Thorax anatomy test page 36 exam 5

1. Which of the following problems/pathological phenomenon can be caused by a

tumor at the apex of the lung?

a. Nerve disorder on the lateral side of the hand- numbness

b. Occlusion of the azygos vein
c. Pupil dilation
d. Damage to the recurrent laryngeal nerve

2. What is the correct sentence regarding the mediastinum

a. The cupula is the upper border of the superior mediastinum
b. The phrenic nerve passes in the anterior mediastinum behind the hilum of the
lung
c. The RLN passes in the superior mediastinum
d. The entire aortic arch is in the superior mediastinum

3. Which of the following blood vessels does not pass even partially, in the AV groove?
a. Coronary sinus
b. RCA
c. PDA
d. Great cardiac vein
e. LCX

4. Where is the transducer for the echo placed?

a. Parasternal 2nd Intercostal space

b. Suprasternal
c. Under costal margin
d. PMI

5. Which of the following structure passing through diaphragm have a mismatch ?

a. Phrenic – caval opening

b. Vagus -oesophageal hiatus
 c. Sympathetic trunk- lateral arcuate ligament
d. Azygos – aortic hiatus

6. When does the fetal heart start beating for the first time?
a. 21 days after fertilization
b. 28 days after fertilization
c. 6 week after “…”
d. 7 weeks after “…”

7. During a fight, a boy was attacked with a knife that penetrated the front part of the
manubrium. What is most likely to be affected?

a. Left ventricle
b. Left atrium
c. Anulus fibrosus
d. Ascending aorta
e. Right Ventricle

8. What is true about PMI?

a. Is located in the parasternal in the space between the 3rd pair of ribs
b. In heart failure the point may move to the left
c. You can listen from there the right heart only
d. The best point for auscultation in aortic insufficiency
e. In echocardiography it will be called the parasternal position

9. Why do you take PA pictures when standing?

a. PA enlarges
b. AP enlarges
c. AP is sharper
d. PA is sharper

10. In a CT examination, what is the correct order of densities from Right to left
a. Air – water- fat- blood -bone
b. Fat – air- water – blood – bone
c. Air – blood – water – fat- bone
d. Air- fat- water – bone – blood

11. Which of the following is true about the silhouette sign ?

a. Blurs differences between tissues of similar thickness
b. Emphasizes differences between tissues with different levels of density
c. Emphasizes differences between tissues with a similar level of density
d. Blurs the differences between tissues with different levels of density
(we don’t know what this is so here is help:

12. Which of the following passes anteriorly to the hilum of the lung?

a. Phrenic nerve
b. Vagus nerve
c. Azygos vein

13. Which part of the rib connects to the transverse process of the vertebra?

a. Superior articular facet

b. Inferior articular facet
c. Tubercle
d. Angle of the rib
e. Neck

14. Medical students were asked about the patient would feel during the procedure of a
thoracocentesis. Which of the following is not true?
a. Only the parietal lobe is sensitive to pain
b. The pain will be caused by the stimulation of the sensory fibers in the
intercostal nerves
c. The “leaves” of the pleura are not sensitive to pain. The pain will be caused if
the needle accidentally hits the lung tissue
d. The pain will be focused, the patient will feel the pain where the needle is
inserted

15. Which of the following is true about the autonomic system?

a. The sympathetic fibers exit from the anterior horn of the spinal cord
b. The origin of the parasympathetic fibers in the T1-L5 vertebrae
c. The parasympathetic system is characterised by short preganglionic fibers
whereas the sympathetic is characterized by long preganglionic fibers
d. The parasympathetic system is characterized by short post ganglionic fibers
whereas the sympathetic system is characterized by long postganglionic
fibres
16. Which of the following statements is true about the thymus gland?
a. A glandular tumor can cause pressure on the SVC
b. Can cause pressure on the hemiazygos vein
 c. The thymus gland is the main organ in the posterior mediastinum
d. Degenerates usually in the first year after birth

17. In which of the following embryonic organs does hematopoeisis not occur?
a. Bone marrow
b. Heart
c. Liver
d. Spleen

18. What is true about the lungs and pleura ?

a. The right costomediastinal recess is deeper and larger than the left
b. The phrenic nerve passes posteriorly to the hilum of the lung
c. The visceral pleura is adjacent to the lung but does not enter the grooves in it
d. The 4 leaves of the pleura makeup the pulmonary ligament at the root of the
lung

19. What is the closest structure to the sternum in the superior mediastinum ?
a. Right Common carotid
b. Phrenic nerve
c. Left common carotid
d. Left brachiocephalic
e. Arch of aorta

20. PFO leads to all the following except:

a. Passage of blood from the Right atrium to the left atrium due to a sudden
increase in pressure in the right heart
b. Asymptomatic clinical presentation in most people
c. Excessive risk of stroke
d. Passage of a blood clot from the right ventricle to the left ventricle
e. The development of Eisenmenger syndrome in the absence of diagnosis and
proper treatment

21. Which part of the diaphragm expands during the inspiration?

a. Aortic hiatus
b. Esophageal hiatus
c. IVC
d. Aperture for the thoracic artery

22. A 45 year old man comes to the emergency department after a heart attack with a
complaint of shortness of breath. An urgent echocardiography showed a tear in the
papillary muscle of the left ventricle. Which of the following is true?
a. It is an aortic insufficiency that causes a drop in blood pressure
b. There will be a leakage of blood from the right ventricle to the left ventricle
resulting in a deformity window?
 c. There will be a leakage of blood from the left ventricle to the right ventricle
resulting in an increase in pressure in the pulmonary circulation
d. This is mitral insufficiency which causes congestion in the pulmonary veins.
e. This is tricuspid insufficiency causing strain on the right ventricle

23. What is not true about the breast (mammary gland?)?

a. Breast canceer cells can invade and shorten the coopers ligament resulting in
dimpling of the breast
b. Breast cancer metastases can spread through the venous drainage
throughout the body and also to the spine
c. The lympathic drainage of the breast begins in the sub areolar lymphatic
plexus and drains mainly to the parasternal lymph nodes
d. The space between the breast and the deep fascia of the pectoralis major is
the retromammary space

24. Where is the intercostal nerve found?

a. In the anterior mediastinum only
b. Between the internal intercostal muscle and innermost intercostal muscle
c. Between the external intercostal muscle and internal intercostal muscle

25. To which system do the sympathetic fibers belong in terms of functional division of
the nervous system:
a. Sensory autonomic
b. Somatic motor
c. Visceral sensory
d. Motor Autonomy

26. Which of the following structures border the transverse pericardial sinus?
a. Pulmonary veins and IVC
b. The Azygos vein and the desceneding aorta
c. Atrioventricular groove (AV groove)
d. The pulmonary artery and bronchus
e. The ascending aorta, pulmonary artery and SVC

27. The origin of which artery comes directly from the aorta?
a. Right common carotid
b. Right subclavian artery
c. Bronchial arteries
d. First costal artery
e. 2nd costal artery

28. Which of the embryonic layer develops to form most of the cardiovascular system?
a. Ectoderm
b. Mesoderm
c. Epidermis
 d. Endoderm

29. Which of the following is not expected in a child born with patent ductus arteriosus.
a. Blueness in the lips
b. Right ventricular workload
c. Increased blood flow in the pulmonary artery
d. Blood flow from the aorta directly to the pulmonary arteries
e. Development of heart failure if the defect is not corrected

30. A patient is urgently taken to the catheterization room following a myocardial

infarction. During the catheterization cardiologist notes that the patient has a large
coronary artery disease. LEFT DOMINANT. From the catheterists statement it can be
understood that ..?
a. The SA node inevitably receives a blood supply from the left artery in this
patient
b. The patient has no left coronary artery at all but only developed right
coronary artery
c. The configuration of the coronary arteries of this patient can be found in 80%
of the population
d. The Circumflex artery exits directly from the LAD
e. The PDA is an extension of the artery that bypasses at this rib .. Um weird
translation

31. Which of the following is not a synovial joint?

a. Connecting the head of the third rib to the third vertebra
b. Sternoclavicular joint
c. The 3rd sternocostal joint
d. Xyphisternal joint

32. All the structures listed below are considered part of the root of the lung except for:
a. The section of the vagus nerve involved in innervating the pulmonary airways
b. Pulmonary arteries and veins
c. Bronchial arteries and veins
d. Sections of the phrenic nerve involved in the innervation of the mediastinal
pleura

33. Which of the following component plays an important role in the right-left shunt in
the fetus?
a. Ductus arteriosus
b. Endocardial cushing
c. Vitelline veins
d. Vitelline duct

34. What is not part of the tetralogy of fallot?

 a. Stenosis of the pulmonary artery
b. Changing the position of the opening of the aorta
c. Right ventricular hypertrophy
d. ASD

35. What mode was the echo taken?

a. Parasternal long axis
b. Parasternal short axis
c. Apical 2 chambers view
d. Subcostal view

36. A person was hit by a bullet on the right side midclavicular in the intercostal space 4.
Which of the following sentences is correct?
a. The projectile will hit the pectoralis minor and pectoralis major
b. The bullet will hit the right chamber of the heart
c. Can cause pneumothorax or hemothorax
d. A+ C
e. All the answers are correct

37. Stab near the sternum on the right side. Through which layer will it not pass?
a. External intercostal muscle
b. Internal intercostal muscle
c. Innermost intercostal muscle
d. Transversus thoracic muscle
e. All answers are right

38. What will a growth in the lactiferous duct cause?

a. Turning the nipple inwards
b. Turning color to orange (discoloration)
c. Dumpling effect
d. All the answers are correct

39. Which of the following doesn’t characterise the left ventricle?

a. Papillary muslces
b. Moderator band
c. Trabecular carnae
d. Chordae tendinae

40. Echo: what does the arrow point to?

a. Right ventricle
b. Left ventricle
c. Let atrium
41. A young man was brought to the emergency room after a fight in a serious condition,
on examination he found a sharp knife injury in the front chest- through the middle
part of the manubrium. A knife wound on the spot, this anatomy ies expected to
damage with high probability in
a. Annulus fibrosis
b. Right ventricle
c. Left atrium
d. Left ventricle
e. Ascending aorta

42. A foreing body penentrated through the skin deep into the fouth intercostal space
on the right in the area of the mid-clavicular line. What are the tissues that will be
damaged and the linear signs that we will expect to see?
a. Pneumothorax and or hemothorax
b. Injury to the right ventricle
c. Damage to the pectoralis major and minor muscles
d. 1+3
e. All are correct

43. Answers are the ones that say 1. 2. 3. 4 etc.. Which of the following structures shows
a discrepancy between the structure and the artery:
a. Respiratory and conductory airways in lung
b. Branches of pulmonary arteries – branches of musculophrenic artery
c. Mediastinal pleura- branches of bronchial artery
d. Conductive airways in the lung – tributaries of pulmonary and bronchial
arteries

1. B and c
2. A and d
3. A and c
4. A and b

44. Sternal angle is not a marker for the following structure ( 2 answers are accepted)
a. Drainage of the thoracic duct into the venous system
b. Draining the azygos vein into the SVC
c. The upper limit of the aortic arch
d. The end of the trachea and and it’s division into the min bronchi

45. Which of the following statement is true about the surface anatomy of the thorax?
a. Horizontal fissure is in the T4 vertebrae
b. Pleural cardiac notch begins at the level of the sevent costal cartilage on the
left
c. The parietal pleura reaches up to the height of the 12th rib in the area of the
scapular line
d. The peaks of the lung are in the mid clavicual line at the height of the first
intercostal space
 e. Optimal listening to the right middle lobe is done in the right posterior chest at
the height of the T4 vertebra

46. Which of the following statements is true about the atrium?

a. Coronary sinus drains into the left ventricle in the sinus venarum
b. A PFO is a condition that allows leakage from the left atrium to the right
atrium
c. The pulmonary veins connect to the left auricle in the area of the auricle
d. A crista terminalis can be identified on the right lobe and a sulcus terminalis
on the left lobe
e. Pectinate muscles are more numerous in the right atrium than in the left
atrium

47. Which of the following is true regarding the manubriosternal joint?

a. Is at the height of the intervertebral space 2 and 3
b. Same as the upper part of the aortic arch
c. Same as the middle part of the trachea
d. A synovial joint that allows the movement of the manubrium in relation to
the sternum
e. Is at the height as the second costal cartilage

48. What is the closest structure to the sternum in the superior mediastinum?
a. Left brachiocephalic vein
b. Phrenic nerve
c. Aortic arch
d. Right common carotid artery
e. Left common carotid artery

49. Find a discrepancy between the following structures:

a. Phrenic nerve – caval opening
b. Sympathetic trunk- lateral arcuate ligament
c. Aortic hiatus- azygos vein
d. Oesophageal opening – vagus nerve

50. A body penetrated the space between the 4 ribs in the midclavicular line, what is the
worse thing it will hit ?

a. Hemothorax and or pneumothorax

b. Right ventricle
c. Pectoralis major and minor
d. 1+ 3
Notes – Horizontal fissures at 4th costal cartilage
Oblique fissure – T4

37 was contested, answer of class is said to be as the professor said e