Below are written questions from previous quizzes and exams. Click here for the new format Practical Quiz. Click here for the old format Practical Quiz.
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Blockage of which of the following arteries would lead to ischemia of the apex of the heart?
Anterior interventricular (descending)
Left circumflex
Posterior interventricular (descending)
Right marginal
Right coronary
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If the ductus arteriosus does not spontaneously close off soon after birth (to become the ligamentum arteriosum), it may have to be surgically ligated. When clamping or ligating it, what important structure immediately behind it must be identified and saved?
arch of the azygos vein
internal thoracic artery
left phrenic nerve
left recurrent laryngeal nerve
left superior intercostal vein
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A hand slipped behind the heart at its apex can be extended upwards until stopped by a line of pericardial reflection that forms the:
Cardiac notch
Costomediastinal recess
Hilar reflection
Oblique pericardial sinus
Transverse pericardial sinus
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A stethoscope placed over the left second intercostal space just lateral to the sternum would be best positioned to detect sounds associated with which heart valve?
aortic
pulmonary
mitral
tricuspid
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Which valves would be open during ventricular systole?
Aortic and pulmonary
Aortic and tricuspid
Mitral and aortic
Tricuspid and mitral
Tricuspid and pulmonary
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Which chamber's anterior wall forms most of the sternocostal surface of the heart?
Left atrium
Left ventricle
Right atrium
Right ventricle
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A 3rd-year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers?
1
2
3
4
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A patient involved in an automobile accident presents with a sharp object puncture of the
middle of the sternum at about the level of the 4th or 5th costal cartilage. If the object also penetrated pericardium and heart wall, which heart chamber would most likely be damaged?
Left atrium
Left ventricle
Right atrium
Right ventricle
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Which statement is true of the right atrioventricular valve?
it is also called the mitral valve
it is open during ventricular diastole
it transmits oxygenated blood
it is opened by the pull of chordae tendineae
it consists of 2 leaflets
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A 23-year-old male injured in an industrial explosion was found to have multiple small metal fragments in his thoracic cavity. Since the pericardium was torn inferiorly, the surgeon began to explore for fragments in the pericardial sac. Slipping her hand under the heart apex, she slid her fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. Her fingertips were then in the:
Coronary sinus
Coronary sulcus
Costomediastinal recess
Oblique sinus
Transverse sinus
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An elderly lady suffers a coronary occlusion and subsequently it is noted that there is a complete heart block (that is, the right and left bundles of the conduction system have been damaged). The artery most likely involved is the:
acute marginal branch
circumflex branch
anterior interventricular (Left anterior descending)
obtuse marginal
posterior interventricular (posterior descending)
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During fetal life and sometimes persisting into the adult there is an opening between the right and left atria; this opening is called the:
atrioventricular canal
coronary sinus
foramen ovale
sinus venosus
truncus arteriosis
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The heart sound associated with the mitral valve is best heard:
In the jugular notch
In the second left intercostal space
In the second right intercostal space
In the fifth left intercostal space
To the right of the xiphoid process
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Which heart valve has leaflets described as "anterior, left and right"?
Aortic
Pulmonary
Left atrioventricular
Right atrioventricular
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In preparation for thoracic surgery, a median sternal splitting procedure was carried out. But an improper depth setting on the saw blade resulted in a slight nick on the underlying sternocostal surface of the heart. Which heart chamber would most likely have been opened had the blade completely penetrated this wall?
Left atrium
Left ventricle
Right atrium
Right ventricle
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The sound associated with tricuspid stenosis (narrowing) in a 40-year-old male would be best heard at which location on the anterior chest wall?
Below the left nipple
In the right 2nd intercostal space near the sternum
Over the apex of the heart
Over the sternal angle
Xiphoid area, just off the sternum
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Blockage of blood flow in the proximal part of the anterior interventricular artery could deprive a large area of heart tissue of blood supply, unless a substantial retrograde flow into this artery develops via an important anastomosis with which other artery?
Circumflex
Left marginal
Posterior interventricular
Right coronary
Right marginal
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Traumatic, acceleration/deceleration injuries to the aorta usually occur where its
mobile and fixed portions meet. This would be at the:
at the ligamentum arteriosum
junction of aortic arch with the descending portion
junction of the ascending aorta with the heart
origin of the brachiocephalic artery on the arch
point where the descending aorta passes through the diaphragm
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Which structure does NOT lie in the coronary sulcus?
circumflex artery
coronary sinus
right coronary artery
right marginal artery
left coronary artery
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Which structure contains postganglionic sympathetic fibers?
greater thoracic splanchnic nerve
recurrent laryngeal nerve
sympathetic trunk
ulnar nerve
vagus nerve
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Which posterior mediastinal structure is most closely applied to the posterior surface of the pericardial sac?
Aorta
Azygos vein
Esophagus
Thoracic duct
Trachea
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In obstruction of the superior or inferior vena cava, venous blood is returned to the heart by an alternate route via the azygos vein, which becomes dilated in the process. Which of the following structures might it compress as a result?
trachea
root of the left lung
phrenic nerve
thoracic duct
descending aorta
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Elevated systolic blood pressure in the right ventricle suggests stenosis of which valve?
Aortic
Mitral
Pulmonary
Tricuspid
- During examination of a 62-year-old man, the senior resident tells you to put your stethoscope on the left 5th intercostal space, slightly below the nipple, and listen for a clearly audible murmur. You hear it distinctly and know it must be associated with severe stenosis of which heart valve?
Aortic
Mitral
Pulmonary
Tricuspid
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A 26-year-old male is brought into the emergency room after having been kicked in the chest by a horse. After examination, it is concluded that the most likely immediate danger is cardiac tamponade (bleeding into the pericardial sac). You prepare to draw off some of the blood from the sac to relieve the pressure on the heart. The safest site at which to insert the needle of the syringe in order to miss the pleura would be:
Just below the nipple on the left
Just to the left of the xiphisternal junction
Near the sternal angle
Through the jugular notch
4th left intercostal space in the midaxillary line
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A 22-year-old male involved in an automobile accident presents with symptoms suggestive of myocardial contusion due to blunt trauma, specifically compression of the sternocostal surface of the heart by the sternum when his chest hit the steering wheel. Which heart chamber was most likely damaged?
Left atrium
Left ventricle
Right atrium
Right ventricle
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While attempting to suture the distal end of a coronary bypass onto the anterior interventricular artery, the surgeon accidentally passed the needle through the adjacent vein. Which vein was damaged?
Anterior cardiac vein
Coronary sinus
Great cardiac vein
Middle cardiac vein
Small cardiac vein
- While listening to a patient's heart sounds with a stethoscope, you identify a high-pitched sound in the second right intercostal space, just lateral to the edge of the sternum. Your correct conclusion is that you have detected stenosis of which heart valve?
Aortic
Mitral
Pulmonary
Tricuspid
