CARDIOPULMONARY Flashcards by Val Josol

Which valve separates left atrium from left
ventricle
A. Mitral
B. Pulmonary
C. Tricuspid
D. Aortic

A. Mitral

Pulmonary right vent to lungs
Tricuspid right A vs R vent Aortic left vent to body

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Which of the following lists of valves will the
blood flow through from the vena cava into the
heart?

Tricuspid valve, pulmonic valve,
mitral valve, aortic valve

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Which of the components of the heart
conduction systems have the slowest rate of
firing?
A. AV node
B. AV bundle
C. bundle branches
D. Purkinje fibers

D. Purkinje fibers

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The Myocardium would be thickest at?
A. R Atrium
B. R Ventricle
C. L Atrium
D. L Ventricle

D. L Ventricle

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This heart valve is best heard at left lower of the
sternum near the fifth intercostal space
A. Aortic valve
B. Tricuspid valve
C. Pulmonic valve
D. Mitral valve

D. Mitral valve

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Adheres to the heart and form the outer
covering
A. Endocardium
B. Epicardium
C. Fibrous pericardium
D. Serous parietal layer

B. Epicardium (visceral layer)

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Valves that are not closed during systole:
A. Mitral
B. AV valve
C. Tricuspid valve
D. Semilunar

D. Semilunar

Semilunar = aortic and pulmonary valves

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The ff is seen overlying the coronary sulcus
except:
A. Right coronary artery
B. Coronary sinus
C. Left coronary artery
D. Circumflex branch of left coronary artery

C. Left coronary artery

Coronary Sulcus
- right coronary artery
- small cardiac vein
- coronary sinus
- circumflex artery

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Which structure accompanies posterior
interventricular arteries?
A. middle cardiac vein
B. great cardiac vein
C. small cardiac vein
D. marginal vein

A. middle cardiac vein

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The ff structures will drain into the right atrium
except:
A. Superior vena cava
B. Coronary sinus
C. Inferior vena cava
D. Foramen of the venae cordis minimae
E. No exceptions

E. No exceptions

A. Superior vena cava- True
B. Coronary sinus- True
C. Inferior vena cava- True
D. Foramen of the venae cordis minimae- True

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Sinus venarum is found in this chamber:
A. Right atrium
B. left atrium
C. Right ventricle
D. Left ventricle

A. Right atrium

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A patient presented with machinery gibson-like
murmur upon auscultation at the cardiothoracic
area. What would be responsible for the
findings?
A. Atrial Septal Defect
B. Ventricular Septal Defect
C. Patent Ductus Arteriosus
D. Patent Ductus Venosus

D. Patent Ductus Venosus

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Most common affected area of Ventricular
Septal Defect (VSD)
A. Fossa Ovalis
B. Muscular Area
C. Membranous Area
D. Both B&C

C. Membranous Area

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Most common site for arterial occlusion leading
to acute myocardial infarction?
A. Right Coronary artery
B. Left Coronary Artery

B. Left Coronary Artery

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Fracture From the sternal angle to 1 inch above
xiphoid process which is involved?
A. Anterior mediastinum
B. Middle mediastinum
C. Posterior mediastinum
D. Superior mediastinum

A. Anterior mediastinum

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Layers pierced by the needle before reaching
pericardial fluid

Fibrous pericardium - parietal layer
of serous pericardium

Fibrous pericardium -> Serous pericardium (parietal layer) -> Pericardial cavity -> Serous pericardium (visceral layer) -> myocardium -> endocardium

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These muscle fibers appear to run downwards
and medially or forwards and attach to the rib
below:
A. External intercostals
B. Innermost internal
C. Internal intercostal
D. Subcostal

A. External intercostals

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Which of the following gives rise to the
intercostobrachial nerve:
A. 1st intercostal nerve
B. 2nd intercostal nerve
C. Subcostal nerve
D. 10th intercostal nerve

B. 2nd intercostal nerve

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Muscles that elevates the ribs:
A. External intercostal ms
B. Subcostals ms
C. Internal intercostals ms

A. External intercostal ms

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Responsible for rib depression during expiration except:
A. Levatores costarum muscle
B. Sternocostalis muscle
C. Subcostalis muscle
D. Internal intercostal muscle

A. Levatores costarum muscle

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True:
A. Anterior thoracic area is supplied by lateral
intercostal vessels
B. Upper 6 anterior vessels arise from the
internal thoracic A
C. Lower 9 posterior vessels arise from the
musculophrenic A
D. 1st and 2nd posterior intercostal A arise from
costocervical trunk

D. 1st and 2nd posterior intercostal A arise from
costocervical trunk

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Where does the 1st posterior intercostal vein
drain?
A. Azygos vein
B. Subclavian vein
C. Innominate vein
D. Superior intercostal vein - union of 2nd and
3rd post. Intercostal vein

C. Innominate vein

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Superior border of the superior mediastinum
A. Thoracic inlet
B. Thymus
C. Thoracic outlet
D. Clavicle

A. Thoracic inlet

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During inspiration:
A. Decrease intrathoracic pressure
B. Decreased intrathoracic volume
C. Ribs move down
D. Diaphragm moves up

A. Decrease intrathoracic pressure

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This covers the internal surface of the thoracic cavity, lines the pulmonary cavities, adheres to the thoracic wall, mediastinum, and diaphragm. A. Visceral pleura B. C. Parietal Pleura D. Simple squamous epithelium

C. Parietal Pleura

Provides the arterial supply of the visceral pleura

Bronchial Artery

The lung hilum is located in what surface A. Mediastinum surface B. Costal surface C. Diaphragmatic surface D. Inferior surface

A. Mediastinum surface

Nerve fiber causes relaxation of bronchi smooth muscle and vasoconstriction of bronchi vessels A. Sympathetic B. Vagus C. Parasympathetic D. Visceral afferent

A. Sympathetic

In the general arrangement of the roots of the hilum, which structure is the anterior most? A. inferior pulmonary vein B. superior pulmonary vein C. main bronchus D. pulmonary artery

B. superior pulmonary vein inferior pulmonary vein (inferior most) main bronchus (middle of the posterior boundary) pulmonary artery (superior most)

True of Parietal Layer A. Sensitive to Pain, Temperature B. Innervated by pulmonary plexus (visceral) C. Blood supply is Intercostal arteries D. A and C

D. A and C A. Sensitive to Pain, Temperature C. Blood supply is Intercostal arteries

True of left bronchus A. Shorter- right B. supported by C shaped cartilage-both C. 20-30-right D. More vertical-right

B. supported by C shaped cartilage A. Shorter- right lung B. supported by C shaped cartilage-both C. 20-30-right lung D. More vertical-right lung

Subdivision of lobe that is a functional unit of lungs: A. Segment B. Bronchopulmonary segment C. Alveoli

B. Bronchopulmonary segment

Surfactant lipoproteins are produced by: A. Alveolar cells B. Goblet cells C. Club cell

C. Club cell

TRUE of neurovascular supply of trachea a. sensory is provided by vagus and recurrent laryngeal nerve b. thyroidea ima is always present and most important vascular supply c. trach fok forgot d. A and C

d. A and C

Lymph drainage of the trachea: A. Deep cervical node B. Inferior Thoraco Brachial node C. Superior Thoraco Brachial node D. B&C

A. Deep cervical node

During respiratory development,at what week does terminal sac begin? A. 8wk B. 20wk C. 16wk D. 26wk

D. 26wk

Pulmonary surfactant lining the alveoli produced by what type of cells? A. Goblet cells B. Type 2 pneumocyte C. SSE cells D. Type 1 pneumocyte

B. Type 2 pneumocyte

Carries deoxygenated blood to the bronchopulmonary segment A. Segmental Artery B. Intersegmental Vein C. Intersegmental Artery D . Segmental Vein

A. Segmental Artery

Are tiny filled pockets with thin walls of simple squamous epithelium and are the sites of gaseous exchange: A. Bronchiole B. Trachea C. Alveoli D. Lungs

C. Alveoli

True for trachea: A. Immobile cartilaginous and membranous tube B. Begins in the neck at the lower border of the cricoid cartilage of the 4th cervical vertebra C. Posterior free end of the cartilage are connected by trachealis muscle D. All of the above

C. Posterior free end of the cartilage are connected by trachealis muscle A. false, should be mobile B. false, should be at the level of the 6th cervical vertebra

The auscultatory area for listening to the aortic area: A. Right 2nd intercostal space B. Left 4th intercostal space C. Left 5th intercostal space D. Left 2nd intercostal space

A. Right 2nd intercostal space

The origin of the coronary arteries are located within these valves A. Tricuspid valve B. Pulmonary semilunar valves C. Aortic valves D. Mitral valve

C. Aortic valves

The fibroserous sac surrounding the heart and the roots of the great vessels A. Pericardium B. Myocardium C. Epicardium D. None of the above

A. Pericardium

Where are the Heart and pericardium located: A. Anterior mediastinum B. Posterior mediastinum C. Middle mediastinum D. Superior mediastinum

C. Middle mediastinum

Unoxygenated blood leaves from the right atrium to right ventricle passing by: A. Mitral valve B. Tricuspid valve C. Aortic valve D. Pulmonary valve

B. Tricuspid valve

A congenital anomaly of the interatrial septum. due to incomplete closure of foramen ovale A. Ventricular septal defect B. Atrial septal defect C. Tetralogy of Fallot D. Coarctation of aorta

B. Atrial septal defect

Oxygenated blood leaves the left atrium to the left ventricle via: A. Tricuspid valve B. Aortic valve C. Pulmonary valve D. Mitral valve

D. Mitral valve

The arterial supply of the pericardium derived from the Internal thoracic artery: A. Pericardiophrenic artery B. Pericardial artery C. Musculophrenic artery D. Coronary arteries

A. Pericardiophrenic artery

The valves that close during the diastole: A. Tricuspid valve B. Semilunar valves C. Mitral valve D. AV valves

B. Semilunar valves

The Sinoatrial node is located at: A. Base of the right atrium near septum B. Right atrium near SVC opening C. Superior vena cava D. Interventricular septum

B. Right atrium near SVC opening

The major vein that drains the heart: A. Great cardiac vein B. Coronary sinus C. Small vein D. Middle vein

B. Coronary sinus

An important surgical landmark in the mediastinum: A. Oblique pericardial sinus B. Transverse pericardial sinus C. Aortic arch D. Sternal angle of louis

B. Transverse pericardial sinus

The apex of the heart is mainly formed by the: A. Left atrium B. Left ventricle C. Right ventricle and right atrium D. Right ventricle

B. Left ventricle

A male vendor came to the clinic due to difficulty breathing. On chest X-ray, haziness of the R middle lobe was identified. What pulmonary segments supply this area: A. R apical, posterior and anterior tertiary bronchus B. R apical, posterior, anterior and medial tertiary bronchus C. R lateral and medial tertiary bronchus D. R apical, lateral and medial tertiary bronchus

C. R lateral and medial tertiary bronchus

At which level of the costal cartilage posteriorly does the anterior border of the lung deeply notched by the pericardium? A. 5th costal cartilage B. 4th costal cartilage C. 6th costal cartilage D. 2nd costal cartilage

A. 5th costal cartilage

Which of the following structures is not seen in the (L) lung? A. Pulmonary ligament B. groove for the descending aorta C. cardiac impression D. horizontal fissure

D. horizontal fissure

A large depressed area in the lung where most or the great structures leave and enter: A. hilum B. cardiac notch C. cardiac impression D. Lingula

A. hilum

When there is a need to collect pleural fluid for diagnostic studies, where is the most likely site of puncture for fluid extraction? A. between 6th and 7th rib B. between 7th and 8th rib C. between 10th and 11th rib D. Between 8th and 10th rib

D. Between 8th and 10th rib

A patient was rushed to the E.R due to a stabbing injury. V/S were noted to be unstable and the patient was noted to have laboured breathing. On examination a penetrating puncture wound was noted in an area over the (R) anterior chest wall lateral to the sternum mid -clavicular line one inch above thenipple. Which part of the lung is most likely hit? A. (R) costomediastinal recess B. (R) superior lobe C. (R) middle lobe D. (R) inferior lobe

C. (R) middle lobe

The posterior intercostal arteries arise from which of the following? A. costocervical trunk B. musculophrenic artery C. costophrenic artery D. internal thoracic artery

A. costocervical trunk

True of the apex of the lungs except. A. reaches 1-cm above the medial 3rd or clavicle B. has groove for subclavian vein C. concave and semilunar D. covered by cervical pleura

C. concave and semilunar

Innervation of the diaphragmatic pleura is by.. A. recurrent laryngeal nerve B. Phrenic nerve C. intercostal nerve D. Vagus nerve

B. Phrenic nerve

What is the parasympathetic innervation of the lung? A. Phrenic nerve B. glossopharyngeal nerve C. Vagus nerve D. Recurrent laryngeal nerve

C. Vagus nerve

The following structures give rise to the posterior intercostal arteries except... A. internal thoracic artery B. descending aorta C. subclavian artery D. none

A. internal thoracic artery Posterior intercostal arteries of 3rd-11th intercostal spaces arise posteriorly from thoracic aorta Posterior intercostal arteries of 1st and 2nd intercostal spaces arise from supreme (superior) intercostal artery, a branch of costocervical trunk of subclavian artery

What is the blood supply of the ® middle lobe? A. (R) pulmonary vein B. (R) superior bronchial artery C. (R) pulmonary artery D. (R) bronchial artery

D. (R) bronchial artery

Which of the following best describes the lungs? A. both lungs have apex, base, costal, medial surfaces and three lobes B. both are of the same weight and are separated from each other by a mediastinum C. both has the horizontal fissure which allows pleura to extend so that the lungs can move freely D. both are enclosed by a parietal pleura and are separated from each other by a mediastinum

D. both are enclosed by a parietal pleura and are separated from each other by a mediastinum

True of the horizontal fissure. A. runs horizontally backwards to meet the oblique fissure at the midclavicular line B. extends from the anterior margin of the 6th costal cartilage C. the pulmonary ligament extends into the fissure so that the lungs can move freely during inspiration D. can be seen in both lungs

A. runs horizontally backwards to meet the oblique fissure at the midclavicular line

Which of the ff is not important in preventing backflow: A. Chordae tendineae B. AV valves C. Papillary muscles D. Endocardium

D. Endocardium

Boundary of middle mediastinum A. Epicardium B. Fibrous pericardium C. Myocardium D. Serous pericardium

B. Fibrous pericardium

Which anatomical landmark separates the artery from the veins of the heart? A. Costodiaphragmatic recess B. Oblique pericardial sinus C. Transverse pericardial sinus D. Both B and C only

C. Transverse pericardial sinus

Which structure corresponds to the base of the heart? A) Right Ventricle B) Left Atrium C) Right Atrium D) Left Ventricle

B) Left Atrium

Externally, what structure demarcates the atria from the ventricles? A) Interventricular Septum B) Coronary Sulcus C) Crista Terminalis D) Interatrial Septum

B) Coronary Sulcus

Crista terminalis is found in which chamber of the heart? A) Right Ventricle B) Left Atrium C) Right Atrium D) Left Ventricle

C) Right Atrium

Structures of Right Ventricle A) Septomarginal band B) Trabeculae carneae C) Anterior, Posterior, Septal Papillary Muscles D) AOTA

D) AOTA

Dominance of the coronary arterial system is defined by which artery gives rise to what structure A) Anterior Interventricular (IV) Artery B) Circumflex Artery C) Posterior Interventricular (IV) Artery D) Left Marginal Artery

C) Posterior Interventricular (IV) Artery

Which of the following structures is NOT typically found in the coronary sulcus? A) Right coronary artery B) Coronary sinus C) Circumflex branch of the left coronary artery D) Middle cardiac vein E) No exceptions

D) Middle cardiac vein

The second heart sound is due to: A. Opening of semilunar valves B. Opening AV valve C. Closure of semilunar valves D. Closure of AV valves

C. Closure of semilunar valves First heart sound- AV valves = tricuspid and mitral/bicuspid valves Second heart sound - semilunar valves = aortic and pulmonary valves

Which of the following does NOT drain into the coronary sinus? A) Great cardiac vein B) Small cardiac vein C) Middle cardiac vein D) Vena cordis minimae

D) Vena cordis minimae

These structures are found in the superior mediastinum, except? a. Thymus b. Phrenic nerve c. Trachea d. Azygous vein

d. Azygous vein

Which valve surrounds the superior vena cava (SVC)? A) Thebesian valve B) Eustachian valve C) Valve of Aurantii D) None of the above

D) None of the above Thebesian valves - coronary sinus Eustachian valve - inferior vena cava

16.This structure is found in the moderator band? A) AV bundle B) Bundle of His C) Right branch of AV bundle D) Left branch of AV bundle

C) Right branch of AV bundle

The following are seen in cardiac tamponade, except: A. Engorged neck veins B. Distant heart sounds C. Hypotension D. Absent breathing sounds

D. Absent breathing sounds

Anatomical valve area of tricuspid valve A. 3rd costal B. Left 4th ICS C. Sternal margin of 3rd ICS D. 4th and 5th costal and 4th ICS

D. 4th and 5th costal and 4th ICS

Most commonly affected artery in MI A. RCA B. Circumflex branch of LCA C. LAD D. Posterior IV branch

C. LAD

A patient came in the ER with chest pain and ECG showing ST elevation in II, III, AVF (inferior wall MI). What is the blood supply of the inferior wall? A. L Anterior Descending A B. Posterior Descending A C. RCA D. LCA

C. RCA

Which of the following is the terminal branch of the internal thoracic artery. A. Musculophroenic Artery B. Coronary Artery C. Pericardiacophrenic Artery D. Superior Phrenic Artery

A. Musculophroenic Artery

The remnant of the embryological left SVC: A. Coronary sinus B. Vein of Marshall C. Middle cardiac vein D. Great cardiac vein

B. Vein of Marshall

Which papillary muscle is the largest A) Anterior B) Posterior C) Septal D) A and B

A) Anterior

What is the structure responsible for tightening the semilunar valve? A. Papillary muscles B. Chordae tendineae C. Trabeculae carneae D. Annulus fibrosus

D. Annulus fibrosus Annulus fibrosus (Fibrous ring)

26-30. Match muscle to action. Choices: A. Elevates the ribs B. Depresses ribs C. Assists in weight lifting D. Weakly depresses the ribs E. Assists the external and internal intercostals

Innermost intercostal - Assists the external and internal intercostals Posterior inferior serratus - Depresses ribs Transversus thoracis - Weakly depresses the ribs External intercostal - Elevates the ribs Diaphragm - Assists in weight lifting

Innervation of Accessory Phrenic Nerve Before merging with the Phrenic Nerve (non verbatim) A. Subclavius B. Diaphragm C. Intercostals D. Pectoralis Major

A. Subclavius

During surgery, a surgeon accidentally damages the structure passing through the diaphragmatic chuchu at the level of the 8th thoracic vertebra, what complication is the patient likely to experience? A. Respiratory distress B. Cardiac Arrhythmias C. Venous return D. A&B

C. Venous return Caval hiatus = vena cava = 8 letters = 8th thoracic vertebra

A patient complained of frequent heartburns and regurgitation of stomach contents. Which complication is described that may need surgery? (non verbatim) A. Traumatic diaphragmatic hernia B. Lumbar Hernia C. Congenital diaphragmatic hernia D. Hiatal hernia E. All of the above

D. Hiatal hernia

How many lobes and fissures of the right lung are present? A. 3 lobes, 2 fissures B. 2 lobes, 3 fissures C. 2 lobes, 2 fissures D. 3 lobes, 3 fissures

A. 3 lobes, 2 fissures

Usually, the right lung can be described as: A. Heavier and larger than left lung B. Shorter and wider than left lung C. Both A and B D. None of the above

C. Both A and B A. Heavier and larger than left lung B. Shorter and wider than left lung

This is the inferior surface of a lung which accommodates the ipsilateral dome of the diaphragm: A. Apex B. Inferior border C. Base D. Horizontal fissure

C. Base

The cardiac notch shapes the most inferior and anterior part of the superior lobe of the left lung into thin tongue like process called: A. Left oblique fissure B. Cupula C. Horizontal fissure D. Lingula

D. Lingula

The left lung has how many lobes A. 1 B. 2 C. 3 D. 4

B. 2

Which of the following is true about trachea? A. B. It bifurcates at the level of the manubriosternal joint C. It terminates behind the heart D. It bifurcates in the level of the xiphoid process

B. It bifurcates at the level of the manubriosternal joint

Elongated airways densely lined with alveoli, leading to common spaces called alveolar sacs, into which clusters of alveoli open A. Termination bronchiole B. Alveoli C. Respiratory bronchiole D. Alveolar ducts

D. Alveolar ducts

The pulmonary artery: A. Carries venous blood to the lungs B. Arises from the aorta C. Carries oxygenated blood from the lungs D. Receives blood from the bronchopulmonary segments as it runs towards the hilum

A. Carries venous blood to the lungs

These supply blood for nutrients to the roots of the lungs, supporting tissues of lungs and visceral pleura. A. Bronchial Artery B. Bronchial Vein C. Pulmonary Artery D. Pulmonary Vein

A. Bronchial Artery

True about subpleural lymphatic plexus A. Drains the structures that form the root of the lung B. Drains the lung parenchyma and visceral pleura C. Drains initially into the intrinsic pulmonary lymph nodes D. Lies deep to parietal pleura

B. Drains the lung parenchyma and visceral pleura

true of intervertebral joint except it is symphysis A. Involves t1 and t2 vertebrae B. Associated with anterior and posterior longitudinal ligaments C. Adjacent vertebrae are bound by radiate ligament

C. Adjacent vertebrae are bound by radiate ligament * it should be longitudinal ligament

sternoclavicular joint is a

Saddle type of synovial joint