Gray's Anatomy Chapter 58 - Great Vessels Sample PDF

Question Answer Which of the following is NOT a major blood E) Femoral artery vessel of the thorax? Explanation: The major blood vessels of the thorax include the pulmonary trunk, thoracic A) Pulmonary trunk...

Question Answer Which of the following is NOT a major blood E) Femoral artery vessel of the thorax? Explanation: The major blood vessels of the thorax include the pulmonary trunk, thoracic A) Pulmonary trunk aorta, superior vena cava, and inferior vena cava. The femoral artery is not a major blood B) Thoracic aorta vessel of the thorax; it is located in the thigh. C) Superior vena cava D) Inferior vena cava E) Femoral artery What is the primary function of the pulmonary B) Convey deoxygenated blood from the right ventricle to the lungs trunk? Explanation: The pulmonary trunk conveys deoxygenated blood from the right ventricle to A) Convey oxygenated blood to the body the lungs for oxygenation. B) Convey deoxygenated blood from the right ventricle to the lungs C) Supply blood to the heart muscle D) Return deoxygenated blood to the right atrium E) Transport nutrients to the liver At what vertebral level does the pulmonary C) T6 trunk typically bifurcate into the right and left Explanation: The pulmonary trunk typically bifurcates into the right and left pulmonary pulmonary arteries? arteries at the level of the body of the sixth thoracic vertebra (T6). A) T2 B) T4 C) T6 D) T8 E) T10 What structure connects the left pulmonary D) Ductus arteriosus artery to the aortic arch in the fetus? Explanation: In the fetus, the left pulmonary artery is connected to the aortic arch by the A) Ligamentum arteriosum ductus arteriosus, which forms the ligamentum arteriosum in the adult. B) Ductus venosus C) Foramen ovale D) Ductus arteriosus E) Umbilical vein Which of the following veins is NOT part of the E) Femoral vein major blood vessels of the thorax? Explanation: The femoral vein is not part of the major blood vessels of the thorax; it is A) Superior vena cava located in the thigh. The major blood vessels of the thorax include the superior vena cava, B) Inferior vena cava inferior vena cava, and internal thoracic veins. C) Left internal thoracic vein D) Right internal thoracic vein E) Femoral vein What structure does the pericardium blend A) Adventitia with and disappear into within the pulmonary Explanation: The pericardium gradually blends with and disappears within the adventitia of arteries? the pulmonary arteries. A) Adventitia B) Intima C) Media D) Endothelium E) Tunica externa Which structure lies posterior to the proximal B) Ascending aorta part of the pulmonary trunk near its origin? Explanation: The ascending aorta and left coronary artery are posterior relations of the A) Left atrium proximal part of the pulmonary trunk near its origin. B) Ascending aorta C) Right ventricle D) Superior vena cava E) Right atrium What is the typical length of the ascending B) 5 cm aorta? Explanation: The ascending aorta is typically about 5 cm in length. A) 3 cm B) 5 cm C) 7 cm D) 10 cm E) 12 cm Which structure is located superiorly to the C) Pulmonary trunk ascending aorta? Explanation: The pulmonary trunk is located to the left and superiorly to the ascending A) Right atrium aorta. B) Left atrium C) Pulmonary trunk D) Superior vena cava E) Right ventricle What is the aortopulmonary window bordered B) Ascending aorta by anteriorly? Explanation: The aortopulmonary window is bordered by the ascending aorta anteriorly. A) Descending aorta Question Answer B) Ascending aorta C) Left main bronchus D) Mediastinal pleura E) Pulmonary trunk Which congenital anomaly involves the A) Pulmonary atresia pulmonary trunk? Explanation: Pulmonary atresia is a congenital anomaly involving the pulmonary trunk. A) Pulmonary atresia B) Coarctation of the aorta C) Aortic aneurysm D) Aortic dissection E) Patent ductus arteriosus Which structure lies between the branching of B) Superficial cardiac plexus the pulmonary trunk and the aortic arch? Explanation: The superficial cardiac plexus lies between the branching of the pulmonary A) Deep cardiac plexus trunk and the aortic arch. B) Superficial cardiac plexus C) Left recurrent laryngeal nerve D) Right coronary artery E) Trachea What is the typical location of the aortic arch in B) 2.5 cm inferior relation to the jugular notch? Explanation: The most superior level of the aortic arch is typically about 2.5 cm inferior to A) 1 cm superior the jugular notch. B) 2.5 cm inferior C) 5 cm inferior D) At the same level E) 3 cm superior Which structure is located posterior and to the B) Trachea right of the aortic arch? Explanation: The trachea is located posterior and to the right of the aortic arch. A) Left lung B) Trachea C) Left atrium D) Pulmonary trunk E) Left recurrent laryngeal nerve What is the significance of a right-sided aortic B) It is associated with transposition of the thoraco-abdominal viscera arch? Explanation: A right-sided aortic arch is usually associated with transposition of the A) It is associated with coarctation of the aorta thoraco-abdominal viscera (situs inversus). B) It is associated with transposition of the thoraco-abdominal viscera C) It is associated with pulmonary atresia D) It is associated with aortic aneurysm E) It is associated with patent ductus arteriosus What is the primary issue in B) The myocardium is supplied with deoxygenated pulmonary blood Bland–White–Garland syndrome (ALCAPA)? Explanation: In Bland–White–Garland syndrome (ALCAPA), the left coronary artery arises A) The myocardium is supplied with from the pulmonary artery, causing the myocardium to be supplied with deoxygenated oxygenated systemic blood pulmonary blood instead of oxygenated systemic blood, which can lead to myocardial B) The myocardium is supplied with ischemia and cardiac failure. deoxygenated pulmonary blood C) The right coronary artery originates from the pulmonary trunk D) The pulmonary trunk is absent E) The aorta is underdeveloped Which of the following is NOT a symptom of C) Strong cry Bland–White–Garland syndrome in infants? Explanation: Symptoms of Bland–White–Garland syndrome in infants include pallor, A) Pallor fatigue, irritability, weak cry, cough, dyspnoea, and signs of ischemia and cardiac failure, B) Fatigue particularly during or after feeding, or during defecation or crying. C) Strong cry D) Cough E) Dyspnoea What radiological finding is associated with B) Cardiomegaly with left ventricular and left atrial enlargement Bland–White–Garland syndrome? Explanation: Radiologically, Bland–White–Garland syndrome is associated with A) Normal heart size cardiomegaly, specifically with left ventricular and left atrial enlargement. B) Cardiomegaly with left ventricular and left atrial enlargement C) Right ventricular hypertrophy D) Pulmonary artery stenosis E) Aortic aneurysm What is the cause of pulmonary atresia? A) Absence or defect of the pulmonary valvular leaflets A) Absence or defect of the pulmonary valvular Explanation: Pulmonary atresia is caused by a complete obstruction of pulmonary outflow Question Answer leaflets due to an absence or defect of the pulmonary valvular leaflets, leading to a blind-ending B) Overdevelopment of the pulmonary trunk pulmonary trunk and right ventricular hypoplasia. C) Excessive blood flow to the lungs D) Underdeveloped aortic valve E) Presence of a ventricular septal defect What is a common feature of truncus B) Single common arterial trunk exiting the heart arteriosus? Explanation: In truncus arteriosus, a single common arterial trunk exits the heart and A) Separate pulmonary trunk and ascending subsequently divides into the pulmonary trunk and the ascending aorta. This condition aorta often coexists with a ventricular septal defect and requires expedited surgical repair to B) Single common arterial trunk exiting the avoid congestive heart failure and other complications. heart C) Absence of ventricular septal defect D) Normal neonatal life without surgery E) Isolated right ventricular hypertrophy What condition describes the presence of air in B) Pneumomediastinum the mediastinum? Explanation: Pneumomediastinum describes the presence of air in the mediastinum, which A) Pneumothorax can arise from various pathological conditions or physiological states, such as penetrating B) Pneumomediastinum trauma, ruptured major airways, or hyperventilation. C) Pulmonary embolism D) Pleural effusion E) Aortic dissection What condition can lead to increased venous B) Portal venous hypertension flow through the left superior intercostal vein? Explanation: Portal venous hypertension is one of the conditions that can lead to increased A) Arterial hypertension venous flow through the left superior intercostal vein. B) Portal venous hypertension C) Pulmonary embolism D) Myocardial infarction E) Aortic stenosis What is a common variant involving a C) The descending thoracic aorta passes anterior to the oesophagus and trachea right-sided aortic arch? Explanation: A common variant is when a right-sided aortic arch and the upper part of the A) The aortic arch passes posterior to the descending thoracic aorta pass anterior to the oesophagus and trachea. trachea B) The ductus arteriosus passes anterior to the oesophagus C) The descending thoracic aorta passes anterior to the oesophagus and trachea D) The left subclavian artery arises from the right aortic arch E) The right common carotid artery arises from the left aortic arch What is a 'bovine arch'? A) When the left common carotid artery arises from the brachiocephalic trunk A) When the left common carotid artery arises Explanation: A 'bovine arch' refers to the anatomical variant where the left common carotid from the brachiocephalic trunk artery arises from the brachiocephalic trunk. B) When the right subclavian artery arises from the left aortic arch C) When the left subclavian artery arises from the right aortic arch D) When the right common carotid artery arises from the left aortic arch E) When the left common carotid artery arises from the left subclavian artery What is an aberrant right subclavian artery B) Lusoria artery sometimes referred to as? Explanation: An aberrant right subclavian artery is sometimes referred to as a lusoria A) Kommerell's diverticulum artery. B) Lusoria artery C) Bovine arch D) Right-sided ductus arteriosus E) Aortic diverticulum What can a diverticulum of Kommerell cause C) Fatal haemorrhage during endoscopy? Explanation: A diverticulum of Kommerell can become aneurysmal and cause fatal A) Pulmonary embolism haemorrhage during endoscopy. B) Myocardial infarction C) Fatal haemorrhage D) Aortic stenosis E) Portal venous hypertension What is a rare avian form of branching from the A) The right common carotid and right subclavian arteries arise from the aortic arch aortic arch? Explanation: A rare avian form of branching involves the right common carotid and right A) The right common carotid and right subclavian arteries arising from the aortic arch. Question Answer subclavian arteries arise from the aortic arch B) The left common carotid and left subclavian arteries arise from the aortic arch C) The right common carotid and left subclavian arteries arise from the aortic arch D) The left common carotid and right subclavian arteries arise from the aortic arch E) The right common carotid and left common carotid arteries arise from the aortic arch What is a rare variation in the branching of the B) Both carotid arteries originating from the same common trunk aortic arch? Explanation: A rare variation reported is where both carotid arteries originate from the A) Both carotid arteries originating from same common trunk, and the left subclavian artery originates from the aortic arch, while separate trunks the right subclavian artery arises from the descending thoracic aorta. B) Both carotid arteries originating from the same common trunk C) The right subclavian artery originating from the aortic arch D) The left subclavian artery originating from the descending thoracic aorta E) Both vertebral arteries originating from the same trunk What happens when a right aortic arch and B) The common carotid arteries may have a single trunk descending thoracic aorta occur? Explanation: When a right aortic arch and descending thoracic aorta occur, the A) The arrangement of its three branches is arrangement of its three branches is reversed, and the common carotid arteries may have a normal single trunk. B) The common carotid arteries may have a single trunk C) The left subclavian artery arises from the descending thoracic aorta D) The right subclavian artery arises from the aortic arch E) The vertebral arteries arise from the common carotid artery Which arteries may branch from the aortic arch C) Bronchial arteries and thyroidea ima artery in addition to the common carotid and Explanation: Other arteries that may branch from the aortic arch include one or both subclavian arteries? bronchial arteries and the thyroidea ima artery. A) Pulmonary arteries B) Coronary arteries C) Bronchial arteries and thyroidea ima artery D) Renal arteries E) Hepatic arteries What is the clinical relevance of the 'aortic C) It is associated with the left superior intercostal vein nipple' appearance on a chest radiograph? Explanation: The 'aortic nipple' appearance on a chest radiograph is associated with the A) It indicates a pulmonary embolism left superior intercostal vein, which can be clinically relevant in cases of B) It shows the presence of a pneumothorax pneumomediastinum. C) It is associated with the left superior intercostal vein D) It indicates a myocardial infarction E) It shows the presence of a pleural effusion What is a lusoria artery? D) A retrotracheal aberrant right subclavian artery A) A common carotid artery that arises from the Explanation: A lusoria artery is a retrotracheal aberrant right subclavian artery, which is a aortic arch variation in the branching pattern of the aortic arch. B) A right subclavian artery that arises from the descending thoracic aorta C) A left subclavian artery that arises from the aortic arch D) A retrotracheal aberrant right subclavian artery E) A vertebral artery that arises from the common carotid artery What is the preductal type of coarctation of the A) Aortic arch hypoplasia thoracic aorta commonly associated with? Explanation: In the preductal type of coarctation, aortic arch hypoplasia is common, and A) Aortic arch hypoplasia the left subclavian and even the brachiocephalic trunk may be involved. B) Enlargement of the left subclavian artery C) Formation of aortic aneurysms D) High vascularity of the thoracic wall E) Enlargement of the scapular vessels What is a characteristic feature of the B) High vascularity of the thoracic wall postductal type of coarctation of the thoracic Explanation: The postductal type of coarctation is characterized by high vascularity of the aorta? thoracic wall, with many arteries forming a bypass route and becoming greatly enlarged. Question Answer A) Aortic arch hypoplasia B) High vascularity of the thoracic wall C) Patent ductus arteriosus-dependence D) Involvement of the brachiocephalic trunk E) Formation of aortic aneurysms Which arteries are involved in forming a bypass C) Posterior intercostal arteries route in the thoracic wall in cases of Explanation: In cases of coarctation, the posterior intercostal arteries are involved in coarctation? forming a bypass route and become greatly enlarged. A) Coronary arteries B) Pulmonary arteries C) Posterior intercostal arteries D) Renal arteries E) Femoral arteries What is the function of para-aortic bodies? B) Respond to changes in arterial gas concentrations A) Regulate blood pressure Explanation: Para-aortic bodies are chemoreceptors that respond to changes in arterial gas B) Respond to changes in arterial gas concentrations such as lowered pO2, increased pCO2, and increased hydrogen ion concentrations concentration. C) Produce red blood cells D) Filter lymphatic fluid E) Store fat Where is the brachiocephalic trunk located? C) Anterior to the trachea, then on its right A) Between the left and right pulmonary Explanation: The brachiocephalic trunk ascends posterolaterally to the right, initially arteries located anterior to the trachea, then on its right. B) Posterior to the trachea C) Anterior to the trachea, then on its right D) Between the right and left common carotid arteries E) Adjacent to the aortic arch What major role do degeneration of the aortic B) They lead to the formation of cystic spaces filled with mucoid material tunica media and intimal dissection play in the Explanation: Degeneration of the aortic tunica media and intimal dissection result in the pathogenesis of aneurysms affecting the loss of smooth muscle cells and degeneration of elastic fibers, producing cystic spaces in ascending aorta and aortic arch? the media that fill with mucoid material, leading to wall weakening and progressive A) They cause the formation of blood clots dilation. B) They lead to the formation of cystic spaces filled with mucoid material C) They increase the elasticity of the aortic wall D) They reduce the risk of hypertension E) They strengthen the aortic wall Which syndrome is associated with a particular B) Marfan syndrome pattern of aortic root involvement known as Explanation: Anulo-aortic ectasia, a specific pattern of aortic root involvement, is seen in anulo-aortic ectasia? Marfan syndrome. A) Turner syndrome B) Marfan syndrome C) Ehlers–Danlos syndrome D) Homocysteinuria E) Takayasu’s arteritis What is the primary cause of descending aortic B) Atherosclerosis aneurysms? Explanation: Descending aortic aneurysms are generally caused by atherosclerosis, A) Hypertension accounting for 90% of cases. B) Atherosclerosis C) Mycotic disease D) Trauma E) Cigarette smoking Which classification system categorizes aortic B) DeBakey classification dissections as types I, II, IIIa, and IIIb? Explanation: The DeBakey classification system categorizes aortic dissections into types I, A) Stanford classification II, IIIa, and IIIb. B) DeBakey classification C) Baliga classification D) Mohiaddin classification E) Fattoni classification What is a common symptom of aortic B) Severe retrosternal, neck, or interscapular chest pain dissection? Explanation: Aortic dissections typically present acutely with severe retrosternal, neck, or A) Mild headache interscapular chest pain. B) Severe retrosternal, neck, or interscapular chest pain C) Nausea without pain D) Mild fever E) Frequent urination Question Answer Which diagnostic methods are used to B) Echocardiography and contrast-enhanced CT or MRI establish the diagnosis of aortic dissection? Explanation: Diagnosis of aortic dissection is established by echocardiography and on A) Blood tests and X-rays contrast-enhanced CT or magnetic resonance imaging (MRI). B) Echocardiography and contrast-enhanced CT or MRI C) Ultrasound and PET scan D) ECG and angiography E) Physical examination and biopsy What is the recommended treatment for C) Surgical repair ascending aortic or aortic arch dissection? Explanation: Surgical repair is essential for ascending aortic or aortic arch dissection. A) Medical management B) Lifestyle changes C) Surgical repair D) Physical therapy E) Dietary supplements Which condition is associated with a higher B) Marfan syndrome prevalence of aortic dissection in males than Explanation: Aortic dissection is associated with Marfan syndrome and has a higher females? prevalence in males than females. A) Turner syndrome B) Marfan syndrome C) Ehlers–Danlos syndrome D) Homocysteinuria E) Takayasu’s arteritis What is a potential complication of aortic B) Cardiac tamponade and circulatory collapse dissection extending into the pericardium? Explanation: Extension of aortic dissection into the pericardium can cause cardiac A) Pulmonary embolism tamponade and circulatory collapse. B) Cardiac tamponade and circulatory collapse C) Stroke D) Renal failure E) Liver cirrhosis Which connective tissue disease is associated B) Homocysteinuria with thoracic aortic aneurysm? Explanation: Thoracic aortic aneurysm is associated with connective tissue diseases such A) Osteogenesis imperfecta as homocysteinuria. B) Homocysteinuria C) Scleroderma D) Rheumatoid arthritis E) Systemic lupus erythematosus What is shown in the contrast-enhanced CT B) Double-barrelled aortic lumen with true and false lumina images of thoracic aortic dissection? Explanation: The CT images show a double-barrelled aortic lumen with both true (T) and A) Single aortic lumen false (F) lumina, which is characteristic of aortic dissection. B) Double-barrelled aortic lumen with true and false lumina C) Triple aortic lumen D) Only the true lumen E) Only the false lumen What characterizes a Stanford type A aortic B) Involves both the ascending aorta and descending thoracic aorta dissection? Explanation: Stanford type A aortic dissection includes both the ascending aorta and A) Involves only the descending thoracic aorta descending thoracic aorta, as shown in the axial section of the CT image. B) Involves both the ascending aorta and descending thoracic aorta C) Involves only the abdominal aorta D) Involves only the ascending aorta E) Involves the pulmonary arteries What additional feature is present in the CT B) Pericardial effusion image of a Stanford type A aortic dissection? Explanation: The CT image of a Stanford type A aortic dissection shows a pericardial A) Pleural effusion effusion, indicated by a white arrow. B) Pericardial effusion C) Pulmonary embolism D) Aneurysm of the abdominal aorta E) No additional features Where does the dissection flap originate in a B) Distal to the left subclavian artery Stanford type B aortic dissection? Explanation: In a Stanford type B aortic dissection, the dissection flap originates A) Proximal to the left subclavian artery immediately distal to the origin of the left subclavian artery, as shown in the sagittal B) Distal to the left subclavian artery oblique section of the CT image. C) At the aortic root D) At the aortic arch E) At the abdominal aorta Question Answer What does the intimal defect in a Stanford type A) Opening between the true and false lumina B aortic dissection indicate? Explanation: The intimal defect in a Stanford type B aortic dissection indicates an opening A) Opening between the true and false lumina between the true and false lumina, as shown in the axial sections of the CT image. B) Complete blockage of the aorta C) Presence of an aneurysm D) Absence of a dissection flap E) Normal aortic anatomy From which vessels can the thyroidea ima A) Aortic arch, brachiocephalic trunk, common carotid, subclavian, pericardiacophrenic, or artery arise? internal thoracic arteries A) Aortic arch, brachiocephalic trunk, common Explanation: The thyroidea ima artery is a small and inconstant artery that may arise from carotid, subclavian, pericardiacophrenic, or the aortic arch, brachiocephalic trunk, common carotid, subclavian, pericardiacophrenic, internal thoracic arteries or internal thoracic arteries. B) Pulmonary trunk, left atrium, right atrium, superior vena cava, or inferior vena cava C) Coronary arteries, pulmonary veins, hepatic artery, renal artery, or mesenteric artery D) Femoral artery, popliteal artery, tibial artery, radial artery, or ulnar artery E) Jugular vein, cephalic vein, basilic vein, median cubital vein, or saphenous vein Where does the descending thoracic aorta A) Begins at the lower border of the fourth thoracic vertebra and ends at the aortic hiatus begin and end? Explanation: The descending thoracic aorta begins level with the lower border of the body A) Begins at the lower border of the fourth of the fourth thoracic vertebra and ends anterior to the lower border of the body of the thoracic vertebra and ends at the aortic hiatus twelfth thoracic vertebra at the aortic hiatus. B) Begins at the upper border of the first thoracic vertebra and ends at the diaphragm C) Begins at the lower border of the second thoracic vertebra and ends at the heart D) Begins at the upper border of the fifth thoracic vertebra and ends at the lungs E) Begins at the lower border of the third thoracic vertebra and ends at the liver Which structures are located anterior to the A) Hilum of the left lung, pericardium, oesophagus, and respiratory diaphragm descending thoracic aorta? Explanation: Anterior to the descending thoracic aorta are the hilum of the left lung, the A) Hilum of the left lung, pericardium, pericardium separating it from the left atrium, the oesophagus, and the lumbar part of the oesophagus, and respiratory diaphragm respiratory diaphragm. B) Right lung, liver, stomach, and pancreas C) Heart, spleen, kidneys, and intestines D) Trachea, bronchi, esophagus, and thymus E) Vertebral column, spinal cord, ribs, and sternum What do the bronchial arteries supply? A) Pulmonary areolar tissue, bronchopulmonary lymph nodes, pericardium, visceral pleura, A) Pulmonary areolar tissue, and thoracic oesophagus bronchopulmonary lymph nodes, pericardium, Explanation: The bronchial arteries supply the pulmonary areolar tissue, visceral pleura, and thoracic oesophagus bronchopulmonary lymph nodes, pericardium, visceral pleura, and thoracic oesophagus. B) Heart, liver, kidneys, and intestines C) Brain, spinal cord, eyes, and ears D) Skin, muscles, bones, and joints E) Stomach, pancreas, spleen, and gallbladder What is the survival rate for blunt aortic rupture A) 20% commonly occurring in road traffic accidents? Explanation: Blunt aortic rupture commonly occurs in road traffic accidents and has a 20% A) 20% survival rate. B) 50% C) 70% D) 90% E) 10% What imaging technique allows detailed A) Echocardiography, particularly transoesophageal assessment of proximal aortic atherosclerosis? Explanation: Echocardiography, particularly transoesophageal, allows detailed assessment A) Echocardiography, particularly of proximal aortic atherosclerosis implicated in systemic embolic events and strokes. transoesophageal B) X-ray C) Ultrasound D) CT scan E) PET scan Question Answer Which of the following is NOT a common D) Left lower lobe primary bronchogenic carcinoma cause of superior vena cava obstruction? Explanation: Superior vena cava obstruction is usually caused by mediastinally invasive right A) Right upper lobe primary upper lobe primary bronchogenic carcinoma, metastatic involvement of the right paratracheal bronchogenic carcinoma lymph nodes, or non-Hodgkin lymphoma. Left lower lobe primary bronchogenic carcinoma is not B) Non-Hodgkin lymphoma a common cause. C) Mediastinal haematoma D) Left lower lobe primary bronchogenic carcinoma E) Metastatic involvement of the right paratracheal lymph nodes What forms the right brachiocephalic A) Right internal jugular and right subclavian veins vein? Explanation: The right brachiocephalic vein is formed by the joining of the right internal jugular A) Right internal jugular and right and right subclavian veins. subclavian veins B) Right common carotid and right subclavian veins C) Right internal thoracic and right vertebral veins D) Right superior intercostal and right internal thoracic veins E) Right vagus and right phrenic nerves Where does the superior vena cava B) Posterior to the right second costal cartilage typically form? Explanation: The superior vena cava is typically formed posterior to the right second costal A) Posterior to the right first costal cartilage or first intercostal space. cartilage B) Posterior to the right second costal cartilage C) Posterior to the left first costal cartilage D) Posterior to the left second costal cartilage E) Posterior to the right third costal cartilage Which structure is located posterior to D) Left subclavian artery the left common carotid artery? Explanation: The left subclavian artery is one of the structures located posterior to the left A) Sternohyoid muscle common carotid artery. B) Left brachiocephalic vein C) Trachea D) Left subclavian artery E) Thymic remnants What is the origin of the right common B) From the brachiocephalic trunk carotid artery? Explanation: The right common carotid artery arises from the brachiocephalic trunk posterior to A) Directly from the aortic arch the superior part of the right sternoclavicular joint. B) From the brachiocephalic trunk C) From the left subclavian artery D) From the left common carotid artery E) From the thoracic duct Which veins serve as collateral channels C) Azygos and hemiazygos veins in the obstruction of the superior part of Explanation: In obstruction of the superior part of the inferior vena cava, the azygos and the inferior vena cava? hemiazygos veins and vertebral venous plexuses are the main collateral channels that maintain A) Jugular veins venous circulation. B) Subclavian veins C) Azygos and hemiazygos veins D) Pulmonary veins E) Renal veins What extracardiac condition is associated B) VACTERL association with a persistent left superior vena cava? Explanation: A persistent left superior vena cava may be associated with extracardiac conditions A) Marfan syndrome such as VACTERL association. B) VACTERL association C) Ehlers-Danlos syndrome D) Turner syndrome E) Klinefelter syndrome What is a radiographic sign of a B) Paramediastinal bulge anterior to the aortic arch persistent left superior vena cava? Explanation: Radiographically, a persistent left superior vena cava shows a paramediastinal A) Enlarged heart shadow bulge anterior to the aortic arch. B) Paramediastinal bulge anterior to the aortic arch C) Enlarged pulmonary arteries D) Narrowing of the trachea E) Displacement of the esophagus What is the main function of the inferior C) To return blood from the infradiaphragmatic tissues to the heart vena cava? Explanation: The inferior vena cava returns blood to the heart from infradiaphragmatic tissues. Question Answer A) To return blood from the head to the heart B) To return blood from the upper limbs to the heart C) To return blood from the infradiaphragmatic tissues to the heart D) To return blood from the lungs to the heart E) To return blood from the gastrointestinal tract to the heart What is a potential complication of a C) The catheter may enter the coronary sinus left-sided superior vena cava when Explanation: The angle at which the catheter enters the right atrium causes difficulty when placing a cardiac catheter? attempting to place it into the right ventricle and pulmonary trunk, generally leaving the catheter A) The catheter may enter the left tip against the coronary sinus. ventricle B) The catheter may enter the pulmonary artery C) The catheter may enter the coronary sinus D) The catheter may enter the left atrium E) The catheter may enter the right atrium Which vein may drain directly into a B) Hemiazygos vein persistent left superior vena cava? Explanation: The hemiazygos vein may drain directly into the persistent left superior vena cava. A) Azygos vein B) Hemiazygos vein C) Inferior vena cava D) Jugular vein E) Subclavian vein What happens if the cardinal vein does B) It forms a left-sided superior vena cava not obliterate during embryological Explanation: If the cardinal vein does not obliterate during embryological development, it development? persists as a left-sided superior vena cava. A) It forms a right-sided superior vena cava B) It forms a left-sided superior vena cava C) It forms a double inferior vena cava D) It forms a left-sided inferior vena cava E) It forms a right-sided inferior vena cava Which of the following is a potential A) Increased risk of deep vein thrombosis consequence of congenital agenesis of Explanation: Congenital agenesis of the inferior vena cava may be associated with a higher risk the inferior vena cava? for deep vein thrombosis due to the altered venous drainage pathways. A) Increased risk of deep vein thrombosis B) Decreased risk of heart failure C) Improved pulmonary function D) Enhanced blood flow to the liver E) Reduced risk of respiratory infections What is a common variation of the B) Left-sided inferior vena cava inferior vena cava? Explanation: A common variation of the inferior vena cava is the left-sided inferior vena cava, A) Right-sided inferior vena cava which occurs if the right supracardinal vein regresses and the left supracardinal vein persists. B) Left-sided inferior vena cava C) Superior vena cava duplication D) Absence of the inferior vena cava E) Inferior vena cava with multiple branches What condition is associated with an B) Scimitar syndrome abnormal connection between the right Explanation: Scimitar syndrome is a form of anomalous pulmonary venous drainage where there pulmonary vein(s) and the inferior vena is an abnormal connection between the right pulmonary vein(s) and the inferior vena cava, often cava? leading to respiratory insufficiency and increased risk of right ventricular failure. A) Situs inversus B) Scimitar syndrome C) Polysplenia D) Dextrocardia E) Cloacal extrophy What is the embryological cause of the A) Failure of the right subcardinal vein to anastomose with the hepatic sinusoids failure of the hepatic segment of the Explanation: The hepatic segment of the inferior vena cava fails to develop if the right subcardinal inferior vena cava to develop? vein fails to anastomose with the hepatic sinusoids. A) Failure of the right subcardinal vein to anastomose with the hepatic sinusoids B) Regression of the left supracardinal vein Question Answer C) Persistence of the right supracardinal vein D) Malformation of the right subcardinal-hepatic anastomosis E) Failure of the left subcardinal vein to anastomose with the hepatic sinusoids What is the significance of the azygos B) It should be spared to avoid circulatory collapse vein in neonates with azygos Explanation: In neonates with azygos continuation of the inferior vena cava, the azygos vein continuation of the inferior vena cava should be spared during surgical procedures like repair of oesophageal atresia and during surgical procedures? tracheo-oesophageal atresia to prevent intraoperative circulatory collapse and death. A) It should be ligated to prevent blood loss B) It should be spared to avoid circulatory collapse C) It should be divided to improve blood flow D) It should be removed to prevent infection E) It should be bypassed to maintain circulation