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CRRAB 1 Week 1 > Severson Heart Anatomy and Vignette Questions > Flashcards

Severson Heart Anatomy and Vignette Questions Flashcards

1
Q 
What structure guards the opening between the right atrium and the right ventricle?
A. Aortic semilunar valves
B. Mitral valve
C. Pulmonary semilunar valve
D. Tricuspid valve
E. Valve of the coronary sinus
A

D - tricuspid valve

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2
Q

Where are sounds from the aortic semilunar valves auscultated?
A. Left, second intercostal space close to the sternum
B. Right, fifth intercostal space close to the sternum
C. Fifth intercostal space below the left nipple
D. Right, second intercostal space close to the sternum
E. Below the xiphoid process

A

D - right, second intercostal space close to the sternum

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3
Q

Disturbances of the conduction system of the heart are common. Which of the following statements is CORRECT?
A. Purkinje fibers cross the cavity of the left ventricle by means of the septomarginal trabecula (moderator band).
B. Preganglionic fibers of the vagus nerve terminate directly on the specialized cardiac muscle cells of the sinoatrial node.
C. The sinoatrial node usually receives its blood supply from the right pulmonary artery.
D. The atrioventricular bundle divides into two branches at the upper end of the muscular part of the interventricular septum.
E. The sinoatrial node is located in the membranous portion of the interventricular septum.

A

D - The atrioventricular bundle divides into two branches at the upper end of the muscular part of the interventricular septum.

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4
Q 
Which of these structures is found only in the ventricles?
A. Crista terminalis
B. Fossa ovalis
C. Opening of the coronary sinus
D. Pectinate muscles
E. Trabeculae carneae
A

E. Trabeculae carneae

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5
Q

Which of the following is an INCORRECT statement concerning the sinoatrial node?
A. It receives autonomic innervation.
B. The stimulus from it spreads out through the wall of the atrium and reaches the atrioventricular node.
C. Its activation by the vagus nerve increases the rate and force of contraction of the heart.
D. It is located in the wall of the right atrium near the opening of the superior vena cava and the upper part of the crista terminalis.
E. It is called the heart’s pacemaker.

A

C - Its activation by the vagus nerve increases the rate and force of contraction of the heart.

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6
Q

Where is the mitral valve (left atrioventricular) heard best?
A. At the cardiac apex in the left, fifth intercostal space
B. Over the medial end of the second, left intercostal space
C. Over the medial end of the second, right intercostal space
D. Over the right half of the lower end of the body of the sternum
E. Over the sternal angle

A

A. At the cardiac apex in the left, fifth intercostal space

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7
Q 
What portion of the mediastinal pleura extends as a double layer inferior to the root of the lungs?
A. Costomediastinal recess
B. Cupola of the lung
C. Pleural recess
D. Pulmonary ligament
E. Sternal pleural reflection
A

D. Pulmonary ligament

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8
Q

Which of the following would NOT be found with dissection in the coronary sulcus (atrioventricular groove) of the heart?
A. Circumflex branch of the left coronary artery
B. Coronary sinus
C. Great cardiac vein
D. Middle cardiac vein
E. Right coronary artery

A

D. Middle cardiac vein

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9
Q

Which of the following nerve cell processes do NOT pass through the cardiac plexus?
A. Nerves that innervate the diaphragm
B. Non-myelinated postganglionic sympathetic fibers
C. Preganglionic parasympathetic fibers
D. Visceral afferent fibers mediating pain
E. Visceral afferent fibers mediating reflexes

A

A. Nerves that innervate the diaphragm

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10
Q

Which of the following associations is INCORRECT regarding the heart?
A. Maintains constant tension on the cusps of the atrioventricular valves : chordae tendineae
B. Extends from the interventricular septum to the base of the anterior papillary muscle of the right ventricle : septomarginal trabecula (moderator band)
C. A vertical muscular ridge representing the junction between the sinus venarum and the atrium proper : crista terminalis
D. The sinoatrial node is in this chamber : left atrium
E. Loops around the arch of the aorta near the ligamentum arteriosum : left recurrent laryngeal nerve

A

D. The sinoatrial node is in this chamber : left atrium

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11
Q 
What forms the epicardium of the heart?
A. Cardiac muscle fibers
B. Fibrous pericardium
C. Parietal pleura
D. Parietal layer of serous pericardium
E. Visceral layer of the serous pericardium
A

E. Visceral layer of the serous pericardium

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12
Q 
The heart is situated in what area of the thorax?
A. Anterior mediastinum
B. Costodiaphragmatic recess
C. Middle mediastinum
D. Posterior mediastinum
E. Superior mediastinum
A

C. Middle mediastinum

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13
Q

Which of the following statements about the heart and thorax is INCORRECT?
A. The parietal layer of the serous pericardium lines the inner surface of the fibrous pericardium.
B. The phrenic nerves are located lateral to the fibrous pericardium.
C. Accumulation of fluid in the pericardial cavity causes increased pressure around the heart and reduces the ability of the heart to fill during diastole.
D. The posterior interventricular artery is most often a branch of the left coronary artery.
E. The ligamentum arteriosum connects the left pulmonary artery to the aortic arch.

A

D. The posterior interventricular artery is most often a branch of the left coronary artery.

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14
Q 
1. An emergency tracheotomy is performed on a 2-month-old infant following admission to the emergency department after an automobile collision.  Which of the following structures is MOST COMMONLY at high risk during this procedure?
A. Left brachiocephalic vein
B. Left common carotid artery
C. Phrenic nerve
D. Thoracic duct
E. Vagus nerve
A

A - left brachocephalic vein

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15
Q
  1. Physical examination of a 28-year-old man in the emergency department following a motorcycle accident revealed tachycardia. What is the location of the preganglionic nerve cell bodies involved in increasing the heart rate?
    A. Deep cardiac plexus
    B. Lateral horn of the T5 to T9 spinal cord segments
    C. Lateral horn of the T1 to T4 spinal cord segments
    D. Nucleus ambiguus
    E. Superior, middle and inferior cervical ganglia
A

C. Lateral horn of the T1 to T4 spinal cord segments

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16
Q 
3. A 48-year-old woman is admitted to the hospital with difficulty speaking following a history of hoarseness for the past month.  A chest x-ray reveals a mass in the area of the aortic arch where it passes over the left pulmonary artery and bronchus.  Which of the following nerves is MOST LIKELY compressed?
A. Greater thoracic splanchnic
B. Left recurrent laryngeal
C. Phrenic
D. Right recurrent laryngeal
E. Vagus
A

B. Left recurrent laryngeal

17
Q 
4. A 42-year-old female complains of severe retrosternal pain that radiates to the left shoulder.  Auscultation reveals a pericardial friction rub, leading to a diagnosis of pericarditis.  Which of the following nerves is responsible for the radiating pain? 
A. Cardiopulmonary
B. Greater thoracic splanchnic
C. Intercostobrachial
D. Long thoracic
E. Phrenic
A

E. Phrenic

18
Q 
5.. An 84-year-old male is brought to the emergency department because of severe chest pain radiating to his left arm.  An ECG provides evidence of significant myocardial infarction of the posterior wall of the left ventricle.  What nerve is responsible for radiation to the arm during myocardial infarction?
A. Greater thoracic splanchnic
B. Intercostobrachial
C. Phrenic
D. Suprascapular
E. Vagus
A

B

19
Q 
6. A 49-year-old man is admitted to the hospital with severe chest pain.  During examination a slight rhythmic pulsation on the chest wall at the left fifth intercostal space is noted at the midclavicular line.  What part of the heart is responsible for this pulsation?
A. Aortic arch
B. Apex of the heart
C. Left atrium
D. Mitral valve
E. Right atrium
A

B - apex of the heart

20
Q 
7. A 58-year-old female is undergoing a coronary bypass operation involving the vessel that supplies much of the left ventricle and the right and left bundle branches of the cardiac conduction system.  With which artery is the surgeon MOST concerned?
A. Anterior interventricular
B. Artery to the sinoatrial (SA) node
C. Circumflex
D. Posterior interventricular
E. Right coronary
A

A - anterior interventricular

21
Q 
8. A 60-year-old male with severe angina is found to have significant occlusion in his right coronary artery, just distal to the right sinus of the aortic valve.  His collateral cardiac circulation is minimal.  Assuming the patient is right coronary dominant, which of the following arteries would MOST LIKELY still have normal blood flow?
A. Anterior interventricular artery
B. Atrioventricular nodal artery
C. Posterior interventricular artery
D. Right marginal artery
E. Sinoatrial nodal artery
A

A - anterior itnerventricular artery

22
Q
  1. A 72-year-old male is admitted to the hospital with severe chest pain. An ECG provides evidence of severe myocardial infarction of the lower part of the muscular interventricular septum. The function of which of the following valves will be MOST severely affected?
    A. Aortic
    B. Mitral
    C. Pulmonary
    D. Tricuspid
    E. Valve of the inferior vena cava (Eustachian valve)
A

D - tricuspid

23
Q 
10. During the physical examination of a 45-year-old woman, it is noted that there is a wide splitting in her S2 heart sound.  An ECG reveals a right bundle branch block.  Which of the valves is MOST LIKELY defective?
A. Aortic and mitral
B. Mitral valve
C. Pulmonary
D. Tricuspid
E. Tricuspid and aortic
A

C - pulmonary

24
Q
  1. If the posterior interventricular branch in a patient arises from the right coronary artery, which part of the myocardium will MOST LIKELY have it’s blood supply reduced if the circumflex branch of the left coronary artery becomes occluded by an atherosclerotic plaque?
    A. Anterior part of the interventricular septum
    B. Diaphragmatic surface of the right ventricle
    C. Infundibulum
    D. Lateral wall of the left ventricle
    E. Posterior part of the interventricular septum
A

D - lateral wall of the left ventricle

25
Q 
12. A 53-year-old is diagnosed with mitral stenosis.  During the physical examination, the first heart sound is abnormally loud.  Which of the following heart valves are responsible for the production of the first heart sound?
A. Aortic and mitral
B. Aortic and tricuspid
C. Mitral and pulmonary
D. Tricuspid and mitral
E. Tricuspid and pulmonary
A

D - tricuspid and mitral

26
Q
  1. A pacemaker was implanted in a 63-year-old male with cardiac arrhythmia. When passing the electrical leads for the pacemaker into the heart, which of the following is the CORRECT order of structures for passage of the leads into the right ventricle?
    A. Brachiocephalic vein, superior vena cava, mitral valve, right ventricle
    B. Brachiocephalic vein, superior vena cava, right atrium, mitral valve, right ventricle
    C. Brachiocephalic vein, superior vena cava, right atrium, tricuspid valve, right ventricle
    D. Superior vena cava, right atrium, mitral valve, right ventricle
    E. Superior vena cava, right atrium, tricuspid valve, right ventricle
A

C- Brachiocephalic vein, superior vena cava, right atrium, tricuspid valve, right ventricle

27
Q 
14. A 58-year-old female is admitted to the hospital with swelling (edema) of the lower limbs.  Ultrasound examination reveals an incompetent tricuspid valve.  Into which area will regurgitation of blood occur in this patient?
A. Ascending aorta
B. Left atrium
C. Left ventricle
D. Pulmonary trunk
E. Right atrium
A

E - right atrium

28
Q 
15. When pericardiocentesis is performed, the needle is inserted up from the infrasternal angle.  If the needle passes too deeply, piercing the visceral pericardium and entering the heart, which of the chambers would be the first to be penetrated by the needle?
A. Cardiac apex
B. Left atrium
C. Left ventricle
D. Right atrium
E. Right ventricle
A

E - right ventricle

29
Q 
16. A 65-year-old man is brought to the emergency department with severe chest pain radiating to his left arm, neck and jaw.  An ECG reveals an acute myocardial infarction of the posterior left ventricular wall.  Which of the following spinal cord segments would MOST LIKELY receive the sensations of pain in this case?
A. T1, T2, T3
B. T1, T2, T3, T4
C. T1, T2
D. T4, T5, T6
E. T5, T6, T7
A

B - T1, T2, T3, and T4

30
Q 
17. A 56-year-old male carpenter fell from the roof of a house he was shingling.  After being brought to the emergency department, physical examination revealed an absence of heart sounds, reduced systolic pressure, reduced cardiac output, and engorged jugular veins.  Which condition is MOST LIKELY characterized by these signs?
A. Cardiac tamponade
B. Deep vein thrombosis
C. Hemopneumothorax
D. Hemothorax
E. Pneumothorax
A

A - cardiac tamponade

31
Q 
18. A 65-year-old woman is brought to the walk-in clinic with a complaint of shortness of breath.  During physical examination it is noted that there is wide splitting in her S2 heart sound.  Which of the following valves is/are responsible for production of the S2 heart sound?
A. Aortic and mitral
B. Mitral valve
C. Pulmonary and aortic
D. Tricuspid
E. Tricuspid and aortic
A

C - pulmonary and aortic

32
Q 
19. A 47-year-old female is admitted to the hospital with dyspnea.  During physical examination her S1 heart sound is very loud.  Which of the following valves is/are responsible for production of the S1 heart sound?
A. Aortic and mitral
B. Mitral valve
C. Pulmonary and aortic
D. Tricuspid
E. Tricuspid and mitral
A

E- tricuspid and mitral

33
Q 
20. A 62-year-old female is admitted to the hospital with severe chest pain.  An ECG reveals that the woman is suffering from an acute myocardial infarction.  Because of the low ejection fraction of the right and left ventricles, a cardiac pacemaker is placed in the heart.  Which of the following structures is essentially replaced by the insertion of a pacemaker?
A. AV node
B. SA node
C. Bundle of His
D. Moderator band
E. Purkinje fibers
A

B - SA node

CRRAB 1 Week 1 (9 decks)

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