Thorax Practice Examination

1. Which of the following cardiac veins empties directly into the right atrium of the heart?
  1. middle cardiac
  2. anterior cardiac
  3. small cardiac
  4. great cardiac
  5. none of the above
2. A blood clot (embolus) found in the left pulmonary artery probably came from which of the following?
  1. pulmonary veins
  2. left atrium
  3. right ventricle
  4. left brachiocephalic vein
  5. left ventricle
3. All of the following are true statements about the azygos system of veins EXCEPT that:
  1. the ascending lumbar veins enter it
  2. it communicates with the common iliac vein
  3. it frequently receives the left pulmonary vein
  4. it empties into the superior vena cava
  5. it drains the thoracic wall
4. The heart is located in which anatomical subdivision of the mediastinum?
  1. anterior
  2. middle
  3. posterior
  4. lateral
  5. superior
5. The aortic arch is located in which subdivision of the mediastinum?
  1. superior
  2. middle
  3. posterior
  4. anterior
  5. none of the above
6. Which group of structures empties directly into the right atrium?
  1. superior vena cava, coronary sinus and hemiazygos vein
  2. coronary sinus and pulmonary vein
  3. pulmonary and bronchial veins the following
  4. superior and inferior venae cavae and coronary sinus
  5. coronary sinus and azygos vein
7. The esophageal branches of the right vagus nerve in the lower thorax (just before it enters the stomach) are found mainly on:
  1. the posterior wall of the esophagus
  2. the left wall of the esophagus
  3. the right wall of the esophagus
  4. the anterior wall of the esophagus
  5. none of the above
8. The trachea bifurcates into right and left primary bronchi at the level of the:
  1. plane of the sternal angle
  2. suprasternal (or jugular) notch
  3. first rib
  4. seventh cervical vertebra
  5. xiphoid process
9. The ligamentum arteriosum is:
  1. a ligament connecting the liver to the anterior abdominal wall
  2. a fibrous remnant of a fetal channel connecting the left pulmonary artery to the aorta
  3. remnant of the embryonic umbilical artery
  4. remnant of a fetal channel connecting the right atrium to the left atrium
  5. remnant of a channel that allowed the blood to bypass the liver
10. Which of the following does NOT occur during contraction of the left ventricle of a normal heart?
  1. the pulmonary semilunar valve opens
  2. the right atrioventricular valve closes
  3. blood enters the coronary arteries
  4. the left atrioventricular valve closes
  5. the aortic semilunar valve opens
11. Increased resistance to pulmonary blood flow in the lungs would cause a direct strain on which chamber of the heart?
  1. right ventricle
  2. left atrium
  3. right atrium
  4. left ventricle
  5. none of the above
12. Which of the following accompanies the anterior interventricular artery?
  1. middle cardiac vein
  2. coronary sinus
  3. small cardiac vein
  4. great cardiac vein
  5. anterior cardiac vein
13. A layer of visceral pleura is normally present:
  1. on the mediastinal surface of the lung
  2. within the major fissure/s of the lung
  3. between all the pulmonary segments of the lung
  4. on or between both A and B
  5. within or between both B and C
14. The vagus nerve accompanies which of the following through the diaphragm?
  1. sympathetic chain
  2. inferior vena cava
  3. phrenic nerve
  4. aorta
  5. esophagus
15. During surgical repair of a patent ductus arteriosus, the surgeon must be careful not to injure the:
  1. right recurrent laryngeal nerve
  2. left phrenic nerve
  3. left recurrent laryngeal nerve
  4. left vagus
  5. right phrenic nerve
16. When considering the structures that make up the thoracic wall, which of the following is most superficial?
  1. subserous (or extrapleural) fascia
  2. internal intercostal muscle
  3. parietal pleura
  4. intercostal vessels and nerve
  5. external intercostal muscles
17. During the early stages of tuberculosis infections, the costal parietal pleura becomes inflamed and results in pain at the involved area. What nerve carries these painful sensations?
  1. phrenic nerve
  2. vagus nerve
  3. recurrent laryngeal nerve
  4. intercostal nerve
  5. splanchnic nerve
18. On the diagram, identify the structure labeled A.
visceral pleura
19. When you inhale, the diaphragm:
  1. does not move
  2. moves upward
  3. moves downward
  4. relaxes
  5. does none of the above
20. The left lung is made up of how many lobes?
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
21. The bifurcation of the trachea lies at about the level of the:
  1. plane of the sternal angle
  2. xiphisternal junction
  3. second thoracic vertebra
  4. attachment of the 4th costal cartilage to the sternum
  5. plane of the jugular notch
22. Which structure below leaves the most pronounced impression on the right lung of the cadaver?
  1. right vagus nerve
  2. azygos vein
  3. right phrenic nerve
  4. thoracic aorta
  5. right common carotid artery
For questions 23 - 30, select the lettered item that best matches with the numbered structure. A letter may be used more than once.
23. mitral valveC

24. musculi pectinatiA

25. carinaE

26. moderator band or (septomarginal band)B

27. crista terminalisA

28. tricuspid valveB

29. infundibulum (or conus arteriosus)B 30. fossa ovalisA
  1. right atrium
  2. right ventricle
  3. left ventricle
  4. pericardial cavity
  5. trachea
31. The sinuatrial node is located in the:
  1. right atrial wall
  2. left atrial wall
  3. right ventricular wall
  4. left ventricular wall
  5. interventricular septum
32. Which vein accompanies the posterior interventricular coronary artery?
  1. great cardiac
  2. marginal
  3. middle cardiac
  4. small cardiac
  5. coronary sinus
33. Overdistension of the valves of the atrioventricular orifices of the heart is prevented by the papillary muscles and the:
  1. crista terminalis
  2. ligamentum teres
  3. chordae tendineae
  4. trabeculae carneae
  5. ligamentum venosum
34. The apex of the heart is formed by the:
  1. left atrium
  2. left ventricle
  3. right atrium
  4. right ventricle
  5. both left and right ventricles
35. During diastole, the aortic valve:
  1. prevents reflux of blood into the right ventricle
  2. prevents reflux of blood into the right atrium
  3. prevents reflux of blood into the left atrium
  4. prevents reflux of blood into the left ventricle
  5. the pulmonary artery
36. The pacemaker of the heart is the:
  1. AV node
  2. bundle of His
  3. purkinje system
  4. SA node
37. Which of the following structures lies between the azygos vein and the thoracic aorta in the posterior mediastinum of the thorax?
  1. hemiazygos vein
  2. left posterior superior intercostal vein
  3. pericardiacophrenic artery
  4. thoracic duct
  5. right superior intercostal vein
38. The azygos vein drains into the:
  1. superior vena cava
  2. inferior vena cava
  3. right atrium
  4. left brachiocephalic vein
  5. right brachiocephalic vein
39. Which of the following structures is NOT found in the posterior mediastinum?
  1. esophagus
  2. aortic arch
  3. azygos vein
  4. hemiazygos vein
  5. splanchnic nerves
40. The anterior boundary of the posterior mediastinum is the:
  1. manubrium
  2. sternal angle
  3. body of the sternum
  4. pericardium on anterior aspect of the heart
  5. pericardium on posterior aspect of the heart
41. Which of the following structures is found in both the superior and the posterior mediastinum?
  1. internal thoracic artery
  2. thoracic duct
  3. thymus
  4. aortic arch
  5. pericardiacophrenic artery
Match the following numbered items with the mediastinal region in which they are found.
42. thymus A, B

43. right brachiocephalic vein A

44. esophagus A, D

45. left vagus nerve A, D

46. arch of the azygos vein A

47. trachea A

48. heart C

49. right recurrent laryngeal nerve E

  1. superior mediastinum
  2. anterior mediastinum
  3. middle mediastinum
  4. posterior mediastinum
  5. not found in the mediastinum
50. Identify the part of the heart marked with an "X". left ventricle
51. The upper right border of the mediastinal shadow as seen on the P-A chest radiograph represents the:
  1. apex of the heart
  2. pulmonary artery
  3. right auricle
  4. right ventricle
  5. superior vena cava
52. The thoracic duct usually drains into the:
  1. left internal jugular vein
  2. left subclavian vein
  3. junction of the left internal jugular and subclavian veins
  4. superior vena
  5. junction of the right internal jugular and subclavian veins
53. The lymph nodes found in the hilum of the lung are the:
  1. pulmonary lymph nodes
  2. bronchopulmonary lymph nodes
  3. tracheobronchial lymph nodes
  4. bronchomediastinal lymph nodes
  5. anterior mediastinal lymph nodes
54. When air is allowed into the pleural cavity, either from a stab wound or a blown out alveolus of the lung, the lung will collapse because of:
  1. the action of the muscles of expiration
  2. the elasticity of the visceral pleura
  3. the elasticity of the lung parenchyma
  4. expansion of the rib cage
  5. paralysis of the muscles of inspiration
55. Contraction of the diaphragm causes an increase in the thoracic volume by increasing primarily which of the diameters of the rib cage?
  1. lateral
  2. anteroposterior
  3. superior-inferior
  4. any two diameters to the same extent
  5. all three diameters to the same extent
56. When foreign objects are aspirated into the trachea, they will usually pass into the right primary bronchus because:
  1. it is larger, straighter and shorter than the left
  2. it is more curved, longer and smaller than the left
  3. it is straighter, longer and larger than the left
  4. it is at a 90 degree angle to the trachea
  5. there really is a good reason
57. The pacemaker for the heart is ordinarily the:
  1. sinoatrial node
  2. atrioventricular node
  3. atrioventricular bundle (of His)
  4. subendocardial plexus
  5. membranous interventricular septum
58. Regarding the diaphragm, which of the following it NOT true?
  1. both diaphragms are usually depressed in emphysema
  2. the posterior attachment is inferior to the anterior attachment
  3. the lateral attachment is inferior to the posterior attachment
  4. in dextrocardia, the right diaphragm is inferior to the left
  5. the left diaphragm is usually inferior to the right

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