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BCR 1 > Anatomy - Practical 07 : Anatomy of the airways and lungs > Flashcards

Anatomy - Practical 07 : Anatomy of the airways and lungs Flashcards

1
Q

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

A

b.2

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2
Q

what method is undertaken to inspect the pleural cavity?

a. thoracocentesis
b. thoracostomy
c. thoracoscopy

A

c.thoracoscopy

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3
Q

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

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

A

b/serous pericardium

mesothelium

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4
Q

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

A

b.adhesions in the pleural cavity

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5
Q

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

a. true
b. false

A

a.true

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6
Q

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

A

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

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7
Q

what is assessed through lung auscultation?

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

A

c.airflow through the trachiobronchial tree

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8
Q

where is the superior lobe of the lungs listened to?

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

A

a.2nd ICS

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

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9
Q

where is the middle lobe auscultated?

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

A

b.4th ICS

nipple is in 4th ICS

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10
Q

where is the inferior lobe auscultated?

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

A

c. 6-7th ICS

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11
Q

quiet lung sounds indicate..

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

A

a.pleural effusion/pneumothorax

reduced air entry

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12
Q

what do harsh bronchial sounds indicate?

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

A

b.consolidation

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13
Q

what does a wheeze indicate?

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

A

c.obstruction by foreign body/asthma

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14
Q

what do crackles indicate ?

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

A

d.copd/pneumonia

popping sound due to sudden opening of a collapsed airway

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15
Q

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

A

e.inflammed pleura

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16
Q

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

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

A

c.latissimus dorsi

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17
Q

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

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

A

b.trapezius

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18
Q

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

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

A

a.medial border of scapula

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19
Q

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

A

b.crossing arms over chest and bending forward

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20
Q

resonant lung percussion indicates…

a. tissue density
b. underlying air
c. solid

A

b.underlying air

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21
Q

dull lung percussion indicates…

a. tissue density
b. underlying air
c. solid

A

a.tissue density

organs/fluid filled/tumout

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22
Q

hyperesonant lung percussion indicates…

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

A

d.pneumothorax

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23
Q

flat lung percussion indicates..

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

A

d.underlying bone

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24
Q

which pleura layer is insensitive to pain?

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

A

a.visceral

contains autonomic nerves detecting stretch only

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25
Q

what nerve innervates the costal parietal pleura?

a. intercostal/subcostal
b. autonomic
c. phrenic

A

a.intercostal/subcostal

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26
Q

what nerve innervates the mediastinal/diaphragmatic parietal pleura?

a. intercostal/subcostal
b. autonomic
c. phrenic

A

c.phrenic

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27
Q

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

A

d.somatic

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28
Q

pain from the parietal pleura can refer to the corresponding dermatomes of which nerve?

a. phrenic
b. intercostal
c. subcostal

A

a.phrenic

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29
Q

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

A

a.c3,c4,c5

especially 4

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30
Q

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

A

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

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31
Q

inflammation/injury of what causes pleuritic pain?

a. mediastinum
b. lungs
c. pleura
d. parietal pleura
e. visceral pleura

A

d.parietal pleura

32
Q

lung carcinoma, pleuritis pneumonia, pneumothorax, mesothelioma, pulmonary embolism, pericarditis, rib fracture, gall bladder inflammation may all cause..

a.adhesions
c,pleuritic pain
d.wheeze

A

c,pleuritic pain

33
Q

which of these does not have an impression on the left lung?

a. aorta
b. heart
c. azygous vein

A

c.azygous vein

34
Q

which of these is not seen as an impression on the right lung?

a. heart
b. oesophagus
c. svc
d. ivc
e. azygous vein

A

e.azygous vein

35
Q

an extra azygous vein on the right leaves a ……… groove in the lung

a. shallow
b. deep

A

b.deep

36
Q

what plexus do the visceral pleura and lung parenchyma drain to?

a,superficial lymphatic plexus

b.deep lymphatic plexus

A

a,superficial lymphatic plexus

37
Q

what plexus do the bronchi submucosa and peribronchial CT drain to?

a,superficial lymphatic plexus

b.deep lymphatic plexus

A

b.deep lymphatic plexus

38
Q

what does the deep lymphatic plexus drain to before the hilar nodes

a. paratracheal nodes
n. tracheobronchial nodes
c. pulmonary nodes

A

c.pulmonary nodes

39
Q

what do the superficial lymphatic plexus and pulmonary nodes drain to?

a. hilar nodes
b. tracheobronchial nodes
c. paratracheal nodes
d. bronchomediastinal lymph trunks

A

a.hilar nodes

40
Q

what do the hilar nodes drain to?

a. pulmonary nodes
b. tracheobronchial nodes
c. paratracheal nodes
d. bronchomediastinal nodes

A

b.tracheobronchial nodes

41
Q

what do the tracheobronchial nodes drain to?

a. hilar nodes
b. pulmonary nodes
c. paratracheal nodes
d. bronchomediastinal lymph trunks

A

c.paratracheal nodes

42
Q

what do the paratracheal nodes drain to?

a. bronchomediastinal trunks
b. hilar nodes
c. traheobronchial nodes
c. pulmonary nodes

A

a.bronchomediastinal trunks

43
Q

where are the paratracheal nodes found?

a. along side the trachea
b. near the carina
c. along side the bronchi

A

a.along side the trachea

44
Q

where are the tracheobronchial nodes found?

a. along side the trachea
b. near the carina
c. along side the bronchi

A

b.near the carina

45
Q

where are the pulmonary nodes found?

a. along side the trachea
b. near the carina
c. along side the bronchi

A

c.along side the bronchi

46
Q

what is the right bronchomediastinal lymph trunk?

a. lymphatic duct
b. thoracic duct

A

a.lymphatic duct

47
Q

what is the left bronchomediastinal lymph trunk?

a. lymphatic duct
b. thoracic duct

A

b.thoracic duct

48
Q

what veins can the bronchomediastinal lymph trunks join directly

a. internal thoracic
b. subclavian
c. vena cava

A

b.subclavian

49
Q

which nodes are known as virchows nodes?

a. right supraclavicular
b. left supraclavicular
c. paratracheal
d. tracheobronchial

A

b.left supraclavicular

50
Q

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

A

b.left supraclavicular

virchows nodes - trossiers sign

51
Q

in troisiers sign virchows nodes appear…

a. hard, swollen and painful
b. malleable, swollen and painless
c. hard,swollen and painless

A

c.hard,swollen and painless

52
Q

the right lymphatic duct drains..

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

A

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

53
Q

what causes swollen painful virchows nodes?

a. infection
b. lung/stomach/oesophagus cancer metastases

A

a. infection

eg. tb

54
Q

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

A

b.located on path of left thoracic duct

drains lymph from left side of body and right subdiaphragmatic body

55
Q

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

A

a.left supraclavicular

virchows

56
Q

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

A

b.multiple rib fractures resulting in a floating mobile island of ribs and muscles

must be immobilised surgically

57
Q

what type of movement is exhibited by a flail segment?

a. paradoxical
b. no movement
c. sporadic random movements

A

a.paradoxical

58
Q

what direction doe a flail segement move in inspiration?

a. inwards
b. outwards

A

a.inwards

59
Q

which type of pneumothorax is made up of the subgroups simple and tension?

a. open
b. closed

A

a.open

60
Q

a closed penumothorax with no underlying disease process or trauma is known as..

a. primary spontaneous
b. secondary spontaneous
c. iatrogenic
d. tension

A

a.primary spontaneous

61
Q

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

A

a.primary spontaneous

62
Q

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

A

b.secondary spontaneous

63
Q

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

A

a.marfan syndrome, tall and thin

64
Q

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

A

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

65
Q

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

A

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

66
Q

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

a. true
b. false

A

a.true

67
Q

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

a. true
b. false

A

b.false

diaphragm not pushed inferiorly so pressure can only rise equal to that of the atmosphere

68
Q

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

A

a.true

69
Q

low bp , muffled heart sounds and raised jvp make up which triad?

a. carneys
b. virchows
c. becks

A

c.becks

70
Q

pneumopericardium (air in the pericardial cavity) can lead to which of these conditions?

a. pneumothorax
b. cardiac tamponade
c. pleural effusion

A

b.cardiac tamponade

71
Q

what is a pneumopericardium associated with?

a. metastases
b. lung and pericardial injury
c. diaphragmatic injury

A

b.lung and pericardial injury

72
Q

what is a pneumoperitoneum?

a. air in the peritoneal cavity
b. fluid in the peritoneal cavity

A

a.air in the peritoneal cavity

eg from diaphragmatic injury/left over from laprascopic injury

73
Q

where is the origin of the bronchial arteries?

a. thoracic aorta
b. ascending aorta
c. subclavian
d. pulmonary arteries

A

a.thoracic aorta

74
Q

where does the blood seen in haemoptysis normally originate from?

a. visceral pleura
b. trachea
c. bronchioles
d. bronchial arteries

A

d.bronchial arteries

75
Q

where do the right bronchial veins drain to?

a. azygous vein
b. accessory hemiazygous vein

A

a.azygous vein

76
Q

where do the left bronchial veins drain to?

a. azygous vein
b. accessory hemiazygous vein

A

b.accessory hemiazygous vein

BCR 1 (60 decks)

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