gross anatomy quiz 2

A patient sustains trauma causing damage to the pleura covering the lung fissures. Which pleural layer is affected?

Visceral pleura

The lubricating fluid that allows the lungs to move smoothly during respiration is found within the:

Pleural cavity

Which portion of the parietal pleura is reinforced by Sibson fascia?

Cervical pleura

A thoracentesis is most commonly performed in which location?

9th intercostal space

In a standing patient with pleural effusion, fluid is most likely to accumulate in the:

Costodiaphragmatic recess

Why is the left costomediastinal recess larger than the right?

Presence of cardiac notch

When the thoracic cavity is opened during surgery, the lungs normally recoil to approximately:

One-third size

Which part of the lung serves as the point where structures enter and leave the lung?

Hilum

The pulmonary ligament is formed by:

Continuation of visceral and parietal pleurae

Which structure is located most anteriorly in the root of both lungs?

Pulmonary vein

At the root of the right lung, the pulmonary artery is located:

Anterior and superior to the bronchus

At the root of the left lung, the pulmonary artery is:

Superior to the bronchus

Which lung has the deeper diaphragmatic concavity?

Right lung

A large cardiac enlargement would most directly affect which lung surface?

Mediastinal

Which groove is found only on the right lung?

Groove for arch of azygos vein

Which groove is continuous with the groove for the arch of the aorta on the left lung?

Groove for descending aorta

The cardiac impression is larger on the:

Left lung

The anterior border of the lungs is formed by the junction of which surfaces?

Costal and mediastinal

How many lobes are present in the right lung?

3

Which fissure is present in both lungs?

Oblique fissure

The lingula is anatomically analogous to which lobe of the right lung?

Middle

A patient aspirates a dental crown while lying supine. The object is most likely to enter the:

Right main bronchus

The trachea bifurcates at the level of the:

Sternal angle

Why is the right main bronchus a more common site for aspirated foreign bodies?

Wider and shorter

Bronchopulmonary segments are surgically removable primarily because they:

Have independent bronchial and arterial supply

Which bronchi directly supply bronchopulmonary segments?

Segmental bronchi

Which airway is the first to contain alveoli in its wall?

Respiratory bronchiole

Which structure is considered the basic unit of gas exchange?

Alveolus

Bronchioles differ from bronchi because bronchioles:

Lack cartilage

The pulmonary arteries carry:

Low-oxygen blood

The pulmonary veins drain into the:

Left atrium

Within the lungs, pulmonary arteries are generally located _____ to the corresponding airway.

Anterior

Pulmonary veins travel:

Independently between bronchopulmonary segments

The left bronchial arteries most commonly arise directly from the:

Thoracic aorta

The right bronchial artery most commonly arises from the:

Third right posterior intercostal artery

The right bronchial vein drains into the:

Azygos vein

The left bronchial vein drains into the:

Accessory hemiazygos vein

The superficial lymphatic plexus primarily drains:

Visceral pleura and lung parenchyma

The deep lymphatic plexus first drains into:

Pulmonary lymph nodes

Bronchopulmonary lymph nodes drain directly into:

Superior and inferior tracheobronchial nodes

The pulmonary plexuses are located:

Anterior and posterior to the root

Parasympathetic fibers to the lungs are carried by:

Vagus nerve

Which structure forms the middle mediastinum?

Pericardium and its contents

The superior mediastinum extends inferiorly to which anatomical landmark?

Sternal angle and T4-T5 disc

Which layer of the pericardium is directly attached to the central tendon of the diaphragm?

Fibrous pericardium

A stab wound penetrates the fibrous pericardium. Which function of the pericardium would be most directly compromised?

Prevention of sudden cardiac overfilling

The epicardium is derived from which structure?

Visceral layer of serous pericardium

The transverse pericardial sinus lies between:

IVC and coronary sinus

A surgeon places a clamp through the transverse pericardial sinus during cardiac surgery. Which vessels can be isolated?

Ascending aorta and pulmonary trunk

The oblique pericardial sinus is formed primarily by reflection around the:

Left atrium

A patient develops pericardial tamponade. What is the major consequence?

Compression of the heart within the pericardial sac

The primary arterial supply of the pericardium is the:

Pericardiacophrenic artery

Pain from the pericardium is carried primarily by the:

Phrenic nerve

A patient with pericarditis reports pain radiating to the shoulder. This is due to irritation of:

Phrenic nerve (C3-C5)

The first heart sound ("lub") results from closure of the:

Tricuspid and mitral valves

The myocardium consists primarily of:

Cardiac muscle

The coronary sulcus separates:

Atria from ventricles

The apex of the heart is formed by the:

Left ventricle

The apex is normally located deep to the:

Left 5th intercostal space

Where is the sound of mitral valve closure best auscultated?

Left 5th intercostal space near apex

Most of the base of the heart is formed by the:

Left atrium

Which chamber forms most of the anterior (sternocostal) surface?

Right ventricle

The diaphragmatic surface is formed primarily by:

Left ventricle with some right ventricle

Which vessel does NOT enter the right atrium?

Pulmonary veins

The smooth posterior wall of the right atrium is known as the:

Sinus venarum

The rough muscular ridges in the right atrium are the:

Pectinate muscles

The external groove separating smooth and rough portions of the right atrium is the:

Sulcus terminalis

The oval fossa is a remnant of the fetal:

Foramen ovale

Which structure forms the smooth outflow tract of the right ventricle?

Conus arteriosus

The moderator band contains part of the:

Right bundle branch

Damage to the moderator band could most directly affect:

Right ventricular conduction

The tricuspid valve has how many cusps?

3

Which papillary muscle is the largest in the right ventricle?

Anterior

The pulmonary valve separates the:

Right ventricle and pulmonary trunk

The left atrium receives blood from:

Pulmonary veins

Compared with the right ventricle, the left ventricular wall is:

2-3 times thicker

The smooth outflow tract leading to the aortic valve is the:

Aortic vestibule

How many cusps does the mitral valve normally possess?

2

A myocardial infarction involving the LAD would most likely affect blood supply to:

Anterior interventricular region

Which coronary artery most commonly determines coronary dominance?

RCA via posterior interventricular branch

The great cardiac vein primarily drains territories supplied by the:

LCA

Which vein drains directly into the right atrium rather than the coronary sinus?

Anterior cardiac veins

Sympathetic stimulation of the heart causes:

Increased HR and force of contraction

Parasympathetic fibers to the heart arise primarily from the:

Vagus nerve

A patient has a resting heart rate of 45 bpm due to excessive vagal stimulation. Which effect is expected?

Decreased HR

Cardiac pain from myocardial ischemia is commonly referred to the left upper limb because visceral afferents enter spinal cord levels:

T1-T3

Which structure separates the right and left pulmonary cavities?

Central mediastinum

What is the mediastinum?

The central compartment of the thoracic cavity, extending from the superior thoracic aperture to the diaphragm, containing all thoracic viscera except the lungs.

What are the parts of the mediastinum?

Superior mediastinum and inferior mediastinum, which is further divided into anterior, middle (pericardium and heart), and posterior mediastinum.

What is the pericardium?

A fibroserous membrane that covers the heart and the roots of its great vessels.

What are the layers of the pericardium?

Fibrous pericardium (tough outer layer) and serous pericardium (which has parietal and visceral layers).

What is the function of the fibrous pericardium?

It stabilizes the heart and protects it against sudden overfilling.

What is the pericardial cavity?

The potential space between the parietal and visceral layers of the serous pericardium.

What can excessive fluid in the pericardial cavity lead to?

Pericardial tamponade, which compresses the heart within the pericardial sac.

What arteries supply the pericardium?

Pericardiacophrenic artery, a branch of the internal thoracic artery.

What nerves innervate the pericardium?

Phrenic nerve (C3-C5), sympathetic trunk, and vagus nerve.

What are the external features of the heart?

The heart has 4 chambers: 2 atria and 2 ventricles.

What is the cardiac cycle?

The synchronous pumping action of the atrioventricular chambers during diastole and systole.

What are the heart sounds and what do they signify?

1st sound (lub) is the closure of the tricuspid and mitral valves; 2nd sound (dub) is the closure of the semilunar valves.

What are the three layers of the heart wall?

Epicardium (outer layer), myocardium (muscle layer), and endocardium (inner layer).