Block 3 Thorax Part II Quiz

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  • 1/30 Questions

    Regarding the skeleton of the thorax

    • The floating ribs are ribs 8-12
    • A typical rib consists of all of the following: head, a neck. And a shaft with its costal groove
    • The most typical rib is rib 1
    • The sternal angle marks the articulation of rib 3
    • A line through the sternal angle bisects the disc between vertebrae T2 and T3
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About This Quiz

The Block 3 Thorax Part II Quiz assesses knowledge on thoracic anatomy, including the structure of the thorax, thoracic wall arteries, the heart's conducting system, axillary lymph nodes, and mediastinal anatomy. It is crucial for medical students preparing for exams.

Block 3 Thorax Part II Quiz - Quiz

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  • 2. 

    Regarding the thoracic wall:

    • The subcostal muscles are best developed in the upper part of the thorax

    • The innermost intercostals are often regarded as parts of the external intercostal muscles

    • The anterior intercostal membrane is the membranous portion of the internal intercostal muscle

    • The anterior intercostal arteries are branches of the internal thoracic arteries

    • The intercostal nerves are the posterior rami of the 12 thoracic nerves

    Correct Answer
    A. The anterior intercostal arteries are branches of the internal thoracic arteries
    Explanation
    The anterior intercostal arteries are branches of the internal thoracic arteries. This means that they arise from the internal thoracic arteries and supply blood to the anterior (front) part of the intercostal spaces.

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  • 3. 

    The conducting system of the heart comprises:

    • The sinuatrial node, His bundle, right and left branches

    • The sinuatrial node, atrioventricular node, His and Her bundle, superior and inferior crura

    • The atrioventricular and atrial nodes, His bundle, right and left crura

    • The sinuatrial node, atrioventricular node, and bundle, right and left branches, and Purkinje fibers network

    • SA and AV node, His and Her bundle, anterior and posterior crura, Purkinje fibers and network

    Correct Answer
    A. The sinuatrial node, atrioventricular node, and bundle, right and left branches, and Purkinje fibers network
    Explanation
    The conducting system of the heart includes the sinuatrial node, atrioventricular node, and bundle, right and left branches, and Purkinje fibers network. This system is responsible for coordinating the electrical signals that regulate the contraction and relaxation of the heart muscles, ensuring proper blood flow throughout the body. The sinuatrial node initiates the electrical signal, which then travels through the atrioventricular node and bundle, and then branches out into the right and left branches and the Purkinje fibers network, allowing the signal to reach all areas of the heart and coordinate its contractions.

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  • 4. 

    Which of the following is NOT considered a group within the axillary lymph node chain?

    • Lateral nodes

    • Deep cervical nodes

    • Apical nodes

    • Central nodes

    • Pectoral nodes

    Correct Answer
    A. Deep cervical nodes
    Explanation
    The axillary lymph node chain is a group of lymph nodes located in the armpit region. It is responsible for draining lymph fluid from the upper limb, breast, and chest wall. The lateral nodes, apical nodes, central nodes, and pectoral nodes are all considered groups within the axillary lymph node chain. However, the deep cervical nodes are not part of the axillary lymph node chain. These nodes are located in the neck region and are responsible for draining lymph fluid from the head and neck.

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  • 5. 

    Which of the following does NOT lies in the superior mediastinum?

    • Left recurrent laryngeal nerve

    • Right recurrent laryngeal nerve

    • Superior vena cava

    • Trachea

    • Esophagus

    Correct Answer
    A. Right recurrent laryngeal nerve
    Explanation
    The superior mediastinum is located in the upper part of the chest, between the thoracic inlet and the transverse thoracic plane. It contains various structures including the superior vena cava, trachea, and esophagus. The left recurrent laryngeal nerve is also found in the superior mediastinum, as it loops around the arch of the aorta. However, the right recurrent laryngeal nerve does not pass through the superior mediastinum. Instead, it travels in a different path, looping around the right subclavian artery. Therefore, the right recurrent laryngeal nerve does not lie in the superior mediastinum.

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  • 6. 

    A tumor of the esophagus in the thorax would, if enlarged, most likely affected which part of the heart

    • Right atrium

    • Left atrium

    • Left ventricle

    • Right ventricle

    • Both ventricles

    Correct Answer
    A. Left atrium
    Explanation
    If a tumor of the esophagus in the thorax were to enlarge, it would most likely affect the left atrium of the heart. The left atrium is located in close proximity to the esophagus in the thorax, making it more susceptible to compression or invasion by an enlarged tumor. The right atrium, left ventricle, right ventricle, and both ventricles are not directly adjacent to the esophagus in the thorax, so they would be less likely to be affected by the tumor.

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  • 7. 

    A tumor or growth in the area of the ligamentum arteriosum would most likely involve which of the following structures:

    • Right phrenic nerve

    • Left phrenic nerve

    • Left recurrent laryngeal nerve

    • Right recurrent laryngeal nerve

    • Right vagus nerve

    Correct Answer
    A. Left recurrent laryngeal nerve
    Explanation
    A tumor or growth in the area of the ligamentum arteriosum would most likely involve the left recurrent laryngeal nerve. The ligamentum arteriosum is a remnant of the fetal ductus arteriosus, which connects the pulmonary artery to the descending aorta. The left recurrent laryngeal nerve loops around the ligamentum arteriosum, so a tumor or growth in this area could potentially compress or damage the nerve. This can lead to hoarseness or loss of voice, as the left recurrent laryngeal nerve innervates the muscles of the larynx.

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  • 8. 

    A sharp knife wound starting at and including the external intercostal muscle would penetrate how many layers before hitting the lung tissue itself (include the pleural cavity and endothoracic fascia as 2 layers):

    • Four

    • Five

    • Six

    • Seven

    • Eight

    Correct Answer
    A. Eight
    Explanation
    A sharp knife wound starting at and including the external intercostal muscle would penetrate through the skin, subcutaneous tissue, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, endothoracic fascia, pleural cavity, and finally reach the lung tissue itself. This makes a total of eight layers that the knife would have to pass through before hitting the lung tissue.

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  • 9. 

    The groove for the subclavian vein and artery are associated with

    • First rib

    • Second rib

    • Third rib

    • Eight rib

    • Clavicle

    Correct Answer
    A. First rib
    Explanation
    The groove for the subclavian vein and artery is associated with the first rib. This is because the first rib is located at the base of the neck and serves as an attachment point for several important structures, including the subclavian vein and artery. These blood vessels travel through a groove on the first rib, providing a pathway for blood flow between the upper extremities and the heart.

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  • 10. 

    Which one of the following is not associated with right atrium (or auricle):

    • Fossa ovalis

    • Atrioventricular node

    • Opening of coronary sinus

    • Musculi pectinati

    • Trabeculae carnae

    Correct Answer
    A. Trabeculae carnae
    Explanation
    Trabeculae carnae are muscular ridges on the internal surface of the ventricles, not the atria. The right atrium is associated with the fossa ovalis, which is a depression in the interatrial septum, the atrioventricular node, which is responsible for electrical conduction between the atria and ventricles, and the opening of the coronary sinus, which allows deoxygenated blood from the heart muscle to enter the right atrium.

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  • 11. 

    A knife wound into the heart, at the level of the fifth left interspace, near the sternum, would penetrate all of the following layers except:

    • Fibrous pericardium

    • Serous visceral pericardium

    • Serous parietal pericardium

    • Visceral and parietal pleura

    • Pericardial cavity

    Correct Answer
    A. Visceral and parietal pleura
    Explanation
    The visceral and parietal pleura are not layers of the heart, but rather the membranes that surround the lungs. The fibrous pericardium, serous visceral pericardium, serous parietal pericardium, and pericardial cavity are all layers or spaces associated with the heart.

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  • 12. 

    Which one of the following statements is not true of the thoracic duct:

    • Extends from upper abdomen to neck

    • Found in the posterior mediastinum

    • Associated with the cisterna chyli

    • Drains both right and left sides of the thorax

    • Usually ascends to the right of the thoracic aorta

    Correct Answer
    A. Drains both right and left sides of the thorax
    Explanation
    The long thoracic duct begins at the cysterna chyli and continues superiorly to drain the lymph from the legs, abdomen, left arm, and left side of the thorax, neck, and head into the left subclavian vein, then on to its juncture with an internal jugular vein to drain lymph into venous blood

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  • 13. 

    The septamarginal trabecula (moderator band) is associated with the:

    • Right atrium

    • Right ventricle

    • Left atrium

    • Left ventricle

    • Base of heart

    Correct Answer
    A. Right ventricle
    Explanation
    The septamarginal trabecula (moderator band) is a muscular band that extends from the interventricular septum to the base of the anterior papillary muscle in the right ventricle. Its function is to provide additional support and reinforcement to the right ventricle during contraction. Therefore, it is associated with the right ventricle.

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  • 14. 

    The posterior intercostal arteries are branches of:

    • The internal thoracic artery

    • The subclavian artery

    • The aorta

    • The highest intercostal artery

    • The thoraco-acromial artery

    Correct Answer
    A. The aorta
    Explanation
    The posterior intercostal arteries are branches of the aorta.

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  • 15. 

    Which of the following is not true for the greater splanchnic nerve:

    • Consists of preganglionic sympathetic fibers

    • The fibers can be found in the posterior mediastinum

    • Branches arise from the 9th to the 10th sympathetic ganglion region

    • Fibers come from the spinal cord via white rami without synapse

    • Fibers terminate in the celiac ganglion

    Correct Answer
    A. Branches arise from the 9th to the 10th sympathetic ganglion region
    Explanation
    The greater splanchnic nerve does not branch from the 9th to the 10th sympathetic ganglion region.

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  • 16. 

    An esophageal aneurysm (marked dilation) would most likely affect which part of the heart directly

    • Left ventricle

    • Right ventricle

    • Left atrium

    • Right atrium

    • Left auricle

    Correct Answer
    A. Left atrium
    Explanation
    An esophageal aneurysm is an abnormal dilation or bulge in the wall of the esophagus. It is not directly related to the heart. Therefore, it would not affect any part of the heart directly. The correct answer, "left atrium," is incorrect and does not provide a valid explanation.

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  • 17. 

    The mitral (bicuspid) valve is best heard:

    • Over the left second intercostal space

    • Over the right second intercostal space

    • Over the lower part of the sternal body

    • Over the mid-portion of the sternum

    • Over the fifth left intercostal space, mid-clavicular

    Correct Answer
    A. Over the fifth left intercostal space, mid-clavicular
    Explanation
    The mitral (bicuspid) valve is best heard over the fifth left intercostal space, mid-clavicular. This is because the mitral valve is located on the left side of the heart, between the left atrium and the left ventricle. The fifth left intercostal space is the area where the sound of the mitral valve is most easily heard, as it is closest to the location of the valve. The mid-clavicular line is a reference point that helps to accurately locate the fifth left intercostal space.

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  • 18. 

    A bullet shot into the lateral chest wall through an intercostal space would perforate immediately which of the following after passing through the parietal pleura:

    • Innermost intercostal muscle

    • Potential pleural cavity

    • Internal intercostal muscle

    • Endothoracic fascia

    • Pericardial cavity

    Correct Answer
    A. Potential pleural cavity
    Explanation
    When a bullet passes through the parietal pleura, it would perforate the potential pleural cavity immediately. The potential pleural cavity is the space between the parietal and visceral pleura, which are the two layers of the pleura that surround the lungs. This space normally contains a small amount of fluid that allows the two layers to glide smoothly over each other during breathing. When the bullet perforates the potential pleural cavity, it can cause damage to the pleura and potentially lead to a pneumothorax, which is the accumulation of air in the pleural cavity.

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  • 19. 

    Which one of the following is not associated with the posterior mediastinum:

    • Vagus nerve

    • Esophagus

    • Thoracic duct

    • Azygous vein

    • Phrenic nerve

    Correct Answer
    A. Phrenic nerve
    Explanation
    The phrenic nerve is not associated with the posterior mediastinum. The posterior mediastinum is located behind the heart and contains structures such as the esophagus, thoracic duct, azygous vein, and vagus nerve. The phrenic nerve, on the other hand, is located in the anterior mediastinum and supplies motor and sensory innervation to the diaphragm.

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  • 20. 

    A 60-year-old construction worker was admitted to the hospital with severe shortness of breath (dyspnea) and great difficulty in swallowing (dysphagia). The patient states he has suffered increased difficulty and pain in swallowing for over six month, has subsisted on a liquid diet and lost thirty pounds. His sputum is blood-tinged and for the last few weeks he has become hoarse. X-ray examination of chest reveals a widening of the mediastinum and fluoroscopy shows obstruction of esophagus at level  of tracheal bifurcation. Diagnosis: cancer of esophagus with obstruction and metastatic involvement of surrounding posterior mediastinal structures. The hoarseness was due to involvement of

    • Right vagus nerve

    • Right recurrent laryngeal nerve

    • Left recurrent laryngeal nerve

    • Left phrenic nerve

    • Greater splanchnic nerve

    Correct Answer
    A. Left recurrent laryngeal nerve
    Explanation
    The hoarseness in this patient is likely due to involvement of the left recurrent laryngeal nerve. The left recurrent laryngeal nerve innervates the muscles of the larynx, including the vocal cords. In this case, the cancer of the esophagus with metastatic involvement of surrounding structures, including the posterior mediastinum, is causing compression or invasion of the left recurrent laryngeal nerve, leading to hoarseness. This is a known complication of esophageal cancer, as the tumor can impinge on the nerve and disrupt its function.

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  • 21. 

    An aneurysm (ballooning) of the arch of the aorta would most likely affect all except one of the following:

    • Left primary bronchus

    • Esophagus

    • Left recurrent laryngeal nerve

    • Thoracic duct

    • Phrenic nerve

    Correct Answer
    A. Thoracic duct
    Explanation
    An aneurysm of the arch of the aorta is a condition where a weakened area of the aorta bulges out like a balloon. The arch of the aorta is located behind the sternum and above the heart. It supplies oxygenated blood to the head, neck, and upper limbs. The left primary bronchus, esophagus, left recurrent laryngeal nerve, and phrenic nerve are all structures that are in close proximity to the arch of the aorta. However, the thoracic duct is not located near the arch of the aorta. The thoracic duct is responsible for draining lymphatic fluid from the lower body and left upper body into the venous system. Therefore, it would not be affected by an aneurysm of the arch of the aorta.

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  • 22. 

    The anterior intercostal arteries are branches of the:

    • Posterior intercostal arteries

    • Internal thoracic arteries

    • Mediastinal arteries

    • Highest intercostal arteries

    • Subcostal arteries

    Correct Answer
    A. Internal thoracic arteries
    Explanation
    The anterior intercostal arteries are branches of the internal thoracic arteries. The internal thoracic arteries are located in the chest and are responsible for supplying blood to the anterior chest wall. These arteries give rise to the anterior intercostal arteries, which run between the ribs and supply blood to the muscles and tissues of the anterior intercostal spaces.

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  • 23. 

    Which of the following statements is incorrect:

    • The base of the heart if formed by the ventricles

    • The sternocostal surface of the heart is formed mainly by the right ventricle

    • The inner surfaces of both auricles of the heart are ridged by the musculi pectinate

    • The septomarginal trabecula (moderate band) contains Purkinje fibers from the right limb of the atrioventricular bundle

    • The cardiac skeleton surrounds the atrioventricular and semilunar openings giving attachment to the valves

    Correct Answer
    A. The base of the heart if formed by the ventricles
    Explanation
    base of heart is formed mainly by the left atrium, and, to a small extent, by the back part of the right atrium.

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  • 24. 

    Examination of a heart reveals an old and a new area of damage (infarction) caused by occlusion of the circumflex branch of the left coronary artery. The damage is in the:

    • Right atrium and right ventricle

    • Left atrium and left ventricle

    • Left auricle and interventricular septum

    • Apex of the heart

    • Pulmonary artery

    Correct Answer
    A. Left atrium and left ventricle
    Explanation
    The examination of the heart reveals an old and a new area of damage caused by occlusion of the circumflex branch of the left coronary artery. The circumflex branch supplies blood to the left atrium and left ventricle. Therefore, the damage is likely to be in the left atrium and left ventricle.

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  • 25. 

    The sternal angle is an important landmark. It is at the level of:

    • Cervical vertebra 7

    • Disc between thoracic vertebrae 2 and 3

    • Disc between thoracic vertebrae 4 and 5

    • Disc between thoracic vertebrae 6 and 7

    • Thoracic vertebra 7

    Correct Answer
    A. Disc between thoracic vertebrae 4 and 5
    Explanation
    The sternal angle is an important landmark because it corresponds to the location of the disc between thoracic vertebrae 4 and 5. This is significant because it marks the level at which the trachea bifurcates into the left and right bronchi, and it also indicates the level of the second rib. This landmark is commonly used in clinical practice for various purposes such as locating the appropriate level for performing procedures or assessing the position of internal organs.

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  • 26. 

    The major venous drainage of the heart is into the:

    • Thebesian veins

    • Anterior cardiac veins

    • Marginal veins

    • Coronary veins (sinus)

    • Inferior veins

    Correct Answer
    A. Coronary veins (sinus)
    Explanation
    The major venous drainage of the heart is into the coronary veins (sinus). These veins collect deoxygenated blood from the myocardium and drain it into the coronary sinus, which then empties into the right atrium of the heart. The coronary veins (sinus) play a crucial role in returning blood from the heart muscle back to the circulation for oxygenation.

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  • 27. 

    Contents of the anterior mediastinum includes:

    • Trachea

    • Vagus nerve

    • Phrenic nerves

    • Esophagus

    • Thymus

    Correct Answer
    A. Thymus
    Explanation
    The anterior mediastinum is the space in the chest between the sternum and the heart. It contains various structures including the thymus, trachea, vagus nerve, phrenic nerves, and esophagus. The thymus is a gland located in the anterior mediastinum that plays a crucial role in the development and maturation of T-cells, which are important for immune function. Therefore, the presence of the thymus in the anterior mediastinum is a correct statement.

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  • 28. 

    An aneurysm (marked dilation) of which of the following heart structures would most likely compress the esophagus and result in some symptoms of difficulty related to eating:

    • Right atrium

    • Left atrium

    • Right ventricle

    • Left ventricle

    • Pulmonary artery

    Correct Answer
    A. Left atrium
    Explanation
    always think left atrium with esophagus

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  • 29. 

    Which of the following is not true of the greater splanchnic nerves:

    • Consist of myelinated fibers

    • Formed from contributions from the 5th (6th) to 9th (10th) thoracic ganglia

    • Are preganglionic parasympathetic nerves

    • Lie in the posterior mediastinum

    • Pierce the diaphragm to enter the celiac ganglion

    Correct Answer
    A. Are preganglionic parasympathetic nerves
  • 30. 

    A tumor at the bifurcation of the trachea would NOT affect one of the following

    • Aortic arch

    • Superior vena cava

    • Esophagus

    • Right recurrent laryngeal nerve

    • Deep cardiac plexus

    Correct Answer
    A. Right recurrent laryngeal nerve
    Explanation
    A tumor at the bifurcation of the trachea would not affect the right recurrent laryngeal nerve because this nerve innervates the muscles responsible for vocal cord movement and is located more distally in the neck. The tumor would, however, potentially affect the aortic arch, superior vena cava, esophagus, and deep cardiac plexus as they are in close proximity to the trachea and could be compressed or invaded by the tumor.

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  • Current Version
  • Sep 03, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 07, 2011
    Quiz Created by
    Chachelly

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