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WorksheetsThorax, Lungs and Heart
Total questions: 57
Worksheet time: 29mins
What is the difference between the extrinsic and intrinsic muscles of the thorax?
Extrinsic muscles attach to the thorax and to other areas of the body, whereas the intrinsic muscles attach only to the thorax
Extrinsic muscles are located deeper than intrinsic muscles
Intrinsic muscles assist in arm movement, extrinsic muscles aid in respiration
Intrinsic muscles are voluntary, extrinsic are involuntary
What intrinsic muscles are deep to the internal and innermost intercostal muscles?
Pectoralis major, serratus anterior, diaphragm
External oblique, internal oblique, transversus abdominis
Transversus thoracic muscle, innermost intercostal muscle, subcostal muscle
Levator costarum, subclavius, scalenes
What passes through the esophageal hiatus?
Abdominal aorta and vagus nerve
Esophagus and vagal trunks (X)
Esophagus and thoracic duct
Azygos vein and vagus nerve
What passes through the aortic hiatus?
Esophagus and thoracic duct
Inferior vena cava and azygos vein
Abdominal aorta, azygos vein, and thoracic duct
Thoracic duct, vagal trunks, and esophagus
What passes through the psoas gap?
Sympathetic trunk, genitofemoral nerve, and ilioinguinal nerve
Femoral artery, obturator nerve, and iliohypogastric nerve
Inferior vena cava, sympathetic trunk, and pudendal nerve
Aorta, psoas muscle, and vagal trunk
What is the origin of the anterior intercostal arteries?
Subclavian A; thoracoacromial A; costocervical trunk
Aorta; axillary A; brachiocephalic trunk
Axillary A; internal thoracic A; musculophrenic A
Internal thoracic A; radial A; vertebral A
For a spinal nerve lesion at T5, what would be affected?
Upper limb muscles and skin over the deltoid
Intercostal muscles and skin on the lateral and anterior aspects of the 5th intercostal space
Diaphragm and abdominal wall
Skin of the back and posterior thoracic wall
For a lesion of a lateral cutaneous nerve of an intercostal nerve, what would be affected?
Skin along the anterior but not lateral aspect of the intercostal space of the lesion
Skin along the lateral but not anterior aspect of the intercostal space of the lesion
Skin over the posterior thorax only
Entire dermatome of the affected intercostal nerve
For a lesion of the anterior cutaneous nerve of an intercostal nerve, what would be affected?
Skin along the lateral but not anterior aspect of the intercostal space of the lesion
Skin of the abdomen and pelvis
Skin along the anterior but not lateral aspect of the intercostal space of the lesion
Deep thoracic musculature
What is the difference between the parietal and visceral pleura?
The visceral pleura lies adjacent to the lung tissue and the parietal pleura lies adjacent to the inner surface of the thoracic rib cage
The parietal pleura lies within the alveolar sac, and the visceral pleura covers the bronchi
The visceral pleura lines the chest wall, and the parietal pleura covers the lung
There is no anatomical difference between the two pleurae
What bronchopulmonary segments are in the right lung but not in the left?
Superior and inferior lingual segments
Apical and posterior segments
Medial and lateral segments
Basal and anterior segments
What bronchopulmonary segments are in the left lung but not in the right?
Apical and anterior
Superior and inferior lingual
Medial and lateral
Posterior and basal
What are the differences between the left upper lobe and the right upper lobe?
The right upper lobe has more segments than the left
The left upper lobe is smaller and has fewer segments
The left upper lobe is larger than the right and has 5 segments, while the right has 3
The right upper lobe is larger and contains the lingula
What is the difference in the bronchopulmonary segment arrangement between the right lower lobe and the left lower lobe?
The right has 4 segments while the left has 5
The left lower lobe includes the lingula, the right does not
The segments of the right lower lobe and the left lower lobe are the same. There is no difference
The left lower lobe has a unique medial segment not found on the right
Beginning with the primary bronchus and ending in the alveolus, what are the sequential divisions of the bronchial tree?
Secondary bronchi > terminal bronchioles > alveolar duct > alveolus
Primary bronchus > tertiary bronchi > respiratory bronchioles > alveolus
Secondary (lobar) bronchi > tertiary (segmental) bronchi > terminal bronchi > respiratory bronchioles > alveolar duct > alveolar sac
Bronchi > bronchioles > alveolar sacs > alveoli
What are the boundaries of the superior mediastinum?
Below the diaphragm and behind the heart
Between the heart and lungs
Above a line connecting the sternal angle and the T4-T5 vertebrae to the top of the thoracic cavity
Between the spine and pericardium
What are the boundaries of the anterior mediastinum?
Above the superior mediastinum and behind the heart
Below the superior, above the diaphragm, and between the sternum and the pericardium
Posterior to the heart and spine
Between the lungs and ribs
What are the boundaries of the middle mediastinum?
Above the superior mediastinum, behind the anterior region
Between the lungs and thoracic vertebrae
Below the superior, above the diaphragm, and behind the anterior; contains the heart and pericardium
Between the sternum and ribs
What are the boundaries of the posterior mediastinum?
Between the ribs and diaphragm
Below the superior, above the diaphragm, and between the heart and the spine
Behind the sternum and in front of the heart
Between the lungs and pericardial sac
What cell in the alveolus is responsible for surfactant production?
Type I cells
Alveolar macrophages
Type II cells
Goblet cells
The pericardial sac (cavity) lies between which two pericardial layers?
Fibrous pericardium and myocardium
Parietal pericardium and fibrous layer
Visceral serous pericardium and parietal serous pericardium
Visceral and fibrous pericardium
Which of the following describes the correct flow of blood from the inferior vena cava to the aorta?
Inferior vena cava > Left atrium > Pulmonary veins > Aorta
Inferior vena cava > Right atrium > Left atrium > Left ventricle > Aorta
Inferior vena cava > Right atrium > Pulmonary trunk > Pulmonary veins > Aorta
Inferior vena cava > Right atrium > Right A-V valve > Right ventricle > Pulmonary trunk > Pulmonary arteries > Lung > Pulmonary veins > Left atrium > Left A-V valve > Left ventricle > Aortic valve > Aorta
If the anterior chest is crushed inward, what anterior (sternal) structures may be directly damaged?
Left atrium, coronary sinus, and pulmonary veins
Right atrium and ventricle, left ventricle, auricles, SVC, pulmonary trunk and arteries, coronary arteries, right marginal artery, small and anterior cardiac veins, anterior interventricular artery, great cardiac vein
Aortic arch and descending aorta
Trachea and esophagus
If a large tumor mass presses on the posterior heart, what structures might be compressed?
Trachea and main bronchi
Pulmonary veins, all chambers of the heart, superior and inferior vena cava, pulmonary arteries, right coronary artery, coronary sinus, and cardiac veins
Superior vena cava and aortic arch
Pulmonary trunk, left auricle, anterior cardiac veins
What structures of the heart cannot be seen with a posterior view of the heart?
Left atrium and pulmonary veins
Coronary sinus and inferior vena cava
Right and left auricles, anterior interventricular artery, right marginal artery, anterior cardiac veins, coronary sinus, middle cardiac vein, and inferior vena cava
Pulmonary arteries and pulmonary trunk
What structures of the heart cannot be seen with an anterior view of the heart?
Right atrium and pulmonary trunk
Pulmonary veins, left atrium, circumflex artery, left marginal artery, posterior interventricular artery, coronary sinus, middle cardiac vein, inferior vena cava
Right coronary artery and aortic arch
Anterior interventricular artery and left auricle
What areas of the heart could be damaged by an occlusion of the right coronary artery?
Right and left atria, right and left ventricles
Left atrium only
Anterior right ventricle only
Right atrium and left atrium only
What area would be affected by an occlusion of the right marginal artery?
Anterior right ventricle
Posterior left atrium
Left ventricle and interventricular septum
Left atrium and left ventricle
What area would be affected by an occlusion of the posterior interventricular artery (from the right coronary artery)?
Anterior right and left atria
Posterior right and left ventricles
Anterior left and right ventricles
Right atrium only
The areas of the heart that could be damaged by an occlusion of the left coronary artery include:
the anterior wall of the left ventricle and the interventricular septum
the right atrium and right ventricle
the posterior wall of the left ventricle only
the sinoatrial node exclusively
What areas would be affected by occlusion of the anterior interventricular, circumflex, and left marginal branches of the left coronary artery?
Only the right ventricle
Only the left atrium and left ventricle
Anterior left and right ventricles (anterior interventricular), left atrium and ventricle (circumflex), and left ventricle (left marginal)
Posterior atrial walls and aortic valve
Which veins flow into the coronary sinus?
Pulmonary veins and great cardiac vein
Superior vena cava and middle cardiac vein
Great cardiac, small cardiac, and middle cardiac veins
Anterior cardiac veins only
Which four veins empty into the right atrium?
Pulmonary veins, coronary sinus, and superior vena cava
Inferior vena cava, superior vena cava, coronary sinus, anterior cardiac veins
Coronary sinus, azygos vein, pulmonary trunk, and left atrium
Anterior cardiac veins, pulmonary veins, and inferior vena cava
What artery runs with the great cardiac vein?
Posterior interventricular artery
Right coronary artery
Circumflex artery
Anterior interventricular artery
What artery runs with the middle cardiac vein?
Anterior interventricular artery
Posterior interventricular artery
Marginal artery
Right coronary artery
What artery runs with the small cardiac vein?
Anterior interventricular artery
Left coronary artery
Right coronary artery
Circumflex artery
What is the difference between the coronary sinus and the coronary sulcus?
The coronary sinus is a venous structure that collects blood from the heart and drains into the right atrium. The coronary sulcus is a groove between the atrium and ventricle that contains vessels like the coronary sinus, circumflex artery, and right coronary artery.
The coronary sinus is a groove between the atria and ventricles, while the coronary sulcus is a vein that drains into the right ventricle.
The coronary sinus carries oxygenated blood to the heart wall, while the coronary sulcus is a muscle separating atria from ventricles.
The coronary sinus and coronary sulcus are both arteries that run along the anterior heart surface and drain into the aorta.
Which of the following describes the pathway for conduction in the heart correctly?
AV node > SA node > Bundle of His > Right and Left bundle branches to the ventricles
SA node > AV node > Bundle of His > Right and Left bundle branches to the ventricles
Bundle of His > SA node > AV node > Right and Left bundle branches to the ventricles
SA node > Bundle of His > AV node > Right and Left bundle branches to the ventricles
What are three similarities between arteries and veins?
They both have valves, three layers, and thick muscular walls
They have three sizes, three layers, and are lined with simple squamous epithelium
They both carry oxygenated blood, have valves, and are elastic
They have a single layer, valves, and smooth muscle
What are the 3 layers of arteries and veins?
Intima, media, and adventitia
Endocardium, myocardium, and epicardium
Tunica externa, tunica interna, and tunica muscularis
Pericardium, myocardium, and endocardium
What are three differences between arteries and veins?
Arteries have valves, veins have elastic media, and adventitia is thicker in arteries
Intima and media of arteries are elastic and contain smooth muscle cells, but veins do not; the adventitia of arteries consists of connective tissue, but veins contain longitudinal bundles of smooth muscle cells
Veins have thicker walls than arteries, and arteries have valves but veins do not
Arteries carry deoxygenated blood, veins carry oxygenated blood, and veins have thicker adventitia
How is the foramen ovale formed and how does it relate to the separation of the common atrium?
The septum primum grows to divide the common atrium and develops an opening called the foramen secundum. Then, the septum secundum forms and overlaps the foramen secundum, creating a one-way valve known as the foramen ovale.
The foramen ovale forms when the septum secundum fuses completely with the septum primum, permanently separating the atria.
The foramen ovale forms from the interventricular septum and connects the ventricles instead of the atria.
The common atrium is divided by a single septum that leaves an open hole called the foramen ovale, which closes before birth.
How are the pulmonary trunk and aorta formed from the common bulbus cordis?
There is one tube and this common tube is then separated by a spiral septum. This septum divides the tube into equally sized tubes – one will be the pulmonary trunk and the other aorta
The common bulbus cordis divides into three separate vessels, forming the pulmonary trunk, aorta, and superior vena cava
The pulmonary trunk grows from the right atrium, while the aorta grows from the left ventricle independently
The pulmonary trunk and aorta fuse into one vessel that later separates into branches
In what two ways does circulation bypass the lungs in the fetus and what happens to the bypasses after birth?
One bypass is through the foramen ovale, where blood from the right atrium passes directly into the left atrium, bypassing the non-functional lungs; another is through the ductus arteriosus connecting the pulmonary trunk to the aorta, allowing blood from the right ventricle to bypass the lungs
Blood bypasses the lungs through the umbilical arteries and veins; both bypasses remain open after birth
Blood flows directly from the left ventricle to the right ventricle, bypassing the lungs, and the bypass closes only in adulthood
The lungs are bypassed by the tricuspid valve and mitral valve, which shut after birth
What is the tetralogy of Fallot?
Membranous interventricular septal defect
Pulmonary stenosis (narrowing of the pulmonary trunk opening from the right ventricle)
Overriding aorta so that the aortic opening overrides the right and left ventricles
Right ventricular hypertrophy
All of these
What structures in the superior mediastinum do not enter the middle or posterior mediastina?
Brachiocephalic veins, internal jugular and subclavian veins, brachiocephalic artery, common carotid and subclavian arteries, arch of the aorta and recurrent laryngeal nerve
Vagus nerve, phrenic nerve, and esophagus
Trachea, thoracic duct, and azygos vein
Thoracic duct, sympathetic trunk, and descending aorta
What structures are common to the superior and middle mediastina?
Esophagus, sympathetic trunk, azygos vein, vagus nerve, thoracic duct, and aorta
Superior vena cava, vagus nerve, phrenic nerve, and trachea
Brachiocephalic veins, internal jugular vein, and recurrent laryngeal nerve
Thoracic duct, aorta, and azygos vein
What structures are common to the superior and posterior mediastina?
Superior vena cava, vagus nerve, phrenic nerve, and trachea
Esophagus, sympathetic trunk, azygos vein, vagus nerve, thoracic duct, and aorta
Brachiocephalic artery, common carotid artery, and subclavian artery
Pulmonary trunk, right atrium, and right ventricle
In which mediastina do each of the three parts of the aorta lie?
Ascending aorta - superior mediastinum; arch - middle mediastinum; descending aorta - posterior mediastinum
Ascending aorta - middle mediastinum; arch - superior mediastinum; descending aorta - posterior mediastinum
Ascending aorta - posterior mediastinum; arch - superior mediastinum; descending aorta - middle mediastinum
Ascending aorta - posterior mediastinum; arch - middle mediastinum; descending aorta - superior mediastinum
What drains into the azygos and hemiazygos veins?
Anterior intercostal veins, vertebral venous plexus, esophageal and bronchial veins
Posterior intercostal veins, vertebral venous plexus, esophageal and bronchial veins
Coronary veins and hepatic veins
Jugular veins and subclavian veins
Which of the following describes the azygos vein?
It lies on the left side of the spine, draining structures on the left side and emptying into the left brachiocephalic vein
It lies on the right side of the spine, draining structures on the right side and emptying into the superior vena cava
It drains directly into the inferior vena cava
It lies anterior to the heart and drains into the pulmonary veins
Which of the following describes the hemiazygos vein?
Lies on the right side of the spine and drains structures for the upper thoracic levels into the azygos vein
Lies on the left side of the spine and drains structures for the lower thoracic levels into the azygos vein
Drains directly into the superior vena cava
Drains the abdominal veins into the inferior vena cava
Which of the following describes the accessory hemiazygos vein?
It drains structures in the upper left thoracic levels into the hemiazygos vein
It drains the right thoracic wall into the azygos vein
It drains into the inferior vena cava directly
It drains the abdominal cavity into the thoracic duct
Into which vein does the azygos vein drain?
Inferior vena cava
Superior vena cava
Left brachiocephalic vein
Pulmonary vein
Into which vein does the hemiazygos vein drain?
Superior vena cava
Left brachiocephalic vein
Azygos vein
Inferior vena cava
The thoracic duct receives lymphatic drainage from what area of the body?
Only the right thoracic structures
Abdomen, pelvis, lower limb into the cisterna chyli, and left thoracic structures; right thoracic structures mainly drain into the right lymphatic duct
Only the head and neck region
Only the left arm and left thoracic region
What happens to the lymphatic drainage in the thoracic duct if it is blocked?
Lymph reroutes through the right lymphatic duct with no symptoms
Extracellular fluids from the regions drained by these lymphatics are not removed, resulting in edema in those regions
Lymph drains directly into the vena cava bypassing the thoracic duct
There is no effect on lymphatic drainage
