GROSS ANATOMY 2nd bimex Flashcards
Which one of the following muscles is attached along the ANTERIOR surface of the body of STERNUM?
A. Sternocostalis B. Internal oblique C. Pectoralis major D. Rectus abdominis E. Transversus abdominis
Pectoralis major
The DERMATOME presents over the NIPPLE is: *
A. T2
B. T4
C. T6
D. T8
B. T4
The STERNAL ANGLE (ANGLE OF LOIS. char) is an angle formed at the junction between the manubrium and sternum (manubriosternal joint). It lies at the level of the lower border of T4, it is used as landmark to identify the following EXCEPT: *
A. The 2nd costal cartilage B. The bifurcation of the trachea C. The pulmonary trunk D. The anterior and posterior ends of the arch of the aorta E. None of the above
The bifurcation of the TRACHEA
This LINE of the thorax is formed by the PECTORALIS MAJOR muscle: *
A. Posterior median line
B. Posterior axillary line
C. Anterior axillary line
D. Anterior median line
ANTERIOR AXILLARY line
This typical rib landmark includes the most COMMON site of RIB FRACTURE: *
A. Tubercle
B. Head
C. Shaft
D. Neck
C. Shaft
The shaft of the typical rib has a costal angle, which is described as the weakest point of the rib
All the following are characteristics of the STERNUM EXCEPT: *
A. The manubrium articulates with the clavicle and first rib
B. The body of the sternum articulates with the manubrium to form the subcostal angle
C. The xiphoid process can be cartilaginous or ossified
D. Palpation of the sternal angle is a guide for the location of the 2nd rib
The BODY of the sternum articulates with the MANUBRIUM to form the SUBCOSTAL angle
The POSTERIOR INTERCOSTAL arteries: *
A. Travel anteriorly between the ribs
B. Descend along the anterior wall of the rib cage
C. Travel between ribs and anastomose with anterior intercostal arteries
D. Are provided by blood from the subclavian arteries
Travel ANTERIORLY BETWEEN the RIBS
The LINGULA of the LEFT LUNG is “similar” to which structure of the right lung? *
A. Superior lobe B. Inferior lobe C. Middle lobe D. Oblique fissure E. Horizontal fissure
MIDDLE lobe
Which of the following is FALSE of the RIGHT and LEFT LUNG? *
A. Both lungs divide into 10 bronchopulmonary segments
B. Both lungs have a superior and inferior lobe
C. The left lung differs from the right lung in that it has 2 lobes while the right has 3 lobes
D. The bronchopulmonary segment of the right lung includes 5 from the superior lobe, while in the left bronchopulmonary segments includes 2 from the superior lobe
The BRONCHOPULMONARY SEGMENT of the RIGHT lung includes 5 from the superior lobe, while in the left bronchopulmonary segments includes 2 from the superior lobe
The INFERIOR border of the HEART: *
A. Is primarily the left ventricle
B. Is the right atrium
C. Is primarily the right ventricle
D. Is the junction where the great vessels leave and enter the heart
Is primarily the RIGHT VENTRICLE
The RIGHT VENTRICLE can be examined along the 3 – 5th intercostal spaces of which SURFACE of the HEART? *
A. Sternocostal / anterior surface
B. Diaphragmatic / inferior surface
C. Pulmonary / left surface
D. Visceral / posterior surface
Sternocostal / anterior surface
Which of the following is NOT found in the normal adult RIGHT ATRIUM? *
A. SVC opening
B. Tricuspid valve
C. Foramen ovale
D. Fossa ovalis
Foramen ovale
Regarding the great vessels of the heart, which of the following is TRUE? *
A. The SVC returns blood to the right atrium from areas superior to the diaphragm, including from the heart and lungs
B. The right and left pulmonary veins return deoxygenated blood back to the left atrium
C. The IVC drains blood from the right atrium to areas inferior to the diaphragm
D. The aorta sends blood to the body from the left ventricle
The AORTA sends blood to the body from the LEFT VENTRICLE
At which intercostal space is one able to AUSCULTATE the AORTIC VALVE? *
A. Left 4th or 5th ICS
B. Left 2nd ICS
C. Right 2nd ICS
D. The aortic valve cannot be auscultated
RIGHT 2nd ICS
Which of the following correctly describes the conducting pathway of the heart? *
A. SA node –> AV bundle of His –> AV node –> L/R bundle branch –> Purkinje fibers
B. AV node –> SA node –> L/R bundle branch –> AV bundle of His –> Purkinje fibers
C. SA node –> AV node –> AV bundle of His –> Purkinje fibers –> AV bundle of His
D. SA node –> AV node –> AV bundle of His –> L/R bundle branch –> Purkinje fibers
SA node --> AV node --> AV bundle of His --> L/R bundle branch --> Purkinje fibers
What is the somatic INNERVATION of the PERICARDIUM? *
A. Phrenic nerve
B. Vagus nerve
C. Superficial cardiac plexus
D. Cardia sympathetic plexus
Phrenic nerve
Which of the following statements does NOT describe the LOCATION of the TRANSVERSE PERICARDIAL
SINUS? *
A. It lies posterior to the ascending aorta and pulmonary trunk
B. It is anterior to the superior vena cava
C. It is superior to the left atrium
D. It lies posterior to the inferior mediastinum
It lies POSTERIOR to the inferior MEDIASTINUM
What layer lies between the endocardium and myocardium? *
A. Epicardium
B. Purkinje layer
C. Subendocardial layer
D. Pericardium
Subendocardial layer
Which of the following is NOT a function of the PERICARDIUM? *
A. It fixes the heart in the mediastinum
B. It allows overfilling of the heart and allows it to expand in size
C. It provides lubrication during contraction
D. It serves as a physical barrier, thus protecting the heart from infection
It allows overfilling of the heart and allows it to expand in size
A patient suffered from an inferior wall infarct. ECG tracings showed ST segment depression on leads II, III, and AVF. What artery could have been occluded? *
A. Right coronary artery
B. Left anterior descending artery
C. Circumflex artery
D. Proximal left coronary artery
A. Right coronary artery
A 35-year-old woman was seen in the emergency department after an automobile accident. While driving her car, she had been wearing a lap belt but without the shoulder strap; she hit a utility pole head-on. Examination of the thoracic cage revealed a fracture of the body of the sternum and of the third and the fourth left ribs. In this case, the following structure(s) located behind the body of the sternum and the left ribs could have been injured except which one(s)? *
A. The pericardium B. The right ventricle of the heart C. The right atrium of the heart D. The left ventricle of the heart E. The esophagus
The esophagus
A 22-year-old man was seen in the emergency department after a street shootout. The patient showed signs of severe hemorrhagic shock. A small entrance wound was found in the third left intercostal space approximately 1 in. (2.5 cm) from the lateral margin of the sternum, but there was no exit wound. The left side of his thorax was dull on percussion, and breath sounds were absent on that side of the chest. It was decided to open the chest (thoracotomy) through the fourth left intercostal space, after which it was found that the left atrium had been perforated by the bullet. When the thoracotomy incision was made to enter the pleural cavity, the following structures were incised except for which one? *
A. The skin and subcutaneous tissue
B. The pectoral muscles and the serratus anterior muscle
C. The latissimus dorsi muscle
D. The external intercostal muscle and the anterior intercostal membrane
E. The internal intercostal and innermost intercostal muscles
The latissimus dorsi muscle
The following important structures are in the region of the THORACOTOMY incision EXCEPT which one? *
A. The internal thoracic artery B. The intercostal nerve C. The superior epigastric artery D. The intercostal artery E. The intercostal vein
The superior epigastric artery
A patient was admitted into hospital with acute pericarditis. Because the movements of the heart were compromised by the excess of fluid in the pericardial cavity, and the cause of the infection was unknown, it was decided to perform a pericardiocentesis. A specimen of the fluid was kept for bacteriological examination. PERICARDIOCENTESIS is best performed by passing a NEEDLE through *
A. the fourth intercostal space.
B. the sixth intercostal space at the left paravertebral border.
C. the second intercostal space at the midclavicular line.
D. the subcostal angle.
E. the second intercostal space at the right sternal angle.
the subcostal angle.
A patient was seen in the Emergency Department in cardiac arrest. During cardiopulmonary resuscitation the POSTERIOR SURFACE of the HEART was compressed by which of the following structures? *
A. The body of the sternum B. The heads of the ribs C. The tracheal bifurcation D. The inferior vena cava E. The bodies of the vertebrae
The bodies of the VERTEBRAE
A patient is examined in the standing position with a LEFT-SIDED PLEURAL EFFUSION. Where would you expect the pleural fluid to gravitate down to which of the following? *
A. The oblique fissure B. The cardiac notch C. The costomediastinal recess D. The costodiaphragmatic recess E. The horizontal fissure
The costodiaphragmatic recess
PAIN arising in the HEART is commonly referred to the following SKIN AREAS EXCEPT which? *
A. Up into the neck and jaw B. Down the medial side of the arm C. The point of the shoulder D. The epigastric area E. Over the sternum
The point of the shoulder
The following anatomic events occur at the level of the STERNAL ANGLE (angle of Louis) EXCEPT which? *
A. The right and the left pulmonary arteries enter the lungs.
B. The right recurrent laryngeal nerve arises from the right vagus nerve.
C. The trachea bifurcates.
D. The ascending aorta becomes continuous with the arch of the aorta.
E. The second costal cartilages articulate with the sternum.
The RIGHT RECURRENT laryngeal nerve arises from the RIGHT VAGUS nerve.
With aging, the following DETRIMENTAL CHANGES occur in the THORAX EXCEPT which of the following? *
A. The ribs and the costal cartilages become more rigid.
B. The elastic tissue in the lungs tends to degenerate.
C. The manubriosternal joint becomes more mobile.
D. The thoracic and the abdominal muscles tend to atrophy.
E. The xiphoid process becomes ossified.
The MANUBRIOSTERNAL joint becomes more mobile.
When passing a NEEDLE through the chest wall and into the PLEURAL CAVITY in the MIDAXILLARY line, the following structures will be pierced EXCEPT which? *
A. The external intercostal muscle B. The skin C. The parietal pleura D. The levator costarum E. The internal intercostal muscle
The levator costarum
The following statements concerning THORACIC structures are correct EXCEPT which? *
A. The carina is the name given to the site of bifurcation of the trachea.
B. The ligamentum arteriosum is the remains of the ductus arteriosus.
C. The ductus arteriosus is formed from the sixth left pharyngeal arch.
D. The thymus lies in the middle mediastinum.
E. The thymus receives its arterial supply mainly from the internal thoracic arteries.
The THYMUS lies in the middle mediastinum.
The following statements concerning an INTERCOSTAL SPACE are correct EXCEPT which? *
A. The anterior intercostal arteries of the lower five intercostal spaces are branches of the musculophrenic artery.
B. The sensory fibers in the lower five intercostal nerves supply the skin of the lateral thoracic and anterior abdominal walls.
C. The posterior intercostal arteries of the lower nine spaces are branches of the thoracic aorta.
D. Throughout an intercostal space, the intercostal nerves and blood vessels lie close to the upper border of the lower rib.
E. The intercostal nerves and blood vessels run between the internal and the innermost intercostal muscles.
Throughout an intercostal space, the intercostal nerves and blood vessels lie close to the UPPER BORDER of the LOWER RIB.
The STERNAL ANGLE is formed by the JUNCTION of which two bones? *
A. Sternal body and manubrium B. Manubrium and xiphoid process C. Sternal body and the clavicles D. Manubrium and the 2nd rib E. Manubrium and clavicle
Sternal body and manubrium
Air inside the pleura describes what condition? *
A. Pleural effusion B. Pneumothorax C. Pneumonia D. Ascites E. Subcutaneous emphysema
B. Pneumothorax
A patient is undergoing a bronchoscopy for removal of a foreign object. At approximately which vertebral level does the TRACHEA BIFURCATE? *
A. C6 B. T2 C. T4 D. T6 E. T7
T4
The BREAST SPANS vertically between which costal cartilages? *
A. 1st and 5th B. 2nd and 6th C. 3rd and 7th D. 4th and 8th E. 5th and 9th
2nd and 6th
What vessel provides arterial SUPPLY to the MEDIAL aspect of the BREAST? *
A. Mammary artery B. Thoracoacromial artery C. Internal thoracic artery D. Internal thoracic vein E. External thoracic artery
Internal thoracic artery
Which of the following nodes receives the majority of breast tissue lymph? *
A. Posterior intercostal nodes B. Parasternal nodes C. Infraclavicular nodes D. Axillary nodes E. Mediastinal nodes
Axillary nodes
Which one is a characteristic feature of the thoracic vertebrae? *
A. Vertebral body kidney shaped B. Bifid spinous process C. Long and slanted spinous processes D. Transverse foramina E. Has the characteristic vertebra prominens
Long and slanted spinous processes
Which of these LIGAMENT is unique to the THORACIC SPINE? *
A. Anterior longitudinal ligament B. Costotransverse ligament C. Nuchal ligament D. Interspinous ligament E. Ligamentum nuchae
Costotransverse ligament