Thorax- Anatomy 2nd Sem, 2nd Year- PMU

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Pectoral nerves are branches of the medial and lateral cords of the brachial plexus

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Long thoracic nerve is a direct branch of the roots of the brachial plexus

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Dorsal scapular nerve is a direct branch of the roots of the brachial plexus

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Superior trunk of the brachial plexus gives off n.suprascapularis and nerve to the subclavius

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Mediastinum is the space in thoracic cavity where the lungs are located

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The lower border of parietal pleura is projected at the level of 12th rib on the back of the thorax

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The surasternal space is between the superficial (investing) and middle lamina of deep cervical fascia

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The phrenic nerve is a part of the neurovascular bundle of the neck

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The cervical parietal pleura farms the dome of each pleural cavity

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The parietal and visceral pericardium are separated by a thin film of fluid

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*The subclavian vessels arch over the anterior surface of the dome of the pleura

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The costomediastinal recess lies along the inferior margin of the pleura

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The costodiaphragmatic recess extends between the thoracic wall and the vertical part of the diaphragm

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The phrenic nerve and its accompanying vessels pass anterior to the lung root

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The vagus nerve descends posterior to the lung root

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The phrenic and vagus nerves descend between the pericardium and sternum

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The thoracic duct enters the thoracic cavity through hiatus aorticus

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The lower boundary of mediastinum superius is the plane between angulus sterni and Th4/Th5

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The upper boundary of mediastinum superius is the plane between the sternal notch and Th1

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Phrenic nerve passes posteriorly to the root of the lungs

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Vagus nerve passes anteriorly to the root of the lungs

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Phrenic and vagus nerves pass together posteriorly to the root of the lungs

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In the thorax sympathetic trunk is ultimately related to the esophagus

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Aortic arch may have from 1 to 6 branches

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The pleural cavity contains:

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*In lymphatic drainage of the breast, the major portion (about 75%) enters eventually into which group of nodes?

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A woman with breast cancer subsequently develops metastases in her vertebral column. The most direct route for spread of the tumor to the vertebral column was via:

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*The clavipectoral fascia is penetrated by which artery?

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*During a motorcycle accident, an 18-year-old male landed on the right lateral side of his rib cage with his right upper limb abducted. In the hospital he was found to have "winging” of the right scapula. Which nerve was likely damaged in the accident?

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Breast cancer cells can spread directly to the cranial cavity and brain via the vertebral venous plexus. Thmngh which route can they reach this plexus?

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While observing a mastectomy on a 60-year-old female patient, a medical student was asked by the surgeon to help tie off the arteries that supply the medial side of the breast. The artery that gives origin to these small branches is the:

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*Upon finding a malignant tumor in the medial portion of the breast of a 40-year-old female, the surgeon began to search for the lymph nodes that would be the first ones reached by metastatic spread of cancer cells from this site. Which group(s) would have to be examined to determine whether metastasis had occurred?

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When inserting a chest tube, intercostal vessels and nerves are avoided by placing the tube immediately:

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Because of its angle with the trachea and size of the main bronchus. a bronchoscpe would pass more readily into which lung?

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The second costal cartilage can be located by palpating the:

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The thoracic wall is innervated by:

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A 3rd~year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers?

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The portion of the parietal pleura that extends above the first rib is called the:

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A stethoscope placed over the left second intercostal space just lateral to the sternum would be best positioned to detect sounds associated with which heart valve?

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Which valves would be open during ventricular systole?

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Which statement is true of the right atrioventricular valve?

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The heart sound associated with the mitral valve is best heard:

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You are attending an operation to remove a thymic tumor from the superior mediastinum. The surgeon asks, “What important nerve lying on and partly curving posteriorly around the arch of the aorta should we be careful of as we remove this mass?” You quickly answer, “The--

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The sternocostal surface of the heart is formed primarily by the anterior wall of which heart chamber?

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Which of the following layers provides a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall?

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The diaphragm receives its main motor nerve supply from:

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Which structure does NOT lie in the coronary sulcus?

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Which posterior mediastinal structure is most closely applied to the posterior surface of the pericardial sac?

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In obstruction of the superior or inferior vena cava, venous blood is returned to the heart by an alternate route via the azygos vein, which becomes dilated in the process. Which of the following structures might it compress as a result?

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Elevated systolic blood pressure in the right ventricle suggests stenosis of which valve?

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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?

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The pleural space into which lung tissue just above the cardiac notch would tend to expand during deep inspiration is the:

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Which vessel courses across the mediastinum in an almost horizontal fashion?

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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:

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Sympathetic fibers in the greater thoracic splanchnic nerve arise from neuron cell bodies found in the:

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Gray rami communicantes contain postganglionic sympathetic fibers that innervate which of the following structures in the thoracic region?

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In the midregion of the thorax the thoracic duct lies immediately posterior to the:

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Lymph nodes can be found in which mediastinal compartments?

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A tumor of the posterior mediastinum is most likely to compress which of the following structures?

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The aorta is located in which mediastinal compartments?

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While performing transesophageal echocardiography on a patient, the posterior wall of the esophagus, immediately behind the left atrium, was punctured from within. The patient subsequently developed an infection in the Space around the esophagus at this point, namely the:

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Since the puncture in the previous question was through the posterior wall of the esophagus, the doctors were also very concerned about possible damage to a thin-walled vessel just behind the esophagus and between the azygos vein and aorta, i.e., the:

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During a surgical procedure, a patient’s right sympathetic trunk was accidentally severed just cranial to the level of spinal nerve T1. Which function would be left intact in the affected region?

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Most of the drainage of the thoracic body wall reaches the superior vena cava via the azygos vein. A notable exception is the left superior intercostal vein, which normally drains into the:

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You are observing a physician perform a thoracoscopic procedure. She pushes the deflated lung anteroinferiorly and points out a nervous structure lying across the heads of the ribs. You identify this structure as the

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An enlarging lymph node gradually constricts the flow of blood in the azygos venous arch. Which vessel would enlarge as a result of collateral drainage?

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A cancerous growth from the body of the 9th thoracic vertebra exerts pressure anterolaterally. Which structure lies in direct contact with this growth?

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A 45-year-old female patient complains of excessive sweating on the right side of the face and neck and in the right armpit region, where it leaves her clothing constantly stained with moisture. It is now such a terrible social embarrassment that she has become withdrawn and self-conscious. Since no medical treatment has proven effective, she is considering surgical denervation of the sweat glands in the affected areas. Which structure(s) might be removed or cut in order to alleviate her condition?

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The mammary gland

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The average female breast

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The blood supply of the mammary gland includes the following arteries:

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*The structures that pass through quadrangular space are:

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*The anterior wall of fossa axillaris comprises:

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*The medial cord of the brachial plexus

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*The axillary nerve

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*The pectoralis major muscle

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*The approximate vertebral level of

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*The posterior cord of the brachial plexus

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*The median nerve

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*The upper trunk of the brachial plexus

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*Foramen axillare laterale contains:

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Which of the following statements are true or false?

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The heart

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Regarding the surface projections on the chest:

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The root of the right lung

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The left phrenic nerve

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The left coronary artery

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The diaphragm

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The right main bronchus

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The right atrioventricular valve

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In relation to the diaphragm

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The left phrenic nerve

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A typical intercostal nerve

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The left main bronchus

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Inside the right atrium

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The esophagus

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On the mediastinal surface of the left lung

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The fibrous pericardium

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The arch of the aorta

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Sympathetic nerves in the thorax

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The right phrenic nerve

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The pleura

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The left vagus nerve

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The right coronary artery

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The trachea

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With the heart in its usual position in the body

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The oesophagus

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Parasympathetic nerves in the thorax

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The following elements are part of posterior mediastinum:

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The following elements are part of middle mediastinum:

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The following elements are part of the root of the lung:

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Match each numbered term with the most proper lettered one
A. Medial Cord (Fasciculus medialis) ( 2, 1, 3, 4, 5, 6, 7, 8 ), ( 5, 1, 2, 3, 4, 6, 7, 8 ), ( 6, 1, 2, 3, 4, 5, 7, 8 ), ( 7, 1, 2, 3, 4, 5, 6, 8 )
B. Lateral cord (Fasciculus lateral) ( 1, 2, 3, 4, 5, 6, 7, 8 ), ( 4, 1, 2, 3, 5, 6, 7, 8 )
C. Posterior Cord (Fasciculus posterior) ( 3, 1, 2, 4, 5, 6, 7, 8 ), ( 8, 1, 2, 3, 4, 5, 6, 7 )

1. Musculotaneous nerve
2. Ulnar nerve
3. Radial nerve
4. Lateral root of the median nerve
5. Medial cutaneous nerve of the arm
6. Medial cutaneous nerve of the forearm
7. Medial root of the median nerve
8. Axillary nerve

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Regarding the three parts of the axillary artery match the part and the branches
A. in trigonum clavipectoralis (first part) ( 2, 1, 3, 4, 5, 6 ), ( 5, 1, 2, 3, 4, 6 )
B. in trigonum pectorale (second part) ( 3, 1, 2, 4, 5, 6 )
C. in trigonum subpectorale (third part) ( 1, 2, 3, 4, 5, 6 ), ( 4, 1, 2, 3, 5, 6 ), ( 6, 1, 2, 3, 4, 5 )

1. Anterior humeral circumflex a.
2. Thoraco-acromial a.
3. lateral thoracic a.
4. Posterior humeral circumflex a.
5. Superior thoracic a.
6. Subscapular a.

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A. lnfraclavicular region ( 2, 1, 3 )
B. Mammary region ( 1, 2, 3 )
C. Axilla ( 3, 1, 2 )

1. Between 3rd and 6th ribs
2. Between clavicle and 3rd rib
3. Between ant. and post. axillary lines

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Which of the following A to F is. associated with 1 to 6?
A. Beginning of brachiocephalic (innominate) vein ( 4, 1, 2, 3, 5, 6 )
B. Division of trachea ( 3, 1, 2, 4, 5, 6 )
C. Inferior vena cava enters thorax ( 2, 1, 3, 4, 5, 6 )
D. Right atrioventricular orifice ( 6, 1, 2, 3, 4, 5 )
E. Esophagus enters abdominal cavity ( 1, 2, 3, 4, 5, 6 )
F. None of these ( 5, 1, 2, 3, 4, 6 )

1. Level of tenth thoracic vertebra
2. Level of eight thoracic vertebra
3. Manubriosternal joint
4. Sternoclavicular joint
5 . Seventh costal cartilage
6. Fourth costal cartilage

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Which of the following A to F is commonly used for the surface marking of 1 to 6?
A. Fourth right costal cartilage ( 4, 1, 2, 3, 5, 6 )
8. Fifth left intercostal space ( 1, 2, 3, 4, 5, 6 )
C. Body of sternum ( 2, 1, 3, 4, 5, 6 )
D. Fourth left costal cartilage ( 6, 1, 2, 3, 4, 5 )
E. Manubriosternal joint ( 3, 1, 2, 4, 5, 6 )
F. None of these ( 5, 1, 2, 3, 4, 6 )

1. Apex of heart
2. Valves of heart
3. Division of trachea
4. Horizontal (transverse) fissure of lung
5. Cardiac notch
6. Arch of aorta

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Match the anatomical region on the right with the appropriate element on the left:
A. Thymus ( 1, 2, 3, 4, 5 )
B. N. Splanchnicus major ( 4, 1, 2, 3, 5 )
C. A. Facialis ( 5, 1, 2, 3, 4 )
D. Ligg. Sternopericardiaca ( 2, 1, 3, 4, 5 )
E. Aorta Ascendens ( 3, 1, 2, 4, 5 )

1. Mediastinum superius
2. Mediastinum anterius
3. Mediastinum medius
4. Mediastinum posterius
5. Trigonum submandibulare

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Match the anatomical region on the left with the appropriate element on the right:
A. Superior mediastinum ( 5, 1, 2, 3, 4 )
B. Anterior mediastinum ( 1, 2, 3, 4, 5 )
C. Root of the lung ( 4, 1, 2, 3, 5 )
D. Middle mediastinum ( 2, 1, 3, 4, 5 )
E. Posterior mediastinum ( 3, 1, 2, 4, 5 )

1. Sternopericardiac ligaments
2. Left auricle
3. Esophagus
4. Pulmonary artery
5. Thymus

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Match the anatomical region on the left with the most appropriate element on the right:
A. Superior mediastinum ( 2, 1, 3, 4, 5 )
B. Anterior mediastinum ( 4, 1, 2, 3, 5 )
C. Root of the lung ( 1, 2, 3, 4, 5 )
D. Middle mediastinum ( 5, 1, 2, 3, 4 )
E. Posterior mediastinum ( 3, 1, 2, 4, 5 )

1. Bronchus principalis
2. Arcus aortae
3. N. splanchnicus major
4. A. thoracica interna
5. Aorta ascendens