Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

eMRCS questions > Thorax > Flashcards

Thorax Flashcards

1
Q

Where metallic valves are located on X ray

A

Aortic
Usually located medial to the 3rd interspace on the right.

Mitral
Usually located medial to the 4th interspace on the left.

Tricuspid
Usually located medial to the 5th interspace on the right.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Root of lung - ant to posterior

A

Ant- phrenic
Pul vein
Pul artery sup post
Bronchus posterior to artery and superior to vein
Post- vagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which muscles/nerves are closely related to the carotid sheath at

A

Above the level of the hyoid the vessels pass deep to the posterior belly of digastric and stylohyoid

Opposite the hyoid bone the sheath is crossed obliquely by the hypoglossal nerve.

Opposite the cricoid cartilage - crossed by the superior belly of omohyoid.

At its lower end -sternohyoid and sternothyroid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aortic arches origins

A

1- disappears -maxillary
3- common carotid and prog internal carotid
4- aortic arch left, right subclavian prox
6- left and right pulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is divided routinely in midline sternotomy

A

Interclavicular ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If pleural reflections are divided in stenotomy what should be done

A

Chest drain inserted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chest drain inserted and blood apparent at site- which structure damaged

A

Intercostal artery
Most inferior

V
A
N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which nerve is often damaged in axillary surgery and what is the result

A

Intercostalbrachial

Parasthesia in armpit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Each heart valve, number of cusps, number of anterior cusps, muscle attachments

A

Mitral- 2, 1 anterior
Attached to chord tenindae

Aortic-3, 2 anterior
No chordae

Pulmonary- 3,2 anterior
No chordae

Tricuspid- 3, 2 anterior
Attached to chordae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which fascia overlies apices of lungs

A

Sibsons
C7 to the first rib -It lies between the parietal pleura and the thoracic cage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How persistent SVC drains into heart

A

Via coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Foramen of Morgani contents

A

Superior epigastric artery and vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ligaments of diaphragm

A

Central tendon

Left and right crus-Median Arcuate around aorta

Then medial arcuate - around psoas
then lateral arcuate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contents of Middle Mediastinum

A
  • P ericardium
  • H eart
  • A ortic root
  • A rch of azygos vein
  • Bronchi

BAAPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Contents Posterior Mediastinum

A

D escending aorta
A zygous and hemiazygos vein
T horacic duct
E sophagus
S ympathetic trunk/ganglia; splanchnic nerves
Vagus nerve

DATES V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does the Great Cardiac Vein begin, run and drain

A

Begins at the cardiac apex

Runs in the anterior interventricular sulcus with LAD

Drains both ventricles and left atrium – to Left extremity of coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does the middle Cardiac Vein begin, run and drain

A

Begins at the cardiac apex

Runs in the posterior interventricular sulcus with PDA

Drains the areas supplied by PDA of right – to Right extremity of coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where does the small Cardiac Vein begin, run and drain

A

Runs in the right posterior atrioventricular (AV) groove

Drains the posterior part of right atrium & ventricle – to Right extremity of coronary sinus near its atrial end.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Receptors in heart and location

A

The ventricles: beta-1 adrenoceptors The atria: cholinergic receptors.
The aortic arch: contains baroreceptors. The carotid body: contains baroreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Unique feature of right atrium

A

Musculi pectinati

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CI to lung cancer surgery

A

SVC obstruction
FEV <1.5
Malignant pleural effusion
Vocal cord paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do thebsian veins drain into

A

Atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

With SVC obstruction how many collaterals are there

A

Azygos venous system
Internal mammary venous pathway
Long thoracic venous system with connections to the femoral and vertebral veins (2 pathways)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which artery is likely encountered in axillary surgery

A

Thoracodorsal

If damaged lat flap can’t be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What prolapses in disc prolapse

A

Nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does thyroid ima arise from

A

Brachiocephalic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

At which level does the trachea bifurcate?

A

T5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

From which structure is the central tendon of the diaphragm derived?

A

Septum transversus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which nerves are commonly damaged in axillary node biopsies

A

Thoracodorsal - problems painting etc
intercostobrachial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the outer layer of the intrathoracic oesophagus?

A

Loose connective tissue
Adventita

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What level is the apex of the middle lobe

A

6th interspace in MAL

Where oblique runs up and meets horizontal

Horizontal runs from 4thCC to 6th MAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where are the greatest proportion of musculi pectinati found?

A

Right atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What directly innervated the heart

A

Superior and inferior cardiac plexuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is found at sternal angle

A

T4-5
2nd CC
Start/end of aortic arch
SVC
Bifurcation of trachea
Bifurcation of pulmonary trunk
Azygous arching to SVC
Thoracic duct crosses midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Lung projection in relation to first rib

A

Projects up and beyond constrained by SIbson fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Passage of sympathetic trunk into abdomen

A

Posterior to medial arcuate
Over psoas major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Name of foramen IVC goes through in diaphragm

A

Caval foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What lies anterior and posterior to transverse pericardial sinus

A

Aorta and pulmonary trunk anterior

SVC posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What does the oblique sinus go between

A

Blind ended sinus between pulmonary veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Dermatome nipple sits in

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Main arterial supply of breast

A

Internal thoracic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Surface location of lungs vs pleura at base

A

Lungs 6th MCL, 8th MAL, 10 posterior

Pleural- 8th MCL, 10 MAL, 12 post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Anterior to posterior of heart valves

A

Pulmonary
Aortic
Mitral and tricuspid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Source of aortic valves

A

Left- left CA
Right- right CA
Posterior - nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Where is AV located

A

Koch triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pleural location relative to clavicle and name

A

Cupola

2.5cm above clavicle in middle 1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What does the posterior descending coronary supply

A

Post 1/3 of IV septum
Right and left ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does the left circumflex supply

A

Left atrium and ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which muscles retract scapula

A

Trap
Rhomboids
Lat

50
Q

Which muscle protract scapula

A

Serratus anterior

51
Q

Serratus anterior attachements

A

Upper 8 ribs
Insert into medial border of scapula

52
Q

Which part of the lung does azygous lobe effects

A

Right upper zone
Super to hilum

Reverse comma sign

53
Q

What part of diaphragm foes IVC, oesophagus and aorta pass through

A

IVC- central tendon
Oesophagus- Right crus
Aorta- median arcuate

54
Q

External intercostal action and attachment

A

Fibres run inferomedially

Raises ribs and expands in forced inspiration

55
Q

What path does the oblique fissure follow

A

Medial border of scapula when abducted

Right- T4 to 6th rib

Left- between T3/4- 6th rib

56
Q

Horizontal fissure path

A

6th ICS MAL
to 4th CC anterior border

57
Q

Phrenic nerve relative to subclavian and scalene

A

Ant to subclavian artery
Post to subclavian vein
Anterior and Medial to lower border of scalene anterior

58
Q

Where is the right coronary sulcus and what runs through it

A

Atrioventricular groove
RCA

59
Q

Which nodes are difficult to sample in cervical mediastinosocpy

A

Aortopulmonary

Accessed via VAT instead

60
Q

What is most likely to be affected in right bronchus lymphadenopathy in superior aspect

A

Azygous
As loops over

61
Q

Root of lung vertebral level

A

T5/6

62
Q

Vertebral level of xiphoid

A

T7

63
Q

Liver biopsy, now pain on tip of right shoulder

A

Phrenic nerve- supplies here

64
Q

Location of crest terminals and what is contained here

A

Posterolateral wall of RA
SA node

65
Q

Stenosis of what artery is most sever

A

Anterior inter ventricular - widow maker - widespread ST

66
Q

Which artery supplies upper 1/3 oesophagus

A

Inferior thyroidR

67
Q

Risk of pericardectomy

A

Phrenic nerve damage

68
Q

What level does the aortic arch become descending

A

T4

69
Q

What covers arch of aorta anteriorly

A

Left pleura

70
Q

Aorta relation to brachiocephalic veins

A

Apex of arch poster inferior to left brachiocepahlic

71
Q

How many segments does right and left lung have

A

10 -R
8-9- L

72
Q

What contains lingual lobe

A

Left upper lobe

Anteroinfeiror projection

73
Q

Level hemiazygous crosses over to join azygous

A

T8

74
Q

What is located in anterior wall of right atrium

A

Musclini pectin in auricle

75
Q

Where coronary sinus sits

A

Postero inferior
Posterior part of RA next to IVC

76
Q

Smooth posterior part of RA

A

Sinus venarum

Joins rough anterior at crest terminals

77
Q

Level SVC joins RA

A

3rd CC

78
Q

Types of joint that steno manubrium is

A

Secondary cartilaginous

79
Q

Where is the coronary sinus opening located

A

located between the inferior vena cava and tricuspid valve

80
Q

What organs foes subclavian supply

A

Thyroid gland- via thyrocervical
Breast, RA, diaphgram- internal thoracic
Brainstem, cerebellum- vertebral
Upper limb

81
Q

Vessel damaged in sternotomy

A

Brachiocephalic artery vein
Left carotid and subclavian

82
Q

% of AV branch supplied by RCA

A

70-80

83
Q

Central venous cannulation landmark

A

1-2cm below and lateral to junction between medial 1/3 and lateral 2/3 of clavicle

Subclavian vein location

84
Q

What does the left marginal branch branch off of

A

Left circumflex

85
Q

Level of carina

A

T4/5

86
Q

What does the LCA pass between

A

Left atrial appendage
and pulmonary trunk

87
Q

Level thoracic duct passes posterior and to left of oesophagus

A

T5

88
Q

Right, co and left dominance stats

A

right 80
co- 10-20
5-10 left

89
Q

Diagnosis of mesothelioma

A

Pleural biopsy

90
Q

Defect in connective tissue disorder causing dissection

A

Fibrillin 1

91
Q

Most common lung neoplasms

A

Mets

92
Q

Heart transplant rejection types

A

Acute- T cell, cell death

AB mediated- month to years

Allograft vasculopathy- CA disease- months to years
Diffuse proliferation of intima

93
Q

Marantic endocarditis

A

Non bacterial thrombotic endocarditis

Advanced malignancy

Vegetations on mitral and aortic

94
Q

Major + Minor criteria for IE

A

Echo findings
2 + blood futures , 1 if coxiella

Fever
Skin
Vascular
IVDU

95
Q

What would suggest a small cell lung cancer is unresectable

A

SIADH

96
Q

Mutation in primary small cell cancers

A

p53

97
Q

Paraneoplastic of small cells

A

PTHrP
ACTH
SIADH

98
Q

Differentiating TB and sarcoid

A

TB- caseated calcified lesion

Sarcoid- non caseating

99
Q

What cells does bronchoalveolar carcinoma rise from

A

Pneumocytes type 2

100
Q

What way empyema cause

A

Frozen chest - pleural stick together

101
Q

Cortisol after cardiopulmonary bypass

A

Fall

102
Q

Tracheostomy effect on V/Q, dead space and secretions

A

Decrease mismatch and dead space

Used for bronchial toiler- clearing of secretions those unable to cough

103
Q

End management for IE with pan systolic murmur

A

Mechanical mitral valve

104
Q

Type 1 vs 2 resp failure

A

1- V/Q mismatch
2- hyperventilated alveoli

105
Q

Strep bovis IE, what next Ix

A

Colonsocpy as linked to colon cancer

106
Q

CURB65

A

Confusion
Urea >7
Resp >30
Bp <90 or 60
>65

2- admission

107
Q

Most common complication of FNA lung

A

Pneumothorax

108
Q

Acquired RF for atherosclerosis

A

HTN, hyperlipid, smoking, high fibrinogen, obesity, hypothyroid

109
Q

Normal PAWP

A

6-12 mmHg

110
Q

Artery for AV node

A

Posterior IV artery

111
Q

Tension pneumothorax CVP and Bp

A

High CVP and low BP

112
Q

Caveatting lesion lung

A

Staph aureus

113
Q

BP and temp in bypass

A

Controlled hypotension and hypothermia
To reduce dissection risk and metabolic rate

114
Q

What is used for bypass

A

Left internal mammary

If unavailable or not suitable - RIMA

Better than. veins as withstand high pressure and flow during systole and diastole

115
Q

Use of hyperbaric oxygen therapy

A

CO poisoning

116
Q

Small peripheral lesion in healthy non smoker

A

Pulmonary harmatoma

117
Q

Bypass coagulopathy

A

THrombocytosis

118
Q

Tx of lung abcess

A

Prolonged Abx 4-6w
Surgical if do not respond or complications

119
Q

Where bypass machine works

A

Cannula in right atrium where it is then oxygenated and return in the ascending aorta

Lungs are deflated to allow access

120
Q

Mx of inhaled FB

A

Bronchoscopy if visualised

Fibre optic bronchoscopy if not visualised

121
Q

Mx of empyema

A

Simple-chest drain
Disabling resp symptoms, fibrous peel, pleural peel for 4-6w -thoracotomy

eMRCS questions (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions