Mitral and aortic

Tricuspid and mitral

Practice Quiz - Heart Tricuspid and pulmonary
6. Which chamber's anterior wall forms most of the sternocostal surface of the heart?
Left atrium
Below are written questions from previous quizzes and exams. Click here for the new Left ventricle
format Practical Quiz. Click here for the old format Practical Quiz.
Right atrium
1. Blockage of which of the following arteries would lead to ischemia of the apex of the Right ventricle
heart?
Anterior interventricular (descending) 7. 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
Left circumflex the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal
Posterior interventricular (descending) cartilage) level were her fingers?
1
Right marginal
2
Right coronary
3
2. 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 4
it, what important structure immediately behind it must be identified and saved? 8. A patient involved in an automobile accident presents with a sharp object puncture of the
arch of the azygos vein middle of the sternum at about the level of the 4th or 5th costal cartilage. If the object
internal thoracic artery also penetrated pericardium and heart wall, which heart chamber would most likely be
damaged?
left phrenic nerve Left atrium
left recurrent laryngeal nerve Left ventricle
left superior intercostal vein Right atrium
3. A hand slipped behind the heart at its apex can be extended upwards until stopped by a Right ventricle
line of pericardial reflection that forms the:
Cardiac notch 9. Which statement is true of the right atrioventricular valve?
it is also called the mitral valve
Costomediastinal recess
it is open during ventricular diastole
Hilar reflection
it transmits oxygenated blood
Oblique pericardial sinus
it is opened by the pull of chordae tendineae
Transverse pericardial sinus
it consists of 2 leaflets
4. 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? 10. A 23-year-old male injured in an industrial explosion was found to have multiple small
aortic 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
pulmonary the heart apex, she slid her fingers upward and to the right within the sac until they were
mitral stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart.
Her fingertips were then in the:
tricuspid Coronary sinus
5. Which valves would be open during ventricular systole? Coronary sulcus
Aortic and pulmonary
Costomediastinal recess
Aortic and tricuspid

Oblique sinus Below the left nipple

Transverse sinus In the right 2nd intercostal space near the sternum
11. An elderly lady suffers a coronary occlusion and subsequently it is noted that there is a Over the apex of the heart
complete heart block (that is, the right and left bundles of the conduction system have
been damaged). The artery most likely involved is the: Over the sternal angle
acute marginal branch Xiphoid area, just off the sternum
circumflex branch 17. 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
anterior interventricular (Left anterior descending)
into this artery develops via an important anastomosis with which other artery?
obtuse marginal Circumflex
posterior interventricular (posterior descending) Left marginal
12. During fetal life and sometimes persisting into the adult there is an opening between the Posterior interventricular
right and left atria; this opening is called the:
Right coronary
atrioventricular canal
Right marginal
coronary sinus
18. Traumatic, acceleration/deceleration injuries to the aorta usually occur where its mobile
foramen ovale
and fixed portions meet. This would be at the:
sinus venosus at the ligamentum arteriosum
truncus arteriosis junction of aortic arch with the descending portion
13. The heart sound associated with the mitral valve is best heard: junction of the ascending aorta with the heart
In the jugular notch
origin of the brachiocephalic artery on the arch
In the second left intercostal space
point where the descending aorta passes through the diaphragm
In the second right intercostal space
19. Which structure does NOT lie in the coronary sulcus?
In the fifth left intercostal space circumflex artery
To the right of the xiphoid process coronary sinus
14. Which heart valve has leaflets described as "anterior, left and right"? right coronary artery
Aortic
right marginal artery
Pulmonary
left coronary artery
Left atrioventricular
20. Which structure contains postganglionic sympathetic fibers?
Right atrioventricular greater thoracic splanchnic nerve
15. In preparation for thoracic surgery, a median sternal splitting procedure was carried out. recurrent laryngeal nerve
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 sympathetic trunk
have been opened had the blade completely penetrated this wall? ulnar nerve
Left atrium
vagus nerve
Left ventricle
21. Which posterior mediastinal structure is most closely applied to the posterior surface of
Right atrium the pericardial sac?
Aorta
Right ventricle
16. The sound associated with tricuspid stenosis (narrowing) in a 40-year-old male would be Azygos vein
best heard at which location on the anterior chest wall? Esophagus
 Thoracic duct Right ventricle
Trachea 27. 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
22. In obstruction of the superior or inferior vena cava, venous blood is returned to the heart
vein. Which vein was damaged?
by an alternate route via the azygos vein, which becomes dilated in the process. Which
Anterior cardiac vein
of the following structures might it compress as a result?
trachea Coronary sinus
root of the left lung Great cardiac vein
phrenic nerve Middle cardiac vein
thoracic duct Small cardiac vein
descending aorta 28. 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
23. Elevated systolic blood pressure in the right ventricle suggests stenosis of which valve? correct conclusion is that you have detected stenosis of which heart valve?
Aortic
Aortic
Mitral
Mitral
Pulmonary
Pulmonary
Tricuspid
Tricuspid
24. 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 Copyright© 2000 The University of Michigan. Unauthorized use prohibited.
clearly audible murmur. You hear it distinctly and know it must be associated with severe
stenosis of which heart valve?
Aortic
Mitral
Pulmonary
Tricuspid
25. 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
26. 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