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ANATOMY - 1st Year 1st Sem Comprehensive Exam > Thorax Reviewer - 2017 > Flashcards

Thorax Reviewer - 2017 Flashcards

1
Q

The following are true about manubrium except:

a. Is the upper part of the sternum
b. Articulates the body of the sternum at the manubriosternal joint
c. Articulates with the clavicles and with the 1st costal cartilage and the lower part of the 2nd costal cartilages on each side
d. It lies opposite the 3rd and 4th thoracic vertebrae

A

b. Articulates the body of the sternum at the manubriosternal joint

 Articulates with the clavicles and with the 1st costal cartilage and the UPPER part of the 2nd costal cartilages on each side

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2
Q

Angle of Louis is found

a. 1st costal cartilage
b. 2nd costal cartilage
c. Opposite the intervertebral disc (b/w 4th and 5th thoracic vertebrae)
d. A and B
e. B and C

A

e. B and C

 Sternal Angle or Angle of Louis is at the level of 2nd costal cartilage and lies opposite the intervertebral disc (b/w 4th and 5th thoracic vertebrae)

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3
Q

Xiphisternal joint lies opposite the body of the

a. 7th thoracic vertebrae
b. 8th thoracic vertebrae
c. 9th thoracic vertebrae
d. None of the above

A

c. 9th thoracic vertebrae

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4
Q

True ribs

a. Upper 7 pairs
b. Upper 8 pairs
c. Upper 9 pairs
d. Upper 10 pairs

A

b. Upper 8 pairs

 True ribs: upper 7 pairs
 False ribs: 8 – 10th pair of ribs
 Floating: 11 – 12th pair

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5
Q

True of typical rib except

a. Flat
b. Sharp, smooth superior border
c. Rounded, thin inferior border
d. B and C
e. None of the above

A

d. B and C

 Typical rib: long, twisted, flat bone having a ROUNDED, smooth superior border and SHARP and thin inferior border

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6
Q

Parts of the rib include, except

a. Head
b. Tubercle
c. Shaft
d. Angle
e. None of the above

A

e. None of the above

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7
Q

Atypical rib

a. 1st rib
b. 2nd rib
c. 3rd rib
d. All of the above

A

a. 1st rib

 1ST rib is an atypical rib; costal cartilage are fixed to the manubrium and immobile (cartilaginous joint)

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8
Q

When intercostals muscles contract, they tend to

a. Pull the ribs away from one another
b. Pull the ribs nearer to one another
c. None of the above

A

b. Pull the ribs nearer to one another

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9
Q

Posterior intercostal veins drain backward into

a. Azygous veins or Hemiazygous veins
b. Internal thoracic and musculophrenic veins

A

.a. Azygous veins or Hemiazygous veins

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10
Q

Anterior intercostal veins drain forward into

a. Azygous veins or Hemiazygous veins
b. Internal thoracic and musculophrenic veins

A

b. Internal thoracic and musculophrenic veins

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11
Q

Connect the intercostals nerve to a ganglion of the sympathetic trunk

a. Collateral branches
b. Rami communicantes
c. Lateral cutaneous branch
d. Anterior cutaneous branch

A

b. Rami communicantes

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12
Q

True of Herpez Zoster, except

a. Aka shingles
b. Reactivation of the latent varicella zoster virus
c. Occurs more frequently in patients older than 20 years
d. Formation of vesicles

A

c. Occurs more frequently in patients older than 20 years

 Occurs more frequently in patients older than 50 years

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13
Q

____ intercostal nerve supplies the skin of the armpit and the upper medial side of the arm.

a. 1st
b. 2nd
c. 3rd
d. 4th
e. 5th

A

b. 2nd

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14
Q

Diaphragm, true

a. A thin, muscular and tendinous septum
b. Separates the chest cavity above from the abd’l cavity below
c. A and B
d. None of the above

A

c. A and B

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15
Q

Origin of diaphragm can be divided into 3 parts, except

a. Sternal part
b. Cervical part
c. Costal part
d. Vertebral part

A

b. Cervical part

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16
Q

In deep respiration, the costal and diaphragmatic pleurae are in apposition to each other below the lower border of the lung.
A. True
B. False

A

B. False

 False - this happens in QUIET respiration

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17
Q

It covers and forms the lateral boundary of the mediastinum.
A. Parietal pleura
B. Visceral pleura
C. Mediastinal pleura

A

C. Mediastinal pleura

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18
Q 
The parietal pleura is sensitive to:
A. Pain
B. Temprature
C. Pressure
D. A & B only
E. All of the above
A

D. A & B only

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19
Q 
Nerve supply of the mediastinal pleura.
A. Intercostal nerves
B. Pulmonary plexus
C. Phrenic nerve
D. Vagus nerve
A

C. Phrenic nerve

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20
Q

Lines the thoracic wall
A. Visceral pleura
B. Mediastinal pleura
C. Parietal pleura

A

C. Parietal pleura

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21
Q

Allows the movement of pulmonary vessels and large bronchi in the hilum during respiration
A. Costodiaphragmatic recess
B. Pleura
C. Pulmonary ligament

A

C. Pulmonary ligament

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22
Q 
What constitutes the lung root?
A. Pulmonary vein
B. Pulmonary artery
C. Primary bronchi
D. A & B only
E. All of the above
A

E. All of the above

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23
Q 
Nerve supply of diaphragmatic pleura
A. Phrenic nerve
B. Lower 6 Intercostal nerves
C. A & B 
D. None of the above
A

C. A & B

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24
Q

True of the adult lungs except

a. Become dark and mottled because of the inhalation of dust particles that become trapped in the phagocytes of the lung
b. Pinkish
c. None of the above

A

b. Pinkish

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25
Q

True of the left lung

a. Cardiac notch
b. Esophageal impression
c. Lingula
d. A and B
e. Aand C

A

e. Aand C

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26
Q

The left lung is slightly larger than the right lung

a. True
b. False

A

b. False

 Right lung is slightly larger than the left lung to accommodate the liver

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27
Q

A fissure that runs from the inferior border upward and backward across the medial and costal surfaces until it cuts the posterior border about 2.3 in below the apex

a. Horizontal fissure
b. Oblique fissure
c. Diagonal fissure
d. None of the above

A

b. Oblique fissure

 Oblique fissure - runs from the inferior border upward and backward across the medial and costal surfaces until it cuts the posterior border about 2.3 in below the apex
 Horizontal fissure – runs horizontally across the costal surface at the level of the 4th costal cartilage to meet the oblique fissure in the midaxillary line
 Diagonal fissure – there is none

28
Q

These are the anatomic, functional and surgical units of the lungs

a. Bronchial segments
b. Bronchopulmonary segments
c. Pulmonary segments
d. None of the above

A

b. Bronchopulmonary segments

29
Q

The diameter of respiratory bronchiole is about

a. 0.05 mm
b. 0.5 mm
c. 5 mm
d. 50mm

A

b. 0.5 mm

30
Q

Main characteristics of bronchopulmonary segment except

a. It is a subdivision of a lung lobe
b. Surrounded by connective tissue
c. It is triangle shaped with apex toward the lung root
d. It has a segmental bronchus, a segmental artery, lymph vessels, and autonomic nerves

A

c. It is triangle shaped with apex toward the lung root

 It is PYRAMID shaped, with apex toward the lung root

31
Q

Form of structures that are entering or leaving the lung.

a. Hilum
b. Root of the lung
c. Pulmonary ligament
d. Lingula

A

b. Root of the lung

32
Q 
Trachea bifurcates behind the arch of aorta into, 
A. Right and left principal bronchi
B. Right principal bronchi only
C. Left principal bronchi only
D. None of the above
A

A. Right and left principal bronchi

33
Q 
Which is wider and shorter and more vertical about 1 inch (2.5cm) long bronchus?
A. Left primary bronchus
B. Right and left primary bronchus
C. Right primary bronchus
D. All of the above
A

Right primary bronchus

34
Q 
On entering left lung, the principal bronchus divides into,
A. Left and right primary bronchus
B. Left and right secondary bronchus
C. Anterior and Posterior lobar bronchus
D. Superior and Inferior lobar bronchus
A

D. Superior and Inferior lobar bronchus

35
Q 
Which does not contain cartilage?
A. Primary bronchus
B. Secondary bronchus
C. Terminal Bronchioles
D. Larynx
E. Trachea
A

C. Terminal Bronchioles

36
Q

The main characteristics of bronchopulmonary segment are, EXCEPT
A. Surrounded by connective tissue
B. Subdivision of lung lobe
C. Pyramid shape, with apex toward the lung root
D. The segmental vein lies in the connective tissue between parallel bronchopulmonary segments
E. All of the above is correct

A

D. The segmental vein lies in the connective tissue between parallel bronchopulmonary segments

37
Q 
Arrange the following events in the correct order as they occur during inspiration:
1. air flows into the lungs
2. alveolar volume increases
3. thoracic volume increases
4. pleural pressure decreases
5. alveolar pressure decreases
A. 1,2,3,4,5
B. 2,5,1,3,4
C. 3,4,2,5,1
D. 4,5,2,1,3
A

C. 3,4,2,5,1

38
Q 
Which of these conditions increase compliance of the lungs?
A. Airway obstruction
B. Emphysema
C. Fibrosis of Lungs
D. Pulmonary edema
E. All of these
A

B. Emphysema

 Only emphysema produces increased compliance of the lungs, as there is destruction of elastic lung tissue resulting in decreased elastic recoil, the lungs are easier to expand.

39
Q 
It is associated with bronchial asthma, where the lungs consequently become greatly distended and thoracic cage becomes permanently enlarged. 
A. Emphysema
B. Pulmonary fibrosis
C. Pneumonia
D. Barrel chest
E. All of these
A

D. Barrel chest

 Bronchial asthma reduces diameter of bronchioles during expiration, resulting to lungs distention and enlarged thoracic cage called Barrel chest.

40
Q 
It is a passive phenomenon and is brought about by the elastic recoil of the lungs, the relaxation of the intercostal muscles and diaphragm, and increase tone of the muscles of the anterior abdominal wall, which forces the relaxing diaphragm upward, term as
A. Forced expiration
B. Quiet inspiration
C. Forced inspiration
D. Quiet expiration
E. Both B and D
A

B. Quiet inspiration

41
Q 
What part of the lung projects above rib 1 and into the root of the neck?
A. Apex
B. Base
C. Costal surface
D. None of the above
A

A. Apex

 The apex of the lung projects above rib 1 into the root of the neck. It can be mapped out on the anterior surface of the body by drawing a curved line, convex upward, from the sternoclavicular joint to a point 1 inch (2.5cm) above the junction of the medial and intermediate thirds of the clavicle

42
Q

Pulmonary ligament is a thin, blade-like fold of pleura projects superiorly from the root of the lung and extends from the hilum to the mediastinum.
A. True
B. False

A

B. False

 Pulmonary ligament is a thin, blade-like fold of pleura projects INFERIORLY from the root of the lung and extends from the hilum to the mediastinum.
 It may stabilize the position of the inferior lobe and may also accommodate the down-and-up translocation of structures in the root during breathing.

43
Q 
Structures that supply oxygenated blood to the lungs.
A. Pulmonary arteries
B. Pulmonary veins
C. Aorta
D. All of the above
A

B. Pulmonary veins

 Pulmonary veins are inferior to the pulmonary artery. It is the only vein that supplies oxygenated blood.

44
Q

There are two fissures that separate the lobe of the lungs: oblique fissure and horizontal fissure.
A. The orientations of the fissures determine where clinicians should listen to lung sounds from each lobe.
B. The orientations of the fissures determine where clinician would check for tactile fremitus.
C. All of the above
D. None of the above

A

A. The orientations of the fissures determine where clinicians should listen to lung sounds from each lobe.

 The orientations of the fissures determine where clinicians should listen to lung sounds from each lobe.
When listening to the lung sounds from each of the lobes, the stethoscope should be placed on those areas of the thoracic wall related to the underlying positions of the lobes.

45
Q

The approximate position of left oblique fissure during quiet respiration
A. Spinous process of vertebrae T3 and T4, crosses the 5th interspace laterally, and follows the contour rib 6 anteriorly.
B. Spinous process of vertebrae T4 and T5, crosses the 5th interspace laterally, and follows the contour rib 6 anteriorly.
C. Spinous process of vertebrae T5 and T6, crosses the 5th interspace laterally, and follows the contour rib 6 anteriorly.

A

A. Spinous process of vertebrae T3 and T4, crosses the 5th interspace laterally, and follows the contour rib 6 anteriorly.

46
Q

Structures located within the root of the lung:
A. Azygos vein, hemiazygos vein, thoracic duct and esophagus
B. Pulmonary artery, pulmonary veins, main bronchus, bronchial vessels, nerves and lymphatics
C. Vagus nerve, left current laryngeal nerve and esophageal plexus

A

B. Pulmonary artery, pulmonary veins, main bronchus, bronchial vessels, nerves and lymphatics

47
Q 
The articular part of a rib tubercle articulates
with which of the following structures?
(A) body of the vertebra
(B) costal cartilage
(C) adjacent rib
(D) sternum
(E) transverse process
A

(E) transverse process

 The tubercle has a smooth articular part for articulating with the corresponding transverse process of the vertebra and a rough nonarticular part for attachment of the costotransverse
ligament (Moore, p 63).

48
Q 
Where is the groove for the subclavian artery located?
(A) posterior to the scalene tubercle
(B) on the clavicle
(C) on the manubrium
(D) at the sternal angle
(E) at the angle of the 1st rib
A

(A) posterior to the scalene tubercle

 The surface of the 1st rib has two transversely directed shallow grooves, anterior and posterior to the scalene tubercle, for the subclavian vein and the subclavian artery respectively

49
Q 
The retromammary space is located between which of the following structures?
(A) skin and the areola
(B) pectoralis major and minor
(C) breast and deep pectoral fascia
(D) suspensory ligament and the skin
(E) lactiferous sinus and the nipple
A

(C) breast and deep pectoral fascia

 Between the breast and deep pectoral fascia is a loose connective tissue plane or potential space known as the retromammary space

50
Q

Which of the following statements correctly
apply to the internal thoracic artery?
(A) It runs posterior to the transversus thoracis muscle.
(B) It ends in the 6th intercostal space.
(C) It divides into the superior and inferior epigastric arteries.
(D) It runs posterior to the superior six ribs.
(E) It gives rise to the posterior intercostals arteries.

A

(E) It gives rise to the posterior intercostals arteries.

 Because the axillary lymph nodes are the most common site of metastases from a breast cancer, enlargement of the palpable nodes in a woman suggests the possibility of breast cancer and may be key to early detection. However, the absence of enlarged axillary nodes is no guarantee that metastasis from a breast cancer has not occurred, because the malignant cells may have passed to other nodes, such as the infraclavicular and supraclavicular lymph nodes

51
Q

Which of the following statements concerning the sternal angle is correct?
(A) It lies at the level of the intervertebral disk between T4/T5.
(B) It is flanked by the costal cartilage of the 3rd pair of costal cartilages.
(C) It is crossed by the superior epigastric artery.
(D) It lies in the epigastric fossa.
(E) It is located 3 mm superior to the jugular notch.

A

(A) It lies at the level of the intervertebral disk between T4/T5.

 The sternal angle is located opposite the 2nd pair of costal cartilages at the level of the 4th intervertebral disc between T4 and T5 vertebrae

52
Q 
The pleural cavity contains which of the following?
(A) lungs
(B) bronchi
(C) serous pleural fluid
(D) lymph nodes
(E) pulmonary arteries and veins
A

(C) serous pleural fluid

 The pleural cavity, the potential space between the layers of pleura, contains a capillary layer of serous pleural fluid. It provides the lubrication and cohesion that keep the lung surface in contact with the thoracic wall (Moore, p 95).

53
Q 
The parietal pleura consists of all of the following
parts EXCEPT
(A) costal
(B) pericardial
(C) mediastinal
(D) diaphragmatic
(E) cervical
A

(B) pericardial

54
Q

All of the following statements correctly apply
to the right lung EXCEPT
(A) The superior and oblique fissures divide it
into three lobes.
(B) It is larger and heavier than the left lung.
(C) It is shorter and wider than the left lung.
(D) It contains a thin, tongue like process called the lingula.
(E) It has three surfaces.

A

(D) It contains a thin, tongue like process called the lingula.

 The right lung has three lobes, the left two. The right lung is larger and heavier than the left, but it is shorter and wider, because the right dome of the diaphragm is higher and the heart and pericardium bulge more to the left. The anterior margin of the right lung is relatively straight, whereas the margin of the left lung has a deep cardiac notch. The cardiac notch primarily indents the anteroinferior aspect of the superior lobe of the left lung. This often creates a thin, tongue-like process of the superior lobe, called the lingula

55
Q

All of the following statements correctly apply
to the left main bronchus EXCEPT
(A) It is wider, shorter, and runs more vertically
than the right main bronchus.
(B) It passes anterior to the esophagus.
(C) It passes anterior to the thoracic aorta.
(D) It contains c-shaped rings of hyaline
cartilage.
(E) It arises at the level of the sternal angle

A

(A) It is wider, shorter, and runs more vertically
than the right main bronchus.

 The right main bronchus is wider and shorter, running more vertically than the left main bronchus as it passes directly to the hilum of the lung. The left main bronchus passes inferolaterally, inferior to the arch of the aorta and anterior to the esophagus and thoracic aorta, to reach the hilum of the lung

56
Q

All, but one belongs to the posterior of the mediastinum

a. Aorta
b. Esophagus
c. Thoracic duct
d. Trachea
e. Vagus nerves

A

d. Trachea

57
Q

In the superior mediastinum, the trachea is:

a. Anterior to the esophagus
b. Anterior to the ligamentum arteriosum
c. Posterior to the right recurrent laryngeal nerve
d. None of the above

A

a. Anterior to the esophagus

58
Q

The tracheoesophageal septum separates the:

a. Laryngotracheal tube and nasopharynx
b. Laryngoesophageal tube and oropharynx
c. Laryngoesophageal tube and esophagus
d. Esophagus and oropharynx
e. None of the above

A

c. Laryngoesophageal tube and esophagus

59
Q

The plane of sternal angle gives approximate location to the :

a. Bifurcation of the trachea
b. Cervical dome
c. Lower end of pharynx
d. Hemiazygos vein
e. All of the above

A

a. Bifurcation of the trachea

60
Q

It is a thick, movable partition that extends superiorly to the thoracic outlet and the root of the neck and inferiorly to the diaphragm. It also extends anteriorly to the sternum and posteriorly to the vertebral column.

a. Pleurae
b. Trachea
c. Mediastinum
d. Bronchi

A

c. Mediastinum

61
Q

The Mediastinum is divided into _____ and _____ mediastina by an imaginary plane passing from the sternal angle anteriorly to the lower border of the body of the 4th thoracic vertebra posteriorly.

a. anterior, posterior
b. superior, inferior
c. proximal, distal
d. internal, external

A

b. superior, inferior

62
Q

Which of the following are arranged in order from anterior to posterior within the Superior Mediastinum:

a. Trachea, Thymus, Large veins, Large arteries, Sympathetic trunk, Esophagus and Thoracic Duct
b. Thymus, Trachea, Large arteries, Large veins, Esophagus and Thoracic Duct, Sympathetic trunk
c. Thymus, Large arteries, Large veins, Trachea, Esophagus and Thoracic Duct, Sympathetic trunk
d. Thymus, Large veins, Large arteries, Trachea, Esophagus and Thoracic Duct, Sympathetic trunk

A

d. Thymus, Large veins, Large arteries, Trachea, Esophagus and Thoracic Duct, Sympathetic trunk

63
Q

Which of the following are arranged in order from anterior to posterior within the Inferior Mediastinum:

a. Thymus, Heart within the pericardium with phrenic nerves at the sides, Esophagus and Thoracic Duct, Descending aorta, Sympathetic trunks
b. Heart within the pericardium with phrenic nerves at the sides,Thymus, Esophagus and Thoracic Duct,Descending aorta, Sympathetic trunks
c. Esophagus and Thoracic Duct,Heart within the pericardium with phrenic nerves at the sides,Thymus,Sympathetic trunks, Descending aorta
d. Thymus, Esophagus and Thoracic Duct, Heart within the pericardium with phrenic nerves at the sides, Descending aorta, Sympathetic trunks

A

a. Thymus, Heart within the pericardium with phrenic nerves at the sides, Esophagus and Thoracic Duct, Descending aorta, Sympathetic trunks

64
Q

Each lung is covered with ____ pleura

a. Mediastinal
b. Costal
c. Diaphragmatic
d. Visceral

A

d. Visceral

65
Q

At the middle of the mediastinal surface, is the ____, a depression in which the bronchi, vessels, and nerves that form the root enter and leave the lung.

a. Apex
b. Base
c. Hilum
d. None of the above

A

c. Hilum

66
Q

The Left lung is unique, in that it has:

a. Upper and lower lobes
b. No horizontal fissure
c. A Cardiac impression
d. A & B only
e. All of the above

A

e. All of the above

67
Q

The Right lung is unique, in that it has:

a. Upper, Middle, and Lower lobes
b. An oblique fissure
c. A horizontal fissure
d. B & C only
e. All of the above

A

e. All of the above

ANATOMY - 1st Year 1st Sem Comprehensive Exam (46 decks)

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