1.
The second costal cartilage can be located by palpating the:
A. 
B. 
C. 
D. 
E. 
2.
The thoracic wall is innervated by:
A. 
B. 
C. 
D. 
E. 
3.
The sternocostal surface of the heart is formed primarily by the anterior wall of which heart chamber?
A. 
B. 
C. 
D. 
4.
A patient involved in an automobile accident presents with a sharp object puncture of the middle of the sternum at about the level of the 4th or 5th costal cartilage. If the object also penetrated pericardium and heart wall, which heart chamber would most likely be damaged?
A. 
B. 
C. 
D. 
5.
You are caring for a 68-year-old male who has copious amounts of fluid in the left pleural cavity due to acute pleurisy. When you examine him as he sits up in bed (trunk upright), where would the fluid tend to accumulate?
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
6.
A 23-year-old male injured in an industrial explosion was found to have multiple small metal fragments in his thoracic cavity. Since the pericardium was torn inferiorly, the surgeon began to explore for fragments in the pericardial sac. Slipping her hand under the heart apex, she slid her fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. Her fingertips were then in the:
A. 
B. 
C. 
D. 
E. 
7.
When inserting a chest tube, intercostal vessels and nerves are avoided by placing the tube immediately:
A. 
Above the margin of a rib
B. 
Below the margin of a rib
8.
A hand slipped behind the heart at its apex can be extended upwards until stopped by a line of pericardial reflection that forms the:
A. 
B. 
C. 
D. 
Oblique pericardial sinus
E. 
Transverse pericardial sinus
9.
The first rib articulates with the sternum in close proximity to the:
A. 
B. 
C. 
D. 
E. 
10.
The portion of the parietal pleura that extends above the first rib is called the
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
11.
You are attending an operation to remove a thymic tumor from the superior mediastinum. The surgeon asks, "What important nerve lying on and partly curving posteriorly around the arch of the aorta should we be careful of as we remove this mass?" You quickly answer, "The--
A. 
B. 
C. 
D. 
E. 
12.
In cardiac surgery it is sometimes necessary to clamp off all arterial flow out of the heart. This could be done within the pericardial sac by inserting the index finger immediately behind the two great arteries and compressing them with the thumb of the same hand. The index finger would have to be inserted into which space?
A. 
B. 
C. 
Oblique pericardial sinus
D. 
E. 
Transverse pericardial sinus
13.
A needle inserted into the 9th intercostal space along the midaxillary line would enter which space?
A. 
B. 
Costodiaphragmatic recess
C. 
D. 
E. 
Oblique pericardial sinus
14.
During a heart transplant procedure, the surgeon inserted his left index finger through the transverse pericardial sinus, and then pulled forward on the two large vessels lying ventral to his finger. Which vessels were these?
A. 
Pulmonary trunk and brachiocephalic trunk
B. 
Pulmonary trunk and aorta
C. 
Pulmonary trunk and superior vena cava
D. 
Superior vena cava and aorta
E. 
Superior vena cava and right pulmonary artery
15.
While observing in the OR, you see the resident insert a needle through the body wall just above the ninth rib in the mid-axillary line. She was obviously trying to enter the:
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
16.
The pleural cavity near the cardiac notch is known as the:
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
17.
The tubercle of the 7th rib articulates with which structure?
A. 
B. 
C. 
D. 
Transverse process of vertebra T6
E. 
Transverse process of vertebra T7
18.
The ductus arteriosus sometimes remains open after birth requiring surgical closure. When placing a clamp on the ductus, care must be taken to avoid injury to what important structure immediately dorsal to it?
A. 
Accessory hemiazygos vein
B. 
Left internal thoracic artery
C. 
D. 
Left recurrent laryngeal nerve
E. 
19.
A 16-year-old male suffered a stab wound in which a knife blade entered immediately superior to the upper edge of the right clavicle near its head. He was in extreme pain, which was interpreted by the ER physician as a likely indicator of a collapsed lung following disruption of the pleura. If that was true, what portion of the pleura was most likely cut or torn?
A. 
B. 
C. 
D. 
E. 
20.
During a lung transplant procedure, an observing 4th year attempted to pass his index finger posteriorly inferior to the root of the left lung, but he found passage of the finger blocked. Which structure would most likely be responsible for this?
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
21.
Which of the following layers provides a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?
A. 
B. 
C. 
D. 
E. 
Transversus thoracis muscle fascia
22.
The lowest extent of the pleural cavity, into which lung tissue does not extend, is known as the:
A. 
Costodiaphragmatic recess
B. 
C. 
D. 
E. 
23.
The sternal angle is a landmark for locating the level of the:
A. 
B. 
C. 
D. 
E. 
24.
A 3rd-year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers?
A. 
B. 
C. 
D. 
E. 
25.
The thoracic wall is innervated by
A. 
B. 
C. 
D. 
E.