A plain radiograph of a patient following a knife wound to the left side of his neck showed elevation of the left hemidiaphragm, narrowing of the left intercostals spaces, and displacement of the trachea to the left. You suspect:
A) hemothorax due to blood from the wound.
B) pneumothorax due to knife penetration of the cervical pleura.
C) transection of the phrenic nerve.
D) transection of the sympathetic trunk.
E) pleurisy.
Ans: B
(
Question 2) Pertaining to the pleura, the:
A) diaphragmatic pleura is part of the visceral pleura.
B) suprapleural membrane is part of the parietal pleura.
C) costodiaphragmatic recess is larger during inspiration than during expiration.
D) costal pleural reflection passes obliquely across the 6th rib in the midclavicular line, the 8th rib in the midaxillary line, and the 10th rib at its neck.
E) parietal and visceral layers of pleura are continuous at the pulmonary ligament.
(
Question 3) Which of the following would be the safest locations to insert a needle for thoracocentesis of the pleural cavity during expiration?
A) immediately superior to the 10th rib at the midaxillary line
B) immediately inferior to the 9th rib at the midaxillary line
C) immediately superior to the 5th rib at the midclavicular line
D) between the costal cartilages of the left 4th and 5th ribs
E) between the costal cartilages of the right 4th and 5th ribs
(
Question 4) Simple mastectomy for breast cancer involves removal of:
A) all breast tissue and the underlying muscles.
B) the nipple and areola.
C) only one breast quadrant.
D) all breast tissue superficial to the retromammary space.
E) all of the lymph nodes that drain the breast.
(
Question 5) It is common to explain the relationships between the lung and surrounding structures by using the analogy of a fist inserted into a balloon. Accordingly, which of the following group of associations would be accurate?
A) fistpleural cavity; space between inner and outer balloon layersmediastinum; outer layer of balloonendothoracic fascia
B) fistlung; space between inner and outer balloon layerspleural cavity; outer layer of balloonendothoracic fascia
C) fistlung; space between inner and outer balloon layerspleural cavity; outer layer of balloonparietal pleura
D) fistlung; space between inner and outer balloon layerspleural cavity; outer layer of balloonvisceral pleura
E) fistpleural cavity; inner layer of balloonvisceral pleural; space between inner and outer balloon layersendothoracic surgical plane
(
Question 6) Your examination of a male patient reveals a tender subareolar mass in his breast. Which of the following conditions is most likely based on this finding?
A) gynecomastia
B) Klinefelter's syndrome
C) cancer
D) shingles
E) fibrous atrophy of his pectoralis major
(
Question 7) Lymphatic drainage of the breast:
A) is principally to the ipsilateral parasternal lymph nodes.
B) and ultimately from both breasts enters the thoracic duct.
C) is principally to the ipsilateral internal thoracic vein.
D) is principally to the ipsilateral axillary nodes.
E) is principally to the ipsilateral lymph vessels running deep to the pectoralis major.
(
Question 8) A women patient complains to you that her breasts have a strange appearance. Upon examination you notice dimples in the skin of her breast. You know that the most likely explanation for these dimples (peau d' orange sign) is:
A) interference with lymph drainage.
B) pregnancy.
C) overproduction of milk.
D) menopause.
E) bacterial infection of the lactiferous ducts (ductus lactiferi).
(
Question 9) Which of the following is incorrect pertaining to the internal thoracic (mammary) artery?
A) It helps supply the breast via its anterior intercostal branches.
B) It passes anterior to the clavicle.
C) It lies superficial to the slips of the transverse thoracic muscle.
D) It is in contact with the parietal pleura.
E) It terminates in the 6th intercostal space by becoming the superior epigastric and musculophrenic arteries.
(
Question 10) The endothoracic fascia:
A) is continuous with the clavipectoral fascia.
B) provides a surgical cleavage plane between the thoracic wall and the costal parietal pleura.
C) attaches to the suspensory ligaments of the breast.
D) contains the intercostal muscles.
E) may become fibrous and thus interfere with normal respiratory movements.
Quick Reply
