E. 105. A. B. C. D. E. * 106. A. B. * C. D. E. 107. A. * B. C. D. E. 108. A. B. C. * D. E. 109. A. B. C. D. * E. 110. A. B. * C. No lymph vessels are located in the walls of the pulmonary alveoli Rarely is this lymph drainage responsible for transfer of cancer cells to other organs In what way does the root of the right lung differ from that of the left lung? In numbers of pulmonary arteries In numbers of pulmonary veins In numbers of primary bronchi In the presence of a pulmonary plexus of nerves In numbers of bronchial veins During cardiac surgery, which of the following vessels could be compressed between a finger placed in the transverse sinus and an anteriorly placed thumb? The superior vena cava The inferior vena cava The descending aorta The right pulmonary vein The pulmonary artery The chamber contributing most to the anterior (ventral) aspect of the heart is the: Right atrium Right ventricle Left atrium Left ventricle All four chambers contribute about equally The right border of the heart is formed by the: Right atrium Right ventricle Left atrium Right and left atria Right atrium and right ventricle Which of the following is in direct posterior relation to the left atrium? The right atrium The trachea The esophagus The aorta The transverse pericardial sinus The base of the heart corresponds to the: Diaphragmatic surface of the heart Left ventricle and left atrium Right ventricle and right atrium Left and right atria None of these A physician has detected something while examining a patient’s heart. He is now listening carefully over the fourth intercostal space immediately to the left of the sternum. His suspicion has evidently been directed toward the: Mitral valve Tricuspid valve Aortic valve D. E. 111. A. B. C. D. E. * 112. A. B. * C. D. E. 113. A. B. * C. D. E. 114. A. B. C. D. E. * 115. A. B. * C. D. E. 116. A. B. C. * D. E. 117. A. * B. Pulmonic valve Valve of the coronary sinus During a surgical procedure involving the coronary arteries, you would find the circumflex artery in the: Anterior atrioventricular groove Posterior interventricular groove Right atrioventricular sulcus Left atrioventricular sulcus Posterior interatrial sulcus A man past 50 years old suddenly collapsed and died while shoveling snow. A massive area of necrotic heart muscle was found over the anterior wall of the right ventricle with the involvement of the anterior wall of the left ventricle as well. Assuming that this was the result of acute coronary arterial occlusion, the occlusion was probably of the: Left coronary artery Anterior interventricular artery Circumflex branch Right coronary artery Coronary sinus You hear a loud systolic murmur (i.e., while the ventricles are contracting) most clearly over the right second chondrosternal junction. You suspect: Pulmonary stenosis (narrowing of the pulmonary valve) Aortic stenosis (narrowing of the aortic valve) Mitral stenosis (narrowing of the mitral valve) Tricuspid stenosis (narrowing of the tricuspid valve) A patent ductus arteriosus The artery of the sinuatrial node is usually a branch of the: Posterior interventricular artery Anterior interventricular artery Anterior ventricular artery Left coronary artery Right coronary artery The coronary sinus receives blood from the veins listed below, except the: Small cardiac vein Anterior cardiac veins Middle cardiac vein Oblique vein of the left atrium Great cardiac vein All of the following arteries are branches of the right coronary artery, except the: Nodal branch Anterior ventricular branches Anterior interventricular branch Posterior interventricular branch Right marginal branch The apex of the heart usually receives most of its blood supply from the: Anterior interventricular artery Circumflex branch of the left coronary artery C. D. E. 118. A. * B. C. D. E. 119. A. B. C. * D. E. 120. A. B. C. D. * E. 121. A. B. C. D. E. * 122. A. B. * C. D. E. 123. A. B. * C. D. Posterior interventricular artery Marginal branch of the right coronary artery Main division of the right coronary artery The great cardiac vein contributes to the drainage of all of the chambers of the heart except the: Right atrium Left atrium Right ventricle Left ventricle It contributes to the drainage of all of the chambers Which of the following is usually a branch of the left coronary artery? Nodal branch Anterior ventricular branches Anterior interventricular branch Posterior interventricular branch Right marginal branch The following statements concerning an intercostal space are correct except which? The anterior intercostals arteries of the lower five intercostals spaces are branches of the musculophrenic artery The sensory fibers in the lower five intercostals nerves supply the skin of lateral thoracic and anterior abdominal walls The posterior intercostals arteries of the lower nine spaces are branches of the thoracic aorta Throughout an intercostals space, the intercostals nerves and blood vessels lie close to the upper border of the lower rib The intercostals nerves and blood vessels run between the internal and the innermost intercostals muscles. The vein which can be seen in the anterior interventricular sulcus with the interventricular branch of the left coronary artery is the: Anterior cardiac vein Small cardiac vein Middle cardiac vein Left marginal vein Great cardiac vein The following statements concerning the structure of the heart are correct except which? The trabeculae carneae are internal surface structures of both the left and the right ventricles The pericardial cavity is the potential space between the fibrous and the serous pericardia The coronary arteries are functional end arteries The sinuatrial node is supplied by the right and sometimes the left coronary artery The four pulmonary veins open through the posterior wall of the left atrium and there are no valves. The following statements regarding the innervation of thoracic structures are correct except which? The lung and visceral pleura are innervated by the autonomic nerves and are not sensitive to sensation of temperature, touch, and pressure The motor innervation of the diaphragm is provided by the third, fourth, and fifth cervical spinal nerves and by the lower six intercostals nerves The sensory nerve supply to the mucous membrane of the lower part of the trachea is from the vagus and the recurrent laryngeal nerves The nerve supply of the pericardium is the phrenic nerves E. 124. A. B. C. D. * E. 125. A. B. C. * D. E. 126. A. B. C. D. * E. 127. A. B. * C. D. E. 128. A. B. C. D. E. * 129. A. B. C. D. E. * 130. A. B. * C. D. E. The sinuatrial node is supplied by sympathetic and parasympathetic nerves via the cardiac plexuses. The following statements concerning thoracic structures are correct except which? The carina is the name given to the site of bifurcation of the trachea The ligamentum arteriosum is the remains of the ductus arteriosus The ductus arteriosus is formed from the sixth left pharyngeal arch The thymus lies in the middle mediastinum The thymus receives its arterial supply mainly from the internal thoracic artery. The following events occur on inhalation except which? The diaphragm descends The external intercostals muscles contract The abdominal muscles contract and push the abdominal viscera cranially The ribs are raised The vertical dimension of the thoracic cavity increases. When passing a needle through the chest wall and into the pleural cavity in the midaxillary line, the following structures will be pierced except which? The external intercostal muscle The skin The parietal pleura The levator costarum The internal intercostal muscle. The following statements concerning the bronchopulmonary segments are correct except which? It is a subdivision of a lung lobe It is pyramidal in shape, with its apex toward the lung surface It is surrounded by connective tissue It has a segmental bronchus, a segmental artery, lymph vessels, and autonomic nerves When diseased, it can be removed surgically as a structural unit. The following statements concerning the main bronchi are correct except which? The right main bronchus is wider than the left main bronchus The right main bronchus is shorter than the left main bronchus The right main bronchus is longer than the left main bronchus The left main bronchus passes to the left in front of the esophagus The left main bronchus gives off the superior lobar bronchus before entering the hilum of the lung. The following structures open into the right atrium except which? The superior vena cava The coronary sinus The anterior cardiac vein The inferior vena cava The right pulmonary veins. The conducting system of the heart is composed of the following structures except which? The Purkinje plexus The deep cardiac plexus The sinuatrial node The atrioventricular bundle The atrioventricular node. 131. A. B. * C. D. E. 132. A. B. C. * D. E. 133. A. B. * C. D. E. 134. A. B. C. D. * E. 135. A. B. * C. D. E. 136. A. B. C. D. E. * 137. A. B. * C. D. E. 138. In repairing a patent interventricular septum, a cardiac surgeon must beware of catching the stem of the atrioventricular bundle in his stitches. The most dangerous area is _________ to the septal defect. Anterior Posterior Superior Inferior The atrioventricular bundle is not near the septal defect All of the following structures are anterior to the pericardium except the: Thymus Sternal lymph nodes Phrenic nerve Internal thoracic artery Transversus thoracis muscle The only one of the following structures which lies in contact with the fibrous pericardium is the: Azygos vein Phrenic nerve Thoracic sympathetic ganglia Thoracic duct Bodies of the thoracic vertebrae An aneurysm (sac-like dilatation) on the ascending aorta also involves the anterior sinus. Which of the following is anatomically unlikely? Erosion into the pulmonary artery Involvement of the right coronary artery Rupture into the pericardium Pressure on the recurrent laryngeal nerve causing hoarseness Extension forward to erode the sternum The right ventricle includes all of the structures listed below, except the: Conus arteriosus pulmonaris Aortic ostium Trabeculae carneae Anterior, septal and posterior papillary muscles Crista supraventricularis All of the following are closely applied to the anterior surface of the esophagus except the: Trachea Left bronchus Pericardium Diaphragm All of these are closely applied to its anterior surface The sternal angle serves as a landmark for locating the: First rib Second rib Third rib Fourth rib None of the ribs All of the following are useful surface landmarks for thoracic structures except the: A. B. C. * D. E. 139. A. B. C. D. * E. 140. A. B. C. * D. E. 141. A. B. * C. D. E. 142. A. B. C. D. * E. 143. A. B. C. D. * E. 144. A. B. C. * D. Sternal angle Suprasternal notch Nipple in the female Anterior axillary fold Xiphisternal junction A stab wound with a two inch blade in the left fifth interspace close to the edge of the sternum would most likely penetrate the: Left atrium Right atrium Left ventricle Right ventricle Liver A stab wound just lateral to and at the level of the right nipple, passing six inches straight posteriorly would penetrate all of the following except the: Pectoralis major muscle Pectoralis minor muscle Right lobe of the liver Middle lobe of the right lung Lower lobe of the right lung A perforating wound involving the pleural cavity is likely to result in a pneumothorax. The right pleural sac could be punctured by a stab wound in any of the following places except the: Ninth intercostal space – midaxillary line Ninth intercostal space – midclavicular line Level of the sternal angle at right border of the sternum Ninth intercostal space – midscapular line Anterior part of the posterior triangle of the neck an inch above the clavicle A man was shot with a 22 caliber rifle. The bullet entered his chest through the right fourth intercostal space in the midclavicular line and emerged at the inferior angle of his right scapula. He can be expected to have: Hemorrhage into his pericardium Horner’s syndrome from injury to his right sympathetic chain A traumatic aneurysm of the thoracic aorta Collapse of the right lung Perforation of the diaphragm with injurry to the liver A bullet entering the chest in the midline at the sternal angle and striking the disc between the fourt and fifth thoracic vertebrae would be expected to perforate which of the following last? The ascending aorta The bifurcation of the trachea The thymus The esophagus None of these would be perforated The apex of the heart is located in the left: Third interspace Fourth interspace Fifth interspace Sixth interspace E. 145. A. B. C. * D. E. 146. A. * B. C. D. E. 147. A. B. * C. D. E. 148. A. B. C. D. * E. 149. A. B. C. * D. E. 150. A. * B. C. D. E. 151. None of these If, during quiet breathing, you locate the inferior border of the right lung at the eighth rib in the midaxillary line, the border is: Two spaces lower than normal One space lower than normal In normal position One space higher than normal Two spaces higher than normal During a sternal marrow puncture in the lower half of the manubrium the needle inadvertently was inserted too far and produced 20 ml of blood. The source of the blood was probably the: Aorta Left atrium Pulmonary vein Azygos vein Right atrium A horizontal anteroposterior bullet wound at the left edge of the sternum in the fifth interspace would most likely penetrate the: Right atrium Right ventricle Superior vena cava Inferior vena cava It would be unlikely to perforate any of these A patient with a wound from a 22 caliber bullet in the tenth intercostal space in the right midaxillary line was X-rayed and the bullet was found to have penetrated medially about two inch inches. It is almost certain that the bullet was lodged in the: Costophrenic recess Right lung Posterior mediastinum Liver Right atrium A physician wishes to drain fluid from a pleural recess on the right side. With the patient in maximum expiration he can place his needle at the lateral border of the erector spinae in the: Eighth intercostal space Ninth intercostal space Eleventh intercostal space Subcostal space Cannot be done from behind A horizontal anteroposterior bullet wound at the right edge of the sternum in the fifth interspace would most likely penetrate the: Right atrium Right ventricle Superior vena cava Inferior vena cava It would be unlikely to perforate any of these A physician wishing to drain fluid from the pericardial cavity by approaching from the front must be careful to avoid all but which one of the following? A. B. C. D. * E. 152. A. B. C. D. * E. 153. A. * B. C. D. E. 154. A. B. * C. D. E. 155. A. B. C. D. * E. 156. A. B. C. D. E. * 157. A. B. * C. D. E. 158. The pleura The internal thoracic vessels The intercostal vessels The phrenic nerve All of these are at risk and must be carefully avoided All of the following are located partly or entirely above the level of the sternal angle (Louis) except the: Arch of the aorta Left recurrent laryngeal nerve Left brachiocephalic vein Pulmonary valve Remains of the thymus gland All of the following are related to the sternal angle, except the: Termination of the hemiazygos vein Bifurcation of the trachea Arch of the aorta Attachment of the second rib to the sternum Termination of the azygos vein A chest X-ray of a one-year-old child shows a broad shadow occupying the superior mediastinum. The child is free from any symptoms of disease. The shadow is probably that of: His noncalcified sternum His thymus His congenitally abnormal heart His double aortic arch A tumor All of the following structures are located in the superior mediastinum, except the: Thymus Aortic arch Thoracic duct Azygos vein Esophagus The density of the shadow of the superior mediastinum on a chest x-ray is determined by the size of all but which one of the following structures in the normal adult? The superior vena cava The brachiocephalic artery The left common carotid artery The left subclavian artery All of these contribute to the shadow If the intercostal muscles are paralyzed, the most obvious effect which can be observed by a physician in the living subject is that: Breathing is impossible Breathing is obviously extremely difficult The intercostal spaces move in during inspiration Movement of the liver in respiration is decreased Expiration, but not inspiration, is impaired The volume of the thorax is increased through the action of all of the following muscles except the: A. B. C. D. * E. 159. A. B. C. D. * E. 160. A. * B. C. D. E. 161. A. B. C. D. E. * 162. A. B. C. D. E. * 163. A. B. C. D. E. * 164. A. B. C. D. E. * External intercostals Levator costarum Diaphragm Rectus abdominis Serratus anterior Inspiration is accomplished by all of the following except: Elevation of the rib cage with an increase in the cross-sectional area of the thoracic cavity Contraction of the diaphragm The fact that the pleural cavities are completely closed and contain no air Contraction of the abdominal wall musculature Atmospheric pressure All of the following muscles can be involved in respiratory movements except the: Psoas major Serratus anterior Scalenus anterior Subcostals Transversus thoracis In several clinical condition, patients use all the major and accessory muscles of respiration. Which of the following is not a muscle of inspiration? Pectoralis major Scalenus anterior Erector spinae Serratus anterior All of these can assist in inspiration Which of the following muscles is not used in forced respiration? Scalenus anterior Sternomastoid Rectus abdominis Serratus anterior All of these are used In a case where the eleventh rib on the left side was fractured by a blow, what critical situation might arise? Torn diaphragm Punctured pleura Punctured spleen Punctured kidney All of these may arise Which of the following structures is adjacent to the left lung? The superior vena cava The inferior vena cava The arch of azygos vein The right phrenic nerve None of these 165. A. B. C. * D. E. 166. A. * B. C. D. E. 167. A. B. C. * D. E. 168. A. B. * C. D. E. 169. A. B. C. D. E. * 170. A. B. C. * D. E. 171. A. B. C. * If you were to open the right pleural cavity by a vartical incision parallel to the border of the sternum, and slide your hand in dorsally between the mediastinal pleura and the medial surface of the lung below the right pulmonary veins, you would be stopped by encountering the: Vertebral column Diaphragm Pulmonary ligament Thymus gland Aorta The two pleural cavities are in contact: Behind the sternal angle Above the aortic arch Behind the left atrium Underneath the aortic arch (“the aortic window”) They are not in contact The trachea bifurcates at the level of the _________ vertebral body: Seventh cervical Second thoracic Fourth thoracic Sixth thoracic Eighth thoracic If you were to explore the interval between the mediastinal pleura and the fibrous pericardium anterior (ventral) to the root of the lung, the only one of the following structures you would expect to encounter would be the: Greater splanchnic nerve Phrenic nerve Inferior vena cava Internal thoracic artery Deep cardiac plexus Which of the following structures is least likely to be involved in the local spread of a carcinoma of the apex of the right lung? The vagus nerve The right phrenic nerve The right sympathetic trunk The first thoracic nerve to the brachial plexus The thoracic duct The right lung: Is smaller than the left lung Has a lingula which is homologous to the middle lobe of the left lung Has an epiarterial bronchus Has a cardiac notch in addition to an impression Lies adjacent to the aorta near the hilus In lung surgery which of the following may be of use as guide to distinguish the line of separation between adjacent bronchopulmonary segments? the pulmonary arteries and the bronchi the pulmonary arteries and pulmonary veins the pulmonary veins and the connective tissue septa D. E. 172. A. B. C. D. E. * 173. A. B. C. D. * E. 174. A. B. C. D. E. * 175. A. B. C. D. E. * 176. A. B. C. D. E. * 177. A. B. C. D. * E. 178. A. B. the pulmonary arteries and the connective tissue septa there is no line of separation, adjacent bronchopulmonary segments merely diffuse into one another Diseases of the lungs sometimes lead to involvement of the structures in contact with them. Which of the following structures is not adjacent to the right lung? the superior vena cava the inferior vena cava the arch of azygos vein the right phrenic nerve all of these are adjacent to the right lung Structures which are in contact with, and groove, the left lung include all of the following except the: aortic arch left subclavian artery esophagus inferior vena cava all of these are in contact with the left lung The mediastinal surface of the right lung presents impressions corresponding to all of the following structures except the: esophagus right brachiocephalic vein azygos vein superior vena cava all of these make impressions on the right lung An infant is brought to you having “swallowed” an open safety pin. Respiratory distress suggests to you that it may have entered the trachea. this is a dangerous situation because of the close relationship between the trachea and all but which one of the following? the arch of the aorta the brachiocephalic artery the esophagus the superior vena cava all of these are closely related The thoracic duct: is without valves is thick walled lies to the left of the aorta at the level of T8 lies deep to the lateral arcuate ligament passes through the aortic opening of the diaphragm Which of the following lymph nodes are most likely to compress the left recurrent laryngeal nerve if they become involved in malignant disease? posterior thoracic retrosternal infraclavicular tracheobronchial or paratracheal broncho-pulmonary The anterior intercostal arteries are branches of the: ascending aorta descending aorta C. 184. superior epigastric artery internal thoracic artery lateral thoracic artery The drainage of the superior vena cava includes blood from the: second intercostals space right quadratus lumborum left lung trachea all of these The vessels with the shortest intrathoracic course is the: superior vena cava ascending aorta azygos vein left brachiocephalic vein inferior vena cava The concavity of the arch of the aorta is in close or direct relationship with all of the following except the: right pulmonary artery left bronchus right superior pulmonary vein left recurrent laryngeal nerve ligamentum arteriosum Coarctation of the aorta is a congenital constriction which usually occurs just distal to the ligamentum arteriosum. Which of the following findings would you expect in such a case? blood pressure unequal in the two arms blood pressure higher in the right arm and leg than in the left arm and leg blood pressure higher in the legs than in the arms blood pressure higher in the arms than in the legs blood pressure equal wherever taken An aneurysm of the arch of the aorta could produce all of the following except: hoarseness sternal erosion dullness to percussion in the second intercostals space on the left side of the sternum dyspnoea (difficulty in breathing) it could produce any or all of the above Branches of the internal thoracic artery furnish blood supply to the: A. B. C. D. E. * 185. A. B. C. * breast pericardium diaphragm abdominal muscles all are correct The vagus nerve supplies fibers to each of the plexus below except the: cardiac plexus pharyngeal plexus brachial plexus D. * E. 179. A. B. C. D. E. * 180. A. B. C. D. E. * 181. A. B. C. * D. E. 182. A. B. C. D. * E. 183. A. B. C. D. E. * D. E. 186. A. B. * C. D. E. 187. A. B. C. D. * E. 188. A. B. C. D. E. * 189. A. B. C. D. * E. 190. A. B. C. * D. E. 191. A. B. * C. D. E. 192. A. B. * pulmonary plexus esophageal plexus From your knowledge of the sensory innervation of the pericardium, you might expect pain from the pericardium to be referred to the area of skin which has the same segmental innervation. This is predominantly the: external auditory canal side of the neck and upper shoulder medial side of the arm and forearm epigastrium there is no sensory innervation of the pericardium The thoracic portion of the sympathetic trunk becomes involved in many disease processes. To which of the structures listed below is it not closely related? the neck of the first rib the second thoracic nerve the posterior intercostals arteries the esophagus the parietal pleura The heart receives parasympathetic innervation by way of the: hypoglossal nerve greater splanchnic nerve phrenic nerve superior cardiac nerves vagus nerve Which branch of which vagus nerve hooks around the aortic arch adjacent to the ligamentum arteriosum? The right recurrent laryngeal nerve The left superior laryngeal nerve The anterior vagal trunk The left recurrent laryngeal nerve The vagal cardiac branches The nerve passing anterior to the root of the left lung is the: Vagus nerve Left recurrent laryngeal nerve Phrenic nerve Sympathetic trunk None of these is anterior to the lung root The pain accompanying episodes of pleurisy arises from nerve endings in the: Visceral pleura Parietal pleura Mediastinal pleura Pulmonary ligament All of these Surgical treatment of patient ductus arteriosus involves closure of the ductus. Of the following, the structure nearest to the operative field is the: Greater splanchnic nerve Left recurrent laryngeal nerve C. D. E. 193. A. B. C. D. E. * 194. A. B. C. D. * E. 195. A. B. * C. D. E. 196. A. B. * C. D. E. 197. A. B. C. D. E. * 198. A. B. C. D. E. * 199. A. B. Phrenic nerve Sympathetic trunk None of these is near the ductus arteriosus Which of the following nerves is not related to the arch of the aorta? The left vagus The left cervical cardiac branches of the vagus The left cervical cardiac branches of the sympathetic plexus The left phrenic nerve The left greater splanchnic nerve A patient whom you believe to have a cancer of the lung because of the finding of cancer cells in the sputum, complains of pain over the left shoulder. This would lead you to suspect invasion of the mediastinum immediately: Above the root of the left lung Below the root of the left lung Anterior to the root of the left lung All of these None of these During unaccustomed exercise, pain may be produced in the diaphragm. The innervation of the peripheral margin of the diaphragm from which this pain may be felt is by the: Phrenic nerves Intercostal nerves Splanchnic nerves Vagus nerves All of these nerves All of the following levels for opening in the diaphragm are correct except the: Esophageal hiatus (T10) Inferior vena cava (T12) Aortic hiatus (T12) Thoracic duct (T12) All of these are true The central tendon of the diaphragm is pierced by the: Aorta Right greater splanchnic nerve Esophagus Right vagus nerve Inferior vena cava Which of the following statements in regard to the diaphragm are true? It has attachments to the sternum It has attachments to the lower six ribs It has attachments to the bodies to the first three lumbar vertebrae The pericardium is fused to its superior surface All of these are true Which of the following are in contact with the diaphragm? The middle lobe of the right lung The lingula C. D. E. * 200. A. * B. C. D. E. The right ventricle The left ventricle All of these are in contact with the diaphragm A horizontal stab wound with a short blade in the left second intercostal space close to the sternum is most likely to injure the: Aorta Left brachiocephalic vein Left atrium Left ventricle Right ventricle