Mini 3 - Michigan Questions: Superior Mediastinum And Lungs
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- 1.You are called to perform thoracentesis (remove fluid from the pleural cavity). If you are to avoid injuring lung or neurovascular elements, where would you insert the aspiration needle?
- A.
The top of interspace 8 in the midclavicular line
- B.
The bottom of interspace 8 in the midclavicular line
- C.
The top of interspace 9 in the midaxillary line
- D.
The bottom of interspace 9 in the midaxillary line
- E.
The top of interspace 11 in the scapular line
- 2.The pleural space into which lung tissue just above the cardiac notch would tend to expand during deep inspiration is the:
- A.
Anterior mediastinum
- B.
Costodiaphragmatic recess
- C.
Costomediastinal recess
- D.
Cupola
- E.
Pulmonary ligament
- 3.Which feature is found only in the left lung?
- A.
Cardiac notch
- B.
Horizontal fissure
- C.
Oblique fissure
- D.
Superior lobar bronchus
- E.
Three lobes
- 4.Which of the following nerves would be most vulnerable to irritation when the tracheobronchial lymph nodes are enlarged due to a diseased situation?
- A.
Right phrenic
- B.
Left phrenic
- C.
Right recurrent laryngeal
- D.
Left recurrent laryngeal
- E.
Right vagus
- 5.Which part of the left lung might partially fill the costomediastinal recess in full inspiration?
- A.
Apex
- B.
Cupola
- C.
Hilum
- D.
Lingula
- E.
Middle lobe
- 6.The oblique fissure of the right lung separates which structures?
- A.
Lower lobe from lingula
- B.
Lower lobe from upper lobe only
- C.
Lower lobe from both upper and middle lobes
- D.
Lower lobe from middle lobe only
- E.
Upper from middle lobe
- 7.A 4-year-old girl is brought in with coughing, and you are told by her mother that she had been playing with some beads and had apparently aspirated one (gotten it into her airway). Where would you expect it to most likely be?
- A.
Apicoposterior segmental bronchus of left lung
- B.
Left main bronchus
- C.
Lingular segment of left lung
- D.
Right main bronchus
- E.
Terminal bronchiole of right lung, lower lobe
- 8.Which statement is true about the right lung?
- A.
It is slightly smaller than the left lung
- B.
It has a lingular segmental bronchus
- C.
It occupies the rightmost portion of the mediastinum
- D.
Its upper lobar bronchus lies behind and above the right pulmonary artery
- E.
It has the right phrenic nerve passing posterior to the lung root
- 9.In a post-soccer match brawl, a 35-year-old man was stabbed in the back with a knife that just nicked his left lung halfway between its apex and diaphragmatic surface. Which part of the lung was most likely injured?
- A.
Hilum
- B.
Inferior lobe
- C.
Lingula
- D.
Middle lobe
- E.
Superior lobe
- 10.During a surgical procedure in the vicinity of the descending aorta, a surgeon accidentally cuts the first aortic intercostal arteries. Which of the following structures might be deprived of its main source of blood supply?
- A.
First posterior intercostal space
- B.
First anterior intercostal space
- C.
Left bronchus
- D.
Right bronchus
- E.
Fibrous pericardium
- 11.A sick person, lying supine in bed, aspirates (breathes in) some fluid into her lungs while swallowing. It would most likely end up in which of the following bronchopulmonary segments?
- A.
Anterior segmental bronchus of right superior lobe
- B.
Medial segmental bronchus of right middle lobe
- C.
Superior segmental bronchus of right inferior lobe
- D.
Medial basal segmental bronchus of left inferior lobe
- E.
Inferior segmental bronchus of lingular lobe
- 12.A 22-year-old male involved in a bar-room brawl suffered a stab wound through the posterior thoracic wall that entered the posterior surface of the right lung half way between its apex and diaphragmatic surface. Which part of the lung did the knife first enter?
- A.
Cupola
- B.
Inferior lobe
- C.
Lingula
- D.
Middle lobe
- E.
Superior lobe
- 13.A 20-year-old man was stabbed in the back with a knife that just nicked his right lung halfway between its apex and diaphragmatic surface. Which part of the lung was most likely injured?
- A.
Middle lobe
- B.
Inferior lobe
- C.
Cardiac notch
- D.
Lingula
- E.
Superior lobe
- 14.A 10-year-old boy underwent a tonsillectomy under general anesthesia. At home he lay supine in bed for two weeks and developed a fever and chest pain with cough. He returned to the hospital and was diagnosed as having right lung pneumonia due to aspiration of infectious material during the tonsillectomy. In which bronchopulmonary segment of the lung would fluid (pus) most likely have accumulated by the simple force of gravity?
- A.
Anterior basal segment--inferior lobe
- B.
Anterior segment--superior lobe
- C.
Lateral segment--middle lobe
- D.
Superior segment--inferior lobe
- E.
Superior lingual segment—lingula
- 15.You are observing a doctor perform a bronchoscopy. As he passes the bronchoscope down the trachea, a cartilagenous structure is observed separating the right and left main stem bronchi. He asks what it is called. You reply that it really does look like a ship's keel and that it is called the:
- A.
Carina
- B.
Cricoid cartilage
- C.
Costal cartilage
- D.
Pulmonary ligament
- E.
Tracheal ring
- 16.The minor (horizontal) fissure separates:
- A.
The lower lobe from the lingula
- B.
The upper lobe from the lingula
- C.
The lower lobe from both the middle and upper lobes
- D.
The lower lobe from the middle lobe
- E.
The middle lobe from the upper lobe
- 17.Your patient, an 86-year-old female who has been bed-ridden and lying supine for many weeks, has developed a right lung abscess that is draining by gravity into one particular region of the lung. Where is the most likely site of fluid accumulation?
- A.
Apical segment of upper lobe
- B.
Lingula
- C.
Lower lobe
- D.
Middle lobe
- E.
Superior segment of lower lobe
- 18.Because of its angle with the trachea and size of the main bronchus, a bronchoscope would pass more readily into which lung?
- A.
Left
- B.
Right
- 19.Which vessel courses across the mediastinum in an almost horizontal fashion?
- A.
Left subclavian artery
- B.
Left subclavian vein
- C.
Left brachiocephalic vein
- D.
Left internal jugular vein
- E.
Left common carotid artery
- 20.A 78-year-old female presented with edema of the left upper limb due to poor venous return. Examination revealed an aneurysm of the ascending aorta that was impinging on a large vein lying immediately anterosuperior to it, most likely the:
- A.
Azygos v.
- B.
Internal thoracic v.
- C.
Left brachiocephalic v.
- D.
Left superior intercostal v
- E.
Right brachiocephalic v
- 21.An 8-year-old boy is found to have a mid-line tumor of the thymus gland that is impinging posteriorly on a blood vessel. The affected vessel is most likely the:
- A.
Left brachiocephalic vein
- B.
Left pulmonary vein
- C.
Left bronchial vein
- D.
Right pulmonary artery
- E.
Right superior intercostal vein
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