EVALUATION EXAM (LUNGS; HEART)

1. Which feature is NOT found in the right lung?

A. Oblique fissure
B. Horizontal fissure
C. Cardiac notch
D. Superior lobar bronchus

2. An inhaled object would most likely be in this area of the lung

A. Left main bronchus
B. Right main bronchus
C. Apical segment of left lung
D. Terminal segment of right lung

3. Where would Clerk Abdulmalik expect a lesion on the left lung after 16-year old student
sustained a stab wound that entered through the posterior chest wall along axillary line?
A. Cupola
B. Lingual
C. Middle lobe
D. Inferior lobe

4. Imaginary plane dividing the mediastinum into superior and inferior mediastinum passes
from the sternal angle anteriorly to the lower border of the body of this structure
posteriorly:
A. T2
B. T4
C. T6
D. T8

5. While doing the dissection in the hilar reflection, Mynard noticed a point of continuity
between the pleura extending from the inferior end of hilum downward to diaphragm
below. What structure is this?
A. Mediastinal fissure
B. Pulmonary ligament
C. Pulmonary recess
D. Parietal pleura

6. This rib articulates with the sternum, EXCEPT:

A. Rib 2
B. Rib 4
C. Rib 6
D. Rib 8

7. When you examine a patient with copious amount of fluid in the left pleural cavity,
where would CLERK TAGALOG expect fluid to accumulate as the patient sits up in
bed?
A. Hilar reflection
B. Posterior mediastinum
C. Costodiaphragmatic recess
D. Costomediastinal recess

8. What part of the pleural cavity extends above the level of the first rib into the root of the
neck?
A. Cupola
B. Lingula
C. Hilar reflection
D. Cervical groove
9. The medial surface of the left lung lies adjacent to a number of important structures in the
mediastinum and the root of the neck, EXCEPT:
A. Heart
B. Esophagus
C. Inferior vena cava
D. All of the above

10. Patient with right middle lobe consolidation experienced anterior chest discomfort. What
causes the pain?
A. Dorsal primary rami
B. Intercostal nerves
C. Medial pectoral nerves
D. Thoracodorsal nerves

11. Medical Intern Christian noticed that during deep inspiration, tracheal bifurcation may be
lowered as far as:
A. 4th thoracic vertebra
B. 6th thoracic vertebra
C. 8th thoracic vertebra
D. 10th thoracic vertebra

12. Clerk Sharon observes that this is the type of respiration in female adult
A. Abdominal respiration
B. Thoracic respiration
C. Both
D. None of the above

13. Parasympathetic effects in the lungs, EXCEPT:

A. Bronchoconstriction
B. Vasodilatation
C. Decrease glandular secretion
D. None of the above

14. Blockage of which of the following arteries would lead to ischemia of the apex of the
heart?
A. Left circumflex
B. Right marginal
C. Anterior interventricular
D. Posterior interventricular

15. Upper lobes of the lungs are most easily examined on physical examination
A. Front of chest
B. Back of chest
C. In axillae
D. Neither sides

16. Which is NOT a characteristic of left atrioventricular valve?

A. It is also called mitral valve
B. It transmits oxygenated blood
C. Open during ventricular systole
D. It consists of two leaflets
17. Coronary sinus receives blood from the following, EXCEPT:
A. Anterior cardiac vein
B. Great cardiac vein
C. Middle cardiac vein
D. Small cardiac vein

18. The groove on the heart that separates the atria from the ventricles
A. Auricular sulcus
B. Coronary sinus
C. Coronary sulcus
D. Oblique sinus

19. Heart block due to coronary occlusion of right bundle of HIS may have caused the heart
attack of a 62-year old manager. The artery most likely involved:
A. Right coronary
B. Left coronary
C. Both arteries
D. Neither arteries

20. Persistence of a fetal/embryologic opening between the right and left atria
A. Ductus arteriosus
B. Sinus venosus
C. Foramen ovale
D. Truncus arteriosus

21. The multiple dilated veins around the neck are indicative of venous obstruction. What
common vessel do you think is obstructed?
A. Ascending aorta
B. Superior vena cava
C. Inferior vena cava
D. Celiac trunk
22. A 15-year old gymnast badly fell from a 10-ft height beam during a practice. She was
rushed to the ER where Intern Lopez suspected that sternocostal surface of heart was in
terrible condition. The anterior wall of this chamber is primarily affected:
A. Left atrium
B. Left ventricle
C. Right atrium
D. Right ventricle

23. Don Juan had moderate-severe chest pains late last night. His ECG tracings showed
blockage of a vessel leading to ischemia of the apex of the heart. What supplies the area?
A. Left circumflex
B. Anterior descending
C. Posterior interventricular
D. Right marginal
E. Right coronary

24. Which posterior mediastinal structure is most closely applied to the posterior surface of
the pericardial sac?
A. Aorta
B. Azygos vein
C. Esophagus
D. Thoracic duct
E. Trachea
25. Structure that crosses the midline, carries out the left-to-right shunting, and delivers blood
from the left side of the head and neck, the left upper limb, and part of the left thoracic
wall
A. Left brachiocephalic vein
B. Superior vena cava
C. Inferior vena cava
D. Pulmonary vein
26. Clamping of great arteries is done during cardiac surgery. Compression of these
structures with the index finger and the thumb of the same hand is possible by passing
over this space:
A. Cardiac notch
B. Coronary sinus
C. Oblique pericardial sinus
D. Transverse pericardial sinus

27. A harsh systolic ejection murmur was heard by Clerk Sam over second left intercostal
space while examining a 5-year old boy rushed by her mom early this morning. What
structure would be causing the particular sound?
A. Tricuspid valve
B. Mitral valve
C. Pulmonic valve
D. Aortic valve
28. Which valves would be open during ventricular systole?
A. Aortic and tricuspid
B. Mitral and aortic
C. Aortic and pulmonary
D. Tricuspid and mitral
E. Tricuspid and pulmonary

29. A sharp object puncture over left half of sternum at fourth-fifth costal cartilage was
sustained by a 34-year old policeman after chasing a drug suspect along Sta. Ana
Avenue. If the injury penetrated the pericardium, which chamber would most likely be
damaged?
A. Right atrium-tricuspid valve
B. Right ventricle-pulmonic valve
C. Left atrium-mitral valve
D. Left ventricle-aortic valve

30. Patient with enlarged liver and spleen, distended jugular veins and ascites was brought to
the ER. What caused the following manifestations?
A. Right heart failure: defect in systemic circuit
B. Left heart failure: defect in pulmonary circuit
C. Right heart failure: defect in pulmonary circuit
D. Left heart failure: defect in systemic circuit