Thorax

117. Match the anatomical region on the right with the appropriate element on the left: A. Thymus B. N. splanchnicus major C. A. Facialis D. Lig. sternopericardiaca E. Aorta ascendens 1. Mediastinum superius 2. Mediastinum anterius 3. Mediastinum medius 4. Mediastinum posterius 5. Trigonum submandibulare

A - 1 B - 4 C - 5 D - 2 E - 3

119. Match the anatomical region on the left with the most appropriate element on the right: A. Superior mediastinum B. Anterior mediastinum C. Root of the lung D. Middle mediastinum E. Posterior mediastinum 1. Bronchus principalis 2. Arcus aortae 3. N. splanchnicus major 4. A. thoracica interna 5. Aorta ascendens

A - 2 B - 4 C - 1 D - 5 E - 3

33. When inserting a chest tube, intercostal vessels and nerves are avoided by placing the tube immediately: A. above the margin of a rib B. below the margin of a rib

A. above the margin of a rib

110. The following elements are part of middle mediastinum: (TF) A. aorta ascendens B. aortic arch C. truncus pulmonalis D. n.vagus E. lower half of the superior vena cava

A. aorta ascendens C. truncus pulmonalis E. lower half of the superior vena cava

133. In cardiac surgery it is sometimes necessary to clamp off all arterial flow out of the heart. This could be done within the pericardia( sac by inserting the index finger immediately behind the two great arteries and compressing them with the thumb of the same hand. The index finger would have to be inserted into which space? ....

Transverse pericardial sinus

1. Pectoral nerves are branches of the medial and lateral cords of the brachial plexus.

Yes

10. The parietal and visceral pericardium are separated by a thin film of fluid.

Yes

11. The subclavian vessels arch over the anterior surface of the dome of the pleura.

Yes

13. The costodiaphragmatic recess extends between the thoracic wall and the vertical part of the diaphragm.

Yes

14. The phrenic nerve and its accompanying vessels pass anterior to the lung root.

Yes

15. The vagus nerve descends posterior to the lung root.

Yes

17. The thoracic duct enters the thoracic cavity through hiatus aorticus.

Yes

18. The lower boundary of mediastinum superius is the plane between angulus sterni and Th4/Th5.

Yes

19. The upper boundary of mediastinum superius is the plane between the sternal notch and Thl.

Yes

2. Long thoracic nerve is a direct branch of the roots of the brachial plexus.

Yes

24. Aortic arch may have from 1 to 6 branches.

Yes

3. Dorsal scapular nerve is a direct branch of the roots of the brachial plexus.

Yes

4. Superior trunk of the brachial plexus gives off n. suprascapularis and nerve to the subclavius.

Yes

6. The lower border of parietal pleura is projected at the level of 12th rib on the back of the thorax.

Yes

7. The suprasternal space is between the superficial (investing) and middle lamina of deep cervical fascia.

Yes

9. The cervical parietal pleura forms the dome of each pleural cavity.

Yes

113. Regarding the three parts of axillary artery match the part and the branches. A. in trigonum clavipectoralis (first part) B. in trigonum pectorale (second part) C. in trigonum subpectorale (third part) 1. Anterior humeral circumflex a. 2. Thoraco-acromial a. 3. lateral thoracic a. 4. Posterior humeral circumflex a. 5. Superior thoracic a. 6. Subscapular a.

A - 2, 5 B - 3 C - 1, 4, 6

112. A. Medial cord (Fasciculus medialis) B. Lateral cord (Fasciculus lateralis) C. Posterior cord (Fasciculus posterior) 1. musculocutaneous nerve 2. ulnar nerve 3. radial nerve 4. lateral root of the median nerve 5. medial cutaneous nerve of the arm 6. medial cutaneous nerve of the forearm 7. medial root of the median nerve 8. axillary nerve

A - 2, 5, 6 , 7 B - 1, 4 C - 3, 8

116. Which of the following A to F is commonly used for the surface marking of 1 to 6? A. Fourth right costal cartilage B. Fifth left intercostal space C. Body of sternum D. Fourth left costal cartilage E. Manubriosternal joint F. None of these 1. Apex of heart 2. Valves of heart 3. Division of trachea 4. Horizontal (transverse) fissure of lung 5. Cardiac notch 6. Arch of aorta

A - 4 B - 1 C - 2 D - 6 E - 3 F - 5

114. A. lnfraclavicular region B. Mammary region C. Axilla 1. Between 3rd and 6th ribs 2. Between clavicle and 3rd rib 3. Between ant. and post. axillary lines

A - 4 B - 1 C - 3

115. Which of the following A to F is associated with 1 to 6? A. Beginning of brachiocephalic (innominate) vein B. Division of trachea C. Inferior vena cava enters thorax D. Right atrioventricular orifice E. Esophagus enters abdominal cavity F. None of these 1. Level of tenth thoracic vertebra 2. Level of eighth thoracic vertebra 3. Manubriosternal joint 4. Sternoclavicular joint 5. Seventh costal cartilage 6. Fourth costal cartilage

A - 4 B - 3 C -2 D - 6 E - 1 F - 5

118. Match the anatomical region on the left with the appropriate element on the right: A. Superior mediastinum B. Anterior mediastinum C. Root of the lung D. Middle mediastinum E. Posterior mediastinum 1. Sternopericardiac ligaments 2. Left auricle 3. Esophagus 4. Pulmonary artery 5. Thymus

A - 5 B - 1 C - 4 D - 2 E - 3

40. Which valves would be open during ventricular systole? A. Aortic and pulmonary B. Aortic and tricuspid C. Mitral and aortic D. Tricuspid and mitral E. Tricuspid and pulmonary

A. Aortic and pulmonary

26. In lymphatic drainage of the breast, the major portion (about 75%) enters eventually into which group of nodes? A. Central axillary B. Deltopectoral C. Lateral axillary D. Parasternal E. Subscapular

A. Central axillary

68. A 45-year-old female patient complains of excessive sweating on the right side of the face and neck and in the right armpit region, where it leaves her clothing constantly stained with moisture. It is now such a terrible social embarrassment that she has become withdrawn and self-conscious. Since no medical treatment has proven effective, she is considering surgical denervation of the sweat glands in the affected areas. Which structure (s) might be removed or cut in order to alleviate her condition? A. Cervicothoracic (stellate) ganglion B. Dorsal roots of cervical nerves C. Greater thoracic splanchnic nerve D. Lumbar sympathetic trunk E. Vagus nerve

A. Cervicothoracic (stellate) ganglion

31. 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: A. Internal thoracic B. Musculophrenic C. Posterior intercostal D. Superior epigastric E. Thoracoacromial

A. Internal thoracic

64. Most of the drainage of the thoracic body wall reaches the superior vena cava via the azygos vein. A notable exception is the left superior intercostal vein, which normally drains into the: A. Left brachiocephalic vein 8 . Left bronchial vein C. Left pulmonary vein D. Left subclavian vein E. Superior vena cava

A. Left brachiocephalic vein

82. Which of the following statements are true or false? (TF) A. The pleural cavity lies between the visceral and parietal layers of the pleura. B. The fluid in the pleural cavity lubricates the movement of the lungs. C. During the quite breathing the lungs fill the entire pleural sac within each they lie. D. On entering the lung the two main bronchi divide repeatedly to form smaller bronchi. E. The paired lungs are soft organs of respiration that occupy entirely the thoracic cavity.

A. The pleural cavity lies between the visceral and parietal layers of the pleura. B. The fluid in the pleural cavity lubricates the movement of the lungs. D. On entering the lung the two main bronchi divide repeatedly to form smaller bronchi.

84. Regarding the surface projections on the chest: (TF) A. The upper border of the heart projects on the chest wall at the level of the third ribs. B. The apex of the heart projects on the chest wall at 2 cm medial to the midclavicular line in 3rd intercostal space. C. Cupula pleurae projects 4 cm above the first rib anteriorly. D. The deepest point of pleural cavity is the costodiaphragmatic recess. E. The lower border of the lung projects posteriorly at the level of the 12th rib.

A. The upper border of the heart projects on the chest wall at the level of the third ribs. C. Cupula pleurae projects 4 cm above the first rib anteriorly. D. The deepest point of pleural cavity is the costodiaphragmatic recess.

111. The following elements are part of the root of the lung: (TF) A. a. pulmonalis B. superior vena cava C. vv. pulmonales D. n. phrenicus E. main bronchus

A. a. pulmonalis C. vv. pulmonales E. main bronchus

71. The blood supply of the mammary gland includes the following arteries: (TF) A. a. thoracica interna B. a. thoracica lateralis C. a. thoracica externa D. a. thoracica medialis E. aa. intercostales posteriores

A. a. thoracica interna B. a. thoracica lateralis E. aa. intercostales posteriores

129. Parietal branches of the thoracic aorta are: A B

A. aa.phrenica superiores B. aa.intercostales posteriors III-XI

79. The median nerve (TF) A. arises by two roots, one from the lateral cord and the other from the medial cord of the brachial plexus B. does not contain fibres originating in the first thoracic spinal nerve C. lies medial to the axillary artery in the axilla D. supplies all the flexor muscles in the front of the forearm E. is commonly the motor nerve to the abductor pollicis brevis muscle.

A. arises by two roots, one from the lateral cord and the other from the medial cord of the brachial plexus C. lies medial to the axillary artery in the axilla E. is commonly the motor nerve to the abductor pollicis brevis muscle.

104. The right coronary artery (TF) A. arises from the anterior aortic sinus B. lies between the left auricle and the pulmonary trunk C. supplies the right atrium D. gives off a posterior interventricular branch E. takes part in the blood supply of the sinu-atrial node.

A. arises from the anterior aortic sinus C. supplies the right atrium D. gives off a posterior interventricular branch E. takes part in the blood supply of the sinu-atrial node.

123. The nerves (terminal branches) which emerge from the posterior cord of brachial plexus are: A B

A. axillary B. radial

107. The oesophagus (TF) A. begins at the level of the sixth cervical vertebra B. enters the abdomen at the level of the tenth thoracic vertebra C. is crossed anteriorly by the thoracic duct D. is lined by pseudostratified columnar epithelium E. has an outer longitudinal coat consisting, along its whole length, of striated muscle.

A. begins at the level of the sixth cervical vertebra B. enters the abdomen at the level of the tenth thoracic vertebra

121. List the groups of lymph nodes in the axillary fossa. A B C D E

A. brachial lymph nodes (lateral) B. pectoral axillary lymph nodes (anterior) C. subscapular axillary lymph nodes (posterior) D. central lymph nodes E. apical lymph nodes (subclavicular)

130. Which are the branches in the thoracic part of the aorta? A B C D E F

A. bronchial arteries B. mediastinal arteries C. esophageal arteries D. pericardial arteries E. superior phrenic artery F. posterior intercostal arteries

108. Parasympathetic nerves in the thorax (TF) A. cause contraction of the muscle in the lung B. supply sensory fibres to the lung C. are secretomotor to the oesophagus D. cause the longitudinal muscle of the oesophagus to relax E. supply sensory fibres to the pericardium.

A. cause contraction of the muscle in the lung B. supply sensory fibres to the lung C. are secretomotor to the oesophagus E. supply sensory fibres to the pericardium.

69. The mammary gland (TF) A. consists of 10-20 simple glands. B. consists of 50 - 70 simple glands. C. lies on the deep layer of fascia pectoralis. D. lies between the deep and superficial layer of fascia pectoralis. E. lies on the superficial layer of fascia pectoralis.

A. consists of 10-20 simple glands. E. lies on the superficial layer of fascia pectoralis.

80. The upper trunk of the brachial plexus (TF) A. contains fibres which supply the teres minor muscle B. supplies muscles which abduct the upper limb at the shoulder joint C. contains fibres which supply the skin on the proximal medial aspect of the upper limb D. supplies some of the muscles which flex the upper limb at the shoulder joint E. supplies muscles which produce medial rotation at the shoulder joint.

A. contains fibres which supply the teres minor muscle B. supplies muscles which abduct the upper limb at the shoulder joint D. supplies some of the muscles which flex the upper limb at the shoulder joint

109. The following elements are part of posterior mediastinum: (TF) A. esophagus B. aorta thoracica C. trachea and its bifurcation D. phrenic nerve E. ductus thoracicus

A. esophagus B. aorta thoracica E. ductus thoracicus

74. The medial cord of the brachia! plexus (TF) A. gives a branch to the pectoralis major muscle B. gives origin to the ulnar nerve C. forms part of the median nerve D. contains fibres of the fifth cervical spinal nerve E. lies behind the axillary artery in part of its course.

A. gives a branch to the pectoralis major muscle B. gives origin to the ulnar nerve C. forms part of the median nerve E. lies behind the axillary artery in part of its course.

89. The right main bronchus (TF) A. has the azygos vein arching above it B. is posterior to the ascending aorta C. is at least 6 cm long D. begins at the level of the third thoracic vertebra E. is more vertical than the left main bronchus.

A. has the azygos vein arching above it B. is posterior to the ascending aorta E. is more vertical than the left main bronchus.

83. The heart (TF) A. is a powerful pump that keeps the blood circulation. B. is situated within mediastinum . C. is enclosed within the pleura. D. wall is made up of three layers. E. is only divided into two atria.

A. is a powerful pump that keeps the blood circulation. B. is situated within mediastinum . D. wall is made up of three layers.

98. The fibrous pericardium (TF) A. is firmly attached to part of the diaphragm B. is continuous with the prevertebral cervical fascia C. is innervated by only the vagus nerves D. is separated completely from the sternum by pleura E. is lined by epicardium .

A. is firmly attached to part of the diaphragm

101. The right phrenic nerve (TF) A. is formed mainly by a branch of the fourth cervical spinal nerve B. is usually the only motor nerve of the right side of the diaphragm C. is entirely a motor nerve D. is lateral to the superior vena cava E. is posterior to the suprascapular artery.

A. is formed mainly by a branch of the fourth cervical spinal nerve B. is usually the only motor nerve of the right side of the diaphragm D. is lateral to the superior vena cava E. is posterior to the suprascapular artery.

93. A typical intercostal nerve (TF) A. is inferior to the intercostal vessels in the costal groove B. is the anterior primary ramus of a thoracic spinal nerve C. has a cutaneous distribution limited to the skin of the side and front of the trunk D. anteriorly contains postganglionic sympathetic nerve fibres E. contains sensory fibres supplying the visceral pleura.

A. is inferior to the intercostal vessels in the costal groove B. is the anterior primary ramus of a thoracic spinal nerve D. anteriorly contains postganglionic sympathetic nerve fibres

94. The left main bronchus (TF) A. is longer than the right main bronchus B. is more vertical than the right main bronchus C. lies anterior to the left pulmonary artery D. constricts the esophagus about 25 cm from the incisor teeth E. contains smooth muscle innervated by branches of the vagus and sympathetic nerves.

A. is longer than the right main bronchus D. constricts the esophagus about 25 cm from the incisor teeth E. contains smooth muscle innervated by branches of the vagus and sympathetic nerves.

54. An 8-year-old boy is found to have a mid-line tumor of the thymus gland that is impinging posteriorly on a blood vessel. The affected vessel is most likely the: A. left brachiocephalic vein B. left pulmonary vein C. left bronchial vein D. right pulmonary artery E. right superior intercostal vein

A. left brachiocephalic vein

85. The root of the right lung (TF) A. lies opposite the bodies of the fifth, sixth and seventh thoracic vertebrae B. has the vena azygos arching forwards inferior to it C. has the phrenic nerve passing anterior to it D. has the pulmonary ligament lying behind it E. has the bronchus lying posterior to the pulmonary artery and vein.

A. lies opposite the bodies of the fifth, sixth and seventh thoracic vertebrae C. has the phrenic nerve passing anterior to it E. has the bronchus lying posterior to the pulmonary artery and vein.

73. The anterior wall of fossa axillaris comprises: (TF) A. m. pectoralis minor B. m. pectoralis major C. m. subclavius D. m. serratus ant. E. m. deltoideus

A. m. pectoralis minor B. m. pectoralis major C. m. subclavius

124. The nerves (terminal branches) which emerge from the medial cord of brachial plexus are: A B C D

A. medial cutaneous of arm B. medial cutaneous of forearm C. ulnar D. median

126. Parietal pleura is divided into three parts: A B C

A. mediastinal B. costal C. diaphragmatic

88. The diaphragm (TF) A. moves vertically about 1-2 cm in quiet breathing B. is innervated solely by the phrenic nerves C. has a circular tendinous centre D. forms an anatomical sphincter round the esophagus E. has a motor nerve supply mainly from the fourth cervical segment of the spinal cord.

A. moves vertically about 1-2 cm in quiet breathing E. has a motor nerve supply mainly from the fourth cervical segment of the spinal cord.

122. The nerves (terminal branches) which emerge from the lateral cord of brachial plexus are: A B

A. muscolocutaneous B. median

127. Define three elements of the posterior mediastinum: A B C

A. oesophagus B. vagus nn C. thoracic aorta

103. The left vagus nerve (TF) A. passes behind the root of the lung B. enters the thorax medial to the left common carotid artery C. is anterior to the left brachiocephalic (innominate) vein D. is superficial to the phrenic nerve as they cross the arch of the aorta E. in its thoracic part contains only motor nerve fibres.

A. passes behind the root of the lung

136. During a heart transplant procedure, the surgeon inserted his left index finger through the transverse pericardia) sinus, and then pulled forward on the two large vessels lying ventral to his finger. Which vessels were these? A B

A. pulmonary trunk B. aorta

131. Which are the branches that form vena azygos and hemiazygos? A B

A. right ascending lumbar vein B. left ascending lumbar vein

128. The branches which form the superior vena cava are: A B

A. right brachiocephalic vein B. left brachiocephalic vein

125. The branches that arise from the subscapular artery are A B

A. scapular circumflex artery B. thoracodorsal artery

120. List the branches of the axillary artery. A B C D E

A. superior thoracic artery B. thoraco-acromial artery C. lateral thoracic artery D. subscapular artery E. anterior/posterior humeral circumflex artery

100. Sympathetic nerves in the thorax (TF) A. supply the heart from the first four thoracic spinal segments B. supply mainly postganglionic fibres to the coeliac ganglia C. are vasodilator to the coronary arteries D. cause constriction of the smooth muscle of the bronchi E. give sensory fibres to the parietal pleura.

A. supply the heart from the first four thoracic spinal segments C. are vasodilator to the coronary arteries

77. The approximate vertebral level of (TF) A. the jugular (suprasternal) notch is the second thoracic vertebra B. the sternal angle is the fourth thoracic vertebra C. the xiphoid process of the sternum is the ninth thoracic vertebra D. the lowest level of the costal (subcostal) margin is the third lumbar vertebra E. the transpyloric plane is the first lumbar vertebra.

A. the jugular (suprasternal) notch is the second thoracic vertebra B. the sternal angle is the fourth thoracic vertebra C. the xiphoid process of the sternum is the ninth thoracic vertebra D. the lowest level of the costal (subcostal) margin is the third lumbar vertebra E. the transpyloric plane is the first lumbar vertebra.

97. On the mediastinal surface of the left lung (TF) A. the left ventricle produces a depression in front of and below the hilum B. there is a groove above the hilum for the vena azygos C. the vagus nerve passes anterior to the hilum D. the main bronchus lies anterior to the pulmonary artery E. the thoracic aorta lies behind the hilum.

A. the left ventricle produces a depression in front of and below the hilum E. the thoracic aorta lies behind the hilum.

95. Inside the right atrium (TF) A. the wall is ridged anteriorly and smooth posteriorly B. the wall of the auricle is smooth C. the opening of the superior vena cava has a valve D. the opening of the coronary sinus has a valve E. the fossa ovalis can be seen below the opening of the coronary sinus.

A. the wall is ridged anteriorly and smooth posteriorly D. the opening of the coronary sinus has a valve

105. The trachea (TF) A. usually bifurcates at the level of the intervertebral disc between the fourth and fifth thoracic vertebra B. has the deep cardiac plexus anterior to its bifurcation C. has in the neck the recurrent laryngeal nerves posterior to its lateral borders D. contains complete rings of hyaline cartilage E. contains complete rings of circular smooth muscle.

A. usually bifurcates at the level of the intervertebral disc between the fourth and fifth thoracic vertebra B. has the deep cardiac plexus anterior to its bifurcation C. has in the neck the recurrent laryngeal nerves posterior to its lateral borders

37. A 3rd-year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers? A. 1 B. 2 C. 3 D. 4 E. Can't be determined

B. 2

45. Which of the following layers provides a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall? A. Deep fascia B. Endothoracic fascia C. Parietal pleura D. Visceral pleura E. Transversus thoracis muscle fascia

B. Endothoracic fascia

59. A tumor of the posterior mediastinum is most likely to compress which of the following structures? A. Arch of the aorta B. Esophagus C. Inferior vena cava D. Pulmonary trunk E. Trachea

B. Esophagus

36. The thoracic wall is innervated by: A. Dorsal primary rami B. Intercostal nerves C. Lateral pectoral nerves D. Medial pectoral nerves E. Thoracodorsal nerves

B. Intercostal nerves

81. Foramen axillare laterale contains: (TF) A. A. axillaris B. N. axillaris C. N. subscapularis D. A. circumflexa humeri anterior E. A. circumflexa humeri posterior

B. N. axillaris E. A. circumflexa humeri posterior

34. Because of its angle with the trachea and size of the main bronchus, a bronchoscope would pass more readily into which lung? A. Left B. Right

B. Right

65. You are observing a physician perform a thoracoscopic procedure. She pushes the deflated lung anteroinferiorly and points out a nervous structure lying across the heads of the ribs. You identify this structure as the A. Greater thoracic splanchnic nerve B. Sympathetic trunk C. Phrenic nerve D. Pulmonary plexus E. Vagus nerve

B. Sympathetic trunk

70. The average female breast (TF) A. never extends laterally over the serratus anterior muscle B. has a separate duct for each lobe opening on to the nipple C. develops a large amount of secretory tissue at puberty D. has a lymphatic drainage mainly going direct to the infraclavicular lymph nodes E. is developmentally a collection of modified sweat glands.

B. has a separate duct for each lobe opening on to the nipple E. is developmentally a collection of modified sweat glands.

90. The right atrioventricular valve (TF) A. is related to an opening about 1.5 cm in diameter B. has anterior, posterior and septal cusps C. has three papillary muscles D. is attached to a muscular ring which contracts during ventricular systole E. is formed by cusps consisting largely of endothelium and fibrous tissue.

B. has anterior, posterior and septal cusps C. has three papillary muscles E. is formed by cusps consisting largely of endothelium and fibrous tissue.

92. The left phrenic nerve (TF) A. is posterior to the subclavian artery B. is anterior to the root of the left lung C. is usually motor to both halves of the diaphragm D. contains a majority of sensory fibres (about two-thirds) E. is anterolateral to the arch of the aorta.

B. is anterior to the root of the left lung E. is anterolateral to the arch of the aorta.

99. The arch of the aorta (TF) A. usually extends upwards as far as the jugular (suprasternal) notch B. is crossed anteriorly and to the left by the left phrenic nerve C. lies in front and to the left of the bifurcation of the trachea D. has the superficial cardiac plexus on its upper convex border E. has the recurrent laryngeal nerve passing below it to the right of the ligamentum arteriosum.

B. is crossed anteriorly and to the left by the left phrenic nerve C. lies in front and to the left of the bifurcation of the trachea

41. Which statement is true of the right atrioventricular valve?· A. it is also called the mitral valve B. it is open during ventricular diastole C. it transmits oxygenated blood D. it is opened by the pull of chordae tendineae E. · it consists of 2 leaflets

B. it is open during ventricular diastole

87. The left coronary artery (TF) A. arises from the right posterior aortic sinus B. lies between the pulmonary trunk and left auricle C. has no anastomosis with the right coronary artery D. gives off an anterior interventricular branch E. gives branches to the sinu-atrial node.

B. lies between the pulmonary trunk and left auricle D. gives off an anterior interventricular branch

72. The structures that pass through quadrangular space are: (TF) A. a. axillaris B. n. axillaris C. n. subscapularis D. a. circumflexa humeri ant. E. a. circumflexa humeri post.

B. n. axillaris E. a. circumflexa humeri post.

39. A stethoscope placed over the left second intercostal space just lateral to the sternum would be best positioned to detect sounds associated with which heart valve? A. aortic B. pulmonary C. mitral D. tricuspid

B. pulmonary

35. The second costal cartilage can be located by palpating the: A. costal margin B. sternal angle C. sternal notch D. sternoclavicular joint E. xiphoid process

B. sternal angle

75. The axillary nerve (TF) A. has no cutaneous branches B. supplies the deltoid and teres minor muscles C. passes backwards inferior to the teres major muscle D. contains fibres from the fifth and sixth cervical spinal nerves E. is medial to the long head of the triceps muscle.

B. supplies the deltoid and teres minor muscles D. contains fibres from the fifth and sixth cervical spinal nerves

56. Gray rami communicantes contain postganglionic sympathetic fibers that innervate which of the following structures in the thoracic region? A. aorta B. heart C. lung D. sweat glands E. trachea

D. sweat glands

106. With the heart in its usual position in the body (TF) A. the left ventricle forms most of the anterior surface B. the right border is formed by the right atrium C. no part of the left atrium can be seen on its anterior aspect D. the pulmonary artery lies anterior and to the right of the ascending aorta E. the apex lies approximately in the fifth left intercostal space 8 cm from the midline.

B. the right border is formed by the right atrium E. the apex lies approximately in the fifth left intercostal space 8 cm from the midline.

52. The pleural space into which lung tissue just above the cardiac notch would tend to expand during deep inspiration is the: A. Anterior mediastinum B. Costodiaphragmatic recess C. Costomediastinal recess D. Cupola E. Pulmonary ligament

C. Costomediastinal recess

48. 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

C. Esophagus

30. Breast cancer cells can spread directly to the cranial cavity and brain via the vertebral venous plexus. Through which route can they reach this plexus? A. Axillary lymph nodes B. Internal thoracic vein C. Intercostal veins D. Parasternal lymph nodes E. Thoracoacromial artery

C. Intercostal veins

66. An enlarging lymph node gradually constricts the flow of blood in the azygos venous arch. Which vessel would enlarge as a result of collateral drainage? A. Superior vena cava B. Inferior vena cava C. Internal thoracic vein D. Right brachiocephalic vein E. Superior epigastric vein

C. Internal thoracic vein

53. Which vessel courses across the mediastinum in an almost horizontal fashion? A. Left subclavian artery B. Left subclavian vein C. Left brachiocephalic vein D. Left internal jugular vein E. Left common carotid artery

C. Left brachiocephalic vein

61. While performing transesophageal echocardiography on a patient, the posterior wall of the esophagus, immediately behind the left atrium, was punctured from within. The patient subsequently developed an infection in the space around the esophagus at this point, namely the: A. Anterior mediastinum B. Middle mediastinum C. Posterior mediastinum D. Superior mediastinum

C. Posterior mediastinum

50. Elevated systolic blood pressure in the right ventricle suggests stenosis of which valve? A. Aortic B. Mitral C. Pulmonary D. Tricuspid

C. Pulmonary

25. The pleural cavity contains: A. Blood B. Mucosal fluid C. Serous fluid D. Air

C. Serous fluid

57. In the midregion of the thorax the thoracic duct lies immediately posterior to the: A. aorta B. azygos vein C. esophagus D. superior vena cava E. trachea

C. esophagus

96. The esophagus (TF) A. commences about 25cm from the incisor teeth in the average adult B. is constricted to some extent by the right main bronchus C. is anterior to the thoracic aorta above the diaphragm D. usually passes between the two crura of the diaphragm E. has a sphincter at its lower end just below the diaphragm.

C. is anterior to the thoracic aorta above the diaphragm

43. You are attending an operation to remove a thymic tumor from the superior mediastinum. The surgeon asks, "What important nerve lying on and partly curving posteriorly around the arch of the aorta should we be careful of as we remove this mass?" You quickly answer, "The-- A. left phrenic B. left sympathetic trunk C. left vagus D. right phrenic E. right sympathetic trunk

C. left vagus

58. Lymph nodes can be found in which mediastinal compartment(s)? A. Anterior B. Middle C. Posterior D. All of the above E. None of the above

D. All of the above

42. The heart sound associated with the mitral valve is best heard: A. In the jugular notch B. In the second left intercostal space C. In the second right intercostal space D. In the fifth left intercostal space E. To the right of the xiphoid process

D. In the fifth left intercostal space

60. The aorta is located in which mediastinal compartment(s)? A. Anterior only B. Anterior and middle C. Middle only D. Middle and posterior E. Posterior only

D. Middle and posterior

46. The diaphragm receives its main motor nerve supply from: A. N. vagus B. Truncus sympaticus C. N. intercostalis D. N. Phrenicus E. N. Accessorius

D. N. Phrenicus

29. During a motorcycle accident, an 18-year-old male landed on the right lateral side of his rib cage with bis right upper limb abducted. In the hospital he was found to have "winging" of the right scapula. Which nerve was likely damaged in the accident? A. Accessory B. Lateral pectoral C. Long thoracic D. Phrenic E. Vagus

D. Phrenic

67. A cancerous growth from the body of the 9th thoracic vertebra exerts pressure anterolaterally. Which structure lies in direct contact with this growth? A. Right vagus nerve B . Right phrenic nerve C. Right sympathetic trunk D. Right greater thoracic splanchnic nerve E. Right 9th intercostal nerve

D. Right greater thoracic splanchnic nerve

44. The sternocostal surface of the heart is formed primarily by the anterior wall of which heart chamber? A. Left atrium B. Left ventricle C. Right atrium D. Right ventricle

D. Right ventricle

28. The clavipectoral fascia is penetrated by which artery? A. Anterior circumflex humeral B. Axillary C. Subscapular D. Thoracoacromial E. Thoracodorsal

D. Thoracoacromial

38. The portion of the parietal pleura that extends above the first rib is called the : A. costodiaphragmatic recess B. costomediastinal3 recess C. costocervical recess D. cupola E. endothoracic fascia

D. cupola

102. The pleura (TF) A. has the same surface markings as the lungs B. is wholly innervated by both the intercostal and phrenic nerves C. does not extend into the fissures of the lung D. extends upwards into the neck above the medial third of the clavicle E. is grooved in its uppermost part by the subclavian artery.

D. extends upwards into the neck above the medial third of the clavicle E. is grooved in its uppermost part by the subclavian artery.

78. The posterior cord of the brachial plexus (TF) A. contains fibres from only the seventh and eighth cervical spinal nerves B. gives off a branch which joins the median nerve C. is lateral to the axillary artery in the proximal part of its course D. gives off branches which supply the subscapularis, teres major and latissimus dorsi muscles E. contains fibres which supply the muscles on the back of the forearm.

D. gives off branches which supply the subscapularis, teres major and latissimus dorsi muscles E. contains fibres which supply the muscles on the back of the forearm.

76. The pectoralis major muscle (TF) A. is attached to the floor of the intertubercular sulcus (bicipital groove) B. is supplied by branches of the three cords of the brachial plexus C. is a lateral rotator of the upper arm at the glenohumeral joint D. is involved in flexion of the upper arm at the glenohumeraljoint E. is used in climbing a rope by means of the upper limbs.

D. is involved in flexion of the upper arm at the glenohumeraljoint E. is used in climbing a rope by means of the upper limbs.

47. Which structure does NOT lie in the coronary sulcus? A. circumflex artery B. coronary sinus C. right coronary artery D. right marginal artery E. left coronary artery

D. right marginal artery

55. Sympathetic fibers in the greater thoracic splanchnic nerve arise from neuron cell bodies found in the: A. brainstem B. celiac ganglion C. chain ganglion D. spinal cord E. superior mesenteric ganglion

D. spinal cord

51. You are called to perform thoracentesis (remove fluid from the pleural cavity). If you are to avoid injuring lung or neurovascular elements, where would you insert the aspiration needle? A. the top of interspace 8 in the midclavicular line B. the bottom of interspace 8 in the midclavicular line C. the top of interspace 9 in the midaxillary line D. the bottom of interspace 9 in the midaxillary line E. the top of interspace 11 in the scapular line

D. the bottom of interspace 9 in the midaxillary line

91. In relation to the diaphragm (TF) A. the inferior vena cava passes through its muscular part B. the aorta passes behind it in the midline at the level of the eighth thoracic vertebra C. the subcostal nerve passes laterally behind the medial arcuate ligament D. the esophagus passes through it at the level of the tenth thoracic vertebra E. the anterior and posterior gastric nerves pass through the esophageal opening.

D. the esophagus passes through it at the level of the tenth thoracic vertebra E. the anterior and posterior gastric nerves pass through the esophageal opening.

49. In obstruction of the superior or inferior vena cava, venous blood is returned to the heart by an alternate route via the azygos vein, which becomes dilated in the process. Which of the following structures might it compress as a result? A. trachea B. root of the left lung C. phrenic nerve D. thoracic duct E. descending aorta

D. thoracic duct

32. Upon finding a malignant tumor in the medial portion of the breast of a 40-year-old female, the surgeon began to search for the lymph nodes that would be the first ones reached by metastatic spread of cancer cells from this site. Which group(s) would have to be examined to determine whether metastasis had occurred? A. Central only B. Parasternal only C. Parasternal and apical D. Parasternal and lateral E. Parasternal and pectoral

E. Parasternal and pectoral

62. Since the puncture in the previous question was through the posterior wall of the esophagus, the doctors were also very concerned about possible damage to a thin-walled vessel just behind the esophagus and between the azygos vein and aorta, i.e., the: A. Hemiazygos vein B. Left bronchial vein C. Left pulmonary vein D. Superior vena cava E. Thoracic duct

E. Thoracic duct

63. During a surgical procedure, a patient's right sympathetic trunk was accidentally severed just cranial to the level of spinal nerve Tl. Which function would be left intact in the affected region? A. Arrector pili muscle activity B. Dilation/constriction of blood vessels C. Sweat production D. Visceral reflex activity E. Voluntary muscle activity

E. Voluntary muscle activity

27. A woman with breast cancer subsequently develops metastases in her vertebral column. The most direct route for spread of the tumor to the vertebral column was via: A. branches of the cephalic vein B. branches of the lateral thoracic vein C. branches of the thoracoacromial veins D. lymphatic vessels draining into the axilla E. branches of the intercostal veins

E. branches of the intercostal veins

86. The left phrenic nerve (TF) A. is posterior to the thoracic duct B. is posterior to the vagus nerve as they cross the arch of the aorta C. has no branches in the thorax other than those supplying the diaphragm D. does not give any branches to the right crus of the diaphragm E. is posterior to the left brachiocephalic (innominate) vein.

E. is posterior to the left brachiocephalic (innominate) vein.

12. The costomediastinal recess lies along the inferior margin of the pleura.

No

16. The phrenic and vagus nerves descend between the pericardium and sternum.

No

20. Phrenic nerve passes posteriorly to the root of the lungs.

No

21. Vagus nerve passes anteriorly to the root of the lungs.

No

22. Phrenic and vagus nerves pass together posteriorly to the root of the lungs.

No

23. In the thorax sympathetic trunk is intimately related to the esophagus.

No

5. Mediastinum is the space in thoracic cavity where the lungs are located.

No

8. The phrenic nerve is a part of the neurovascular bundle of the neck.

No

134. Which heart valve has leaflets described as " anter ior, left and right"? ....

Pulmonary

135. Which heart valve has leaflets described as " posterior, left and right"? ...

aortic

132. The pleural cavity near the cardiac notch is known as the.....

costomediastinal recess