Week 9 Plus- Practice Q's

23 Questions | Total Attempts: 100

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Week Quizzes & Trivia

Questions and Answers
  • 1. 
    A 23 year old male student who was stabbed in his right anterior thorax during a bar fight presents to your clinic with dyspnea and . Following radiography, it is determined that the patient has incurred a pneumothorax. Which of the following is the correct path for the knife to take to get to the plural cavity?
    • A. 

      Skin --> Superficial fascia --> Innermost intercostal muscle --> Intercostal vessels --> Internal intercostal muscle --> External intercostal muscle --> Endothoracic fascia --> Parietal pleura

    • B. 

      Skin --> Superficial fascia --> External intercostal muscle --> Intercostal vessels --> Internal intercostal muscle --> Innermost intercostal muscle --> Endothoracic fascia --> Parietal pleura

    • C. 

      Skin --> Superficial fascia --> External intercostal muscle --> Internal intercostal muscle --> Innermost intercostal muscle --> Intercostal vessels --> Endothoracic fascia --> Parietal pleura

    • D. 

      Skin --> Endothoracic fascia --> External intercostal muscle --> Internal intercostal muscle --> Intercostal vessels --> Innermost intercostal muscle --> Superficial fascia --> Parietal pleura

    • E. 

      Skin --> Superficial fascia --> External intercostal muscle --> Internal intercostal muscle --> Intercostal vessels --> Innermost intercostal muscle --> Endothoracic fascia --> Parietal pleura

  • 2. 
    Heart blood flow dominance is determined by the artery responsible for giving which branch?
    • A. 

      Right marginal

    • B. 

      Left marginal

    • C. 

      Anterior Interventricular Artery

    • D. 

      Posterior Interventricular Artery

  • 3. 
    The left coronary artery is responsible for supplying which of the following aspects of the heart in most people?
    • A. 

      Most of the right ventricle

    • B. 

      AV node

    • C. 

      Posterior 1/3 of the interventricular septum

    • D. 

      Apex of the heart

  • 4. 
    Which is the correct pairing?
    • A. 

      Posterior Interventricular Artery -> Great Cardiac Vein

    • B. 

      Right Marginal Artery -> Small Cardiac Vein

    • C. 

      Anterior Interventricular Artery -> Oblique Vein

    • D. 

      Anterior Interventricular Artery -> Coronary Sinus

  • 5. 
    Just before entering the aorta, blood leaving the left ventricle will pass through a smooth portion which is derived from what embryological structure?
    • A. 

      Bulbus Cordis

    • B. 

      Primitive Ventricle

    • C. 

      Foramen Ovale

    • D. 

      Sinus Venosus

  • 6. 
    As a result of rheumatic heart disease, a 67 year old female suffers a ruptured papillary muscle on her tricuspid valve. Subsequently, she develops regurgitation in the same valve. Blood is now flowing, incorrectly, in which direction?
    • A. 

      From left ventricle to left atrium

    • B. 

      From right ventricle to pulmonary artery

    • C. 

      From right ventricle to right atrium

    • D. 

      From right ventricle to left ventricle

  • 7. 
    Trace the blood supply to the (9) posterior intercostal arteries 3-11.
    • A. 

      Aorta -> subclavian a. -> posterior intercostal aa.

    • B. 

      Aorta -> subclavian a. -> internal thoracic a. -> posterior intercostal aa.

    • C. 

      Aorta -> brachiocephalic trunk -> subclavian a. -> posterior intercostal aa.

    • D. 

      Aorta -> posterior intercostal aa.

  • 8. 
    Which of the following ribs only has 1 facet on its head?
    • A. 

      2nd rib

    • B. 

      3rd rib

    • C. 

      5th rib

    • D. 

      9th rib

    • E. 

      11th rib

  • 9. 
    Which of the following ribs attaches to the sternum via it’s personal chondrosternal joint?
    • A. 

      12th rib

    • B. 

      10th rib

    • C. 

      7th rib

    • D. 

      8th rib

    • E. 

      9th rib

  • 10. 
    Which best describes the level of the Manubrium in a normal anatomical presentation?
    • A. 

      T1-T3

    • B. 

      T2-T4

    • C. 

      T3-T4

    • D. 

      T1-T5

    • E. 

      T4-T5

  • 11. 
    A patient is brought unconscious via ambulance after an MVA (motor vehicle accident) to the ER where you are the physician on call. Upon initial physical exam you notice that the patient’s right thoracic wall is not expanding as much as the left thoracic wall on inspiration. Though there could be several differential diagnoses for such a presentation, let’s assume the abnormal chest expansion is due to a phrenic nerve injury. Which answer best describes the unilateral chest expansion seen in this patient?
    • A. 

      The patient’s left phrenic nerve is damaged and the left diaphragm is moving superiorly upon inspiration.

    • B. 

      The patient’s left phrenic nerve is damaged and the left diaphragm is moving inferiorly upon inspiration.

    • C. 

      The patient’s right phrenic nerve is damaged and the diaphragm is moving inferiorly upon inspiration

    • D. 

      The patient’s right phrenic nerve is damaged and the diaphragm is moving superiorly upon inspiration.

  • 12. 
    A 45 year-old male presents to your office with aortic stenosis. At approximately which location on the anterior chest wall would you best be able to hear the sound associated with this type of narrowing?
    • A. 

      Left of the xiphoid area, just off the sternum

    • B. 

      Over the sternal angle

    • C. 

      In the 2nd intercostal space, right parasternal

    • D. 

      Below the left nipple

    • E. 

      Over the apex of the heart

  • 13. 
    The intercostal neurovascular bundle is particularly vulnerable to injury from fractured ribs because it is found in which of the following locations?
    • A. 

      Above the superior border of the ribs, anteriorly

    • B. 

      Beneath the inferior border of the ribs

    • C. 

      Between external and internal intercostal muscle layers

    • D. 

      Deep to the posterior intercostal membrane

    • E. 

      Superficial to the ribs, anteriorly

  • 14. 
    Coronary artery disease is a frequent cause of myocardial infarction in the United States. If an echocardiogram suggests reduced posterior ventricular wall movement, there will be reduced blood flow within which of the following coronary arteries and veins?
    • A. 

      Circumflex branch of the left artery; great cardiac vein

    • B. 

      Anterior interventricular artery; great cardiac vein

    • C. 

      Anterior interventricular artery; middle cardiac vein

    • D. 

      Right marginal branch of the right artery; small cardiac vein

    • E. 

      Posterior interventricular artery; middle cardiac vein

  • 15. 
    A 58-year-old man comes into your emergency room with difficulty breathing. He also reports some left side chest pain and points to the inferior portion of his ribs. You listen to his lung sounds and there seems to be reduced breath sounds in the inferior half of his left plural cavity. Both PA and lateral chest films confirm what is likely fluid in the inferior 1/3 of the left pleural space. There were no obvious rib fractures. You wish to determine the nature of the fluid accumulating in the left pleural cavity, since that will dictate the appropriate treatment. What structures will your 19g needle penetrate as you pass from skin to fluid at the midaxillary line below the sixth rib?
    • A. 

      Skin, subcutaneous tissue, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, parietal pleura

    • B. 

      Skin, subcutaneous tissue, external intercostal muscle, internal intercostal muscle, parietal pleura, innermost intercostal muscle

    • C. 

      Skin, subcutaneous tissue, parietal pleura, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle

    • D. 

      Skin, parietal pleura, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, subcutaneous tissue

    • E. 

      Skin, subcutaneous tissue, innermost intercostal muscle, internal intercostal muscle, external intercostal muscle, parietal pleura

  • 16. 
    The second costal cartilage can be located by palpating the:
    • A. 

      Costal margin

    • B. 

      Sternal angle

    • C. 

      Sternal notch

    • D. 

      Sternoclavicular joint

    • E. 

      Xiphoid process

  • 17. 
    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

  • 18. 
    If a needle was inserted into the 9th intercostal space, midaxillary line, where would it enter?
    • A. 

      Costodiaphragmatic recess

    • B. 

      Cardiac notch

    • C. 

      Costomediastinal recess

    • D. 

      Cupola

    • E. 

      Oblique pericardial sinus

  • 19. 
    The tubercle of the 7th rib articulates with which structure?
    • A. 

      Body of vertebra T6

    • B. 

      Body of vertebra T7

    • C. 

      Body of vertebra T8

    • D. 

      Transverse process of vertebra T6

    • E. 

      Transverse process of vertebra T7

  • 20. 
    The portion of the parietal pleura that extends above the first rib is called the :
    • A. 

      Costodiaphragmatic recess

    • B. 

      Costomediastinal recess

    • C. 

      Costocervical recess

    • D. 

      Cupola

    • E. 

      Endothoracic fascia

  • 21. 
    A 23 year old male suffers a stab wound on the right shoulder above the clavicle. What part of the pleura has been punctured?
    • A. 

      Costal pleura

    • B. 

      Suprapleural membrane

    • C. 

      Sibson's fascia

    • D. 

      Cupola

  • 22. 
    The thoracic duct collects most of the lymph from the body. How does it enter the thorax, and where does it drain to?
    • A. 

      Aortic Diaphragmatic Aperture at T12/ left venous angle

    • B. 

      Aortic Diaphragmatic Aperture at T10/ right venous angle

    • C. 

      Esophageal Diaphragmatic Aperture at T12/ right venous angle

    • D. 

      Esophageal Diaphragmatic Aperture at T10/ left venous angle

  • 23. 
    A 26-year old male  is brought into the Emergency Department after a motorcycle racing accident. He has a racing heart, shortness of breath, low blood pressure and the jugular veins in his neck are distended. The doctor diagnosed cardiac tamponade due to bleeding into the pericardial cavity. Where should a needle be placed to drain the blood collected in the pericardial sac?
    • A. 

      Left 2nd intercostal space, mid-axillary line

    • B. 

      Left 3rd intercostal space, lateral to the sternum

    • C. 

      Left 4th intercostal space, mid-axillary line

    • D. 

      Left 6th intercostal space, lateral to the xiphoid process

    • E. 

      Left 5th intercostal space, lateral to the sternum

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