Anatomy Lec Finals Quiz 1 Samplex PDF

ANATOMY LECTURE QUIZ 1 FINALS 1 Which among the following DOES NOT describe B. It is lined with visceral pleura the thoracic wall? The thoracic wall is lined with parietal pleura, which c...

ANATOMY LECTURE QUIZ 1 FINALS 1 Which among the following DOES NOT describe B. It is lined with visceral pleura the thoracic wall? The thoracic wall is lined with parietal pleura, which covers the inner surface of the thoracic wall. The visceral pleura directly covers the lungs, not the thoracic A. COVERED BY SKIN AND MUSCLES wall. B. IT IS LINED WITH VISCERAL PLEURA C. POSTERIOR ASPECT IS FORMED BY THE THORACIC VERTEBRAE D. THE STERNUM AND COSTAL CARTILAGES ARE THE ANTERIOR STRUCTURES E. INFERIOR BORDER IS THE DIAPHRAGM 2 All BUT one are TRUE regarding the ribs: A. Rib 1 has a ridge for the origin of the serratus A. Rib 1 has a ridge for the origin of the muscle serratus muscle B. A Set of 12 bones forming the cage of the 1st Rib: attachment of the anterior scalene muscle thorax 2nd Rib: attachment with serratus anterior muscle C. The neck of the true rib has a tubercle that articulates with the transverse process of Trans M.15 page 2 the corresponding vertebra D. The groove of the rib contains a neurovascular bundle E. Rib 10 has only 1 facet 3 TRUE statement regarding Flail chest D. FAILURE OF FULL OXYGENATION OCCURS DUE TO THE PARADOXICAL BREATHING A. SINGLE RIB FRACTURE CAN BE A CAUSE Paradoxical breathing is the hallmark of flail chest, OF FLAIL CHEST where the flail segment moves inward during inspiration and outward during expiration, impairing ventilation and B. EXPANSION STILL OCCURS ON THE leading to hypoxia IPSILATERAL LUNG IN THE FLAIL CHEST C. RIBS 1 AND 2 ARE MOST COMMONLY SINGLE RIB FRACTURE CAN BE A CAUSE OF FLAIL INJURED IN FLAIL CHEST CHEST D. FAILURE OF FULL OXYGENATION OCCURS - A single rib fracture cannot cause flail chest; DUE TO THE PARADOXICAL BREATHING multiple rib fractures are required. E. NONE OF THE ABOVE EXPANSION STILL OCCURS ON THE IPSILATERAL LUNG IN THE FLAIL CHEST - The ipsilateral lung's expansion is compromised due to paradoxical motion and potential pulmonary contusion. RIBS 1 AND 2 ARE MOST COMMONLY INJURED IN FLAIL CHEST - Ribs 1 and 2 are protected by the clavicle and surrounding structures, making them less commonly fractured. Mid-thoracic ribs (4–9) are more commonly involved. 4 Which among the following is TRUE about D. MORTALITY IS DUE TO THE INJURIES IN THE Sternal Fracture? THORACIC VISCERA A - FALSE. Sternal fractures are usually not A. NOTABLE DISPLACEMENT OF THE significantly displaced due to the surrounding strong FRACTURE LINE IS EVIDENT connective tissues and thoracic structure. B. COMMON SITE IS THE XIPHISTERNAL JOINT B - FALSE. Fractures in the sternum are rare; however, C. MRI IS THE IMAGING PROCEDURE OF when present, they occur at the junction of the CHOICE TO DOCUMENT STERNAL manubrium and the body (manubriosternal joint).  FRACTURE C - FALSE - CT SCAN is the modality of choice for D. MORTALITY IS DUE TO INJURIES IN evaluating sternal fracture. THE THORACIC VISCERA E. NONE OF THE ABOVE 5 All are TRUE about the sternum EXCEPT: D. THE STERNAL BODY HAS A DEMIFACET FOR A. 7TH COSTAL CARTILAGE IS THE 7TH RIB ATTACHED TO THE XIPHOID The 7th rib articulates with the xiphisternal joint, not B. THE STERNAL ANGLE IS FELT AS A the sternal body. The sternal body has facets or TRANSVERSE RIDGE IN THE demifacets for ribs 3 through 6. ANTERIOR CHEST C. STERNAL ANGLE AIDS IN COUNTING RIBS D. THE STERNAL BODY HAS A DEMIFACET FOR THE 7TH RIB E. THE TIP OF THE XIPHOID IS AT T10 LEVEL 6 The following are TRUE about the costal cartilage B. RIBS 7-10 HAS CARTILAGES ATTCHED TO RIB EXCEPT: 6 A. Flexibility is lost at old age because of calcification The costal cartilages of ribs 7-10 are attached in a B. Ribs 7-10 has cartilages attached to rib 6 series, forming the costal margin, and ultimately C. Costal cartilage contributes to the elasticity connect to the cartilage of rib 7 (not rib 6). of the thoracic wall D. Costochondritis is due to trauma E. Costal cartilage of ribs 11-12 ends at abdominal muscles 7 The following are TRUE about the joints in the A. THE RADIATE LIGAMENT CONNECTS THE chest wall EXCEPT: RIB TO THE INTERVERTEBRAL DISC A. THE XIPHISTERNAL JOINT IS A These ligaments connect the costal cartilage of ribs 2-7 CARTILAGINOUS JOINT to the sternum. They radiate outward from the B. THE RADIATE LIGAMENT CONNECTS costochondral junction. THE RIB TO THE INTERVERTEBRAL DISC C. 2ND TO 7TH COSTAL CARTILAGES ARTICULATE WITH THE STERNUM BY SYNOVIAL JOINTS D. THE CARTILAGE OF THE 11TH AND 12 TH RIB ARE EMBEDDED IN THE ABDOMINAL MUSCLES E. RIB 1 ARTICULATES WITH THE MANUBRIUM AND IS A CARTILAGINOUS JOINT 8 Which among the following is TRUE about the A. THE EXTERNAL INTERCOSTAL MUSCLE RUNS intercostal muscles? DOWNWARD AND FORWARD A. THE EXTERNAL INTERCOSTAL B. FALSE - The internal intercostals and MUSCLE RUNS DOWNWARD AND transversus abdominis muscles do not have the  FORWARD same anatomical orientation or functional B. THE INTERNAL INTERCOSTAL similarity in a way that would make them MUSCLES CORRESPONDS TO THE correspond to each other. TRANSVERSUS ABDOMINIS MUSCLE C. THE INNERMOST INTERCOSTAL C. FALSE - THE INNERMOST INTERCOSTAL TRAVERSE ONLY ONE INTERCOSTAL TRAVERSE TWO INTERCOSTAL SPACES SPACE D. A & C ONLY E. ALL OF THE ABOVE 9 9. Which among the following statement is NOT TRUE D. A & C Only about blood supply of the intercostal muscles? A. FIRST 3 POSTERIOR INTERCOSTAL ARTERIES ARE A. FIRST 3 POSTERIOR INTERCOSTAL ARTERIES ARE FROM THE AORTIC ARCH FROM THE AORTIC ARCH B. DESCENDING AORTA IS THE SOURCE OF SOME NOT TRUE: The first 2 posterior intercostal arteries arise POSTERIOR INTERCOSTAL ARTERIES from the supreme intercostal artery, a branch of the C. LOWER 6 ANTERIOR INTERCOSTAL ARTERY IS A costocervical trunk of the subclavian artery, not directly BRANCH OF THE EXTERNAL MAMMARY ARTERY from the aortic arch. D. A & C ONLY E. ALL OF THE ABOVE C. LOWER 6 ANTERIOR INTERCOSTAL ARTERY IS A BRANCH OF THE EXTERNAL MAMMARY ARTERY NOT TRUE: The lower 6 anterior intercostal arteries are branches of the musculophrenic artery, which is a terminal branch of the internal thoracic (mammary) artery, not the “external mammary artery” (a misnomer). 10 This branch of the subcostal nerve connects the C. RAMI COMMUNICANTES intercostal nerve to the ganglia of the sympathetic trunk. A. Anterior cutaneous branch B. Lateral cutaneous branch C. Rami commicantes D. Collateral branch E. NOTA 11 Sternoclavicular Joint B. SYNOVIAL JOINT A. COSTOCLAVICULAR LIGAMENT B. SYNOVIAL JOINT C. ANTERIOR DISLOCATION D. POSTERIOR DISLOCATION E. INTERCLAVICULAR LIGAMENT 12 E. INTERCLAVICULAR LIGAMENT Reinforces the sternoclavicular joint superiorly A. COSTOCLAVICULAR LIGAMENT B. SYNOVIAL JOINT C. ANTERIOR DISLOCATION D. POSTERIOR DISLOCATION E. INTERCLAVICULAR LIGAMENT 13 Main stabilizing ligament of the sternoclavicular joint A. Costoclavicular ligament A. COSTOCLAVICULAR LIGAMENT  B. SYNOVIAL JOINT C. ANTERIOR DISLOCATION D. POSTERIOR DISLOCATION E. INTERCLAVICULAR LIGAMENT 14 Occurs after a direct blow to the shoulder posteriorly D. POSTERIOR DISLOCATION A. COSTOCLAVICULAR LIGAMENT B. SYNOVIAL JOINT C. ANTERIOR DISLOCATION D. POSTERIOR DISLOCATION E. INTERCLAVICULAR LIGAMENT 15 Occurs after a direct blow to the shoulder C. ANTERIOR DISLOCATION anteriorly A. COSTOCLAVICULAR LIGAMENT B. SYNOVIAL JOINT C. ANTERIOR DISLOCATION D. POSTERIOR DISLOCATION E. INTERCLAVICULAR LIGAMENT 16 Some fibers of the right crus of the diaphragm act as A. TRUE a sphincter of the esophagus, preventing reflux A. TRUE C. FALSE 17 C. FALSE The main arcuate ligament is another peripheral attachment of the diaphragm that The main arcuate ligament is not a peripheral attachment of the diaphragm.It is formed by the right extends from the body of L3 to the tip of the and left crura of the diaphragm as they converge transverse process of L1. medially. The crura are the tendinous structures that arise from the lumbar vertebrae. The right crus arises from the anterior surface of the bodies of L1-L3 A. TRUE vertebrae, while the left crus arises from the anterior C. FALSE surface of the body of L1 and sometimes L2. The medial arcuate ligament connects the right and left crura of the diaphragm. 18 TRUE/FALSE: The Superior phrenic artery supplies the FALSE superior part of the diaphragm. It is a branch of the Branch of the “THORACIC” aorta, not “ABDOMINAL” abdominal aorta A. TRUE C. FALSE 19 BONUS A. ANSWER A. TRUE Ratio C. FALSE 20 The apex of the lungs projects just over the second C. FALSE rib on the side. A. True The apex of the lungs typically projects just above the C. False level of the first rib, not the second rib. It extends into the root of the neck, about 2-4 cm above the first rib at the level of the clavicle. 21 Both the heart and the esophagus lies near the A. True medial surface of the lungs.  A. TRUE C. FALSE 22 The oblique tissue of the lungs runs from the C. FALSE inferior border and ends at the posterior border The oblique fissure of the lungs actually runs from the about 1.5 cm from the арех. posterior border at the level of the T3 vertebra and moves downward and forward, ending at the anterior A. TRUE border at the level of the sixth rib, not 1.5 cm from the C. FALSE apex. The oblique fissure separates the lower lobe from the upper and middle lobes in the right lung, and the lower lobe from the upper lobe in the left lung. 23 A. TRUE The lingular segment of the left lung corresponds to the middle lobe of the right lung. A. TRUE C. FALSE 24 C. FALSE The cardiac notch of the right lung The cardiac notch is found in the “left lung,” not the right lung, to accommodate the heart accommodates the apex of the heart. A. TRUE C. FALSE 25 A teenager sought a consultation due to a B. T6 "mass" felt by the patient between his chest and abdomen on the midline. PE revealed a prominent xiphoid process. What is the dermatomal level that supplies this area? A. T5 B. T6 C. T7 D. T8 E. T9 26 The joint formed by the xiphoid process and the body E. Body of T9 of the sternum lies at what vertebral level? Pertains to the Xiphisternal joint A. Body of T5 B. Body of T6 C. Body of T7 D. Body of T8 E. Body of T9 27 A student is placing ECG leads into the chest wall. C. Manubriosternal joint What landmark is used to help identify proper placement? Landmark for counting the ribs since it corresponds to A. Suprastermal notch the 2nd rib. B. Clavicle C. Coracoid process D. Manubriosternal joint E. Xiphisternal joint 28 The structure being asked in the previous C. Between T4 and T5  question lies at what vertebral level? A. Between T2 and T3 B. Lower border of T3 C. Between T4 and T5 D. Body of T5 E. Upper border of T6 29 In normal individuals, the Point of Maximal C. 5th ICS left mid clavicular line Impulse (PMI) of the heart usually is felt in this region: A. 4th ICS left mid clavicular line B. 4th ICS left parasternal line C. 5th ICS left mid clavicular line D. 4th ICS left anterior axillary line E. 5th ICS left parasternal line 30 The nipple in males is usually found at this B. At the 4th ICS anterior chest wall level (Snell): A. Over the 4th rib B. At the 4th ICS C. Over the 5th rib D. At the 5th ICS E. Over the 6th rib 31 The hallmark of the disease of the pleura is: B. Effusion A. Pneumonia B. Effusion C. Cancer D. Pneumothorax E. Adhesions 32 Approximate volume of effusion needed to C. 250-300 ml obliterate the costophrenic angle on xray is: 250 mL - SURGICAL A. 75-100 ml 300 mL - RADIOLOGIC B. 150-200 ml C. 250-300 ml D. 10-20 ml E. 500 ml 33 The lower border of the lung at the mid-axillary line is C. 8th RIB noted at this particular level A. 6th rib The lower borders of the lung are: B. 7th rib T6 - mid-clavicular line C. 8th rib T8 - mid-axillary line D. 9th rib T10 - posteriorly E. 10th rib The lower borders of the pleura are: T8 - mid-clavicular line  T10 - mid-axillary line T12 - posteriorly 34 Left Vagus Nerve lies at the: A. Anterior esophagus A. Anterior esophagus B. Lateral esophagus F.05, page 5 C. Posterior esophagus D. Medial Esophagus E. NOTA 35 Arterial blood supply of the esophagus arising from B. LEFT GASTRIC ARTERY the celiac artery The left gastric artery is the branch of the celiac artery A. Right gastric artery that supplies the abdominal part (lower third portion) of B. Left gastric artery the esophagus. The splenic artery is also a branch of C. Splenic artery the celiac artery that supplies blood to the spleen, D. Hepatic artery stomach, & pancreas. The right gastric artery and E. Gastroduodenal artery gastroduodenal artery are branches of the hepatic artery. (Reference: Snell, 10th ed.) 36 NOTA DAPAT Contents of the superior mediastinum are as follows, EXCEPT A. Right recurrent laryngeal nerve B. Left phrenic nerve C. Right vagus nerve D. Esophagus E. Thymus 37 Contents of the anterior mediastinum are as follows C. Left Vagus Nerve except: A. Thymus B. Upper sterno-pericardial ligament C. Left vagus nerve D. Lower sterno-pericardial ligament E. AOTA 38 The length size of the esophagus situated in the B. 2 cm abdominal cavity A. 0.5 cm This portion of the esophagus begins after it passes B. 2 cm through the esophageal hiatus in the diaphragm and C. 4 cm ends at the cardia of the stomach. D. 1 cm E. 3 cm The intraabdominal part of the esophagus is related D. LEFT LOBE OF THE LIVER 39 anteriorly to: A. Right lobe of the liver B. Quadrate lobe of the liver C. Caudate lobe of the liver D. Left lobe of the liver E. None of the above 40 Nerve supply of the mediastinal pleura: C. PHRENIC NERVE A. Phrenic nerve: B. Intercostal nerves C. Vagus nerve D. Autonomic nerve 41 Pleura that is sensitive only to stretching D.Visceral Pleura A. Costal Pleura B. Mediastinal Pleura C. Diaphragmatic Pleura D. Visceral Pleura 42 At what level does the left costomediastinal line B. 4th INTERCOSTAL SPACE of pleural reflection start to curve outward or Because of the presence of the heart, it will now curve laterally from the left border of the sternum? at the level at the 4th rib/intercostal space A. 2nd intercostal space B. 4th intercostal space C. 3rd intercostal space D. 5th intercostal space 43 This parietal pleura lines the undersurface of A. CERVICAL PLEURA the suprapleural membrane: The cervical pleura ( cupula) extends up into the neck, A. Cervical pleura lining the undersurface of the suprapleural membrane B. Costal pleura C. Diaphragmatic pleura D. Mediastinal pleura E. None of the above. 44 The vagus nerve, or the 10th cranial nerve (CN C. JUGULAR FORAMEN X), is the longest and most complex of the cranial nerves. It exits the cranium via the: A. Foramen ovale B. Foramen rotundum C. Jugular foramen  D. Carotid canal 45 C. FALSE The phrenic nerve is contained and passes The phrenic nerve does not pass through the hilum of through the hilum of the lung. the lung. It originates from the anterior rami of the C3, C4, and C5 spinal nerve roots (commonly A. TRUE remembered with the mnemonic "C3, 4, and 5 C. FALSE keep the diaphragm alive"). The nerve descends caudally in the thorax, running anterior to the root of the lung, sandwiched between the mediastinal surface of the parietal pleura and the fibrous pericardium. It then continues downward to reach the diaphragm, providing its primary motor innervation, along with some sensory contributions to the diaphragm, pericardium, mediastinal pleura, and diaphragmatic peritoneum. 46 A. TRUE Bronchial arterial system is the main source of bleeding in 90% of the cases of massive hemoptysis. A. TRUE C. FALSE 47 True or False. The bronchial arteries arise from their A. TRUE parent vessels at the T3-T8 levels, most commonly between the T5-T6 level 48 True or False. The bronchial artery supply the bronchi A. TRUE down to the respiratory bronchioles. 49 The trachea ends at E. Sternal Angle level A. T1 level The trachea divides at the level of T4-T5 B. Posterior to the Cricoid cartilage (sternal angle) C. Dorsal to the Thyroid Gland isthmus The trachea bifurcates and terminates D. Superior to the inferior Thyroid superior to the heart at the level of the Arteries sternal angle The trachea extends from C6 (cricoid E. At the sternal angle level cartilage) to T5 (sternal angle), where it divides intothe right and left main bronchus 50 The Tracheobronchial tree consists of the C. TRACHEAL CARTILAGE A following except for: A. Bronchial Cartilage. B Thyroid B. Thyroid Cartilage C. Tracheal Cartilage Cartilage D. Muscle E. Diverticuli 51 The windpipe diameter of an average adult 2.5 cm (1 inch) A. 10.25 in B. 10.25 cm C. 2.5 in D. 2.5 cm E. NOTA 52 The dorsal structure of the Trachea is called the: B. TRACHEALIS A. Esophagus F.03 TRACHEOBRONCHIAL TREE Page 2/7 B. Trachealis C. Tracheostomy tissue D. Posterior Hyaline cartilage E. Posterior connective tissue 53 The trachealis is innervated by the: NOTA A. Vagus nerve ONLY THE FIRST 3 CHOICES INNERVATE THE B. Recurrent Laryngeal Nerve TRACHEALIS MUSCLE. C. Sympathetic trunk D. Phrenic nerve E. All of the Above 54 Where foreign body mostly lodges: Pulmonary B. RIGHT PRINCIPAL BRONCHUS Aspiration of a foreign body is commonly seen Wider lodging in the: A. Left Principal Bronchus B. Right Principal Bronchus 55 The alveoli arise from this structure. A.RESPIRATORY BRONCHIOLE A. Respiratory bronchiole B. Respiratory Ducts C. Respiratory Sacs D. Terminal Bronchus E. Inferior Lobar Bronchus 56 The lower respiratory tract starts at: E. ALL OF THE ABOVE A. Level of C6  B. Inferior to the Cricoid cartilage C. At the area of the Thyroid Gland D. Medial to the inferior Thyroid Arteries E. All of the Above 57 In a cross section of the chest at T4, The D. VENTRAL Superior Vena Cava Is located ______ to the trachea. A. Superior B. Left C. Inferior D. Ventral E. Right 58 Blood supply to the lower 2/3 of the trachea is E. A AND D from the: The inferior thyroid arteries (branches of the subclavian A. Inferior Thyroid Arteries arteries) supply the upper two thirds of the trachea, and B. Interior Thyroid Arteries the bronchial arteries (branches of the thoracic aorta} C. Internal Thoracic Artery supply the lower third. (Snell) D. Bronchial Artery E. A and D 59 When comparing the right main bronchus to the left A. Wider main bronchus, the right main bronchus is: A. Wider Trans F.03 page 4-5 B. Has two divisions C. Longer D. Horizontal E. All of the above i 60 This bronchiole gives rise to the alveolar duct B. TERMINAL (Snell) A. Lobar B. Terminal C. Respiratory D. Lobular  ANATOMY LECTURE QUIZ 2 FINALS Dr. Abraham Cinio | December 10, 2024 1 Where should a physician place a stethoscope to E. LEFT 5TH ICS MCL listen to the sound of the mitral valve? A. Over medial end of left 2nd ICS B. Over medial end of right 2nd ICS C. Over right half of lower end of body of sternum D. Left 4th ICS MCL E. Left 5th ICS MCL 2 An artificial pacemaker is implanted in an elderly male C. SA NODE patient. Which of the following conductive tissue of Sinoatrial (SA) node, located in the right atrium, is the the heart has a defective function natural pacemaker of the heart. It initiates and regulates the A. AV bundle heart's rhythm. B. AV node C. SA node D. Purkinje fiber E. Moderator band 3 If a blood clot blocks the circumflex branch of the left D. Posterior part of the left ventricle coronary artery in a patient with atypical coronary The circumflex branch of the left coronary artery supplies the circulation, which area of the heart musculature is posterior portion of the left ventricle. The anterior most likely ischemic? interventricular artery supplies the anterior aspects of the right A. Anterior part of the left ventricle and left ventricles and the anterior interventricular septum. B. Anterior interventricular region C. Posterior interventricular region BRS Gross Anatomy D. Posterior part of the left ventricle E. Anterior part of the right ventricle 4 An aneurysm of the abdominal aorta at the aortic C. Azygos vein and thoracic duct hiatus of the diaphragm is most likely to result in compression of which of the following pairs of structures? A. Vagus nerve and azygos vein B. Esophagus and vagus nerve C. Azygos vein and thoracic duct D. Thoracic duct and vagus nerve E. Inferior vena cava and phrenic nerve 5 A tumor located just superior to the root of the right B. Azygos vein lung may block blood flow in which of the following The azygos vein arches over the root of the right lung and veins? empties into the SVC. Other veins do not pass over the root of A. Hemiazygos vein the right lung. B. Azygos vein  C. Right subclavian vein BRS Gross Anatomy D. Right brachiocephalic vein E. Accessory hemiazygos vein 6 A large tumor confined in the posterior mediastinum E. Descending aorta may compress which of the following structures? The descending aorta is found in the posterior mediastinum. The superior mediastinum contains the trachea and arch of the aorta, and A. Ascending aorta the middle mediastinum contains the ascending aorta, arch of the B. Arch of the aorta azygos vein, and main bronchi. The phrenic nerve runs in the middle C. Trachea mediastinum. D. Arch of azygos vein BRS Anatomy E. Descending aorta 7 The near simultaneous closure of which of the C. Tricuspid and mitral following valves produces the first heart sound? S1 - Tricuspid and mitral A. Aortic and tricuspid S2 - Aortic and pulmonary B. Aortic and pulmonary C. Tricuspid and mitral D. Mitral and pulmonary E. Tricuspid and pulmonary 8 Which of the following structures maintains constant C. Chordae tendineae tension on the cusps of the AV valve? A. Crista terminalis B. Septomarginal band C. Chordae tendineae D. Pectinate muscles E. Anulus fibrosus 9 A college student was rushed to the clinic due to C. In the left 5th ICS at the midclavicular line vertigo. History revealed the patient stayed up late last night to finish her project. She did not eat breakfast and went to school early. While presenting her project, she fainted. Past medical history revealed the patient was diagnosed mitral valve prolapse. In order to appreciate the murmur produced by this defect, the physician will have to place a stethoscope at this region of the thoracic wall. A. Over the medial end of the 2nd left ICS B. Over the right half of the lower end of the body of the sternum C. In the left 5th ICS at the midclavicular line D. In the left 4th intercostal space at the midclavicular line 10 A female patient sought consultation for an annual C. Azygos vein physical exam. A chest x-ray revealed a “mass” on The azygos vein arches over the root of the right lung and the right lung. A chest CT scan located just superior empties into the SVC. Other veins do not pass over the root of to the root of the right lung. In which of the following the right lung. vessels can blood flow be impeded or blocked? A. Hemiazygos vein BRS Gross Anatomy B. Right brachiocephalic vein C. Azygos vein  D. Inferior vena cava E. Right subclavian vein 11 A male patient was rushed to the emergency room C. Receives the lower left posterior intercostal vein due to a stab wound to the upper left abdomen on Tributaries to the hemiazygos vein come from: the left subcostal region midclavicular line. Which of Lower 4 or 5 left posterior intercostal veins the following statements is true with regards to the Lower end of the accessory hemiazygos hemiazygos vein? A. Receives the left superior intercostal vein Trans F.08 p.3 B. Empties into the superior vena cava C. Receives the lower left posterior intercostal vein D. Is connected to the inferior vena cava 12 Which of the ff anatomic features would most likely B. Bifurcation of the trachea be found at the level of sternal angle? A. Beginning of the ascending aorta The trachea divides into the right and left main bronchi at the B. Bifurcation of the trachea level of the sternal angle (T4-T5). C. Middle of aortic arch D. Superior border of the superior mediastinum E. Articulation of the 3rd rib with the sternum 13 During surgical open repair of a diaphragmatic hernia, D. Thoracic duct a surgical resident inadvertently cut a structure that The thoracic duct is a major lymphatic vessel that runs along courses along the left crus of the diaphragm. Which the left side of the body, and it ascends along the left side of of the following structures is damaged? the vertebral column, passing through the aortic hiatus of the A. Vena azygos major diaphragm. B. Inferior vena cava C. hemiazygos Trans F.08 p.6 D. Thoracic duct E. Accessory hemiazygos 14 Which of the following anatomic features would most B. Pericardium extends from just superior to the angle of Louis likely be found at the level of the sternal angle, to the level of the xiphisternal joint except? A. At the level of T4-T5 intervertebral disc B. Pericardium extends from just superior to The pericardium extends from the level of the sternal angle to the angle of Louis to the level of the about the level of the xiphoid process, NOT the xiphisternal joint XIPHISTERNAL JOINT. C. Superior border of the superior mediastinum D. Articulation of the 2nd rib with the sternum E. It overlies the aortic arch on the left and the superior vena cava on the right 15 Tumors that metastasize via hematogenous spread C. Hemiazygos located in the left thoracic wall region will most likely The hemiazygos vein is a major venous structure on the left affect or pass via these vessels? side of the thorax that drains blood from the left posterior A. Vena azygos major thoracic wall, including the intercostal veins. It drains the lower B. Inferior vena cava left thoracic wall and ascends along the left side of the C. Hemiazygos vertebral column. D. Superior vena cava E. Accessory hemiazygos 16 Average lymph flow through the thoracic duct and B. 2-4 liters/day right lymphatic ducts: 60-190 ml/hour of lymph A. 500-1000 ml/day Estimated of 1.38 ml/kg/hour of lymph to the venous B. 3-4 liters/day system C. 1-2 liters/day 2-4 liters of lymph/day  D. Superior vena cava 17 Male patient diagnosed with gastric cancer presented D.Rule out respiratory infection with a mass on the right supraclavicular area. The patient’s symptoms, including a supraclavicular mass Ultrasound of the “mass” revealed multiple matted and matted lymph nodes, are much more concerning for lymph nodes. The following statements are true with metastasis rather than an infection. The decision-making regards to the case, except: should focus on confirming whether the mass is metastatic A. Mass is probably metastatic in nature from the gastric cancer and staging the disease accordingly, secondary to the gastric cancer not on ruling out an infection. B. Request for chest x-ray C. Need to do a complete physical exam of *not sure huhu the head and neck D. Rule out respiratory tract infection E. Commences in the abdomen as an elongated lymph sac, the cisterna chyli 18 The following statements regarding the thoracic duct B. Thoracic duct drains into the junction between the are true, except? right Subclavian vein A. commence in the abdomen as an elongated lymph sac, the cisterna chyli The thoracic duct drains into the junction of the left subclavian B. thoracic duct drains into the junction vein and internal jugular vein, not the right subclavian vein between the right Subclavian vein C. cisterna chyli lies on the right side of aorta D. thoracic duct usually has 3 main collecting trunks in the abdominal cavity 19 The anterior interventricular artery branch usually B. Left coronary artery arises from the: A. Right coronary artery B. Left coronary artery C. Coronary circumflex artery D. Marginal artery 20 Backward prolapse of the cusps of the atrioventricular C. Chordae tendinae valves are prevented by this structures: A. Pectinate muscles B. Trabeculae carneae C. Chordae tendineae D. Moderator band 21 The first heart sound is due to: B. Closure of the mitral and tricuspid valves A. Contraction of the vesicles B. Closure of the mitral and tricuspid valves C. Contraction of the auricle D. Chordae tendineae E. Moderator band 22 A 5 year old female patient was brought to the ER E. Foramen Ovale due to dyspnea, palpitations, and shortness of breath. Doppler study of the heart reveals atrial septal defect The foramen ovale is an oval-shaped opening in the fetal heart (ASD). This malformation is due to incomplete closure that allows blood to flow directly from the right atrium to the of what embryonic structure? left atrium, bypassing the fetal lungs. Normally, this opening  A. Ductus arteriosus closes shortly after birth. However, if it fails to close B. Sinus Venarum completely, it results in an atrial septal defect (ASD). C. Truncus arteriosus D. Ductus venosus E. Foramen ovale 23 10 y/o patients with atrial septal defect (ASD) shunts C. Anterior cardiac vein blood from left atrium to right atrium causing The anterior cardiac vein drains into the right atrium. The hypertrophy. Which of the following veins opens middle, small, and oblique cardiac veins drain into the coronary directly into the chamber? sinus. The right and left pulmonary veins drain A. Middle cardiac vein into the left atrium. B. Small cardiac vein C. Anterior cardiac vein D. Right pulmonary vein BRS Anatomy 24 A 56 y/o patient was diagnosed to have myocardial C. Anterior interventricular artery infarction of the apex of the heart. The occlusion by The apex of the heart typically receives blood from the anterior atherosclerosis is in which of the following arteries? interventricular branch of the left coronary artery. The marginal A. Marginal artery artery supplies the right inferior margin of the right ventricle, B. Right coronary artery at its origin the right coronary artery at its origin supplies the right atrium C. Anterior interventricular artery and ventricle, and the posterior interventricular artery and a D. Posterior interventricular artery circumflex branch of the left coronary artery supply the left E. Circumflex branch of the left coronary ventricle. artery BRS Anatomy 25 The collecting trunk of the azygos system otherwise C. Accessory hemiazygos vein known as the vena azygos minor superior Also known as the Vena Azygos Minor Superior / Minor A. Azygos vein Superior Azygos Vein / Superior Hemiazygos Vein B. Hemiazygos vein C. Accessory hemiazygos vein D. NOTA 26 Your answer in the previous question enters the D. None of the above thoracic cavity into this particular opening: A. Left crus of diaphragm B. Caval opening C. Aortic opening D. None of the above 27 The thoracic duct enters the thoracic cavity from the c. Aortic Opening abdomen though what diaphragmatic opening? A. Right crus of diaphragm B. Caval opening C. Aortic opening D. None of the above 28 Heart valve that guards the right atrioventricular C. Tricuspid valve orifice: a. Pulmonic valve b. Mitral valve c. Tricuspid valve d. Aortic valve e. Coronary valve 29 Beck’s triad, except: B. Elevated systemic venous pressure A. Hypotension B. Elevated systemic venous pressure Trans F.06 page 1 C. Often with jugular venous distention D. Muffled heart sound 30 The right ventricle contracts passing the blood into D. Pulmonic valve the pulmonary trunk via the ___ to reach the lungs A. Aortic valve B. Mitral valve C. Tricuspid valve D. Pulmonic valve E. Coronary valve 31 The tricuspid valve is loudest or best heard at the: B. 4th Left Intercostal Space A. 2nd left intercostal space. B. 4th left intercostal space C. Left 5th intercostal space at the midclavicular line D. 2nd right intercostal space 32 The esophagus enters the superior mediastinum B. False between the trachea and vertebral column, where it The esophagus is positioned posterior to the trachea and lies anterior to the bodies of the T1-T4 vertebrae the aortic arch, and it lies anterior to the vertebral A. True bodies of the T1-T4 vertebrae. It also passes behind the left C. False mainstem bronchus and continues downward through the posterior mediastinum. 33 The esophagus descends into the posterior A. True mediastinum from the superior mediastinum, passing posterior to and to the right of the arch of the aorta A. True B. False 34 The abdominal portion of the esophagus starts as the A. True esophagus passes through the diaphragmatic hiatus and is surrounded by the phrenoesophageal membrane, a fibroelastic ligament arising from the subdiaphragmatic fascia A. True B. False 35 The cricopharyngeus muscle forms the cervical A. True constriction or the upper esophageal sphincter, and is located approximately 15 cm from the incisor teeth A. True B. False 36 What is the most used, practical and initial imaging B. Chest x ray modality to assess the chest, lungs, and heart? A. Ultrasound B. Chest x ray C. Chest CT Scan D. Chest MRI 37 Rib with manubrial and sternal body articulation? B. 2nd A. 1st B. 2nd C. 3rd D. 4th 38 A rib is classified as a TRUE rib if it has articulation A. Sternum with the thoracic spine and which structure? A. Sternum B. Clavicle C. Scapula D. Xiphoid process 39 The bilateral internal thoracic artery comes from what C. Subclavian artery/ies artery/ies? A. Common carotid artery/ies B. Vertebral artery/ies C. Subclavian artery/ies D. Aorta 40 Accidental ingestion of coin by a 4 year-old. Chest A. ESOPHAGUS x-ray revealed that the coin is in the mid neck region In a chest X-ray, if a coin appears in the mid-neck region and in “profile” appearance. The coin is likely within what shows a profile view (edge-on view), it is most likely located in structure? the esophagus. Coins in the esophagus typically align with the A. Esophagus sagittal plane because the esophagus lies posterior to the B. Trachea trachea and the vertebral column. C. Lungs D. Mouth 41 What xray view will best show that the ingested coin A. Lateral chest xray is in the trachea or esophagus? A. Chest PA B. Chest AP C. Apicogram D. Lateral chest xray 42 Pigeon chest is also known as? C. Pectus carinatum A. Pectus excavatum B. Pectus proventriculus C. Pectus carinatum D. Pectus pectoralis 43 Estimated minimal volume of fluid that may cause a D. At least 200 cc blunted costophrenic angle in chest xray PA? A. 15 cc B. At least 75 cc C. 300 сс D. At least 200 cc 44 The cardiac chamber that is most anterior in location? B. Right Ventricle A. RA B. RV C. LA D. LV 45 Which among the choices is the best method to D. CT aortogram assess the aorta and its branches? Contrast enhanced CT Scan or MRI dedicated to the aorta or A. Plain MRI vena cava (CT/MR AORTOGRAM/VENOGRAM) remains to be B. Contrast enhanced chest and abdominal CT the best modality to assess these great vessels scan Ø CT > MRI C. CT Aortogram D. Ultrasound Trans F.08B p.4 46 Man stabbed in the anterior chest wall. Which A. Right Ventricle chamber of the heart did it primarily affect? A. Right ventricle B. Right atrium C. Left ventricle D. Left atrium 47 This structure is a helpful landmark to identify the B. Moderator Band morphologic right ventricle A. Coronary sinus B. Moderator band C. Fossa ovalis d. D. Coronary cusps (tricuspid valve) 48 Cardiac chamber that does not form a border in the C. LA lateral chest xray? On a lateral chest X-ray, the right atrium (RA) and right A. RA ventricle (RV) are positioned more anteriorly, making them B. RV visible in profile. C. LA The left ventricle (LV), being positioned more posteriorly D. LV and to the left, forms part of the lower border of the heart on the lateral view. The left atrium (LA) is located posteriorly and above the left ventricle, so it typically does not create a discernible border in the lateral view, as it is hidden behind the other chambers. 49 Cardiac chamber that mainly comprises the left and C. Left Atrium posterior cardiac margins? The left atrium (LA) mainly comprises the left and posterior A. RA cardiac margins. B. RV C. LA The left atrium is located posteriorly and to the left side of the D. LV heart, and it is responsible for forming the left margin (and part of the posterior margin) seen on the chest X-ray. *Most posterior portion 50 Which lung lobe has a medial and lateral segment? B. Right middle lobe A. Right upper lobe B. Right lower lobe C. Right middle lobe D. Left upper lobe F02. Lungs and Diaphragm Page 2