Quiz 3

Question 1

Which nerve provides sensory innervation to the little finger?

Answer 1

ulnar nerve

Question 2

A shoulder dislocation would likely cause a loss of sensation to which area?

Answer 2

deltoid area

Question 3

Which nerve is affected by a shoulder dislocation?

Answer 3

axillary nerve

Question 4

Thenar atrophy is due to which nerve?

Answer 4

median nerve

Question 5

A person unable to extend their wrist has an issue with which nerve?

Answer 5

radial nerve

Question 6

The radial nerve innervates which muscles?

Answer 6

Triceps and all extensors and supinators of the wrist and fingers

Question 7

Which nerve provides motor innervation to the biceps brachii?

Answer 7

musculocutaneous nerve

Question 8

The lateral aspect of the forearm receives sensory innervation from which nerve?

Answer 8

the lateral antebrachial cutaneous nerve (terminating branch of musculocutaneous nerve)

Question 9

Nodules in the palm and aponeurosis can lead to what? What is this called?

Answer 9

lead to fascial thickening and shortening on the medial side of the hand; affects 4th & 5th digits; called Dupuytren contracture

Question 10

What is the difference between Heberden’s nodes and Bouchard’s nodes?

Answer 10

Herberden’s are @ distal interphalangeal joint
Bouchard’s are @ proximal interphalangeal joint

Question 11

Describe the mechanism of a trigger finger

Answer 11

a finger or thumb becomes locked in a flexed position due to inflammation of a tendon; sometimes the inflamed area must be forced back into the sheath causing a popping sensation

Question 12

What is tennis elbow?

Answer 12

lateral epicondylitis; inflammation at the insertion of the extensors on elbow

Question 13

What is golfer’s elbow?

Answer 13

medial epicondylitis; inflammation at the insertion of the flexors on elbow

Question 14

The long tendon of the biceps brachii is most frequently ruptured at which location?

Answer 14

intertubercular groove

Question 15

What bone is most commonly fractured in children?

Answer 15

radius

Question 16

The ulnar nerve innervates which muscles of the upper extremity?

Answer 16

flexor carpi ulnaris
1/2 of flexor digitorum profundus (digits 4 & 5)

Question 17

Describe the contents of the cubital fossa from lateral to medial

Answer 17

Tendon of biceps brachii
Artery (brachial)
Nerve (median)

Question 18

Which 2 arteries provide arterial blood supply to the hand?

Answer 18

radial and ulnar arteries

Question 19

Describe the Allen’s test

Answer 19

method of assessing blood flow to the hand; simultaneously occlude the radial and ulnar arteries, then slowly release one artery to assess patency; used before arterial cannulation to determine if the opposing artery is sufficient to maintain blood flow

Question 20

What causes carpal tunnel syndrome?

Answer 20

compression of the median nerve (which passes deep to the flexor retinaculum through Guyen’s Tunnel) due to repetitive wrist motion

Question 21

Which carpal bone is fractured most frequently?

Answer 21

scaphoid

Question 22

Where do wrist dislocations most commonly occur in carpal bones?

Answer 22

lunate

Question 23

Which artery supplies blood supply to the superficial palmar arch?

Answer 23

ulnar artery
(remember: pRofundus in Latin = deep; Radial artery = deep)

Question 24

Which tubular structure is located behind the left atrium?

Answer 24

esophagus

Question 25

Enlargement of the left atrium can cause compression of which structure?

Answer 25

esophagus

Question 26

Which portion of the heart lies in closest proximity to the sternum?

Answer 26

right ventricle

Question 27

Visualization of the mitral valve via ultrasound is best accomplish by placing the probe at what location?

Answer 27

left 5th intercostal space at the midclavicular line

Question 28

Which artery provides the majority of the blood supply to the left ventricle?

Answer 28

left anterior descending (LAD) artery

Question 29

A ventricular septal defect in the upper portion of the interventricular septum could affect which part of the heart's conduction system?

Answer 29

Bundle of His

Question 30

Insertion of a chest tube into the thoracic rib area should be placed where in proximity to the rib?

Answer 30

above the rib (vasculature and nerves run on inferior portion)

Question 31

The body of the manubrium connects to which rib number?

Answer 31

2nd rib

Question 32

Aspiration of a foreign body is most likely to enter which lobe?

Answer 32

right lower lobe

Question 33

What happens during a tension pneumothorax?

Answer 33

A defect in the chest wall leads to air becoming trapped in the lung space with each inhalation. No way for air to escape. Injured side begins to compress the healthy lung side leading to significant reduction in lung tissue.

Question 34

At which landmark does the subclavian artery become something else?

Answer 34

becomes the axillary artery at the lateral border of the 1st rib

Question 35

What structures make up the axillary sheath? Which structures lie outside?

Answer 35

inside: axillary artery, axillary vein, brachial plexus outside: axillary lymph nodes, axillary fat

Question 36

Where is the angle of Louis? What is its significance?

Answer 36

T4/T5, divides body into superior/inferior parts; location of: 2nd rib articulation, aortic arch, left recurrent laryngeal nerve, bifurcation of the pulmonary trunk/trachea

Question 37

Where is the apex of the heart? Where is the base?

Answer 37

apex at the bottom base at the top

Question 38

What is the importance of the transverse sinus?

Answer 38

During cardiac surgery, a surgeon passes a ligature through the transverse sinus to clamp the ascending aorta and pulmonary trunk

Question 39

What are the components of Beck's Triad?

Answer 39

hypotension JVD muffled heart sounds *signs of a cardiac tamponade*

Question 40

How is the mitral valve best visualized?

Answer 40

via TEE; the esophagus is located behind the heart and slightly to the L

Question 41

Where is the tip of a Swan-Ganz catheter most commonly placed?

Answer 41

right pulmonary artery

Question 42

Where does the left marginal artery originate, run, and what does it supply?

Answer 42

originates from the left circumflex, runs down the left border of the heart, supplies the LV

Question 43

What important feature does the left coronary artery supply?

Answer 43

conduction system of the heart

Question 44

Where should an incision be made to prevent injury of the LAD during surgery?

Answer 44

midline longitudinal incision of the pericardium

Question 45

The left subclavian artery marks what?

Answer 45

termination of the aortic arch, beginning of descending aorta

Question 46

During insertion of a central line, you must be certain not to cause damage to which vessel?

Answer 46

left brachiocephalic vein

Question 47

The AV bundle lies within what structure, requiring extra caution during cardiac surgery?

Answer 47

cardiac skeleton

Question 48

What is sick sinus syndrome and what is the treatment?

Answer 48

irregular HR through the SA node; treatment = pacemaker

Question 49

Interruption of the AV node-Bundle of His conduction system can result in what?

Answer 49

fatal arrhythmia (3rd degree AV block) (especially likely during cardiac surgery if the cardiac skeleton is injured)

Question 50

What is the rate of a junctional rhythm?

Answer 50

40-60bpm

Question 51

What is the intrinsic rate of the Purkinje fibers?

Answer 51

15-30bpm

Question 52

Describe what happens with noxious stimuli originating from the heart?

Answer 52

often perceived as pain arising from somewhere else (referred pain); medial UE, neck, shoulder, jaw

Question 53

Describe the difference between true, false, and floating ribs

Answer 53

-true ribs (1-7) attach directly to the anterior sternum through costal cartilage -false ribs (8-10) attach indirectly to anterior sternum via cartilages that are joined to cartilage from the superior rib -floating ribs (11-12) have no attachment to the sternum

Question 54

Thoracic wall muscles (contract/relax) during inspiration

Answer 54

contract

Question 55

Which intercostal muscles are active during inspiration?

Answer 55

external intercostals (elevate ribs, expand chest cavity)

Question 56

Which muscles are active during expiration?

Answer 56

trick question: expiration is typically passive BUT during forced expiration, the internal intercostals and innermost intercostals are active

Question 57

Intercostal spaces are numbered according to what?

Answer 57

the superior rib (there is no intercostal space below the 12th rib)

Question 58

What is the order of structures in the neurovascular bundle of the ribs?

Answer 58

from superior --> inferior (runs just inferior to each rib) vein artery nerve