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  • Question 1 - A victim of assault in a domestic violence is stabbed in the left...

    Incorrect

    • A victim of assault in a domestic violence is stabbed in the left chest. The tip of the pen knife entered the pleural space just above the cardiac notch. Luckily the lung was spared as it would only occupy this space during deep inspiration. Which of these structures was pierced by the knife?

      Your Answer: Cupola

      Correct Answer: Costomediastinal recess

      Explanation:

      The costomediastinal recess is located immediately next to the cardiac notch. The medial aspect of the superior lobe of the left lung, when fully inflated expands to this place. The lung wouldn’t enter the anterior or the posterior mediastinum which are found between the two pleural cavities.

      The costodiaphragmatic recess is the lowest extent of the pleural cavity where the inferior lobes of the lungs would expand into in deep inhalation.

      The cupola, is the part of the pleural cavity that extends above the first rib into the root of the neck. The superior most part of the superior lobe of the lung might extend into this part.

      Pulmonary ligament: pleural fold that is located below the root of the lung where the visceral pleura and the mediastinal pleura are in continuity.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      41
      Seconds

  • Question 2 - A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is...

    Incorrect

    • A 45-year old with sarcoidosis has enlarged tracheobronchial lymph nodes. Which nerve is most likely to be irritated in this patient?

      Your Answer: Right recurrent laryngeal

      Correct Answer: Left recurrent laryngeal

      Explanation:

      Tracheobronchial lymph nodes are located at the bifurcation of the trachea and are in three groups i.e. the right superior, left superior and inferior. The aorta arches over the left bronchus near the point of tracheal bifurcation. Thus, the nerves that are closely associated with the aorta might be irritated if these nodes become inflamed. The left recurrent laryngeal nerve is such a nerve. The phrenic nerves, both the left and the right, are lateral and thus would not be affected. The right recurrent nerve loops around the right subclavian artery and is distant from this area. The right vagus artery is not associated with the aorta and the sympathetic chain is located in the posterior chest parallel to the vertebra, also not associated with the tracheobronchial tree.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      26.7
      Seconds

  • Question 3 - What is the likely course of a pulmonary embolism arising from the leg...

    Incorrect

    • What is the likely course of a pulmonary embolism arising from the leg veins and ending in the apical segmental pulmonary artery that supplies the superior lobe of left lung?.

      Your Answer: Inferior vena cava – right atrium – tricuspid valve – right ventricle – pulmonary trunk – left pulmonary artery – left bronchial artery – left apical segmental artery

      Correct Answer: Inferior vena cava – right atrium – tricuspid valve – right ventricle – pulmonary trunk – left pulmonary artery – left superior lobar artery – left apical segmental artery

      Explanation:

      A clot originating in the leg vein will go to the inferior vena cava, into the right atrium, through the tricuspid valve, into the right ventricle, through the pulmonary trunk, into the left pulmonary artery, into the left superior lobar artery and then finally reach the left apical segmental artery.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      32
      Seconds

  • Question 4 - Which muscle is most likely to be affected following an injury to the...

    Correct

    • Which muscle is most likely to be affected following an injury to the thoracodorsal nerve (C6-C8)?

      Your Answer: Latissimus dorsi

      Explanation:

      Latissimus dorsi is a triangular, flat muscle that covers the lumbar region and the lower half of the thoracic region. It is supplied by the sixth, seventh and eighth cervical nerves through the thoracodorsal (long subscapular) nerve.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      6.3
      Seconds

  • Question 5 - An anatomy instructor is giving a demonstration of the right lung. Which of...

    Correct

    • An anatomy instructor is giving a demonstration of the right lung. Which of the statements about the right lung made by the demonstrator is correct?

      Your Answer: Its upper lobar bronchus lies behind and above the right pulmonary artery

      Explanation:

      The root of the lungs on both sides are similar in that the pulmonary veins are anterior and inferior while the bronchus is posterior. However, on the right side, the pulmonary arteries are anterior to the bronchus while on the left side the pulmonary arteries are superior to the bronchus. The lingual is only found on the left lung. The mediastinum is the space in the thorax between the two pleural sacs and does not contain any lung. The right lung, having three lobes, is slightly larger than the left lung. On both sides, the phrenic nerves passes in front of the root of the lung.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      43.5
      Seconds

  • Question 6 - A computer tomography guided needle biopsy is done on a patient with a...

    Correct

    • A computer tomography guided needle biopsy is done on a patient with a cystic swelling in the left chest. The radiologist inserted the biopsy needle into the 9th intercostal space along the mid axillary line to aspirate the swelling and obtain tissue for histological diagnosis. In which space is the swelling most likely to be?

      Your Answer: Costodiaphragmatic recess

      Explanation:

      The costodiaphragmatic recess is the lowest point of the pleural sac where the costal pleura becomes the diaphragmatic pleura. At the midclavicular line, this is found between ribs 6 and 8; at the paravertebral lines, between ribs 10 and 12 and between ribs 8 and 10 at the midaxillary line.

      The cardiac notch: is an indentation of the heart on the left lung, located on the anterior surface of the lung.

      Cupola: part of the parietal pleura that extends above the first rib.

      Oblique pericardial sinus: part of the pericardial sac located posterior to the heart behind the left atrium.

      Costomediastinal recess: a reflection of the pleura from the costal surface to the mediastinal surface, is on the anterior surface of the chest.

      The inferior mediastinum: is the space in the chest occupied by the heart.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      47.4
      Seconds

  • Question 7 - An operation to resect a tumour of the right lung was stopped as...

    Correct

    • An operation to resect a tumour of the right lung was stopped as the chest surgeon said that the tumour was crossing the oblique fissure. Which structures are separated by the oblique fissure of the right lung?

      Your Answer: Lower lobe from both upper and middle lobes

      Explanation:

      The oblique fissure on the right lung separates the lower lobe from both the middle and upper lobe. The lingual is only found on the left lung and is part of the upper lobe.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      46.6
      Seconds

  • Question 8 - An operation to remove a segment of the oesophagus through a right thoracotomy...

    Correct

    • An operation to remove a segment of the oesophagus through a right thoracotomy is complicated when a tear develops in a large venous structure in the posterior mediastinum that empties into the superior vena cava. Which of the following structures is likely to be injured?

      Your Answer: Azygos vein

      Explanation:

      The azygos vein is formed by the union of the right subcostal veins and the ascending lumbar veins at the level of the 12th thoracic vertebra. It enters the thorax through the aortic hiatus to ascend in the posterior mediastinum and arching over the right main bronchus posteriorly at the root of the right lung to join the superior vena cava before it pierces the pericardium.

      The basilic vein is a vein on the medial aspect of the arm that ascends to become the axillary vein.

      The cephalic vein is also a vein of the arm.

      The external jugular and brachiocephalic vein are not in the posterior mediastinum.

      The median cubital vein is found in the cubital fossa of the arm.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      16.8
      Seconds

  • Question 9 - In order to arrest sudden bleeding during pericardiectomy that started after accidental injury...

    Incorrect

    • In order to arrest sudden bleeding during pericardiectomy that started after accidental injury to a major vasculature in the pericardium; the surgeon inserted his left index finger through the transverse pericardial sinus, pulled forward on the two large vessels lying ventral to his finger, and compressed these vessels with his thumb to control the bleeding. Which vessels were these?

      Your Answer: Pulmonary trunk and brachiocephalic trunk

      Correct Answer: Pulmonary trunk and aorta

      Explanation:

      Transverse pericardial sinus: located behind two great vessels (aorta and pulmonary trunk) and in front of the superior vena cava and is accessed from above as in this case. The brachiocephalic trunk is located above the pericardium and the right pulmonary artery is above the pericardial reflections.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      28.5
      Seconds

  • Question 10 - During work up for a 29 year-old lady who complained of chest pain,...

    Incorrect

    • During work up for a 29 year-old lady who complained of chest pain, a computed tomography showed a large mass in the posterior mediastinum. Which among the following structures could be involved?

      Your Answer: Ascending aorta

      Correct Answer: Lymph nodes

      Explanation:

      Boundaries of the posterior mediastinum include:

      Superior: a plane through the sternal angle and T4/5

      Inferior: the diaphragm

      Anterior: the middle mediastinal structures

      Posterior the spinal cord.

      Structures in the posterior mediastinum include the descending thoracic aorta, the azygos system, oesophagus, thoracic duct and lymph nodes. The great vessels and structures at the root of the lung are part of the middle mediastinum. In this case, the lymph nodes is the correct answer.

    • This question is part of the following fields:

      • Anatomy
      • Thorax
      17.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (5/10) 50%
Thorax (5/10) 50%
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