Block 3 Thorax Quiz

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  • 1/21 Questions

    The conducting system of the heart comprises:

    • The sinuatrial node, bundle of His, 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, the atrioventricular node, and A-V bundle, the right and left branches, and Purkinje fibers network
    • SA and AV node, his and her bundle, anterior and posterior crura, Purkinje’s fibers and network
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Block 3 Thorax Quiz - Quiz
About This Quiz

The 'Block 3 Thorax Quiz' assesses key aspects of thoracic anatomy, focusing on the development of bronchi, aortic structure, fetal circulation derivatives, thoracic skeleton, and cardiac conducting system. It is designed for medical students preparing for exams like USMLE.

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  • 2. 

    Secretion of pulmonary surfactant is a function of

    • Alveolar dust cells

    • Endothelial cells of capillaries in the alveolar septum

    • Small granule cells

    • Type I pneumocytes

    • Type II pneumocytes

    Correct Answer
    A. Type II pneumocytes
    Explanation
    Type II pneumocytes are responsible for the secretion of pulmonary surfactant. Pulmonary surfactant is a substance that reduces surface tension in the alveoli, preventing them from collapsing during exhalation and promoting efficient gas exchange. Type II pneumocytes are specialized cells located in the alveoli of the lungs and are responsible for producing and secreting surfactant. This secretion helps to maintain the elasticity and stability of the alveoli, ensuring proper lung function.

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  • 3. 

    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 horizontal line through the sternal angle bisects the disc between vertebrae T2 and T3

    Correct Answer
    A. A typical rib consists of all of the following: head, a neck, and a shaft with its costal groove
    Explanation
    A typical rib consists of a head, a neck, and a shaft with its costal groove. This means that a typical rib has these three distinct parts which are necessary for its structure and function. The head of the rib articulates with the corresponding vertebra, the neck is a narrow portion connecting the head to the shaft, and the shaft contains the costal groove which protects the intercostal nerves and blood vessels. This description accurately defines the components of a typical rib.

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  • 4. 

    The septomarginal 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 septomarginal trabecula, also known as the moderator band, is a muscular structure located in the right ventricle of the heart. It extends from the interventricular septum to the base of the anterior papillary muscle. Its main function is to provide electrical conduction and mechanical support to the right ventricle during contraction. Therefore, the correct answer is right ventricle.

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  • 5. 

    Coarctation (congenital narrowing) of the aorta most often occurs near the:

    • Bifurcation into common iliac arteries

    • Branching of the renal arteries

    • Ductus arteriosus (ligamentum arteriosum)

    • Brachiocephalic artery

    Correct Answer
    A. Ductus arteriosus (ligamentum arteriosum)
    Explanation
    Coarctation of the aorta is a congenital condition characterized by a narrowing of the aorta. The ductus arteriosus, also known as the ligamentum arteriosum, is a small blood vessel that connects the pulmonary artery to the descending aorta in fetal circulation. This vessel normally closes shortly after birth. In cases of coarctation of the aorta, the narrowing often occurs near the site where the ductus arteriosus used to be. This can lead to restricted blood flow and increased pressure in the upper body, while blood flow to the lower body is reduced.

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  • 6. 

    Damaged heart muscle resulting from occlusion of the circumflex branch of the left coronary artery is most likely found in the

    • Apex

    • Left atrium and left ventricle

    • Right and left ventricle

    • Right atrium and right ventricle

    • Right ventricle and interventricular septum 51

    Correct Answer
    A. Left atrium and left ventricle
  • 7. 

    A tumor in the posterior mediastinum is most likely to involve the

    • Left ventricle

    • Phrenic nerves

    • Recurrent laryngeal nerves

    • Thoracic duct

    • Tracheal bifurcation

    Correct Answer
    A. Thoracic duct
    Explanation
    A tumor in the posterior mediastinum is most likely to involve the thoracic duct. The thoracic duct is the main duct of the lymphatic system and it runs through the posterior mediastinum. Tumors in this area can compress or invade the thoracic duct, leading to obstruction of lymphatic flow and causing lymphatic fluid to accumulate in the body. This can result in symptoms such as swelling, pain, and difficulty breathing. Therefore, the thoracic duct is the most likely structure to be involved in a tumor in the posterior mediastinum.

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  • 8. 

    In congenitall coarctation of the aorta, aortic blood flow is usually obstructed past the left subclavian artery. Collateral circulation develops so that the superior epigastric arteries anastomosing with the inferior epigastric arteries carry the blood flow from the upper part to the lower part of the trunk. The superior epigastric artery arises from the?

    • Anterior intercostals arteries

    • Internal thoracic artery

    • Lateral thoracic artery

    • Musculophrenic artery

    • Posterior intercostal arteries

    Correct Answer
    A. Internal thoracic artery
    Explanation
    In congenital coarctation of the aorta, the aortic blood flow is obstructed past the left subclavian artery. This obstruction leads to the development of collateral circulation, where alternate pathways are formed to carry the blood flow from the upper part to the lower part of the trunk. One of these pathways involves the anastomosis between the superior epigastric arteries and the inferior epigastric arteries. The superior epigastric artery arises from the internal thoracic artery, making it the correct answer.

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  • 9. 

    In examining radiographs of your patient’s chest you noticed that the contents of the middle mediastinum appear to be deviated to the right side. Which of the following structures is located within the middle mediastinum?

    • Aortic arch

    • Esophagus

    • Heart

    • Thymus

    • Trachea

    Correct Answer
    A. Heart
    Explanation
    The correct answer is the Heart. The middle mediastinum is the central compartment of the thoracic cavity, located between the two lungs. It contains the heart, which is a major organ responsible for pumping blood throughout the body.

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  • 10. 

    A 60-year-old construction worker was admitted to the hospital with severe shortness of breath (dyspnea and great difficult in swallowing (dysphagia). The patient states he has suffered increased difficulty and pain in swallowing for over six months has substituted on a liquid diet and lost thirty pound. His sputum is blood-tinged and for the last few weeks he has become hoarse. X-ray examination of the 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 most likely 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 most likely due to the 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 obstruction and metastatic involvement of surrounding structures likely caused compression or invasion of the left recurrent laryngeal nerve, resulting in hoarseness. The other nerves listed are not directly involved in innervating the larynx and would not be expected to cause hoarseness in this scenario.

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  • 11. 

    Premature infants may suffer from respiratory distress due to an inadequate number of terminal air sacs and surfactant deficiency in the lungs. The number of terminal air sacs and the level of surfactant are sufficient for survival

    • 5 to 17 weeks after fertilization

    • 16 to 25 weeks after fertilization

    • 20 weeks after fertilization

    • 24 to 26 weeks after fertilization

    • After birth only

    Correct Answer
    A. 24 to 26 weeks after fertilization
    Explanation
    Premature infants may suffer from respiratory distress due to an inadequate number of terminal air sacs and surfactant deficiency in the lungs. The correct answer is 24 to 26 weeks after fertilization because at this stage of development, the number of terminal air sacs and the level of surfactant in the lungs are sufficient for survival.

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  • 12. 

    A bullet, entering the lateral chest wall through an intercostals space would perforate which of the following after passing through the parietal pleura:

    • Innermost intercostals muscle

    • Potential pleural cavity

    • Internal intercostals muscle

    • Endothoracic fascia

    • Pericardial cavity

    Correct Answer
    A. Potential pleural cavity
    Explanation
    After passing through the parietal pleura, a bullet would perforate the potential pleural cavity. 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. The potential pleural cavity normally contains a small amount of fluid that allows the lungs to move smoothly during respiration. A bullet passing through the parietal pleura would enter this potential pleural cavity before reaching any other structures listed in the options.

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  • 13. 

    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 lymphatic fluid from the upper limb, breast, and surrounding areas. 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. They are located in the neck region and are responsible for draining lymphatic fluid from the head and neck area.

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  • 14. 

    The azygos vein normally drains into the

    • Inferior vena cava

    • Right brachiocephalic vein

    • Right jugular vein

    • Right posterior intercostal veins

    • Superior vena cava

    Correct Answer
    A. Superior vena cava
    Explanation
    The azygos vein is a large vein that drains blood from the thoracic wall and upper abdominal wall. It ascends on the right side of the vertebral column and typically drains into the superior vena cava. The superior vena cava is a major vein that receives blood from the upper body, including the head, neck, and upper limbs. Therefore, the correct answer is superior vena cava.

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  • 15. 

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

    • Fibrous pericardium

    • Serous visceral pericardium

    • Serous parietal pericardium

    • Visceral and parietal pleura

    • Pericardial cavity

    Correct Answer
    A. Visceral and parietal pleura
    Explanation
    A knife wound in the heart at the level of the fifth left interspace near the sternum would penetrate all of the structures listed except the visceral and parietal pleura. The fibrous pericardium, serous visceral pericardium, serous parietal pericardium, and pericardial cavity are all layers or spaces within the pericardium, which surrounds the heart. However, the visceral and parietal pleura are layers of the pleural membrane that surround the lungs, not the heart. Therefore, they would not be affected by a knife wound to the heart.

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  • 16. 

    Correct pairings of fetal structures and adult derivatives associated with fetal circulation include all of the following except:

    • Third aortic arch/common carotid artery

    • Umbilical artery/common iliac artery

    • Ductus arteriosus/ligamentum arteriosum

    • Umbilical vein/ligamentum teres hepatis

    Correct Answer
    A. Umbilical artery/common iliac artery
    Explanation
    Umbilical Artery become INTERNAL iliac artery

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  • 17. 

    Which one of the following does not lie 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 lower border of the fourth thoracic vertebra. It contains various structures including the superior vena cava, trachea, esophagus, and the left recurrent laryngeal nerve. The right recurrent laryngeal nerve, however, does not pass through the superior mediastinum. It descends into the chest through the neck and loops around the right subclavian artery. Therefore, the right recurrent laryngeal nerve does not lie in the superior mediastinum.

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  • 18. 

    The pericardial sac is filled with a straw-colored fluid. This fluid can be removed safely by introducing a needle in an area bounded by the:

    • Left mid-clavicular line and 3rd intercostals space

    • Right mid-axillary line and 4th or 5th intercostals space

    • Suprasternal notch

    • Left parasternal border and 3rd intercostals space

    • Caudal part of the body of sternum and medial ends of left 4th and 5th costal cartilages

    Correct Answer
    A. Caudal part of the body of sternum and medial ends of left 4th and 5th costal cartilages
    Explanation
    The correct answer is the caudal part of the body of sternum and medial ends of left 4th and 5th costal cartilages. This is because the pericardial sac is located in the chest cavity, specifically between the sternum and the heart. The caudal part of the body of sternum refers to the lower part of the breastbone, while the medial ends of the left 4th and 5th costal cartilages refer to the lower ribs on the left side. By introducing a needle in this area, the straw-colored fluid in the pericardial sac can be safely removed.

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  • 19. 

    Which of the following statements do NOT correctly describe development of the bronchi ?

    • Lung buds first form at the caudal end of the laryngotracheal tube

    • During the 5th week of development, the lung buds grow laterally into the primitive pleural cavities (pericardioperitoneal canals)

    • Third generation bronchi ( Tertiary bronchi) supply bronchopulmonary segments

    • The pulmonary cartilage, smooth muscle, and connective tissue are derived from lung bud endoderm

    • By 24 weeks of development, respiratory bronchioles are present

    Correct Answer
    A. The pulmonary cartilage, smooth muscle, and connective tissue are derived from lung bud endoderm
    Explanation
    The smooth muscle, cartilage, and connective tissues of the bronchial tubes and the pleural sacs of the lungs develop from mesenchyme (mesoderm).

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  • 20. 

    A 40-year-old patient, who is a heavy smoker, complains of pain at the root of the neck and over the shoulder. Radiographic examination reveals an abnormal mass invading the mediastinal pleura. The sensory innervation of the mediastinal pleura is mediated by the

    • Celiac ganglia

    • Intercostal nerves

    • Phrenic nerve

    • T1-T4 paravertebral ganglia

    • Vagus nerve

    Correct Answer
    A. Phrenic nerve
    Explanation
    The phrenic nerve is responsible for the sensory innervation of the mediastinal pleura. This nerve originates from the cervical spine (C3-C5) and supplies sensation to the diaphragm and the mediastinal pleura. In this case, the patient's complaint of pain at the root of the neck and over the shoulder suggests involvement of the phrenic nerve, as these areas are innervated by this nerve. Additionally, the fact that the patient is a heavy smoker may suggest a potential cause for the abnormal mass invading the mediastinal pleura.

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  • 21. 

    A 35-year-old male patient suffering from pulmonary hypertension has been diagnosed with ostium secundum atrial septal defect. Abnormal development of the following structure is responsible for this developmental defect:

    • Aorticopulmonary septum

    • Endocardial cushion

    • Interventricular septum

    • Septum primum

    • Sinus venosus

    Correct Answer
    A. Septum primum
    Explanation
    The septum primum is responsible for the development of the atrial septum. In the case of an ostium secundum atrial septal defect, there is a failure of the septum primum to properly close the ostium secundum, resulting in a hole in the atrial septum. This allows blood to flow between the left and right atria, leading to pulmonary hypertension.

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  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 07, 2011
    Quiz Created by
    Chachelly

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