Anatomy - Practical 07 : Anatomy of the airways and lungs

Question 1

how many rib levels does the inferior line of reflection of the pleural sac extend beyond the lung itself?

a. 1
b. 2
c. 3
d. 4

Answer 1

b.2

Question 2

what method is undertaken to inspect the pleural cavity?

a. thoracocentesis
b. thoracostomy
c. thoracoscopy

Answer 2

c.thoracoscopy

Question 3

which layers may deposit fibrin adhering the visceral and parietal layers together if damaged?

a.fibrous pericardium
b/serous pericardium
c.myocardium
d.endocardium

Answer 3

b/serous pericardium

mesothelium

Question 4

fibrin secreted by injured/inflammed mesothelium forms..

a. clots in the pleural cavity
b. adhesions in the pleural cavity
c. inflammation of the serous pericardium

Answer 4

b.adhesions in the pleural cavity

Question 5

true or false sometimes adhesions are caused on purpose (pleurodesis) using chemical/mechanical irritation to prevent recurring lung collapse

a. true
b. false

Answer 5

a.true

Question 6

what is pleurodesis?

a. chemical/mechanical irritation done in order to separate the visceral and parietal layer
b. chemical/mechanical irritation done in order to prevent separartion of the visceral and parietal layer

Answer 6

b.chemical/mechanical irritation done in order to prevent separartion of the visceral and parietal layer

Question 7

what is assessed through lung auscultation?

a. airflow through the trachea
b. airflow through the bronchus and bronchioles
c. airflow through the trachiobronchial tree

Answer 7

c.airflow through the trachiobronchial tree

Question 8

where is the superior lobe of the lungs listened to?

a. 2nd ICS
b. 4th ICS
c. 6-7th ICS

Answer 8

a.2nd ICS

c7 vertebrae palpable and count down from there //sternal angle at level of 2nd cc

Question 9

where is the middle lobe auscultated?

a. 2nd ICS
b. 4th ICS
c. 6-7th ICS

Answer 9

b.4th ICS

nipple is in 4th ICS

Question 10

where is the inferior lobe auscultated?

a. 2nd ICS
b. 4th ICS
c. 6-7th ICS

Answer 10

c. 6-7th ICS

Question 11

quiet lung sounds indicate..

a. pleural effusion/pneumothorax
b. consolidation
c. asthma/obstruction by foreign body
d. copd/pneumonia
e. pleural rub

Answer 11

a.pleural effusion/pneumothorax

reduced air entry

Question 12

what do harsh bronchial sounds indicate?

a. pneumothorax/pleural effusion
b. consolidation
c. obstruction by foreign body/asthma
d. copd/pneumonia
e. pleural rub

Answer 12

b.consolidation

Question 13

what does a wheeze indicate?

a. pneumothorax/pleural effusion
b. consolidation
c. obstruction by foreign body/asthma
d. copd/pneumonia
e. pleural rub

Answer 13

c.obstruction by foreign body/asthma

Question 14

what do crackles indicate ?

a. pneumothorax/pleural effusion
b. consolidation
c. obstruction by foreign body/asthma
d. copd/pneumonia
e. pleural rub

Answer 14

d.copd/pneumonia

popping sound due to sudden opening of a collapsed airway

Question 15

what does a pleural rub sound (creaky/walking on snow) indicate ?

a. pneumothorax/pleural effusion
b. consolidation
c. obstruction by foreign body/asthma
d. copd/pneumonia
e. inflammed pleura

Answer 15

e.inflammed pleura

Question 16

which of these structures makes up the inferior border of the triangle of auscultation?

a. medial border of scapula
b. trapezius
c. latissimus dorsi

Answer 16

c.latissimus dorsi

Question 17

which of these structures makes up the medial border of the triangle of auscultation?

a. medial border of scapula
b. trapezius
c. latissimus dorsi

Answer 17

b.trapezius

Question 18

which of these structures makes up the lateral border of the triangle of auscultation?

a. medial border of scapula
b. trapezius
c. latissimus dorsi

Answer 18

a.medial border of scapula

Question 19

what position exposes the triangle of ascultation best?

a. 45 degrees
b. crossing arms over chest and bending forward
c. straight arms and bending forward
d. standing up

Answer 19

b.crossing arms over chest and bending forward

Question 20

resonant lung percussion indicates…

a. tissue density
b. underlying air
c. solid

Answer 20

b.underlying air

Question 21

dull lung percussion indicates…

a. tissue density
b. underlying air
c. solid

Answer 21

a.tissue density

organs/fluid filled/tumout

Question 22

hyperesonant lung percussion indicates…

a. underlying air
b. tumour
c. fluid filled area
d. pneumothorax
e. solid

Answer 22

d.pneumothorax

Question 23

flat lung percussion indicates..

a. solid
b. underlying air
c. fluid filled area
d. underlying bone

Answer 23

d.underlying bone

Question 24

which pleura layer is insensitive to pain?

a. visceral
b. costal parietal
c. mediastinal and diaphragmatic parietal

Answer 24

a.visceral

contains autonomic nerves detecting stretch only

Question 25

what nerve innervates the costal parietal pleura? a. intercostal/subcostal b. autonomic c. phrenic

Answer 25

a.intercostal/subcostal

Question 26

what nerve innervates the mediastinal/diaphragmatic parietal pleura? a. intercostal/subcostal b. autonomic c. phrenic

Answer 26

c.phrenic

Question 27

what type of nerves are the intercostal, subcostal and phrenic meaning pain is well localised and sharp? a. parasympathetic b. autonomic c. sympathetic d. somatic

Answer 27

d.somatic

Question 28

pain from the parietal pleura can refer to the corresponding dermatomes of which nerve? a. phrenic b. intercostal c. subcostal

Answer 28

a.phrenic

Question 29

which dermatomes correspond to the phrenic nerve allowing for referred pain from the parietal pleura? a.c3,c4,c5 b,c4,c5 d.c2,c3,c4

Answer 29

a.c3,c4,c5 especially 4

Question 30

which of these are the correct set of characteristics for pleuritic pain a. sharp pain,exacerbated by deep breathing/stretching/coughing b. dull pain worsened by lying down c. tight pain referred to the neck and arm

Answer 30

a.sharp pain,exacerbated by deep breathing/stretching/coughing

Question 31

inflammation/injury of what causes pleuritic pain? a. mediastinum b. lungs c. pleura d. parietal pleura e. visceral pleura

Answer 31

d.parietal pleura

Question 32

lung carcinoma, pleuritis pneumonia, pneumothorax, mesothelioma, pulmonary embolism, pericarditis, rib fracture, gall bladder inflammation may all cause.. a.adhesions c,pleuritic pain d.wheeze

Answer 32

c,pleuritic pain

Question 33

which of these does not have an impression on the left lung? a. aorta b. heart c. azygous vein

Answer 33

c.azygous vein

Question 34

which of these is not seen as an impression on the right lung? a. heart b. oesophagus c. svc d. ivc e. azygous vein

Answer 34

e.azygous vein

Question 35

an extra azygous vein on the right leaves a ......... groove in the lung a. shallow b. deep

Answer 35

b.deep

Question 36

what plexus do the visceral pleura and lung parenchyma drain to? a,superficial lymphatic plexus b.deep lymphatic plexus

Answer 36

a,superficial lymphatic plexus

Question 37

what plexus do the bronchi submucosa and peribronchial CT drain to? a,superficial lymphatic plexus b.deep lymphatic plexus

Answer 37

b.deep lymphatic plexus

Question 38

what does the deep lymphatic plexus drain to before the hilar nodes a. paratracheal nodes n. tracheobronchial nodes c. pulmonary nodes

Answer 38

c.pulmonary nodes

Question 39

what do the superficial lymphatic plexus and pulmonary nodes drain to? a. hilar nodes b. tracheobronchial nodes c. paratracheal nodes d. bronchomediastinal lymph trunks

Answer 39

a.hilar nodes

Question 40

what do the hilar nodes drain to? a. pulmonary nodes b. tracheobronchial nodes c. paratracheal nodes d. bronchomediastinal nodes

Answer 40

b.tracheobronchial nodes

Question 41

what do the tracheobronchial nodes drain to? a. hilar nodes b. pulmonary nodes c. paratracheal nodes d. bronchomediastinal lymph trunks

Answer 41

c.paratracheal nodes

Question 42

what do the paratracheal nodes drain to? a. bronchomediastinal trunks b. hilar nodes c. traheobronchial nodes c. pulmonary nodes

Answer 42

a.bronchomediastinal trunks

Question 43

where are the paratracheal nodes found? a. along side the trachea b. near the carina c. along side the bronchi

Answer 43

a.along side the trachea

Question 44

where are the tracheobronchial nodes found? a. along side the trachea b. near the carina c. along side the bronchi

Answer 44

b.near the carina

Question 45

where are the pulmonary nodes found? a. along side the trachea b. near the carina c. along side the bronchi

Answer 45

c.along side the bronchi

Question 46

what is the right bronchomediastinal lymph trunk? a. lymphatic duct b. thoracic duct

Answer 46

a.lymphatic duct

Question 47

what is the left bronchomediastinal lymph trunk? a. lymphatic duct b. thoracic duct

Answer 47

b.thoracic duct

Question 48

what veins can the bronchomediastinal lymph trunks join directly a. internal thoracic b. subclavian c. vena cava

Answer 48

b.subclavian

Question 49

which nodes are known as virchows nodes? a. right supraclavicular b. left supraclavicular c. paratracheal d. tracheobronchial

Answer 49

b.left supraclavicular

Question 50

cancer of the lung, stomach, oesophagus, pancreas, gonads and breast can metastasize at which nodes causing them to be hard, swollen and painless? a. right supraclavicular b. left supraclavicular c. traceobronchial d. paratracheal

Answer 50

b.left supraclavicular virchows nodes - trossiers sign

Question 51

in troisiers sign virchows nodes appear... a. hard, swollen and painful b. malleable, swollen and painless c. hard,swollen and painless

Answer 51

c.hard,swollen and painless

Question 52

the right lymphatic duct drains.. a. the right side of head and neck and right upper limb b. the rest of the body

Answer 52

a.the right side of head and neck and right upper limb

Question 53

what causes swollen painful virchows nodes? a. infection b. lung/stomach/oesophagus cancer metastases

Answer 53

a. infection | eg. tb

Question 54

why do many cancers metastasise to the virchows nodes? a. located along path of right lymphatic duct b. located on path of left thoracic duct

Answer 54

b.located on path of left thoracic duct drains lymph from left side of body and right subdiaphragmatic body

Question 55

which of these nodes are considered sentinel/signal nodes as they may be the first sign of malignancy? a. left supraclavicular b. pulmonary c. hilar d. paratracheal e. right supracalvicular

Answer 55

a.left supraclavicular | virchows

Question 56

what is flail chest? a. single rib fracture resulting in a floating rib island b. multiple rib fractures resulting in a floating mobile island of ribs and muscles c. multiple rib fractures resulting in a floating fixed immobile island of ribs and muscles

Answer 56

b.multiple rib fractures resulting in a floating mobile island of ribs and muscles must be immobilised surgically

Question 57

what type of movement is exhibited by a flail segment? a. paradoxical b. no movement c. sporadic random movements

Answer 57

a.paradoxical

Question 58

what direction doe a flail segement move in inspiration? a. inwards b. outwards

Answer 58

a.inwards

Question 59

which type of pneumothorax is made up of the subgroups simple and tension? a. open b. closed

Answer 59

a.open

Question 60

a closed penumothorax with no underlying disease process or trauma is known as.. a. primary spontaneous b. secondary spontaneous c. iatrogenic d. tension

Answer 60

a.primary spontaneous

Question 61

when the lung surface ruptures eg from a blister like air pocket called a bleb, without trauma what type of pneumothorax is it classed as? a. primary spontaneous b. secondary spontaneous c. iatrogenic d. tension

Answer 61

a.primary spontaneous

Question 62

when the lung surface ruptures due to a disease present but no trauma what type of pneumothorax is it classed as? a. primary spontaneous b. secondary spontaneous c. iatrogenic d. tension

Answer 62

b.secondary spontaneous

Question 63

which of these factors increase the risk of a primary spontaneous pneumothorax? a. marfan syndrome, tall and thin b. cystic fibrosis, emphysema,asthma,lung abscess, septic emboli,neoplasm c. barotrauma from diving, endoscopic perforation of oesophagus,acupuncture,fractured rib perforating the pleura

Answer 63

a.marfan syndrome, tall and thin

Question 64

which of these factors increase the risk of a secondary spontaneous pneumothorax? a. marfan syndrome, tall and thin b. cystic fibrosis, emphysema,asthma,lung abscess, septic emboli,neoplasm c. barotrauma from diving, endoscopic perforation of oesophagus,acupuncture,fractured rib perforating the pleura

Answer 64

b.cystic fibrosis, emphysema,asthma,lung abscess, septic emboli,neoplasm

Question 65

which of these factors increase the risk of a traumatic/iatrogenic pneumothorax? a. marfan syndrome, tall and thin b. cystic fibrosis, emphysema,asthma,lung abscess, septic emboli,neoplasm c. barotrauma from diving, endoscopic perforation of oesophagus,acupuncture,fractured rib perforating the pleura

Answer 65

c.barotrauma from diving, endoscopic perforation of oesophagus,acupuncture,fractured rib perforating the pleura

Question 66

true or false the lung intrapleural pressure increases above atmospheric pressure in a tension pneumothorax a. true b. false

Answer 66

a.true

Question 67

true or false the lung intrapleural pressure increases above atmospheric pressure in a closed pneumothorax a. true b. false

Answer 67

b.false | diaphragm not pushed inferiorly so pressure can only rise equal to that of the atmosphere

Question 68

true or false in most cases a closed pneumothorax is not fatal as there is still one functioning lung and the other is only partially collapsed a. true b. false

Answer 68

a.true

Question 69

low bp , muffled heart sounds and raised jvp make up which triad? a. carneys b. virchows c. becks

Answer 69

c.becks

Question 70

pneumopericardium (air in the pericardial cavity) can lead to which of these conditions? a. pneumothorax b. cardiac tamponade c. pleural effusion

Answer 70

b.cardiac tamponade

Question 71

what is a pneumopericardium associated with? a. metastases b. lung and pericardial injury c. diaphragmatic injury

Answer 71

b.lung and pericardial injury

Question 72

what is a pneumoperitoneum? a. air in the peritoneal cavity b. fluid in the peritoneal cavity

Answer 72

a.air in the peritoneal cavity eg from diaphragmatic injury/left over from laprascopic injury

Question 73

where is the origin of the bronchial arteries? a. thoracic aorta b. ascending aorta c. subclavian d. pulmonary arteries

Answer 73

a.thoracic aorta

Question 74

where does the blood seen in haemoptysis normally originate from? a. visceral pleura b. trachea c. bronchioles d. bronchial arteries

Answer 74

d.bronchial arteries

Question 75

where do the right bronchial veins drain to? a. azygous vein b. accessory hemiazygous vein

Answer 75

a.azygous vein

Question 76

where do the left bronchial veins drain to? a. azygous vein b. accessory hemiazygous vein

Answer 76

b.accessory hemiazygous vein