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  • Question 1 - All of the following typically occurs as part of normal inspiration except: ...

    Correct

    • All of the following typically occurs as part of normal inspiration except:

      Your Answer: Contraction of the internal intercostal muscles

      Explanation:

      Passive inspiration is a result of contraction of the diaphragm (depressing the diaphragm) and the external intercostal muscles (elevating the ribs).
      In inspiration, several movements occur. These are:
      1. elevation of the sternal ends of the ribs (‘pump handle’ movement),
      2. elevation of the lateral shafts of the ribs (‘bucket handle’ movement)
      3. depression of the diaphragm.
      These result in expansion of the thorax in an anteroposterior, transverse and vertical direction respectively. There is an increased intrathoracic volume and decreased intrathoracic pressure and air is drawn into the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      12.4
      Seconds

  • Question 2 - Which of the following anatomical structures is most likely the cause of oedema...

    Correct

    • Which of the following anatomical structures is most likely the cause of oedema and erythema of the arm in a patient who underwent modified radical mastectomy and radiotherapy?

      Your Answer: Axillary lymph nodes

      Explanation:

      Arm oedema is one of the sequelae after breast cancer surgery and radiation therapy. Arm oedema in the breast cancer patient is caused by interruption of the axillary lymphatic system by surgery or radiation therapy, which results in the accumulation of fluid in subcutaneous tissue in the arm, with decreased distensibility of tissue around the joints and increased weight of the extremity. Chronic inflammatory changes result in both subcutaneous and lymph vessel fibrosis.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      7.1
      Seconds

  • Question 3 - All of the following typically occurs as part of normal passive expiration except:...

    Correct

    • All of the following typically occurs as part of normal passive expiration except:

      Your Answer: Contraction of the internal intercostal muscles

      Explanation:

      Passive expiration is produced primarily by relaxation of the inspiratory muscles (diaphragm and external intercostal muscles) in addition to the elastic recoil of the lungs.
      In expiration, several movements occur. There are:
      1. depression of the sternal ends of the ribs (‘pump handle’ movement),
      2. depression of the lateral shafts of the ribs (‘bucket handle’ movement) and
      3. elevation of the diaphragm.
      These result in a reduction of the thorax in an anteroposterior, transverse and vertical direction respectively. There is then a decreased intrathoracic volume and increased intrathoracic pressure and air is forced out of the lungs.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      17
      Seconds

  • Question 4 - Which of the following is true regarding respiration? ...

    Correct

    • Which of the following is true regarding respiration?

      Your Answer: The diaphragm is responsible for abdominal breathing

      Explanation:

      The following are the mechanisms of breathing during inspiration and expiration, whether normal or forced.

      Normal inspiration is an active process, with the diaphragm as the main muscle. The diaphragm descends, ribs move upward and outward, and the lungs become wider and taller.

      In forced inspiration, which commonly occurs during exercise, the external intercostals and accessory muscles, such as the sternocleidomastoid, anterior serrati, scalenes, alae nasi, genioglossus and arytenoid are involved. The ribs move upward and outward, and the abdominal contents move downward.

      Normal expiration is a passive process, while in forced expiration, the internal intercostals and abdominal muscles, such as the rectus abdominis, internal and external obliques and transversus abdominis are involved. The ribs move downward and inward, and the abdominal contents move upward.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      28.3
      Seconds

  • Question 5 - A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from...

    Correct

    • A 38-year-old taxi driver sustained blunt force trauma to his anterior chest from the steering wheel of his car after falling asleep while driving headlong into an oncoming HGV lorry. Bruising around his sternum was observed, which appears to be the central point of impact.

      Which of the following structures is most likely injured by the blunt force trauma?

      Your Answer: Right ventricle

      Explanation:

      In its typical anatomical orientation, the heart has 5 surfaces formed by different internal divisions of the heart:

      Anterior (or sternocostal) – Right ventricle
      Posterior (or base) – Left atrium
      Inferior (or diaphragmatic) – Left and right ventricles
      Right pulmonary – Right atrium
      Left pulmonary – Left ventricle

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.5
      Seconds

  • Question 6 - During quiet respiration, position of the right oblique fissure can be marked by...

    Correct

    • During quiet respiration, position of the right oblique fissure can be marked by a line drawn on the thoracic wall that:

      Your Answer: Begins at the spinous process of T4, crosses the fifth intercostal space laterally and follows the contour of rib 6 anteriorly.

      Explanation:

      During quiet respiration, the approximate position of the right oblique fissure can be marked by a line on the thoracic wall that begins at the spinous process of vertebra T4, crosses the fifth intercostal space laterally and then follows the contour of rib 6 anteriorly.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      10.1
      Seconds

  • Question 7 - Contraction of the diaphragm results in which of the following effects: ...

    Correct

    • Contraction of the diaphragm results in which of the following effects:

      Your Answer: Increased vertical dimension of the thorax

      Explanation:

      Contraction of the diaphragm (as in inspiration) results in flattening (depression) of the diaphragm with an increase in vertical dimension of the thorax. This results in decreased intrathoracic pressure and increased intra-abdominal pressure.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      8.9
      Seconds

  • Question 8 - A 40-year-old woman presents with retrosternal central chest pain that she has been...

    Correct

    • A 40-year-old woman presents with retrosternal central chest pain that she has been complaining about for the past two days. Upon deep inspiration and while lying flat, the pain worsens but relieved by sitting forwards. The pain radiates to both of her shoulders. The result of her ECG shows widespread concave ST-elevation and PR depression. A diagnosis of pericarditis is suspected.

      Which of the following nerves is responsible for the pattern of her pain?

      Your Answer: Phrenic nerve

      Explanation:

      Pericarditis is inflammation of the pericardial sac and is the most common pathologic process involving the pericardium. Frequently, pericardial inflammation can be accompanied by increased fluid accumulation within the pericardial sac forming a pericardial effusion, which may be serous, hemorrhagic or purulent depending on aetiology.

      The classic presentation is with chest pain that is central, severe, pleuritic (worse on deep inspiration) and positional (improved by sitting up and leaning forward). The pain may also be radiating and may involve the ridges of the trapezius muscle if the phrenic nerve is inflamed as it traverses the pericardium.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      11.7
      Seconds

  • Question 9 - Which coronary artery is mostly likely affected if an ECG shows a tombstone...

    Correct

    • Which coronary artery is mostly likely affected if an ECG shows a tombstone pattern in leads V2, V3 and V4?

      Your Answer: Left anterior descending artery

      Explanation:

      Tombstoning ST elevation myocardial infarction can be described as a STEMI characterized by tombstoning ST-segment elevation. This myocardial infarction is associated with extensive myocardial damage, reduced left ventricle function, serious hospital complications and poor prognosis. Tombstoning ECG pattern is a notion beyond morphological difference and is associated with more serious clinical results.

      Studies have shown that tombstoning is more commonly found in anterior than non-anterior STEMI, thus, higher rates of left anterior descending artery disease are observed in patients with tombstoning pattern.

      The following ECG leads determine the location and vessels involved in myocardial infarction:

      ECG Leads Location Vessel involved
      V1-V2 Septal wall Left anterior descending
      V3-V4 Anterior wall Left anterior descending
      V5-V6 Lateral wall Left circumflex artery
      II, III, aVF Inferior wall Right coronary artery (80%) or Left circumflex artery (20%)
      I, aVL High lateral wall Left circumflex artery
      V1, V4R Right ventricle Right coronary artery
      V7-V9 Posterior wall Right coronary artery

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      37.9
      Seconds

  • Question 10 - The 'pump handle' movement of the thoracic wall describes which of the following movements:...

    Correct

    • The 'pump handle' movement of the thoracic wall describes which of the following movements:

      Your Answer: The anterior ends of the ribs moving upwards and forwards

      Explanation:

      Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, the anterior end moves upwards and forwards, moving the sternum upwards and forwards in turn. This ‘pump handle’ upwards and forwards movement changes the anteroposterior (AP) dimension of the thorax.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      16.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (10/10) 100%
Thorax (10/10) 100%
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