Thorax practice q's 07 Flashcards
- Pain referred to the right side of the neck and extending laterally from the right clavicle to the tip of the right shoulder is most likely to involve the
right phrenic nerve
Phrenic nerve: (C3-C5) The phrenic nerve is made up mostly of motor nerve fibres for producing contractions of the diaphragm. In addition, it provides sensory innervation for many components of the mediastinum and pleura, as well as the upper abdomen, especially the liver, and the gall bladder.
- Aspirated small objects tend to lodge in the right inferior lobar bronchus for all the following reasons EXCEPT:
a. The left main stem (primary) bronchus is more horizontal than the right
b. The right inferior lobar bronchus nearly continues the direction of the trachea
c. The right lung has no middle lobe
d. The right main stem (primary) bronchus is of greater diameter than the left
c. The right lung has no middle lobe.
The right lung has three lobes: superior, middle, and inferior.
The left only has two: superior and inferior
- The most obvious abnormal finding in the inspiratory posteroanterior chest x-ray of this patient (viewed in the anatomical position) is
a: left pneumothorax (collapsed lung)
- In the above case, the pronounced mediastinal shift to the right includes all the following structures EXCEPT the:
a. Aorta
b. Esophagus
c. Heart
d. Sternum
e. Trachea
d. Sternum
The sternum is bone and bones generally are not displaced.
Where do we have displaced sterna and ribs? A. Pectus excavatum B. Pectus cavinatum C. Pectus ectopia D. A and B E. All of the above
D. A and B
A. Pectus Excavatum- produces a caved-in or sunken appearance of the chest
Pectus Carinatum- PIGEON CHEST! produces an outward appearance of the chest wall.
What pathway does an electrical signal originating from the pacemaker of the heart follow?
A. SA node, AV node, right and left bundle branches, septomarginal trabecula (moderator band), bundle of His, and purkinje fibers
B. AV node, SA node, Bundle of His, Right and left bundle branches, septomarginal trabecula (moderator band), and purkinje fibers
C. SA node, AV node, bundle of His, right and left bundle branches, septomarginal trabecula (moderator band), and purkinje fibers.
D. SA node, AV node, bundle of his, right and left bundle branches, purkinje fibers, and septomarginal trabecula (moderator band)
C. SA node, AV node, bundle of His, right and left bundle branches, septomarginal trabecula (moderator band), and purkinje fibers.
SA node => AV nod => bundle of His => rt. and left bundle branches => septomarginal trabecula => purkinje fibers
- All of the following statements concerning the phrenic nerve are true EXCEPT that it___.
A. The rt. phrenic n. passes over the brachiocephalic v.
B. The phrenic n. courses behind the root of the lung
C. The left phrenic n. passes over the left ventricle and pierces the diaphragm separately
D. Rt. phrenic n. passes over the rt. atrium
B. The phrenic n. courses behind the root of the lung
Both phrenic nerves run from C3, C4 and C5 along the anterior scalene muscle deep to the carotid sheath.
* The right phrenic nerve passes over the brachiocephalic artery, posterior to the subclavian vein, and then crosses the root of the right lung and then leaves the thorax by passing through the vena cava hiatus opening in the diaphragm at the level of T8. The right phrenic nerve passes over the right atrium. * The left phrenic nerve passes over the left ventricle and pierces the diaphragm separately.
Both these nerves supply motor fibres to the diaphragm and sensory fibres to the fibrous pericardium, mediastinal pleura and diaphragmatic peritoneum.
The pericardiacophrenic artery and vein(s) travel with the phrenic nerve.
The esophagus is most likely to be displaced posteriorly by?
A. enlargement of the left atrium
B. enlargement of the rt. atrium
C. PDA
D. rib fracture
A. enlargement of the left atrium
The left atrium is the most POSTERIOR segment of the heart
- Severely diminished blood flow in the coronary arteries would most likely result from embolization of an atherosclerotic plaque in the___
ascending aorta
The only branches of the ascending aorta are the two coronary arteries which supply the heart; they arise near the commencement of the aorta immediately above the attached margins of the semi lunar valves.
- The thoraco-epigastric veins connect the___
A. Sup. epigastric v. and azygos v.
B. sup. epigastric v. and thoracic v.
C. musculophrenic v. and IVC
D. sup. epigastric v. and musculophrenic v.
E. azygos and hemiazygos v.
D. superior epigastric vein and the musculophrenic vein on each side
Thoracoepigastric, runs along the lateral aspect of the trunk between the superficial epigastric vein below and the lateral thoracic vein above and establishes an important communication between the femoral vein and axillary vein. This is an especially important vein when the inferior vena cava (IVC) becomes obstructed, by providing a means of collateral venous return.
- All of the following statements concerning mediastinal pleura are true EXCEPT:
a. It is continuous with costal pleura anteriorly and posteriorly
b. At the root of the lung, it passes laterally as the pulmonary ligament
c. It is a continuous sheet superior to the root of the lung
d. It is continuous with diaphragmatic pleura inferiorly
e. It is contiuous with cervical pleura (cupula)
Inferiorly!!!
b. At the root of the lung, it passes laterally as the pulmonary ligament
