Thorax and Abdomen

Use the following letters to indicate your answer:

A: Only I is true
B: Only II is true
C: Both are true
D: Both are false

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1. I. The thoracic inlet is the superior opening of the thorax. It is closed

on its lateral
thirds by the nonelastic suprapleural membranes, which are extensions
of the
endothoracic membrane.
II. The internal intercostal muscles cover the posterior surface of the
intercostal
veins, arteries and nerves.

2. I. The subclavian vein as it passes through the thoracic inlet is anterior

to the
subclavian artery.
II. The subclavian vein runs anterior to the anterior scalene muscle.

3. I. Thyrocervical arteries originate from the subclavian arteries.

II. The vagus nerves run medial to the phrenic nerves and anterior to the
subclavian
arteries.

4. I. The diaphragm of the thoracic outlet is connected to the costal cartilage

of ribs
7-10 as well as L1 and L2 vertebrae.
II. The right crus of the aortic hiatus is longer than the left crus. Both
attach to
lumbar vertebra.

5. I. The vena cava foramen in the diaphragm is located to the right of the
body midline.
II. The motor neurons of the phrenic nerves are located at C3, C4 and C5.
C4 is the
most important level. The phrenic nerves also carry sensory
information from the
diaphragm.

6. I. The superior mediastinum contains the thoracic duct, trachea, esophagus,

left and
right common carotid arteries and left and right vagus nerves.

II. The lungs can be found in the middle mediastinum.

7. I. A portion of the parietal pericardium of the heart is fused directly to

the central
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 Thorax and Abdomen
tendon of the diaphragm.

II. The epicardium is a continuation of the parietal pericardium at the base

of the heart.

8. I. The first major vessel branching from the aortic arch, i.e., the vessel
closest to the
ascending aorta, is the brachiocephalic artery.

II. The superior vena cava is anterior to the right pulmonary artery.

9. I. The coronary sinus enters the heart on the posterior side of the heart
left of the
inferior vena cava.
II. The middle cardiac vein can be found in the posterior interventricular
sulcus.

10. I. The circumflex artery arises from the right coronary artery.

II. Four pulmonary veins enter the left atrium.

11. I. Chordae tendineae are fibrous cords that attach the papillary muscle to
the
semilunar heart valves.
II. The interventricular septum is fibrous tissue in its inferior one
third.

12. I. Both AV valves of the heart are posterior to the aortic valve.

II. The left AV valve is bicuspid and the right AV valve is tricuspid.

13. I. The left coronary artery leaves the base of the ascending aorta
posterior to
the pulmonary valve.
II. The coronary artery branching pattern varies among the population.
About half the population is considered "right dominant" coronary
artery
branching pattern. This means that, in those people, the right
coronary
artery is the main blood supply to the posterior wall of the left
ventricle.

14. I. The great cardiac vein can be found in the anterior interventricular
sulcus.
II. Veins found on the right ventricle empty directly into the chamber of
the heart.

15. I. The heart beat originates in the atrioventricular node, which is

specialize
cardiac muscle tissue and is located in the right atrium.

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 Thorax and Abdomen
II. The terminal branches of the bundle of His are the Purkinje fibers.

16. I. Cardiac nerves are made of both parasympathetic and sympathetic fibers.
The sympathetic input can induce tachycardia.

II. The pulmonary valve is located at the left third costosternal junction
and
can be best ausculated at the left third intercostal space.

17. I. The apex of the heart is at the level of the left fifth intercostal
space.

II. The left recurrent laryngeal nerve branches off the vagus nerve and
loops under the left subclavian artery.

18. I. The descending esophagus eventually turns toward the right side of the
body as it penetrates the diaphragm.

II. The superior one third of the esophagus is composed of skeletal

muscle.

19. I. The esophagus is constricted at the bifurcation of the trachea.

II. The right but not the left vagus nerve sends fibers to the esophageal
plexus.

20. I. The hemiazygos vein drains the right inferior thoracic region.

II. The azygos vein passes through the esophageal hiatus and drains into
the
superior vena cava.

21. I. The thoracic duct receives lymphatic drainage from the left upper
extremity
and left side of the face.

II. The internal ridge found at the bifurcation of the trachea is called
the carina.

22. I. If a marble goes into the trachea, the odds are greater that it will be
lodged in
the left primary bronchus as opposed to the right primary bronchus.

II. The apex of both lungs projects above the first rib about an inch.

23. I. Bronchial arteries are unusual in that they carry deoxygenated blood to
the
bronchopulmonary segments.
II. The apical and posterior bronchopulmonary segments of the right lung
are
usually fused.

24. I. The parietal pleura of the thoracic cavity is another term for the
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 Thorax and Abdomen
endothoracic fascia.

II. Pneumothorax is the clinical condition of too much fluid in the

pleural cavity
of the lungs.

25. I. Elevation of ribs 2 through 6 along the anterior to posterior axis

results in the
so called "pump handle" movement. As the ribs are elevated they pull
on
the sternum, which causes the sternum to swing superior and anterior
thus
increasing the anterior to posterior axis.

II. In adults, external intercostal muscles are considered to be muscles

of
inspiration.

26. I. The aponeuroses of the transverse abdominis muscle contributes to the

conjoint tendon.

II. The psoas muscle attaches to both the transverse processes of T12-L5
and the greater trochanter of the femur bone.

27. I. The endo-abdominal fascia forms the innermost layer of the spermatic
cord.

II. The aponeuroses of the internal and external oblique muscles can be
found anterior to the rectus abdominis muscle.

28. I. The tendinous intersections of the rectus abdominis muscle attach to the
anterior
aponeurosis of the transversus abdominis muscle.
II. There is no posterior leaf of the rectus abdominis muscle below the
anterior
superior iliac spine.

29. I. The cremaster muscle is an extension of the external abdominal oblique

muscle.
II. The aponeurosis of the internal abdominal oblique muscle contributes
to both the
anterior and posterior leaf of the rectus abdominis sheath.

30. I. The internal abdominal oblique muscle is attached posteriorly to the

thoracolumbar aponeurosis.

II. The conjoint tendon is formed by the fusion of the internal and
external
abdominal oblique muscles.

31. I. The external and internal abdominal oblique muscles or aponeurosis, but
not
the transverse abdominis, contribute to the spermatic cord.

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 Thorax and Abdomen
II. The linea semilunaris can be found lateral to the rectus abdominis
muscle.

32. I. The deep inguinal ring is formed by the spermatic cord penetrating the
aponeurosis of the transversus abdominis muscle.

II. The superficial inguinal ring is formed by the spermatic cord

penetrating
the external oblique aponeurosis.

33. I. The deep inferior epigastric artery, which is a branch from the internal

iliac artery, is medial to the deep inguinal ring.

II. The femoral artery is lateral to the spermatic cord.

34. I. The femoral vein is medial to the femoral artery in the vascular lacuna.

II. The femoral nerve is lateral to the iliopectineal arch.

35. I. The inguinal triangle is bounded laterally by the lateral border of the
rectus
abdominis muscle.

II. The floor of the inguinal triangle is formed by the transversalis

fascia.

36. I. The folds of the interior lining of the stomach are called the plica
circulares.

II. The cranial horizontal region of the duodenum is the first part of the
small intestines.

37. I. The ligamentum teres hepatis can be found in the superior edge of the
falciform ligament.

II. The quadrate lobe of the liver is right of the falciform ligament.

38. I. The caudate lobe of the liver is posterior to the porta hepatis.
II. The caudate lobe of the liver is considered functionally to be part of

the left lobe.

39. I. The walls of the jejunum are thicker that the walls of the ileum.
II. The cecum is located in the lower right quadrant of the abdomen and is

where the ileum joins the colon.

40. I. Taenia coli are fat filled sacs of the peritoneum located on the colon.

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 Thorax and Abdomen

II. Haustrations are sacculations found in the large intestines and

rectum.

41. I. The common hepatic and the main pancreatic duct empty into the duodenum
distal to where the accessory pancreatic duct empties into the duodenum.

II. The tail of the pancreas can be found left of the duodenum.

42. I. The right gastric artery is a branch off the celiac artery.

II. The left gastric artery is a branch off the splenic artery.

43. I. The cystic artery is a branch off the left hepatic artery.

II. Blood passes through the hepatic proper artery en route to the greater
curvature of the stomach.

44. I. The dorsal pancreatic artery branches off the splenic artery.
II. The following is an anastomotic path between the celiac artery and the
superior
mesenteric artery: celiac --> common hepatic --> gastroduodenal -->
superior pancreaticoduodenal --> inferior pancreaticoduodenal -->
superior mesenteric.

45. I. The vasa recta to the ileum are shorter than those going to the jejunum.

II. Intestinal arteries branching off the superior mesenteric artery

supply the
descending colon.

46. I. The left colic artery, which is a branch off the inferior mesenteric
artery,
supplies blood to the ascending colon.

II. Blood passing through the inferior mesenteric artery will supply part
of the
transverse colon.

47. I. The inferior rectal artery is a branch off the internal iliac artery.
II. The superior, middle and inferior rectal arteries, which are paired,
i.e.,
bilateral vessels, supply the superior, middle and inferior regions of
the rectum.

48. I. The inferior and superior mesenteric veins join to form the hepatic
portal vein.

II. The inferior mesenteric vein drains the sigmoid colon.

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 Thorax and Abdomen

49. I. The anterior vagal trunk carries fibers mostly from the left vagus
nerve.
II. Lumbar splanchnic nerves carry both sympathetic and parasympathetic
fibers.

50. I. The hepatoduodenal ligament is the free border of the lesser omentum and

contains the proper hepatic artery and proper hepatic vein and common
bile duct.
II. The lesser omentum is a two layer part of the peritoneum that is
attached to
the lesser curvature of the stomach and inferior region of the liver.

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Key:
1 A 26 A
2 C 27 C
3 C 28 C
4 C 29 B
5 C 30 A
6 D 31 C
7 B 32 B
8 C 33 B
9 C 34 C
10 B 35 B
11 D 36 B
12 C 37 B
13 C 38 C
14 C 39 C
15 B 40 D
16 A 41 B
17 A 42 D
18 B 43 D
19 A 44 C
20 D 45 A
21 C 46 B
22 D 47 D
23 D 48 B
24 D 49 A
25 C 50 B

Dr.7abeeb

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