.1 :palpating the The second costal cartilage can be located by. 1 A. costal margin B. sternal angle notch C.

sternal D. sternoclavicular joint E. xiphoid process :The thoracic wall is innervated by.2 primary rami A. Dorsal B. Intercostal nerves C. Lateral pectoral nerves pectoral nerves D. Medial E. Thoracodorsal nerves sternocostal surface of the heart is formed primarily by the anterior wall of The .3 ?which heart chamber A. Left atrium B. Left ventricle Right atrium .C D.Right ventricle in an automobile accident presents with a sharp object puncture A patient involved. 4 the sternum at about the level of the 4th or 5th costal cartilage. If of the middle of also penetrated pericardium and heart wall, which heart chamber would the object ?likely be damaged most A. Left atrium B. Left ventricle Right atrium .C D. Right ventricle a 68-year-old male who has copious amounts of fluid in the left You are caring for.5 due to acute pleurisy. When you examine him as he sits up in bed pleural cavity ?upright), where would the fluid tend to accumulate (trunk costodiaphragmatic recess .A B. costomediastinal recess C. cupola reflection D. hilar E. middle mediastinum injured in an industrial explosion was found to have multiple A 23-year-old male.6 fragments in his thoracic cavity. Since the pericardium was torn inferiorly, small metal surgeon began to explore for fragments in the pericardial sac. Slipping her hand the sac until under the heart apex, she slid her fingers upward and to the right within the reflection near the they were stopped by the cul-de-sac formed by the pericardial :base of the heart. Her fingertips were then in the A. coronary sinus B. coronary sulcus recess C. costomediastinal D. oblique sinus

E. transverse sinus inserting a chest tube, intercostal vessels and nerves are avoided by placing When .7 :the tube immediately A. above the margin of a rib the margin of a rib B. below its apex can be extended upwards until stopped A hand slipped behind the heart at.8 :reflection that forms the by a line of pericardial A. Cardiac notch Costomediastinal recess .B B. Hilar reflection sinus C. Oblique pericardial D. Transverse pericardial sinus :articulates with the sternum in close proximity to the The first rib.9 Nipple .A B. Root of the lung C. Sternal angle joint D. Sternoclavicular C. Xiphoid process : parietal pleura that extends above the first rib is called the The portion of the .10 A. costodiaphragmatic recess B. costomediastinal recess costocervical recess .C D. cupola E. endothoracic fascia superior You are attending an operation to remove a thymic tumor from the .11 partly curving mediastinum. The surgeon asks, "What important nerve lying on and as we remove this posteriorly around the arch of the aorta should we be careful of -- mass?" You quickly answer, "The phrenic A. left B. left sympathetic trunk C. left vagus D. right phrenic right sympathetic trunk .E sometimes necessary to clamp off all arterial flow out of In cardiac surgery it is.12 be done within the pericardial sac by inserting the index finger the heart. This could behind the two great arteries and compressing them with the thumb of immediately ?space hand. The index finger would have to be inserted into which the same A. Cardiac notch B. Coronary sinus pericardial sinus C. Oblique D. Coronary sulcus sinus E. Transverse pericardial space along the midaxillary line would A needle inserted into the 9th intercostal.13 ?enter which space

Cardiac notch .A B. Costodiaphragmatic recess recess C. Costomediastinal D. Cupola E. Oblique pericardial sinus index finger During a heart transplant procedure, the surgeon inserted his left.14 on the two large through the transverse pericardial sinus, and then pulled forward ?these vessels lying ventral to his finger. Which vessels were A. Pulmonary trunk and brachiocephalic trunk Pulmonary trunk and aorta .B C. Pulmonary trunk and superior vena cava Superior vena cava and aorta .D artery E. Superior vena cava and right pulmonary resident insert a needle through the body While observing in the OR, you see the .15 mid-axillary line. She was obviously trying to enter wall just above the ninth rib in the :the Costodiaphragmatic recess .A B. Costomediastinal recess C. Cupola reflection D. Hilar E. Pulmonary ligament :cavity near the cardiac notch is known as the The pleural. 16 Costodiaphragmatic recess .A C. B. Costomediastinal recess D. Cupola Hilum .D E. Pulmonary ligament ?th rib articulates with which structure 7 The tubercle of the. 17 T6 A. Body of vertebra B. Body of vertebra T7 C. Body of vertebra T8 of vertebra T6 D. Transverse process E. FTransverse process of vertebra T7 surgical The ductus arteriosus sometimes remains open after birth requiring.18 avoid injury to closure. When placing a clamp on the ductus, care must be taken to ?it what important structure immediately dorsal to A. Accessory hemiazygos vein artery B. Left internal thoracic C. Left phrenic nerve D. Left recurrent laryngeal nerve Thoracic duct .E wound in which a knife blade entered A 16-year-old male suffered a stab .19 the right clavicle near its head. He was in immediately superior to the upper edge of by the ER physician as a likely indicator of a extreme pain, which was interpreted disruption of the pleura. If that was true, what portion of the collapsed lung following

?likely cut or torn pleura was most A. costal pleura B. cupola reflection C. hilar D. mediastinal pleura E.pulmonary ligament attempted to pass his During a lung transplant procedure, an observing 4th year. 20 lung, but he found passage of index finger posteriorly inferior to the root of the left ?likely be responsible for this the finger blocked. Which structure would most A. Costodiaphragmatic recess Cupola .B C. Inferior vena cava D. Left pulmonary vein ligament E. Pulmonary natural cleavage plane for surgical Which of the following layers provides a.21 ?thoracic wall separation of the costal pleura from the A. Deep fascia B. Endothoracic fascia Parietal pleura .C D. Visceral pleura fascia E. Transversus thoracis muscle which lung tissue does not extend, is The lowest extent of the pleural cavity, into.22 :known as the costodiaphragmatic recess .A B. costomediastinal recess C. cupola inferior mediastinum .D E. pulmonary ligament :sternal angle is a landmark for locating the level of the The.23 Costal margin .A B. Jugular notch C. Second costal cartilage Sternoclavicular joint .D E. Xiphoid process rd-year medical student was doing her first physical exam. In order to properly 3 A.24 She .place her stethoscope to listen to heart sounds, she palpated bony landmarks At which .began at the jugular notch, then slid her fingers down to the sternal angle ?rib (costal cartilage) level were her fingers 1 .A B. 2 C. 3 D. 4 E. Can't be determined

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