LECOM Thorax Clinical Supplement Practice Test

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• A high spinal anesthetic may impair sympathetic relay and produce temporary vasodilation. Which option best describes this effect?
• Why does referred pain occur?
• What heart defect is common in Turner syndrome females?
• Pancoast tumors may involve which combination of structures?
• Lower rib fractures can be associated with injury to which abdominal organs?
• Visceral pleura innervation is characterized by which of the following?
• Referred pain from myocardial infarction is perceived along T1-T4 dermatomes on which side?
• What is the typical distribution of SA node arterial supply from the right vs left coronary arteries?
• The parietal pleura is innervated by which nerves for the costal and peripheral diaphragmatic regions, with the mediastinal and central diaphragmatic portions supplied by which nerve?
• Lymphadenopathy results from cancer spreading through lymphatic channels to which tissue?
• Compression of the recurrent laryngeal nerve by a thymic tumor causes which symptom?
• What is the initial event in an aortic dissection?
• What type of joint is the costovertebral joint?
• What condition is characterized by a depression of the sternum?
• Which of the following is a sign indicating possible breast cancer involving the nipple?
• What does compression of the left recurrent laryngeal nerve cause?
• In infantile coarctation of the aorta, which finding is typical?
• Which of the following is NOT a drainage site for the thoracic esophagus?
• Enlarged lung nodes can displace which airway structure?
• Which coronary dominance is associated with better collateral circulation?
• Which coronary artery generally supplies more cardiac muscle?
• Left lung drainage for the left superior lobe proceeds to which nodes?
• Which ribs articulate with the vertebra of the same number and the vertebra above?
• The pericardium receives innervation from which nerves?
• Which nerve supplies the mediastinal and central diaphragmatic portions of the parietal pleura?
• The left superior lobe rarely drains to which lymph node group?
• Thymic tumors are most commonly associated with which autoimmune condition?
• What does LIMA stand for in cardiac surgery?
• Which statement best describes the prevalence of left-dominant coronary circulation?
• Which lymphatic route is described as a pathway for breast cancer metastasis to the liver?
• What are the two described patterns of coronary circulation?
• Which signs and symptoms are typical for open/traumatic pneumothorax?
• Which structure is NOT typically involved in local spread of esophageal cancer?
• The motor component of the cough reflex is aided by which nerves?
• Beck's triad associated with cardiac tamponade includes which signs?
• For the oblique fissure, which rib corresponds to the fissure at the scapular line?
• Thoracic Outlet Syndrome commonly involves compression of which nerve roots?
• Which statement accurately describes the sympathetic innervation of the upper extremity?
• Metastasis occurs by three mechanisms. Which option lists the three mechanisms described?
• Cardiac tamponade refers to which?
• What are risk factors for aortic dissection?
• What can compression of the left recurrent laryngeal nerve be caused by?
• The mediastinal hematoma is a typical finding in which type of aortic injury?
• Which factor increases suspicion for pulmonary embolism?
• Atelectasis is defined as the collapse of a lung or lobe due to airway obstruction. Which statement is true?
• Where is the pulmonary valve auscultated?
• The horizontal fissure of the lung is best located at which rib level along the midaxillary line?
• Pericardiocentesis removes fluid from between which layers?
• Sympathetic innervation of the lungs originates from which spinal levels?
• Breath sounds from the middle lobe are best heard along which region?
• Which statement is true about SVC syndrome?
• Where is the mitral valve auscultated?
• Which ribs form synovial, plane joints with the sternum?
• Upper extremity sympathetic innervation follows which pathway?
• The pleural cavity is best described as which of the following?
• Aortic dissection is best described as
• Which nerve provides primary innervation to the esophagus?
• Injury to which nerve during axillary procedures commonly causes sensory loss in the medial aspect of the arm?
• Angina Pectoris is defined as chest pain due to insufficient oxygen supply to which tissue?
• Compression of the left recurrent laryngeal nerve is most classically caused by an aneurysm of which structure?
• Which statement describes costovertebral articulations for typical ribs (2-10)?
• In the transverse pericardial sinus, inserting a finger through the sinus places which vessels anterior to the finger?
• Which dorsal root ganglia are most commonly affected by herpes zoster eruptions?
• Which procedure can result in sternal fracture, pneumomediastinum, pneumothorax, or cardiac tamponade?
• The thoracic portion drains to which lymph nodes?
• Cervical portion of the esophagus drains to which lymph nodes?
• Hydropneumothorax is defined as which of the following?
• Manubriosternal joint is classified as which type of joint?
• Mesothelioma is characterized by local invasion with seeding to which cavities?
• The posterior interventricular artery is also called which artery?
• Which sternocostal joint is a secondary cartilaginous joint?
• What is the primary purpose of inserting a chest tube?
• In an aortic dissection, what occurs?
• Which rib pairs do not have synovial interchondral joints?
• AV node arterial supply is provided by the right coronary artery in about what percentage, with the remainder from the left coronary artery?
• Which arteries are the most common sites of occlusion in the coronary arteries?
• Which joint type characterizes the sternoclavicular joint?
• Chest tubes are commonly inserted to drain air or fluid from the pleural space. At which intercostal spaces near the midaxillary line is this typically performed?
• The anterior interventricular artery is commonly known as which vessel?
• Which nerve provides somatic sensory innervation to the costal portion of the pleura?
• A Pancoast tumor may affect which structures?
• Herpes zoster reactivation occurs in which anatomical structure, leading to dermatomal pain and vesicular eruption?
• Which structures are exceptions to typical lymph drainage in that they drain bilaterally?
• Thymic tumor compression of the esophagus causes which symptom?
• What percentage of occlusions involve the right coronary artery?
• Which statement about pericardial innervation is true?
• What are the major constrictions of the esophagus?
• Interchondral joints are of which type and located between which ribs?
• What are the anastomoses between the coronary arteries?
• Most malignant breast tumors arise from which quadrant of the breast?
• Most sarcomas spread predominantly by which route?
• Breath sounds from the superior lobes are best heard at which location?
• Breath sounds from the inferior lobes are best heard below which rib?
• The LAD occlusion is associated with the 'widow maker' designation because it accounts for about what percentage of occlusions?
• Caval-to-caval anastomoses can maintain some degree of collateral venous return to the heart via which vessel?
• Which statement correctly describes sympathetic innervation to the upper esophagus?
• The abdominal portion drains to which lymph nodes?
• Which lobe is most commonly affected by obstructive atelectasis due to airway blockage?
• Do ribs 11 and 12 articulate with transverse processes?
• Aortic dissection can cause which of the following complications?
• Which of the following is a sign or symptom of aortic dissection?
• Hemopneumothorax is defined as which of the following?
• Fracture or dislocation of ribs 6-9 can cause laceration of which vessel?
• Thoracentesis is most commonly performed at which intercostal space near the midaxillary line to drain pleural effusions or empyemas?
• Which part of the esophagus contains the highest proportion of smooth muscle?
• What are the three types of pneumothorax?
• Pleurisy is inflammation of which structure?
• Which statement correctly describes septal blood supply in a right-dominant heart?
• In a typical costovertebral articulation, the rib head articulates with which structures?
• What determines the dominant coronary circulation?
• Which statement accurately identifies the location for listening to breath sounds from the superior lobes on both sides?
• What is a cure for Raynaud syndrome?
• Pleural effusion is defined as which of the following?
• Which coronary artery is most often dominant?
• Upper esophagus parasympathetic innervation originates from which structure?
• Parasternal lymph nodes provide a route for breast cancer to reach which organ?
• Lymphatic drainage of the thorax generally follows what pattern?
• Which of the following is NOT an important collateral channel of the superior vena cava?
• Esophageal cancer can spread by which comprehensive pattern?
• A laceration of the aorta can lead to which catastrophic outcome?
• The horizontal fissure is located at which rib levels along the specified lines?
• Pyopneumothorax is defined as which of the following?
• Thymic tumors can compress which structures?
• Lung metastases migrate to distant sites primarily through which venous route?
• Which is NOT a typical route for esophageal cancer spread?
• Where is the tricuspid valve best auscultated?
• Sympathetic innervation of the upper esophagus originates from which levels and pathways?
• During surgical repair of a ventricular septal defect, injury to which conduction pathway is a risk?
• The phrenic nerve innervates which part of the pericardium?
• In an aortic dissection, blood creates a false lumen between which layers?
• Right lung lymphatic drainage primarily goes to which nodes?
• Which of the following correctly describes the origin of parasympathetic innervation to the lungs?
• Which statement is true regarding a fixed point of the aorta?
• The inferior limit of the visceral pleura along the scapular line is at which rib?
• What are among the most common sites of metastasis?
• Parasympathetic innervation of the lungs originates from which nucleus/level?
• The anterior-superior two-thirds of the interventricular septum, including the AV bundle and bundle branches, is supplied by which artery?
• The inferior limit of the parietal pleura along the scapular line is at which rib?
• Which of the following is NOT listed among the most common sites of metastasis from the lung?
• Pulmonary embolism is best defined as which of the following?
• Approximately what percentage of occlusions involve the anterior interventricular artery (LAD)?
• Lymph from the lower quadrants drains to which nodes, providing a route for metastasis to the liver?
• Which two organs are commonly seeded by metastasis via the bloodstream for many sarcomas?
• Empyema is defined as which of the following?
• During axillary lymph node dissection, which nerve is commonly at risk, leading to a winged scapula?
• Which statement best describes mesothelioma's pattern of spread?
• What do most non-penetrating aortic injuries cause?
• Which substance is produced by the sternum?
• Ortner syndrome classically presents with which sequence of symptoms?
• Which of the following can be a sign or symptom of aortic dissection?
• Breast cancer can metastasize to the vertebrae or brain via which venous network?
• Where do aspirated foreign objects most commonly lodge?
• What is the emergency management for tension pneumothorax?
• The aortic isthmus is located between which structures?
• Which option correctly describes the borders of the cardiac silhouette?
• Parasympathetic innervation of the heart originates from which structure?
• The inferior limit of the parietal pleura along the midaxillary line is at which rib?
• Pericardial effusion is best described as which?
• What are the three points to which the aorta is fixed?
• Cardiac visceral afferents arise from which spinal cord levels?
• Which of the following is a risk factor for spontaneous pneumothorax?
• Breast cancer metastasizing to the lungs is most plausibly explained by metastasis through which venous pathway?
• Esophageal cancer spread can occur through which routes?
• The first rib articulates with the sternum by what joint type?
• In an intercostal nerve block, the anesthetic should be deposited between which two muscles to block the intercostal nerves?
• Which of the following is a classic presenting sign of breast cancer?
• Which statement about the transverse pericardial sinus is true?
• Adult Coarctation of the Aorta presents with which of the following?
• On chest X-ray, which finding is most characteristic of a pneumothorax?
• The inferior limit of the visceral pleura along the midclavicular line is at which rib?
• Which nerve irritation may cause shoulder pain in pericarditis?
• Why are esophageal constrictions clinically relevant?
• A diaphragmatic hernia can occur if which structure is pierced?
• Infantile Coarctation of the Aorta is characterized by which of the following?
• Fractures of which ribs are particularly associated with laceration of the aorta or great vessels?
• Referred cardiac pain is perceived along the dermatomes on which side?
• What type of joint is the costochondral articulation?
• Xiphisternal joint is which type?
• For fractures of ribs 6-9 to lacerate the descending aorta, where must the fracture occur?
• Where do sympathetic GSE axons distribute?
• Hemoptysis is most closely associated with bleeding from which vessels?
• Pericardiocentesis is performed by inserting a needle at which location?
• Where do most non-penetrating aortic injuries occur?
• Approximately what percentage of occlusions involve the left circumflex artery?
• Where is the needle site for therapeutic pleural tapping?
• Which statement correctly defines the Sternal Angle of Louis?
• Nipple discharge associated with breast cancer is most likely to be which of the following?
• Where are the cell bodies of the visceral afferent neurons for the heart located?
• A complete bundle block leads to what?
• Which symptom may indicate metastatic spread to the lungs in advanced breast cancer?
• Which statement correctly describes the distribution of muscle types along the esophagus from proximal to distal?
• Where is the intercostal nerve block typically performed to provide analgesia for chest wall procedures?
• Lymph drainage of the cervical portion of the esophagus primarily targets which nodes?
• Open/traumatic pneumothorax results from traumatic injury to which pleural layer?
• Seeding of the pleura and peritoneum as a result of local spread/invasion is an example of which metastasis mechanism?
• Which valve is best auscultated at the left 5th intercostal space along the midclavicular line?
• During pericardiocentesis, which structure must be avoided?
• Which description correctly identifies oblique fissure landmarks?
• Which finding is NOT part of Beck's triad?
• Which of the following can cause arrhythmias?
• Which factor increases the risk for pulmonary embolism?
• Which statement about coarctation of the aorta is true?
• In tension pneumothorax, which statement is correct?
• Ortner syndrome involves compression of which nerve?
• In a right-dominant heart, which artery supplies the posterior-inferior one-third of the interventricular septum?
• Which organ is described as a major lymph-producing organ with multiple routes and lymph channels relevant to metastasis?
• Which cardiac change is commonly seen in long-standing adult coarctation?
• Which ribs articulate only with the thoracic vertebra of the same number?
• Spontaneous pneumothorax occurs due to rupture of which pleural layer, allowing air to enter the pleural cavity?
• Which spinal levels contribute to sympathetic innervation of the heart?
• Which finding is most consistent with tension pneumothorax?
• Pericarditis is characterized by which finding?
• Thymic tumor compression of the great veins causes which symptom?
• Injury to the pectoral nerves would most affect which shoulder motion?
• Pneumothorax is defined as which of the following?
• The majority of breast tissue drains to which lymph nodes?
• Which statement is NOT commonly associated with pulmonary embolism?
• What is the secondary site of lymph drainage in the breast, especially the medial quadrants?
• Which structures are most susceptible to deceleration trauma?
• The inferior limit of the visceral pleura along the midaxillary line is at which rib?
• Which mechanism explains why visceral pain from the heart is often perceived as somatic pain?
• Phrenic nerve irritation can cause referred pain to which region?
• Which coronary artery most often supplies the SA node?
• Lymph from the skin of the breast drains primarily to which group of nodes?
• Chylothorax is defined as which of the following?
• Which sternum joint is primary cartilaginous?
• Which statement about coronary dominance is true?
• What property is maintained in the pleural space to assist breathing?
• Rib notching on chest radiographs is most strongly associated with which condition?
• The posterior interventricular artery is commonly known as which vessel?
• Which nucleus contains the preganglionic parasympathetic neurons that innervate thoracic viscera such as the heart and lungs?
• Which statement correctly describes sympathetic innervation of the heart?
• Hematogenous spread from esophageal cancer commonly targets which organs?
• Where is the aortic valve auscultated?
• In coronary artery bypass grafting, which artery is commonly harvested and used to bypass the LAD?
• Pectus Carinatum is characterized by which of the following?