Thorax - MCQs

(1) Boundaries of thoracic outlet are ALL EXCEPT

a) Lower border of 12th rib

b) Tip of Xiphoid process of sternum

c) 7th to 10th costal cartilages

d) Lower border of 12th thoracic vertebrae

2
(2) Typical intercostal space is supplied by all the following arteries EXCEPT

a) Thoracic Aorta

b) Internal thoracic artery

c) Thyrocervical trunk

d) Musculophrenic artery

3
(3) Inferior border of heart is formed by ALL EXCEPT

a) Right atrium

b) Right ventricle

c) Left atrium

d) Left ventricle

4
(4) The manubrium of the sternum has the following features

a) Jugular notch located on the inferior border

b) Costal facets for the articulation with the first three ribs

c) Costal facet for the articulation with the first rib and a demifacet for the
articulation with the second rib

d) Only the first costo-sternal articulation is a fibrous synarthrosis

5
(5) Which of the following layers provides a natural cleavage plane for
surgical operation of the costal pleura from the thoracic wall

a) Deep fascia

b) Endothoracic fascia

c) Parietal pleura

d) Visceral pleura

6
(6) If the oesophageal mass expands anteriorly into the middle mediastinum,

which part of the heart is compressed

a) Left ventricle

b) Right ventricle

c) Right atrium

d) Left atrium

7
(7) Pace maker of heart is

a) S A node

b) A V node

c) Bundle of His

d) Purkinje fibres

8
(8) How many bronchial arteries supply the right lung?

a) 1

b) 2

c) 3

d) 4

9
(9) Lower limit of pleura at mid-axillary line is at the level of

a) T6

b) T8

c) T10

d) T12

10
(10) The apex beat of the heart is palpated at

a) 9 cm lateral to midclavicular line in right 5th intercostal space

b) 9 cm lateral to midclavicular line in left 5th intercostal space

c) 9 cm lateral to midclavicular line in left 6th intercostal space

d) 9 cm lateral to midclavicular line in right 6th intercostal space

11
(11) The blood vessels opening into the heart are all EXCEPT

a) Superior vena cava

b) Inferior vena cava

c) 4 pulomonary veins

d) Pulmonary trunk

12
(12) Right coronary artery arises from

a) Anterior aortic sinus

b) Right posterior aortic sinus

c) Left posterior aortic sinus

d) Anterior & posterior aortic sinus

13
13) A patient is diagnosed with pleural effusion on the right side. The consultant
instructs the postgraduate of perform pleurocentesis to drain the pleural fluid
and send it for pathological examination. Where should the postgraduate insert
the needle to prevent injury to the neurovascular bundle of the intercostal space?

a) Upper part of the intercostal space

b) Lower part of the intercostal space
c) Parasternal area of the intercostal space
d) Paravertebral area of the intercostal space

14
(14) The coronary dominance refers to the origin of

a) Anterior interventricular

b) Posterior interventricular artery

c) Diagonal artery

d) Kugel’s artery

15
(15) Left coronary artery arises from

a) Anterior aortic sinus

b) Right posterior aortic sinus

c) Left posterior aortic sinus

d) Anterior & posterior aortic sinus

16
(16) The crux of the heart refers to the meeting point of all EXCEPT

a) Posterior interventricular groove

b) Interatrial groove

c) Posterior part of atrioventricular groove

d) Anterior part of atrioventricular groove

17
(17) Typical intercostal nerves are

a) 3rd to 6th intercostal nerves

b) 7th to 11th intercostal nerves

c) 7th to 10th intercostal nerves

d) 1st and 2nd intercostal nerves

18
(18) Which of the following is known as floating ribs

a) 7th pair

b) 9th pair

c) 10th pair

d) None of the above

19
(19) Internal thoracic artery

a) Arises from the subclavian artery

b) Supplies the upper five intercostal spaces

c) Supplies the thyroid gland

d) It gives of Inferior epigastric artery

20
(20) Regarding Intercostal space, correct answer is

a) External intercostal muscle fibres are directed downwards and forwards

and medially

b) Neurovascular bundle traverse between external and internal intercostal

muscle

c) Each intercostal space is supplied by 1 anterior intercostal arteries

d) Posterior intercostal arteries supplying the first two space arise from
descending thoracic aorta.

21
(21) Increase in the vertical diameter of thoracic cavity is brought about by

a) Pump handle movement of the sternum

b) Bucket handle movement of the ribs

c) Contraction of diaphragm

d) Both a and b

22
(22) Anterior intercostal membrane is the continuation of

a) External intercostal muscle

b) Internal intercostal muscle

c) Intercostalis intimus muscle

d) Subcostalis muscle

23
(23) With regard to the thoracic wall the INCORRECT answer is

a) The intercostal vessels and nerves run between the internal intercostal and
innermost intercostal muscles

b) All intercostal nerves have anterior and lateral cutaneous branches

c) The internal intercostals assist inspiration

d) The upper ribs have ‘pump-handle’ movement NOT ‘bucket handle’

movement

24
(24) The branches of all of the following arteries supply blood to intercostal
spaces EXCEPT

a) Descending thoracic Aorta

b) Internal thoracic artery

c) Superior epigastric artery

d) Musculophrenic artery

25
(25) The most dependent area of the pleura in standing position is

a) Costo-mediastinal recess

b) Costo-diaphragmatic recess

c) Vertebro-mediastinal recess

d) Phrenico-mediastinal recess

26
(26) Which of the following nerves form a content of Superior mediastinum

a) Right recurrent laryngeal nerve

b) Left recurrent laryngeal nerve

c) Right supraclavicular nerves

d) Left supraclavicular nerves

27
(27) A 45 year old male comes to the surgery OPD with difficulty in swallowing.
On examination swelling and slight pain is observed in the lower part of right side
of the neck. X-ray revealed radiopaque lesion extending from neck into the thorax.
Infections in the neck in front of prevertebral fascia can track down to

a) T10 level

b) T4 level

c) C7 level

d) T2 level

28
(28) Parietal pleura is supplied by

a) Intercostal nerves

b) Vagus nerve

c) Phrenic nerve

d) Perecardiophrenic nerves

29
(29) Which of the following separates the neck from the thoracic cavity?

a) Parietal pleura

b) Visceral pleura

c) Suprapleural membrane

d) Cervicothoracic membrane

30
30) A 60 yr old man complains of chest pain early in the morning. He is brought to
casualty. The patient also complains of pain radiating to the left arm. He is
diagnosed to have ischemic heart disease and immediately treatment is given.
The artery that is most likely to be affected by atherosclerosis is

a) Left anterior descending artery

b) Left circumflex artery
c) Posterior interventricular artery
d) Right marginal artery

31
(31) Trachea bifurcates at the level of

a) T4

b) T5

c) T6

d) T7

32
(32) Which of the following is the most superficial content of superior
mediastinum?

a) Aorta and its branches

b) Phrenic nerve

c) Vagus nerve

d) Brachiocephalic veins

33
(33) All of the following structures are related to the medial surface of right
lung EXCEPT

a) Superior Venacava

b) Oesophagus

c) Right vagus

d) Thoracic duct

34
(34) Each Bronchopulmonary segment is supplied by tertiary branch of

a) Subclavian artery

b) Pulmonary artery

c) Intercostal artery

d) Internal thoracic artery

35
(35) All the following pierce fibrous pericardium EXCEPT

a) Ascending aorta

b) Superior venacava

c) Inferior venacava

d) Arch of Aorta

36
(36) The chamber of heart which forms the boundary of oblique sinus is

a) Right atrium

b) Left atrium

c) Right ventricle

d) Left ventricle

37
(37) The route preferred for aspiration of pericardial fluid is

a) Parasternal

b) Substernal

c) Retrosternal

d) Suprasternal

38
(38) The vessel which constricts due to change in pulmonary pressure with the

first breath of the baby

a) Ductus venosus

b) Umbilical vein

c) Umbilical artery

d) Ductus arterious

39
(39) Which joint is a primary cartilaginous joint?

a) Costovertebral

b) Costotransverse

c) First sternochondral

d) Manubriosternal

40
(40) The artery which enlarges in coarctation of aorta

a) Subclavian

b) Internal mammary

c) Posterior intercostal

d) Anterior intercostal

41
41) The coronary sinus drains into

a) Right atrium
b) Left atrium
c) Right ventricle
d) Left ventricle

42
42) The Arch of aorta develops from

a) Right 2nd aortic arch

b) Left 2nd aortic arch
c) Right 4th aortic arch
d) Left 4th aortic arch

43
43) Lingula of the left lung belongs to

a) Lower lobe
b) Upper lobe
c) Middle lobe
d) Apical lobe

44
44) Thoracic duct crosses from right to left side at which vertebral level

a) T2
b) T3
c) T4
d) T5

45
45) Azygos vein drains into

a) Superior venacava
b) Inferior venacava
c) Brachiocephalic vein
d) Internal jugular vein

46
46) The neurovascular structures in the intercostal space is arranged from above
downwards as follows:

a) Vein, artery, nerve

b) Nerve, artery, vein
c) Artery, vein, nerve
d) Artery, nerve, vein

47
(47) Pleural tap/Pleurocentesis is usually performed along the

a) Anterior axillary line

b) Posterior axillary line

c) Mid axillary line

d) Lateral axillary line

48
48) A patient is diagnosed with right lung abscess. The apical and anterior basal
segment of the lower lobe is affected. He decides to remove the above
mentioned segments. He has to dissect in the intersegmental plane in order to
prevent rupture and spread of infection. Which of the following structures has to
be followed for a safe segmentectomy?

a) Pulmonary artery
b) Pulmonary vein
c) Bronchial artery
d) Bronchial vein

49
(49) The structure in the posterior interventricular groove is

a) Right coronary artery

b) Left coronary artery

c) Middle cardiac vein

d) Great cardiac vein

50
50) The X-ray below shows the thoracic region. To diagnose cadiomegaly the trans
cardiac diameter should be ____________ than the trans thoracic diameter.

a) More than 50%

b) Less than 50%
c) More than 60%
d) Less than 60%

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THANK YOU

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