exam 1 questions

How many layers of smooth muscle cell do you see in the tunica media of the blood vessel outlined in black? 1 2 3 4 5

2

How many layers of smooth muscle cell do you see in the tunica media of the blood vessel pictured? Identify the blood vessel pictured in the image. Elastic artery Venule Muscular artery Medium vein Arteriole

5 Muscular artery

How does cholestyramine lower plasma cholesterol? How does ezetimibe lower plasma cholesterol? 1. It limits absorption of dietary cholesterol and reabsorption of biliary cholesterol, which leads to increased clearance of plasma LDL by hepatic LDL-receptors 2. It directly inhibits synthesis of plasma cholesterol 3. It inhibits lipolysis and release of fatty acids in adipose, thereby inhibiting VLDL production in the liver and thus lowering LDL levels 4. It inhibits synthesis of intracellular hepatic cholesterol which leads to increased clearance of plasma LDL by the LDL-receptor 5. It blocks bile acid reabsorption, causing hepatic cholesterol to be diverted to the bile, which leads to increased clearance of plasma LDL by hepatic LDL-receptors

5. 1.

What type of tissue is the tunica adventitia composed of? Mesothelium and Loose CT Smooth Muscle and Collagen Fibers Cardiomyocytes and Endomysium Endothelium and Loose CT Dense Irregular CT

Dense Irregular CT

Sinusoids are also known as which type of vessel? Discontinuous capillaries Fenestrated capillaries Post-capillary venules Arterioles Continuous capillaries

Discontinuous capillaries

Which chamber of the heart is most commonly injured in trauma?

The right ventricle, the most anterior part of the heart

Which intermediate of cholesterol synthesis is an immediate precursor for synthesis of vitamin D in the skin upon exposure to UV light? 7-Dehydrocholesterol Correct answer. HMG-CoA Geranyl pyrophosphate Farnesyl pyrophosphate 5-carbon Isoprenoid units Lanosterol Mevalonate

7-Dehydrocholesterol

Which of the following are typical histological features of muscular arteries? Thin tunica media Irregular shaped lumen Thick tunica adventitia Absence of internal elastic laminae

Absence of internal elastic laminae

What type of tissue is the fibrous pericardium composed of? Mesothelium Lamina propria Cardiac muscle Adipose tissue Endothelium

Adipose tissue

Which cardiac cells demonstrate a myocardial action potential?

All cardiac myocytes, except for cells in the SA and AV nodes

A 49-year-old woman is diagnosed with having a large lump in her right breast. Lymph from the cancerous breast drains first into which of the following lymph node groups? Apical Supraclavicular Posterior (subscapular) Anterior (pectoral) Humeral

Anterior (pectoral)

An elderly lady suffers a coronary occlusion and subsequently, it is noted that there is a complete heart block (that is, the right and left bundles of the conduction system have been damaged). The artery most likely involved in the: Left marginal branch Anterior interventricular (Left anterior descending) Right marginal branch Posterior interventricular (posterior descending) Circumflex branch

Anterior interventricular (Left anterior descending) -RCA -Circumflex of LCA

Blockage of which of the following arteries would lead to ischemia of the apex of the heart? Right marginal Posterior interventricular (descending) Left circumflex Right coronary Anterior interventricular (descending)

Anterior interventricular (descending)

Which type of blood vessel directly drains blood from capillary beds in an arterial portal system? Venules Medium veins Arterioles Muscular arteries

Arterioles

Purkinje fibers can be best classified as specialized: Endothelial cells Mesothelial cells Autonomic neurons Cardiac muscle cells Fibroblasts

Cardiac muscle cells

From what cell type are Purkinje fibers derived? Cardiomyocytes Endocardial epithelium Parietal peritoneum Schwann cells Visceral peritoneum

Cardiomyocytes

Which of the following cell types is predominantly found in the myocardium? Epithelial cells Purkinje fibers Smooth muscle cells Cardiomyocytes Mesothelial cells

Cardiomyocytes

Which of the following steps occurs during the exogenous cholesterol pathway? Chylomicron remnants deliver cholesterol to the liver. HMG-CoA is reduced by HMG-CoA reductase to form mevalonate. Mature chylomicrons deliver most of the cholesterol they carry to adipocytes and myocytes. Oxidized LDL in vessel walls is phagocytosed by resident macrophages. Squalene undergoes cyclization and multiple other changes to form cholesterol.

Chylomicron remnants deliver cholesterol to the liver. The correct answer is chylomicron remnants deliver cholesterol to the liver (A). This is the mechanism by which dietary cholesterol is delivered to the liver. HMG-CoA (B) and squalene (E) are intermediates in the endogenous cholesterol synthesis pathway, not exogenous. Mature chylomicrons (C) deliver fatty acids to peripheral adipocytes and myocytes but retain cholesterol esters, which are later taken up by the liver. Oxidization of LDL in vessel walls (D) occurs as a detrimental effect of high cholesterol levels, leading to atherosclerosis. Options (C) and (D) are not part of the endogenous or exogenous pathway.

Why does the left ventricle have the thickest myocardial layer in the heart?

Compared with the other chambers, the left ventricle must generate the most force to push against systemic pressures, which are higher than pulmonary pressures.

The irritation of the vagus nerve in the neck would lead to one of the following symptoms: Increase of the atrial and ventricular contractility Increase in the heart rate Increase of the atrioventricular conduction Constriction of the coronary arteries Stimulation of the SA node

Constriction of the coronary arteries

Which of the following types of capillaries are primarily found in the brain where capillary exchange is highly restricted? Discontinuous capillaries Sinusoids Continuous capillaries Fenestrated capillaries

Continuous capillaries

While observing in the OR, you see the resident insert a needle through the body wall just above the ninth rib in the mid-axillary line. She was trying to enter the: Costodiaphragmatic recess Cupola Costomediastinal recess Pulmonary ligament Hilar reflection

Costodiaphragmatic recess

A 45-year-old man comes to the emergency department because of chest pain and palpitations. Pulse is 160/min and regular, and blood pressure is 135/72 mm Hg. ECG shows narrow complex tachycardia and no visible P waves. The physician places two fingers immediately medial to the sternocleidomastoid at the upper border of the right thyroid cartilage, below the level of the mandible, and massages the patient's neck. The patient's symptoms resolve, and he returns to normal sinus rhythm. Which of the following is the most likely mechanism of action of the maneuver that resolved this patient's symptoms? A Increased conduction through the atrioventricular node B Inhibition of cardiac β-adrenergic receptors C Stimulation of electrical activity D Stimulation of the parasympathetic nervous system E Stimulation of the sympathetic nervous system

D Vagal maneuvers such as carotid massage stimulate the parasympathetic nervous system, which communicates with the SA node of the heart through the vagus nerve to slow the rate of conduction.

Which of the following would lead to an increased risk of cholelithiasis? (Choose all correct answers) Decreased transport of free cholesterol to the bile Decreased concentration of bile acids/salts in the bile Decreased transport of phosphatidylcholine to the bile Increased concentration of free cholesterol in the bile Increased production of bile acids/salts

Decreased concentration of bile acids/salts in the bile Correct answer. Decreased transport of phosphatidylcholine to the bile Correct answer. Increased concentration of free cholesterol in the bile Correct answer.

Select the correct option to fill in the blanks: In fetal circulation the umbilical artery carries ___________, while the umbilical vein carries ___________. Deoxygenated blood, oxygenated blood Deoxygenated blood, deoxygenated blood Oxygenated blood, deoxygenated blood Oxygenated blood, oxygenated blood None of the above is correct

Deoxygenated blood, oxygenated blood

Which type of capillary is the most permeable? Discontinuous capillaries Fenestrated capillaries Continuous capillaries

Discontinuous capillaries

What structures in fetal circulation play a role in shunting blood away from the lungs? Select all that apply: Foramen ovale Ductus venosus Umbilical artery Ductus arteriosus Umbilical vein

Ductus arteriosus Foramen ovale

In which phase of the cardiac cycle does coronary blood flow to the left ventricle and intraventricular septum peak? What 3 areas of the heart are supplied by the left anterior descending artery (LAD)?

Early diastole Anterior surface of the left ventricle, anterolateral papillary muscle, and anterior 2/3 of the interventricular septum

Which types of blood vessels have the thickest walls? Muscular Artery Venules Medium Vein Arterioles Large Vein (Vena Cava) Elastic Artery (Aorta)

Elastic Artery (Aorta)

What type of tissue makes up the innermost layer of the endocardium? Cardiac muscle Mesothelium Adipose tissue Lamina propria Endothelium

Endothelium

What type of tissue is the tunica intima composed of? Dense Irregular CT Mesothelium and Loose CT Endothelium and Loose CT Cardiomyocytes and Endomysium Smooth Muscle and Collagen Fibers

Endothelium and Loose CT

Which of the following layers provides a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall? Deep fascia Parietal pleura Visceral pleura Transversus thoracis muscle fascia Endothoracic fascia

Endothoracic fascia

Which intermediate of cholesterol synthesis is a branch point for the biosynthesis of dolichol, heme A side chains, ubiquinone and prenyl groups on proteins? Geranyl pyrophosphate Mevalonate 5-carbon Isoprenoid units HMG-CoA 7-Dehydrocholesterol Lanosterol Farnesyl pyrophosphate

Farnesyl pyrophosphate

What are the 3 layers of the pericardium, from outermost to innermost?

Fibrous pericardium, parietal pericardium, epicardium (visceral)

Which of the following best explains why the cardiomyocytes of the atria don't directly stimulate contraction of the cardiomyocytes of the ventricles? Purkinje fibers in the fibrous skeleton have inactive sarcomeres Chambers are separated by non-contractile adipose tissue There are large deposits of glycogen in the fibrous skeleton Fibrous skeleton cells do not have gap junctions for ion passage

Fibrous skeleton cells do not have gap junctions for ion passage

Which of the following structures allows for intercellular communication between Purkinje fibers and, thus, rapid propagation of action potentials throughout the heart? Fascia adherens Gap junctions Intercalated discs Macula adherens Striations

Gap junctions

While attempting to suture the distal end of a coronary bypass onto the anterior interventricular artery, the surgeon accidentally passed the needle through the adjacent vein. Which vein was damaged? Great cardiac vein Anterior cardiac vein Small cardiac vein Coronary sinus Middle cardiac vein

Great cardiac vein

decrease his cholesterol and lower his risk of further problems. In addition to lifestyle changes, the most appropriate treatment for this patient's condition is a medication that targets which of the following enzymes involved in cholesterol synthesis? Apolipoprotein B-48 Bile salt hydrolase HMG-CoA reductase HMG-CoA synthase Lipoprotein lipase

HMG-CoA reductase

Coronary arteries supply blood to the myocardium and pacemaker centers of the heart from branches that come off either the right or left coronary arteries. While some regions of the myocardium may receive blood from two different coronary arteries, the pacemaker centers of the heart normally only receive blood from a single coronary artery, but the pattern varies in the human population. The blood supply to the sinoatrial (SA) and atrioventricular (AV) nodes is derived from which coronary artery(ies)? In 60% of the population, the SA node receives its blood from the right coronary artery; in 80% of the population, the AV node receives its blood from the right coronary artery via the posterior interventricular artery. Both the SA and AV nodes are supplied by the posterior interventricular artery Both the SA and AV nodes receive blood from the left coronary artery Both SA and AV nodes may be supplied by the right or left coronary arteries equally (50:50%) In 60% of the population, the SA node receives its blood from the left coronary artery; in 80% of the population, the AV node receives its blood from the left coronary artery via the posterior interventricular artery.

In 60% of the population, the SA node receives its blood from the right coronary artery; in 80% of the population, the AV node receives its blood from the right coronary artery via the posterior interventricular artery.

Which statement below accurately describes the role of the ductus arteriosus? The ductus arteriosus only carries oxygenated blood from the left side of the heart to the right side In fetal circulation, the pulmonary artery and aorta are connected via the ductus arteriosus The ductus arteriosus helps to connect the umbilical artery to the inferior vena cava The ductus arteriosus is found between the right and left atrium

In fetal circulation, the pulmonary artery and aorta are connected via the ductus arteriosus

A 45-year-old man comes to the office for a routine examination. Due to his lipid profile, therapy with a lipid-lowering medication is initiated. The patient is advised that this medication may be associated with muscle pain and liver toxicity. The drug that was most likely prescribed affects cholesterol metabolism by which of the following mechanisms? Decreases the maximum velocity of HMG-CoA reductase Decreases the maximum velocity of hepatic LDL cholesterol receptors Directly decreases the apparent dissociation constant of hepatic LDL cholesterol receptors Directly increases apparent dissociation constant for LDL receptors Increases the apparent Michaelis-Menten constant of HMG-CoA reductase

Increases the apparent Michaelis-Menten constant of HMG-CoA reductase Statins are competitive inhibitors of HMG-CoA reductase that decrease de novo cholesterol production in the liver. Statins also upregulate LDL cholesterol receptors on the liver's surface by increasing LDL cholesterol clearance from the bloodstream.

The "pacemaker" current (If) represents which of the following cellular activities? Efflux of potassium Efflux of sodium Influx of calcium Influx of potassium Influx of sodium

Influx of sodium

During a bar fight, a 23-year-old man's chest is punctured to the left of his sternum with an ice pick. He is brought to the emergency department because he is feeling faint and unable to walk due to weakness. He is muffled and his blood pressure is low despite a very rapid pulse. His lungs sound normal. His jugular veins are becoming more and more distended. How would one use a 3-inch, 19-gauge needle to help the bar fight victim? Insert it just under the left tip of the xiphoid process to remove blood from the pericardial cavity Insert it at the ninth intercostal space at the left midclavicular line in an effort to remove blood from the pleural cavity Insert it at the fourth intercostal space on the right side to remove blood from the right pulmonary artery Insert it just under the left clavicle to remove blood from the right cephalic vein Insert it at the second intercostal space on the left side of the sternum to inject nitroglycerine to increase the strength of cardiac contractions

Insert it just under the left tip of the xiphoid process to remove blood from the pericardial cavity

All layers of the thoracic wall (skin, intercostal muscles, endothoracic fascia) are innervated by which of the following nerves? Lateral pectoral nerves Dorsal primary rami Intercostal nerves Medial pectoral nerves Thoracodorsal nerves

Intercostal nerves

While observing a mastectomy on a 60-year-old female patient, a medical student was asked by the surgeon to help tie off the arteries that supply the medial side of the breast. The artery that gives origin to these small branches is the: Posterior intercostal Superior epigastric Internal thoracic Lateral thoracic Thoracoacromial

Internal thoracic

Which of the following are typical histological features of medium veins? Presence of smooth muscle in tunica adventitia Irregular shaped lumen Presence of internal elastic laminae Thin tunica adventitia Thick tunica media

Irregular shaped lumen

Which intermediate of cholesterol synthesis is the first sterol synthesized? 7-Dehydrocholesterol Geranyl pyrophosphate HMG-CoA 5-carbon Isoprenoid units Lanosterol Correct answer. Farnesyl pyrophosphate Mevalonate

Lanosterol

Which types of blood vessels have the largest lumens? Medium Vein Muscular Artery Large Vein (Vena Cava) Arterioles Elastic Artery (Aorta) Venules

Large Vein (Vena Cava)

Which coronary artery is most commonly occluded? Which artery supplies the posterior 1/3 of the interventricular septum, posterior 2/3 of ventricular walls, and posteromedial papillary muscle?

Left anterior descending artery (LAD) Posterior descending artery (PDA)

Which of the following chambers of the heart is the most closely applied to the esophagus? Right atrium Right ventricle Right auricle Left atrium Left ventricle

Left atrium

Which of the following nerves does participate in the formation of the superficial part of the cardiac plexus? Left superior splanchnic cardiac n. Right superior cardiac branches of the vagus Right inferior splanchnic cardiac n. Left middle splanchnic cardiac n. Right superior splanchnic cardiac n.

Left superior splanchnic cardiac n.

Identify the blood vessel pictured in the middle of the image shown: Medium Vein Large Vein Elastic Artery Arterioles Muscular Artery

Medium Vein

What type of tissue is the serous pericardium composed of? Endothelium Mesothelium Adipose tissue Lamina propria Cardiac muscle

Mesothelium

Which intermediate of cholesterol synthesis represents the product of the rate limiting step?

Mevalonate

Which of the following branches of the cardiac plexus are postganglionic sympathetic? Superior (cervical) cardiac branches Branches of the left recurrent laryngeal n. White rami of T1-T2 spinal nerves Middle splanchnic cardiac branches Inferior (thoracic) cardiac branches

Middle splanchnic cardiac branches

Which of the following is the thickest layer within the heart? Endocardium of the mitral valve Endocardium of the right ventricle Epicardium of the left atrium Myocardium of the left ventricle Myocardium of the right ventricle

Myocardium of the left ventricle

A 23-year-old male injured in an industrial explosion was found to have multiple small metal fragments in his thoracic cavity. Since the pericardium was torn inferiorly, the surgeon began to explore for fragments in the pericardial sac. Slipping her hand under the heart apex, she slid her fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. Her fingertips were then in the: Costomediastinal recess Oblique sinus Coronary sinus Coronary sulcus Transverse sinus

Oblique sinus

A 45-year-old man comes to the clinic because of shortness of breath and hoarseness for the past week. He was hospitalized in India during childhood hospitalization for a major febrile illness. He is found to have mitral stenosis with an enlarged left atrium impinging on a nerve. The affected nerve is a branch of a larger nerve that controls which of the following muscles? Genioglossus Hyoglossus Mylohyoid Palatoglossus Styloglossus Stylopharyngeus

Palatoglossus Mitral stenosis caused by rheumatic fever can lead to atrial enlargement, which could compress the recurrent laryngeal nerve and cause hoarseness, a condition known as Ortner syndrome. The recurrent laryngeal nerve is a branch of the vagus nerve, which innervates the palatoglossus, an extrinsic muscle of the tongue

Which of the following layers make up the borders of the pericardial cavity? Parietal and Visceral Fibrous Pericardium Inner Serous and Outer Fibrous Pericardium Inner Endocardium and Outer Epicardium Purkinje Fibers and Endothelial Cells Parietal and Visceral Serous Pericardium

Parietal and Visceral Serous Pericardium

A 38-year-old woman presents with pain to the left side of the neck, extending laterally to the left clavicle for an hour or two after mild physical activity. A physical examination revealed a slight temperature and friction sound over the middle of the thorax. Examination of her neck and shoulder region suggests that the pain may be referred pain since manipulation of the left shoulder and neck does not reproduce it. Which one of the following nerves is responsible for referred pain in this woman? Vagus nerve Cardiac plexus Intercostal nerve Phrenic nerve Intercostobrachial nerve

Phrenic nerve

Which nerve innervates the pericardium? Which blood vessel runs in the left AV groove and drains into the RA?

Phrenic nerve Coronary sinus

Blockage of blood flow in the proximal part of the anterior interventricular artery could deprive a large area of heart tissue of blood supply unless a substantial retrograde flow into this artery develops via an important anastomosis with which other artery? Right coronary Right marginal Circumflex Left marginal Posterior interventricular

Posterior interventricular

A 35-year-old male driver was involved in a car accident with air-bag deployment. Radiography reveals costochondral joint separation for both the fourth and fifth ribs on the left. While still in the emergency department, he develops dyspnea (difficulty breathing), hypotension, cyanosis, and neck vein distension. These classic signs of cardiac tamponade result from the accumulation of fluid in the: Potential space between the parietal and visceral serous pericardium Costomediastinal recess Potential space between the fibrous and parietal serous pericardium Superior mediastinum Potential space between visceral serous pericardium and myocardium

Potential space between the parietal and visceral serous pericardium

breaking two ribs and causing a right-sided hemothorax. A negative pressure drain (chest tube) must be inserted into the pleural space in order to remove blood from his pleural cavity. What would be a typical location for placement of the chest tube? Left seventh intercostal space in the middle axillary line Right sixth intercostal space in the anterior axillary line The left intercostal space adjacent to the xiphoid process Right 8th intercostal space in the subscapular line Right fourth intercostal space in the midclavicular line

Right 8th intercostal space in the subscapular line

Which of the following describes the normal order of cardiac conduction in healthy individuals? AV node, bundle branches, bundle of His, SA node, Purkinje fibers Bundle branches, SA node, AV node, Purkinje fibers, bundle of His Purkinje fibers, bundle branches, AV node, SA node, bundle of His SA node, AV node, bundle of His, bundle branches, Purkinje fibers SA node, Purkinje fibers, bundle of His, bundle branches, AV node

SA node, AV node, bundle of His, bundle branches, Purkinje fibers

What type of tissue is the tunica media composed of? Smooth Muscle and Collagen Fibers Endothelium and Loose CT Cardiomyocytes and Endomysium Mesothelium and Loose CT Dense Irregular CT

Smooth Muscle and Collagen Fibers

Which of the following types of tissue is uniquely found in the tunica adventitia of large veins? Mesothelium Smooth muscle Dense CT Endothelium Loose CT

Smooth muscle

The second costal cartilage can be located by palpating the: Costal margin Sternal angle Xiphoid process Sternoclavicular joint Sternal notch

Sternal angle

Synthesis of which of the following hormones uses cholesterol as a precursor? Epinephrine Glucagon Insulin Testosterone Thyroid hormone

Testosterone Testosterone is a steroid hormone; like all steroid hormones, it is synthesized from cholesterol. Other steroid hormones include other sex hormones, glucocorticoids, and mineralocorticoids.

Which coronary artery gives rise to the PDA in left dominant circulation?

The PDA arises from the left circumflex artery in left dominant circulation

What is the sequence of contraction during a normal cardiac cycle? In what area of the cardiac conduction system is conduction the slowest?

The atria contract first, then the ventricles contract. Conduction is the slowest within the AV node.

Which structures does the endocardium line?

The endocardium lines the atria, ventricles, and heart valves.

From which embryonic layer is the epicardium derived?

The epicardium is derived from mesoderm; the epicardial epithelium is actually referred to as mesothelium.

Which cells are responsible for initiating cardiac impulse rhythm?

The nodal cells of the sinoatrial node are responsible for initiating cardiac impulse rhythm.

Infarction in which coronary artery territory may cause nodal dysfunction (AV blocks, bradycardia)?

The right coronary artery, which supplies the SA and AV nodes via its branches

Which coronary artery gives rise to the PDA in most people? The pericardial space is located between which 2 layers of the pericardium?

The right coronary artery; right dominant circulation (most common) Parietal pericardium and epicardium (visceral)

Which of the following structures accompany the esophagus through the diaphragm? The sympathetic trunks The phrenic nerves The splanchnic nerves The vagus nerves

The vagus nerves

Coronary angiography done in advance of coronary bypass surgery on a 54-year-old female reveals that she has a "right dominant heart." This condition: Is a major correlate with coronary artery disease Is present in < 10% of female patients Indicates that the right and left coronary arteries are derived from a common trunk This indicates that the posterior interventricular artery is derived from the right coronary artery Is frequently associated with atrial fibrillation

This indicates that the posterior interventricular artery is derived from the right coronary artery

To what areas of the body is pain referred in a patient with pericarditis?

To the neck, arms, or one or both shoulders (often the left)

A premenopausal 51-year-old female describes the recent discovery of a lump in her right breast. Physical examination reveals a mass of approximately 2.5 cm in the upper lateral breast quadrant. There is some dimpling of the skin overlying the mass. This dimpling is due to: Decreased fat in the area of the mass Displacement of glandular tissue by the mass Traction on connective tissue septae by the expanding mass Increased vasculature to the mass Influence of cyclical hormonal changes

Traction on connective tissue septae by the expanding mass

Which type of transport is used during capillary exchange in fenestrated capillaries? Transcellular transport only Transcellular and paracellular transport Paracellular transport only

Transcellular and paracellular transport

The tubercle of the 7th rib articulates with which structure? Body of vertebra T8 Transverse process of vertebra T7 Transverse process of vertebra T6 Body of vertebra T7 Body of vertebra T6

Transverse process of vertebra T7

Which of the following tunics is the thickest layer in the wall of large veins? Tunica Adventitia Tunica Media Tunica Intima

Tunica Adventitia

Which tunic houses the nervi and vasa vasorum? Tunica Media Tunica Adventitia Tunica Intima

Tunica Adventitia

Which of the following tunics is the thickest layer in the wall of elastic arteries? Tunica Adventitia Tunica Intima Tunica Media

Tunica Media

Identify the blood vessel outlined in black in the image. Muscular artery Elastic artery Arteriole Medium vein Venule

Venule

Which types of blood vessels allow the extravasation and migration of white blood cells? Large Vein (Vena Cava) Elastic Artery (Aorta) Venules Arterioles Muscular Artery Medium Vein

Venules

Which of the following cell types makes up the outermost portion of the epicardium? Myocardial cells Purkinje Fibers Endothelial cells Visceral Serous Pericardium Fibrous Pericardium Tissue

Visceral Serous Pericardium

the 5 openings of the thoracic diaphragm . Which one transmits the azygos vein?

aortic

What is the most posterior chamber of the heart?

left atrium

what is this

purkinje fibers

A patient involved in an automobile accident presents with a sharp object puncture of the middle of the sternum at about the level of the 4th or 5th costal cartilage. If the object also penetrated the pericardium and heart wall, which heart chamber would most likely be damaged? Right atrium Left atrium Right ventricle Left ventricle

right ventricle