thorax test questions

8/12/2019 Thorax Test Questions

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Thorax Test Questions

College of Medicine

Gross Anatomy

These Questions have come from the old tests available in the Center For Academic

Excellence. Please note that all of the uestions have not been chec!ed" and theans#ers may be #rong.


2/21

$. A ta%e %assed through the transverse %ericardial sinus #ould lie behind the

A. ascending aorta alone

&. ascending aorta and su%erior vena cavaC. ascending aorta and %ulmonary trun!

'. su%erior vena cava alone

E. su%erior vena and ( %ulmonary veins

). The mediastinum

A. is se%arated into su%erior and inferior %ortions of the sternal angle&. ends inferiorly at the level of the tracheal bifurcation

C. lies anterior to T) to T$*" but not T$" T$$" or T$)

'. does not contain the thoracic duct

E. does not contain the %hrenic nerves

+. ,n the su%erior mediastinum-

A. the brachioce%halic vein lies %osterior to the arteries #hich originate from

the arch of the aorta&. the trachea lies %osterior to the eso%hagus

C. the eso%hagus lies to the right of the arch of the aorta'. the left recurrent laryngeal nerve loo%s around the subclavian artery

E. the thoracic duct lies along the right border of the eso%hagus

(. The mediastinum is bounded laterally by the

A. %arietal layer of serous %ericardium

&. fibrous %ericardium

C. mediastinal %ortions of the right and left %leural sacs'. costal %arts of right and left %leural sacs

E. right and left lungs

. This nerve lies on the lateral side of the su%erior vena cava before %assing anterior

to the root of the lung

A. right vagus&. right %hrenic

C. left %hrenic

'. left vagus

/. ,n a CT scan of the thorax at the level of the right %ulmonary artery" #hat

structure0s1 lie0s1 directly anterior to this artery2

A. su%erior vena cava&. ascending aorta

C. right main bronchus

'. both A and &E. A" & and C

3. 4isceral %ericardium coats each of the follo#ing E5CEPT -

A. %ulmonary trun!


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&. aortic arch

C. lo#er %art of the su%erior vena cava

'. %art of the inferior vena cavaE. right coronary artery

6. 7hich structure lies anterior to the transverse %ericardial sinus2A. su%erior vena cava

&. descending aorta

C. right %ulmonary artery'. %ulmonary trun!

E. right coronary artery

8. The fibrous %ericardium is-A. fused #ith the central tendon of the dia%hragm

&. synonymous #ith the e%icardium

C. both A and &

'. neither A nor &

$*. ,n a normal heart" the left ventricular myocardium is thic!er than the rightventricular myocardium" reflecting the fact that-

A. the left ventricle %um%s more blood than the right ventricle

&. systemic arterial resistance is normally greater than %ulmonary arterialresistance

C. the left ventricle %um%s against gravity #hereas the right ventricle does

not

'. the right ventricle contains oxygenated blood #hereas the left ventriclecontains unoxygenated blood

E. all of the above

$$. The %osterior broncho%ulmonary segment of the su%erior lobe of the right lung is

immediately su%erior and anterior to this broncho%ulmonary segment-

A. su%erior of the inferior lobe&. medial of the middle lobe

C. lateral of the middle lobe

'. su%erior of the middle lobe

E. %osterior of the middle lobe

$). 9u%%ose that the eso%hageal cancer is at the level of bifurcation. 7hich %rimary

bronchus #ould you ex%ect to become directly involved most freuently and#hy2

A. right bronchus" because eso%hagus %asses directly %osterior to it

&. left bronchus" because eso%hagus %asses directly %osterior to itC. right bronchus" because eso%hagus %asses directly anterior to it

'. left bronchus" because eso%hagus %asses directly anterior to it

E. neither bronchus #ould be more freuently involved because the

eso%hagus is not more closely related to one than the other


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$+. The usual number of tertiary bronchi in the right lung is-

A. )&. +

C. 6

'. $*E. )*

$(. 9mall foreign bodies that enter the trachea #ill usually enter the-A. u%%er lobar bronchus of left lung

&. lo#er lobar bronchus of left lung

C. u%%er lobar bronchus of right lung

'. e%arterial bronchus of right lungE. middle or lo#er lobar bronchus of right lung

$. The inferior border of the %arietal %leura" at a %oint ad:acent to the vertebralcolumn" is at a level of #hich rib2

A. (thrib&. /thrib

C. 6thrib

'. $*thribE. $)thrib

$/. The transverse 0hori;ontal1 fissure of the lung can be indicated on the anterior

surface of the thorax by a line that follo#s the-A. second costal cartilage

&. fourth costal cartilage

C. sixth costal cartilage'. eighth costal cartilage

E. medial border of the sca%ula #ith the arm abducted

$3. The most su%erior structure in the root of the left lung is the left-

A. e%arterial bronchus

&. %ulmonary ligament

C. %ulmonary artery'. %ulmonary vein

E. main bronchus

$6. &ecause of their close relationshi%" an invasive tumor in #hich area of the right

lung #ould most li!ely endanger the right recurrent laryngeal nerve2

A. a%ex&. mediastinal surface

C. costal surface

'. dia%hragmatic surface

E. area around the root of the lung


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$8. The vertical extent of the mediastinum is from the dia%hragm inferiorly to the

level of the


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'. %rovides a branch to the sino>atrial node

E. all of the above

). The inter>atrial se%tum-

A. usually exhibits a %atent foramen ovale

&. is the site or origin of the moderator bandC. closes only after birth

'. is attached to coronary valves via chordae tendineae

E. does not contain conduction fibers

)/. 9erous %ericardium-

A. has t#o layers" visceral and %arietal

&. #hen attached to fibrous %ericardium is %arietal %ericardiumC. lining the outside of the heart is e%icardium

'. surrounds the roots of the ascending aorta and %ulmonary trun!

E. all of the above

)3. The obliue %ericardial sinus-

A. is a s%ace lying bet#een the arterial and venous %ericardial reflections&. contains a thin layer of serous fluid

C. is found bet#een t#o layers of %arietal %ericardium

'. lies anterior to the heartE. all of the above

)6. ,n cross sections through the su%erior mediastinum" you usually see the right

%hrenic nerve located directly lateral to the-A. trachea

&. eso%hagus

C. brachioce%halic trun!'. right subclavian

E. su%erior vena cava

)8. 7hich of the follo#ing lies directly inferior to the last tracheal ring 0in the crotch

of the tracheal bifurcation12

A. arch of the a;ygos vein

&. su%erior vena cavaC. left %ulmonary artery

'. lym%h nodes

E. left recurrent laryngeal nerves

+*. ,n a cross section of the thorax at a level one centimeter su%erior fo the aorticarch" the brachioce%halic trun! usually lies directly anterior to the-

A. eso%hagus

&. trachea

C. right brachioce%halic vein


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'. su%erior vena cava

E. right %ulmonary artery

+$. ,n a CT scan of the thorax at the level of the aortic semilunar valve" this valve lies

directly anterior to the-

A. right atrium&. left atrium

C. right ventricle

'. eso%hagusE. descending aorta

+). The central tendon of the dia%hragm lies at 0about1 this vertebral level-

A. T)&. T(

C. T/

'. T6

E. T$*

++. The vagal trun! %asses through the


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+3. The carina lies -

A. #ithin the transverse sinus of the %ericardium

&. in relation to the right side of the interventricular se%tumC. #ithin the lingular division of the right and left main bronchi

'. bet#een the entrances of the right and left main bronchi

E. #ithin the obliue sinus of the %ericardium

+6. True statements concerning the usual vertebral levels of the + ma:or hiatuses in

the dia%hragm include-A. the caval hiatus is at T6

&. the aortic hiatus is at T$)

C. the eso%hageal hiatus is at T$*

'. all the aboveE. both 0only1 & and C

+8. Posterior intercostal arteries-

A. can be found :ust su%erior to the costal groove&. run dee% to the subcostal muscles

C. travel inferior to their corres%onding segmental vein in the lateral thorax'. arise from the internal thoracic artery

E. none of the above

(*. The thoracic duct-

A. drains the right side of the thorax

&. carries lym%h to the cisterna chyli

C. crosses the midline at about the level of the sternal angle'. lies :ust lateral and %osterior to the a;ygous vein

E. em%ties its lym%h into the right subclavian artery

($. 9ensory innervation from the central %art of the dia%hragmatic %leura is %rovided

by the

A. %hrenic nerves&. vagus nerves

C. lo#er intercostal nerves

'. greater s%lanchnic nerves

E. none of the above

(). @ne is most li!ely to damage an intercostal nerve or vessel #hen inserting a

needle through an intercostal s%ace as follo#s-A. :ust above a rib

&. :ust belo# a rib

C. half#ay bet#een ad:acent ribs

(+. The thoracic duct-

A. %asses through the aortic o%ening of the dia%hragm

&. has valves


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C. %asses from right to left %osterior to the eso%hagus in the %osterior

mediastinum

'. all the aboveE. only A and C

((. The connecting %leura bet#een the visceral %leura and mediastinal %leura has ade%endent fold called the-

A. %ulmonary ligament

&. median arcuate ligamentC. sus%ensory ligament

'. a%ical ligament

E. hilar ligament

(. These structures of the su%erior mediastinum lie %osterior to the %lane of the

trachea-

A. eso%hagus

&. right recurrent laryngeal nerveC. left brachioce%halic vein

'. all the aboveE. only A and &

(/. The right main bronchus is shorter" #ider and has its long axis more verticallyoriented than the left main bronchus-

A. true

&. false

(3. The anatomical" functional and surgical units of the lung are the-

A. #hole lung

&. lobesC. broncho%ulmonary segments

'. alveolar sacs

E. alveoli(6. This broncho%ulmonary segment of the right lung is in the middle lobe-

A. anterior basal

&. su%erior

C. anterior'. %osterior

E. medial

(8. The e%icardium-A. lines the heart chambers

&. is tough and fibrous

C. is the visceral layer of the serous %ericardium'. all the above

E. only & and C


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*. ,f you %laced your fingers bet#een the e%icardium of left atrium and the %osterior

%arietal serous %ericardium of the %ericardial sac belo# the venous mesocardium"

your fingers #ould be in this s%ace-A. obliue sinus

&. transverse sinus

C. sinus venarum'. sinus venosus

E. %osterior mediastinum

$. ThisThese %arts of the conducting system of the heart isare found totally or

%artially in the atrial #alls-

A. sino>atrial node

&. atrioventricular nodeC. atrioventricular bundle

'. all the above

E. only A and &

). 7hen naming the cus%s of the %ulmonary semilunar valves according to their

develo%ment #e have a right" left and


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/. The sternal angle-

A. is at the same level as the intervertebral disc bet#een the T( and T

vertebrae&. is at the level #here the aortic arch begins and ends

C. is at the level #here the hemia;ygos vein usually :oins the a;ygos vein

'. all the above are correctE. only A and & are correct

3. The a%ex of the lung-A. lies in the su%erior mediastinum

&. continues above the level of the medial end of the clavicle

C. is innervated by the %hrenic nerve

'. lies anterior to the %hrenic nerveE. lac!s a covering of visceral %leura because it is outside the thoracic cavity

6. The lateral arcuate ligament of the res%iratory dia%hragm-

A. lies anterior to the uadratus lumborum&. is a thic!ening of the transversalis fascia layer

C. extends from the transverse %rocess of =$ to the $)thrib'. all the above

E. only A and &

8. The right dome of the dia%hragm is slightly higher than the left dome" but the t#o

domes usually rise this high during res%iration. 0Bse the midclavicular line as a

reference1

A. +rdrib&. thrib

C. 3thrib

'. 8thribE. $)thrib

/*. The motor su%%ly to the voluntary muscle of the res%iratory dia%hragm is by-A. the %hrenic nerve

&. the lo#er intercostal nerves

C. the vagus nerve

'. all the aboveE. only A and &

/$. The su%erior mediastinum is se%arated from the inferior mediastinum by ahori;ontal line that #ould %ass through the -

A. sternal angle

&. )ndcostal cartilageC. disc bet#een T(>T vertebrae

'. all the above

E. only A and C


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/). ,f a %atient has a flail chest" the flail segment is %ushed out during ins%iration-

A. True

&. False

/+. This structure forms the right border of the heart-

A. right atrium&. left atrium

C. right ventricle

'. left ventricleE. %ulmonary trun!

/(. All thoracic vertebrae have this characteristic-

A. long bifid s%ines &. a !idney bean>sha%ed body

C. costal facets on their bodies

'. costal facets on their transverse %rocesses

E. su%erior articular %rocesses that face medial#ard

/. ,n the midaxillary line the intercostal nerves and blood vessels lie bet#een thesead:acent layers-

A. %arietal %leura>endothoracic fascia

&. endothoracic fascia>transversus thoracis layerC. transversus thoracis layer>internal intercostal layer

'. internal intercostal layer>external intercostal layer

E. external intercostal membrane> internal intercostal membrane

//. The endothoracic fascia forms the-

A. su%ra%leural membrane

&. anterior intercostal membraneC. %osterior intercostal membrane

'. central tendon of the dia%hragm

E. fibrous %ericardium

/3. The %osterior intercostal arteries that arise from the descending thoracic aorta

consist of


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C. The cardiac notch of the %leura does not extend as far to the left as does the

cardiac notch of the lung

'. All the aboveE. @nly & and C are correct

/8. The most laterally %ro:ecting %art of the heart is usually the-A. a%ex

&. base

C. right atrium'. left atrium

E. right ventricle

3*. The %osition of the hori;ontal fissure of the lung 0midins%iration1 is indicated bythis right costal cartilage-

A. )nd

&. (th

C. /

th

'. 6th

E. $*th

3$. The lo#est margin of the %osterior %arietal %leura is usually slightly belo# the nec!

of this rib-A. $)

&. $$

C. $*

'. 3E. 6

3). This structure is not found in the su%erior mediastinum-A. %hrenic nerve

&. vagus nerve

C. thoracic duct'. beginning of brachioce%halic artery

E. greater s%lanchnic nerve

3+. ,f a %erson received a shallo# stab #ould in the anterior %art of the right fifthintercostals s%ace about one>half inch lateral to the sternum" the structure most li!ely to

be damaged is the-

A. right brachioce%halic vein

&. su%erior vena cava

C. thoracic duct'. beginning of the brachioce%halic artery

E. internal thoracic artery


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3(. Posterolaterally the structure that is most su%eriorly situated in the costal groove

is the-

A. %osterior intercostal artery&. %osterior intercostal nerve

C. %osterior intercostal vein

3. The %osterior intercostal veins drain directly into thisthese veins-

A. brachioce%halic

&. a;ygosC. left and right su%erior intercostals

'. hemia;ygos and accessory hemia;ygos

E. all the above

3/. True statements concerning the trachea include-

A. cancer of the trachea near its bifurcation could %araly;e the muscles

of the left side of the larynx" but not the right side

&. the trachea descends during dee% ins%irationC. the Dtracheal tug sign is usually indicative of an aneurysm of the

aortic arch'. all the above

E. both 0only1 A and &

33. The bundle of is contains

A. %arasym%athetic nerve fibers

&. sym%athetic nerve fibers

C. conducting 0Pur!in:e1 fibers'. all the above

E. only A and & above

36. This ligament lies directly anterior to the vertebral canal-

A. ligamentum flavum

&. anterior longitudinal ligamentC. %osterior longitudinal ligament

'. su%ras%inous ligament

E. ligamentum nuchae

38. The follo#ing normal curvatures of the vertebral column are %resent at birth and

in the adult-

A. scoliosis to the right in the u%%er thoracic region in right handedindividuals

&. %osterior concavity in the cervical region

C. lordosis in the lumbar region'. %osterior convexity in the thoracic region

E. %osterior concavity in the lumbar region

6*. The s%inal cord in the adult usually ends at the level of the-


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A. first coccygeal vertebra

&. second sacral vertebra

C. fourth lumbar vertebra'. first lumbar vertebra

E. tenth thoracic vertebra

6$. The anterior edge of the left %arietal %leura %asses obliuely lateral#ard and

do#n#ard from the midline at the level of this costal cartilage to form the cardiac notch-

A. $&. )

C. +

'. (

E.

6). The large o%ening in the central tendon of the dia%hragm transmits the-

A. inferior vena cava

&. eso%hagusC. aorta

'. greater s%lanchnic nerveE. thoracic duct

6+. ,f a %atient has a s%ontaneous %neumothorax on the right side-A. he #ill have a %aradoxical movement of the chest #all on the right

&. his right lung #ould be fully ex%anded because of the loss of the vacuum

effect

C. the mediastinum #ould be shifted to the left'. the lung #ill com%ress the right recurrent laryngeal nerve

E. the right side of his dia%hragm #ill be %araly;ed

6(. 7hen draining fluid from the %leural cavity" the needle should %ass through the

thoracic #all-

A. :ust belo# a rib&. :ust above a rib

C. about half#ay bet#een ad:acent ribs

'. through the %eriosteum and rib to avoid the neurovascular bundle

E. into the anterior mediastinum before entering the %leural cavity

6. The eso%hagus-

A. is about $/ inches long&. %asses through the left crus of the dia%hragm

C. %asses through the the left dome of the dia%hragm

'. is com%ressed by the left main bronchus at the T vertebral levelE. is %ushed to the left by the arch of the aorta in the su%erior mediastinum at the level

of the body of the T+ vertebra

6/. The a;ygos vein usually does not receive blood from these intercostal s%aces-


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A. )>( on the right side

&. )>( on the left side

C. >$$ on the right side'. >6 on the left side via a 0su%erior1 hemia;ygos vein

E. 8>$$ on the left side via a 0inferior1 hemia;ygos vein

63. The lym%h drainage from the lo#er third of the eso%hagus goes first to these nodes-

A. lumbar %ara>aortic

&. bronchomediastinal nodesC. subcarinal nodes

'. %osterior mediastinal nodes

E. left gastric nodes

66. The most im%ortant largest su%%lier of blood to the intercostal s%aces is the-

A. %osterior intercostal artery

&. anterior intercostal artery

C. &oth A and &'. one of the above

68. The %osterior intercostal artery su%%lying the seventh intercostals s%ace arises from

the-

A. thoracic aorta&. internal thoracic artery

C. anterior intercostal artery

'. none of the above

8*. The %hrenic nerve lies


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C. The right %ulmonary artery %asses %osterior to the su%erior vena cava and the

ascending aorta.

'. They enter the hilum of the lung inferior to the %ulmonary veins.E. They lie directly anterior to the lo#er %art of the trachea.

8+. The thoracic duct lies :ust to the right of this structure in the lo#er %art of the thorax-A. descending aorta

&. a;ygos vein

C. %hrenic nerve'. trachea

E. eso%hagus

8(. The follo#ing structures %ass anterior to the trachea in the su%erior mediastinum-A. brachioce%halic artery

&. left common carotid artery

C. right common carotid artery

'. all the aboveE. both A and & but not C

8. Each broncho%ulmonary segment-

A. contains a segmental artery

&. contains a tertiary bronchusC. contains a segmental vein

'. all of the above

E. both A and & but not C

8/. The a%ical broncho%ulmonary segment of the right u%%er lobe is ad:acent to the

%osterior segment of the right u%%er lobe.

A. True&. False

83. The motor nerve su%%ly to the %eri%heral %arts of the dia%hragm is by #ay of the -A. lo#er intercostal nerves

&. subcostal nerve

C. iliohy%ogastric nerve

'. vagus nerveE. %hrenic nerve

86. The internal thoracic artery-A. lies bet#een the transverse thoracic and internal intercostal layers in the u%%er

intercostal s%aces

&. lies about a half inch lateral to the sternumC. gives rise to a branch that su%%lies the %ericardium

'. all the above

E. both A and & but not C


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88. The %hrenic nerve %asses-

A. anterior to the subclavian artery

&. %osterior to the internal thoracic arteryC. anterior to the root of the lung

'. through the middle mediastinum

E. all of the above

$**. The serous %ericardium-

A. attaches to fibrous %ericardium as %art of the %arietal %ericardium&. has t#o layers- visceral and %arietal

C. lines the heart as %art of the e%icardium

'. surrounds the roots of the great vessels

E. all of the above

$*$. The su%ra%leural membrane is formed by-

A. external intercostal membrane

&. internal intercostal membraneC. %retracheal layer of cervical fascia

'. %arietal %leuraE. endothoracic fascia

$*). The thymus gland-A. is a lym%hatic organ

&. is normally found in the su%erior mediastinum

C. descends from the cervical region into the thorax during embryonic develo%ment

'. may extend into the anterior mediastinumE. all of the above

$*+. The inferior angle of the sca%ula lies at the level of the s%ine of this vertebra-A. T$

&. T+

C. T'. T3

E. T8

$*(. ,n the midaxillary line the s%ace bet#een the eighth and tenth ribs corres%onds tothe-

A. costodia%hragmatic recess

&. costomediastinal recessHanteriorC. costomediastinal recessH%osterior

'. dome of the right %art of the dia%hragm

E. location of the lo#er segment of the lingual


19/21

$*. A !nife #ound that %ierces the anterior chest #all about one>half inch lateral to the

sternum but does not enter the heart or lung #ould be most li!ely to damage this

structure-A. thoracic duct

&. su%erior vena cava

C. %hrenic nerve'. vagus nerve

E. internal thoracic artery

$*/. A %atient that has erosion of the lo#er borders of the ribs #ould be a good candidate

for having this %roblem-

A. em%hysema

&. he%atitisC. bloc!age of the inferior vena cava as it enters the heart

'. bloc!age of the thoracic duct

E. narro#ing 0coarctation1 of the %osterior %art of the aortic arch

$*3. The sensory innervation to the %eri%heral %ortions of the dia%hragm is by #ay of-

A. lo#er intercostal nerves&. %hrenic nerve

C. vagus nerve

'. greater s%lanchnic nerveE. lesser and lo#est s%lanchnic nerves

$*6. 7hich of these structures #ould lie in the connective tissue bet#een ad:acent

broncho%ulmonary segments-A. segmental arteries

&. segmental bronchi

C. segmental veins'. segmental lym%h vessels

E. segmental autonomic nerves

$*8. The %osition of the hori;ontal fissure of the lung 0at midins%iration1is indicated by

this right costal cartilage-

A. )nd

&. (th

C. /th

'. 6th

E. $*th

$$*. The lo#est margin of the %osterior %arietal %leura is usually slightly belo# the nec!

of this rib-A. $)

&. $$

C. $*

'. 3


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E. 6

$$$. The sternal angle-

A. is at the same level as the intervertebral disc bet#een the T( nad T vertebrae

&. is at the level #here the aortic arch begins and endsC. is at the level #here the hemia;ygous vein usually :oins the a;ygos vein

'. all the above are correct

E. only A and & are correct

$$). The a%ex of the lung-

A. lies in the su%erior mediastinum

&. continues above the level of the medial end of the clavicleC. is innervated by the %hrenic nerve

'. lies anterior to the %hrenic nerve

E. lac!s a covering of visceral %leura because it is outside the thoracic cavity

$$+. The %ortion of the conducting system of the heart that lies in the atrial se%tum :ust

above the o%ening for the coronary sinus is the-A. sino>atrial node

&. atrioventricular node

C. left bundle branch'. right bundle branch

E. moderator band

$$(. The branch of the aortic arch that arises most %osteriorly is the-A. brachioce%halic artery

&. right common carotid artery

C. left common carotid artery'. left subclavian artery

$$. ,n the u%%er %ortion of the su%erior mediastinum the structure that lies %osterior and

to the left of the eso%hagus is the-

A. thoracic duct

&. a;ygos veinC. su%erior vena cava

'. left brachioce%halic vein

E. left recurrent laryngeal nerve


21/21

Thorax Question Ans#ers-

1 C 41 A 81 D

2 A 42 B 82 A

3 E 43 D 83 C

4 C 44 A 84 B

5 B 45 A 85 A

6 D 46 A 86 B

7 B 47 C 87 E

8 D 48 E 88 A

9 A 49 C 89 A

10 B 50 A 90 A

11 A 51 D 91 C

12 A 52 A 92 C

13 D 53 D 93 E

14 E 54 B 94 E

15 E 55 E 95 E

16 B 56 E 96 A

17 C 57 B 97 E

18 A 58 D 98 D

19 C 59 B 99 E

20 A 60 A 100 E

21 A 61 D 101 E

22 B 62 B 102 E

23 E 63 A 103 D

24 A 64 C 104 A

25 C 65 C 105 E

26 E 66 A 106 E

27 B 67 D 107 A

28 E 68 C 108 C

29 D 69 A 109 B

30 B 70 B 110 A

31 B 71 A 111 E

32 D 72 E 112 B

33 C 73 E 113 B

34 E 74 C 114 D

35 A 75 E 115 A

36 A 76 D

37 D 77 C

38 D 78 C

39 C 79 D

40 C 80 D

thorax test questions

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