1. All of the following commonly occur upon inhalation EXCEPT: a. The ribs are elevated. b.

The abdominal muscles contract pushing abdominal viscera cranially. c. The external intercostal muscles contract. d. The diaphragm contracts. e. The vertical dimension of the thoracic cavity increases. 2. The following structure(s) may impress the esophagus during the passage of a barium meal: I. II. a. b. c. d. Left principal (main) bronchus. Diaphragm.

If only (I) is correct If only (II) is correct If both (I) and (II) are correct If neither (I) nor (II) is correct

3. When passing a needle through the chest wall into the pleural cavity (sac) in the midaxillary line of intercostal space 4, the following structures will be pierced EXCEPT the: a. Transversus thoracis. b. Internal intercostal muscle. c. Parietal pleura. d. External intercostal muscle. e. Skin. 4. The following statements concerning the main (primary, principal) bronchi are true EXCEPT: a. The right main bronchus typically divides into 2 secondary (lobar) bronchi. b. The left main bronchus passes to the left in a more horizontal position than the right main bronchus. c. The right main bronchus is shorter than the left main bronchus. d. The right main bronchus is more vertical than the left main bronchus. e. The right main bronchus is wider than the left main bronchus. 5. Which statement concerning the lungs is INCORRECT? a. Each lung is very elastic, and should the pleural sac be opened by a stab wound, it will collapse. b. The cardiac notch is present on the right lung. c. The visceral pleura covering each lung lines the fissures that are situated between the lobes. d. Anteriorly, the apex of each lung extend superiorly beyond the first rib.

e. The bronchi, connective tissue, and visceral pleura of the lungs are supplied by the bronchial arteries. 6. Which of the following statements regarding structures in the intercostals space is (are) CORRECT? I. The anterior intercostal arteries of the upper five intercostal spaces are direct branches of the internal thoracic artery. II. The sensory fibers in the lower five intercostal nerves supply the skin of the lateral thoracic and anterior abdominal walls. a. If only (I) is correct b. If only (II) is correct c. If both (I) and (II) are correct d. If neither (I) nor (II) is correct 7. A 22-year-old man was seen in the emergency room after a street shoot-out. The patient showed signs of severe hemorrhagic shock. A small entrance wound was found in the third left intercostal space about 2.5 cm from the lateral margin of the sternum. There was no exit wound. The left side of his thorax was dull on percussion, and breath sounds were absent on that side of the chest. It was decided to open the chest (thoracotomy) through the fourth left intercostal space. It was found that the left atrium had been perforated by the bullet. The following important structures are situated in the region of the thoracotomy incision EXCEPT: a. Internal thoracic artery. b. Intercostal nerve. c. Superior epigastric artery. d. Anterior intercostal artery. e. Anterior intercostal vein. 8. Concerning winged scapula, the following facts are correct EXCEPT: a. The medial border of the scapula projects backward. b. The Pectoralis major is paralyzed. c. The long thoracic nerve is damaged. d. The Serratus anterior muscle may be atrophied. e. The scapula can no longer be pulled anteriorly around the chest wall as in thrusting the upper limb anteriorly when reaching. 9. Which of the following statements concerning the Pectoralis major muscle is NOT true? a. It is innervated only by the lateral pectoral nerve. b. It medially rotates the arm at the shoulder joint. c. It adducts the arm at the shoulder joint. d. It attaches to the lateral lip of the intertubercular groove. e. Its clavicular fibers may assist in flexion at the shoulder joint.

10. Which of the following is primarily responsible for moving the heart from its early cranial position to its later mid-thoracic location? a. Coelom formation. b. Tail fold. c. Neural crest migration. d. Head fold. e. Lateral folds. 11. Which of the following statements concerning the mediastinum is INCORRECT? a. The anterior boundary of the mediastinum extends to a lower level than the posterior boundary. b. The mediastinal pleura demarcates the lateral boundaries of the mediastinum. c. The heart occupies the middle mediastinum. d. It forms a partition between the two pleural cavities. e. The sympathetic trunk is found within the posterior mediastinum. 12. All of the following statements regarding the breast is true with the EXCEPTION of: a. It is a modified sweat gland. b. It is composed of 15 to 20 lobes. c. The development of breasts in males is referred to as gynecomastia. d. Most of the lymphatics of the breast drain into the axillary nodes. e. Only the female breast undergoes pathological changes. 13. Regarding the pleural cavities: I. The parietal pleura is extremely sensitive to pain. II. The right and left pleural cavities (sacs) communicate with each other. a. b. c. d. If only (I) is correct If only (II) is correct If both (I) and (II) are correct If neither (I) nor (II) is correct

14. Deep inspiration (i.e., pulmonary ventilation) would be accompanied by all of the following with the EXCEPTION of: a. Contraction of the external intercostal muscles. b. Contraction of the scalene muscles. c. Activation of the sternocleidomastoideus muscles. d. Activation of the phrenic nerve. e. Elastic recoil of the lungs. 15. Which of the following statements concerning the lungs is TRUE? a. The right lung is smaller than the left lung. b. The oblique fissure is found only in the right lung. c. In the root of the lung, the bronchi are anterior to the pulmonary arteries.

d. The lingula is found in the inferior lobe of the left lung. e. The pulmonary arteries, pulmonary veins, and segmental bronchi run together in the center of a bronchopulmonary segment. 16. The eparterial bronchus is the: a. Right superior lobar bronchus. b. Right inferior lobar bronchus. c. Left superior lobar bronchus. d. Left inferior lobar bronchus. 17. Your patient has a space-occupying tumor that compresses structures in the posterior mediastinum. Possible structures involved include all of the following EXCEPT: a. Azygos vein. b. Thoracic duct. c. Superior vena cava. d. Descending (thoracic) aorta. e. Esophagus. 18. In the thorax: a. The azygos vein drains into the right brachiocephalic vein. b. The tubercle of the sixth rib articulates with the transverse process of the fifth thoracic vertebra. c. Visceral and parietal pleura are continuous at the root of the lung and at the pulmonary ligament. d. The pulmonary vein in the root of the right lung is located superior to the right main bronchus. e. During quiet breathing the costodiaphragmatic recess is filled by the lung. 19. All of the following statements are true EXCEPT: a. The internal thoracic artery arise from the subclavian artery. b. The internal thoracic veins drain into the brachiocephalic veins. c. The accessory hemiazygos vein drains into the azygos vein. d. The internal thoracic arteries typically divide into the musculophrenic and superior epigastric arteries at the level of the sixth intercostal space. e. The intercostal nerves innervate the mediastinal pleura and the pleura covering the central portion of the diaphragm. 20. All of the following statements regarding the thorax are true with the EXCEPTION of: a. The greater splanchnic nerve is composed of fibers which pass through the 10th and the 11th thoracic sympathetic trunk ganglia. b. The left recurrent laryngeal nerve is found in the superior mediastinum. c. The order of neurovascular structures in an intercostal space from superior to inferior is vein, artery, and nerve.

d. The manubriosternal junction is typically at the level of the fourth thoracic vertebra. e. The vagus nerves provide preganglionic parasympathetic fibers to the cardiac plexus. 21. The manubriosternal joint is located at the level of: a. The second costal cartilage. b. The boundary between the inferior mediastinum and the superior mediastinum. c. The beginning and end of the aortic arch. d. The bifurcation of the trachea. e. All of the above. 22. A male newborn infant suffered from severe respiratory distress. The abdomen was unusually flat and intestinal peristaltic movements were heard over the left side of the thorax. What congenital anomaly would you suspect? a. Hyaline membrane disease. b. Esophageal atresia. c. Congenital diaphragmatic hernia. d. Tracheoesophageal fistula. e. Gynecomastia. 23. All of the following statements are true with the EXCEPTION of: a. Folding of the embryo is a result of rapid growth of the embryo. b. The septum transversus gives rise to the central tendon of the diaphragm. c. The laryngeal cartilages are derived from the fourth and sixth branchial (pharyngeal) arches. d. The pleural and pericardial cavities are separated by the formation of the pleuropericardial membranes. e. The midgut is formed as a result of the head fold. 24. The female breast: a. Is supported by suspensory ligaments. When carcinoma invades these structures dimpling of the skin will result. b. Is located within the retromammary space. c. Carcinomas will usually metastasize to lymph nodes in the mediastinum. d. Is normally firmly attached to the fascia of the Pectoralis major muscle. e. Never extends into the axilla. 25. All of the following statements regarding the mediastinum are true with the EXCEPTION of: a. The thymus is located in the superior mediastinum. b. The arch of the aorta gives rise to the brachiocephalic trunk, left common carotid, and left subclavian arteries. c. The diaphragm forms the inferior limits of the mediastinum. d. The thoracic duct receives lymph from the right side of the thoracic cavity.

e. The superior vena cava is formed by the union of the left and right brachiocephalic veins deep to the first right costal cartilage. 26. Location of the nerve cell bodies of the nerve fibers in the fifth intercostals nerve include: a. The ventral gray column at T5. b. The fifth thoracic dorsal root ganglion. c. The fifth thoracic sympathetic ganglion. d. All of the above. e. None of the above. 27. Which of the following vessels would be involved in bypassing a coarctation of the aorta just distal to the origin of the left subclavian artery? a. The internal thoracic artery. b. The anterior intercostal arteries. c. The brachiocephalic trunk. d. The left subclavian artery. e. All of the above. 28. All of the following statements regarding the phrenic nerves are true EXCEPT: a. They contain GVE fibers. b. They provide the sole motor innervation of the diaphragm. c. They contain GSA fibers from the parietal pleura around the periphery of the diaphragm. d. They contain GSA fibers from the pericardium. e. They are made up of fibers from the ventral rami of C3, C4, and C5. 29. All of the following describe characteristics of the first rib with the EXCEPTION of: a. It is the broadest rib. b. It possesses grooves for the subclavian artery and vein on its superior surface. c. It possesses a scalene tubercle. d. It has a prominent costal groove. e. The head has a single facet for articulating with T1. 30. All of the following statements regarding the pleura are true EXCEPT: a. The costodiaphragmatic recess is located at the sternal reflection. b. The pleura cavity (sac) normally contains a small amount of serous fluid. c. The visceral pleura receives its innervation from the autonomic nerves of the lungs. d. Pain from irritation of the central diaphragmatic pleura may be referred to the base of the neck or shoulder. e. In the midaxillary region the parietal pleura extends only to the tenth rib.

31. Which of the following statements regarding the lymphatics of the lungs is FALSE? a. The pulmonary nodes are located at the large branchings of bronchi in lung tissue near the hila. b. The tracheobronchial nodes are located at the bifurcation and sides of the trachea. c. The bronchomediastinal trunks may drain into the right lymphatic duct and the thoracic duct. d. Lymph drainage from the lungs is entirely ipsilateral (i.e., to the same side). e. The superficial (subpleural) lymphatic plexus is found in lung tissue just deep to the visceral pleura. 32. A patient comes to you complaining of pain and tingling of the forearm and hand as well as coldness in the ulnar region of the hand. The most likely cause is: a. The presence of a cervical rib. b. The absence of the twelfth pair of ribs. c. The presence of a lumbar rib. d. Scoliosis in the lower thoracic spine. e. All of the above. 33. Which of the following statements is CORRECT? a. The anterior boundary of the superior thoracic aperture is the sternal angle. b. The posterior boundary of the inferior thoracic aperture is the body of T12 and the 12th pair of ribs. c. The lateral boundary of the superior thoracic aperture is the clavicle. d. The posterior boundary of the superior thoracic aperture is the vertebral body C7. e. The anterior boundary of the inferior thoracic aperture is the tip of the xiphoid process. 34. All the following statements are true with regards to a tracheoesophageal fistula with the EXCEPTION of: a. results from the failure of the formation of the pleuroperitoneal membrane. b. represents an abnormal communication between the trachea and the esophagus. c. typically associated with esophageal atresia. d. may result in respiratory distress. e. infants with a tracheoesophageal fistula will cough and gag upon eating. 35. All of the following are subdivisions of the parietal pleura with the EXCEPTION of: a. cervical (cupula) b. mediastinal c. intercostals d. diaphragmatic

e. costal 36. All of the following arteries provide blood to the breast with the EXCEPTION of: a. internal thoracic artery b. anterior intercostal artery c. lateral thoracic artery d. thoracoacromial trunk (artery) e. subcostal artery 37. Which of the following statements concerning the azygos vein is TRUE? a. It receives the left superior intercostal vein. b. It empties directly into the right brachiocephalic vein. c. It is formed by the union of the renal vein with the inferior vena cava. d. It empties directly into the superior vena cava. e. It receives the thoracic duct. 38. Which of the following structures are in the posterior mediastinum? a. Thoracic (descending) aorta b. Thoracic duct c. Sympathetic trunks d. Vagus nerves e. All of the above 39. The greater splanchnic nerve contains: a. preganglionic sympathetic fibers b. preganglionic parasympathetic fibers c. GSA fibers d. postganglionic sympathetic fibers e. postganglionic parasympathetic fibers 40. Which of the following statements concerning the root of the right lung is TRUE? a. The right phrenic nerve passes posterior to the lung root. b. The arch of the azygos vein passes inferior to the lung root. c. The right pulmonary artery lies posterior to the right main bronchus. d. The right bronchial artery lies anterior to the right main bronchus. e. The right main bronchus lies posterior to the right pulmonary artery 41. Which of the following statements concerning the trachea is TRUE? a. The left primary (main) bronchus is more vertical than the right primary (main) bronchus. b. It lies anterior to the esophagus in the superior mediastinum. c. It lies anterior to the aortic arch in the superior mediastinum. d. Visceral afferent (GVA) fibers from the mucous membrane travel in the sympathetic trunks. e. At its bifurcation, the trachea lies posterior to the esophagus.

42. With a patient in the standing position, fluid in the left pleural cavity tends to gravitate down to the: a. oblique fissure b. cardiac notch c. costomediastinal recess d. horizontal fissure e. costodiaphragmatic recess 43. Which of the following statements is CORRECT? a. The visceral pleura is sensitive to the sensation of pain. b. All intercostal nerves are derived from dorsal primary rami of thoracic spinal nerves. c. The arch of the aorta lies directly posterior to the body of the sternum. d. The trachea bifurcates opposite the sternal angle. e. The intercostal blood vessels and nerves are positioned in the order of vein, nerve, artery from superior to inferior in a costal groove. 44. Which of the following costal cartilages articulate directly with the body of the sternum? a. Seventh b. Fourth c. Fifth d. Sixth e. All of the above. 45. Which of the following structures DO NOT contribute to the formation of the diaphragm? a. Septum transversum b. Pleuropericardial (fold) membrane c. Dorsal mesentery of the esophagus d. Pleuroperitoneal (fold) membrane e. Body wall 46. Which of the following results from the folding of the embryo? a. The region of the heart becomes located ventral and caudal to the oropharyngeal membrane. b. The formation of the primitive gut. c. The shape of the embryo changes. d. The formation of the ventral and lateral abdominal walls. e. All of the above. 47. Which of the following statements about the blood supply to the heart is TRUE? a. The circumflex artery runs in the coronary sulcus. b. The left coronary artery usually gives rise to the posterior interventricular artery.

c. The anterior interventricular artery is accompanied by the middle cardiac vein. d. The left coronary artery gives rise to the right marginal branch. e. The SA nodal artery is typically a branch of the left coronary artery. 48. Which of the following statements concerning the pericardium is TRUE? a. The serous pericardium is external to the fibrous pericardium. b. The visceral layer of the serous pericardium is attached to the diaphragm. c. The parietal layer of the serous pericardium reflects onto the bases of the ascending aorta and pulmonary trunk to become continuous with the visceral layer of the serous pericardium. d. The fibrous pericardium is continuous with the adventitia over the trachea. e. The phrenic nerves are in direct contact with the parietal layer of the serous pericardium. 49. Which of the following structures is NOT found in the right ventricle? a. Moderator band b. Infundibulum (conus arteriosus) c. Trabeculae carnae d. Crista terminalis e. Papillary muscles. 50. Which of the following statements about the conduction system of the heart is FALSE? a. It consists of specialized cardiac muscle cells. b. The sinoatrial node normally receives arterial blood from a branch of the right coronary artery. c. The atrioventricular node is located in the interatrial septum. d. The left bundle branch passes through the moderator band. e. The atrioventricular bundle passes adjacent to the membranous part of the interventricular septum. 51. The left border of the heart is made up of which of the following structures? a. Left ventricle b. Left atrium c. Superior vena cava d. Left auricle e. A and B 52. Which of the following statements is CORRECT? a. The right coronary artery most often gives off the anterior interventricular artery. b. The anterior cardiac veins open directly into the left atrium. c. Coronary arteries may be classified as functional end arteries. d. The right coronary artery typically supplies the anterior one-half of the interventricular septum.

e. The coronary arteries are branches of the descending aorta. 53. Which of the following structures are found within the right atrium? a. Opening of the coronary sinus b. Fossa ovalis c. Musculi pectinati d. Sinus venarum e. All of the above. 54. Which of the following veins open directly into the right atrium? a. Inferior vena cava b. Coronary sinus c. Anterior cardiac veins d. All of the above e. None of the above 55. The apex of the heart is normally located: a. at the level of the 5th thoracic vertebra in the left midclavicular line. b. at the level of the xiphoid process one finger breadth to the left of the midline. c. deeply to the 3rd intercostal space in the left midclavicular line. d. deeply to the left 5th intercostal space just medial to the midclavicular line. e. None of the above. 56. Closure of the foramen primum results from fusion of the: a. septum secundum b. septum secundum and septum primum c. septum primum and endocardial cushions d. septum secundum and endocardial cushions e. septum primum and sinoatrial valve 57. During the fourth week of development, the formation of the right and left atrioventricular canals results from the: a. fusion of the dorsal and ventral endocardial cushions b. development of the interventricular septum c. fusion of the septum primum and septum secundum d. partitioning of the truncus arteriosus e. closure of the foramen ovale 58. The most common ventricular septal defect results from the: a. transposition of the great vessels b. persistence of the truncus arteriosus c. failure of the aorticopulmonary septum to develop d. failure of development of the membranous part of the interventricular septum

e. absence of the muscular part of the interventricular septum. 59. The valve of the foramen ovale is formed by the: a. endocardial cushions b. lower part of the septum secundum c. septum intermedium d. septum primum e. ostium secundum 60. The aortic arch is formed by the: a. left fourth aortic arch b. right fourth aortic arch c. left sixth aortic arch d. right sixth aortic arch e. third aortic arch 61. At birth, the obliterated left umbilical vein forms the: a. ligamentum venosum b. ligamentum teres hepatis c. ligamentum arteriosum d. inferior vena cava e. portal vein 62. Tetralogy of Fallot typically includes each of the following defects EXCEPT: a. an overriding aorta b. a ventricular septal defect c. stenosis of the pulmonary trunk d. right ventricular hypertrophy e. stenosis of the aortic semilunar valve 63. Trauma to the sternocostal surface of the heart would most likely damage the: a. right atrium b. right ventricle c. left ventricle d. right auricle e. left atrium 64. Dissection in the coronary sulcus (atrioventricular groove) of the heart would demonstrate each of the following EXCEPT the: a. right coronary artery b. circumflex branch of the left coronary artery c. great cardiac vein d. anterior cardiac veins e. coronary sinus

65. A myocardial infarct that damages the heart muscle in the anterior one-half of the interventricular septum would result primarily from occlusion of the: a. posterior interventricular artery b. marginal branch of the right coronary artery c. marginal branch of the left coronary artery d. anterior interventricular artery e. circumflex branch of the left coronary artery 66. To evaluate the aortic valve one would place the stethoscope: a. over the 2nd intercostal space just to the left of the sternum b. over the 2nd intercostal space just to the right of the sternum c. over the apex of the heart d. just to the left of the lower end of the body of the sternum over the left 5th intercostal space e. over the left 5th intercostal space, just medial to the midclavicular line