01. (a) (b) (c) (d) (e) 02. (a) (b) (c) (d) (e) 03.

(a) (b) (c) (d) (e)

Regarding the surface anatomy of the thorax Trachea ends at suprasternal notch Apex beat is normally felt in the left 3rd intercostal space Cervical pleura doesnt extend above the level of the clavicle Aortic arch lies behind the manubrium sterni Intercostal vessels are just below the corresponding ribs T/F Suprapleural membrane reflex towards the root of the neck When insert a needle through the 8th intercostal space in the mid axillary line the lung can be damaged The weakest part of an adult rib is at the angle The lower limit of the pleural refection crosses 12th rib The sternum has red heamopoietic marrow throughout the life Regarding the diaphragm Thoracic duct pierces it at T10 level Branches of the left gastric artery & vein traverses through the esophageal opening Central tendon is formed by the septum transversum Sensory supply to the peripheral is from the phrenic nerve When paralyze unilaterally it shows paradoxical respiratory movements

04. T/F (a) The posterior interventricuar sulcus separates the left ventricle from right atrium on the diaphragmatic surface of the heart (b) Visceral pleura is sensitive to pain (c) Intercostals nerve derived from anterior ramus of thoracic spinal nerve (d) Left vagus nerve pass through aortic opening (e) Thoracic duct courses through posterior mediastinum between aorta & azygos vein 05. T/F regarding inferior vena cava (a) Closely related to left phrenic nerve (b) Pierce the diaphragm at T8 level (c) Is related to right crus of the diaphragm 06. (a) (b) (c) (d) (e) 07. (a) (b) (c) (d) (e) 08. (a) (b) (c) (d) (e) Regarding the diaphragm Crura are developed from the mesentry of the esophagus Hemiazgos vein pierce the left crus of the diaphragm Congenital hernias can occur through the foramen of Bochdaleck Rolling hernia is congenital in origin Siding hernia is less common than rolling hernia T/F regarding the heart Coronary arteries are anatomical end arteries Right coronary artery supplies AV node In cross section left ventricle is crescentic in shape The posterior cusp of the mitral valve lies between the atrio-ventricuar & aortic orifices Transverse sinus is formed by the refection of the serous pericardium around the large veins T/F Lymphatic vessels are numerous in alveolar wall In paraoesophogeal hernia oesophogocardiac junction remains intact Lungs are more transluscent in full inspiration than in expiration Lung tissue is devoid of pain fibers Mediastinal pleura form pulmonary ligaments

09. (a) (b) (c) (d) (e)

T/F regarding the anterior posterior chest X-ray Right heart shadow is formed by right atrium I.V.C. can be seen Pulmonary veins lie below the aortic knuckle Pyopneumothorax can be distinguished from heamoneumothorax in a plain X-ray Carina lies at T2 & T3

10. T/F (a) The anterior part of the interventricular septum is supplied by descending anterior interventricuar branch of left coronary artery (b) Oblique fissure extends from T3 vertebra to 5th rib in midaxillary line (c) The upper 5 thoracic sympathetic supply the deep cardiac plexus (d) Lymphatics from the posterior part of the lower intercostals spaces drain to the cistern chili (e) The left superior intercostal vein drains to the accessory hemiazygos vein 11. T/F (a) Aortic aneurism can be palpated at the suprasternal angle (b) The commonest combination of congenital abnormalities causing cyanosis is fallots tetra logy (c) Imperfect closure of fossa ovalis result in ASD (d) The ostium premium defect can be associated with a defect of the pars membranacea septi of the ventricular (e) Trilocular heart result in huge defect in the ventricular septum 12. (a) (b) (c) (d) 13. (a) (b) (c) (d) (e) 14. (a) (b) (c) (d) (e) 15. (a) (b) (c) (d) (e) 16. (a) (b) (c) (d) T/F The left ventricular apex is situated in the 5th intercostal space just media to the midclavicular line Aortic sound is best heard over the apex beat Aneurism in arch of aorta results horsiness of voice Anterior cusp of mitral valve intervenes between inflow & outflow tract Which of the following is/are directly related to the trachea The arch of the aorta The azygos vein The left superior intercostal vein The oesophogus Recurrent laryngeal nerve Regarding the lungs If deep lymph vessels are obstructed, lymph can flow from superficial to deep lymph vessels Deep lymph vessels have numerous valves In deep inspiration pleural cavity is fully occupied by the lungs Pneumothorax can spread in to the neck In bronchoscopy interior of the lobar bronchi & beginning of the segmental bronchi can be seen Left bronchus differ from right bronchus, because the right bronchus More vertical Less wider Right lung is more easily inflamated than the left lung Shorter Compress the oesophogus T/F Bifurcation of the trachea descend 2 vertebra in inspiration Musculae pectinati can be seen in right ventricle Septomarginal trabeculae transmit the right bundle branch of his Anterior 1/3 of interventricuar septum is supplied by left coronary artery

17. (a) (b) (c) (d) (e) 18. (a) (b) (c) (d)

Structures pass posterior to root of the right lung Hemiazygos vein Right vagus nerve Right phrenic nerve Left vagus nerve Azygos vein Which of the following structures is/are damaged by a stab wound at the level of T2 in right side Superior vena cava Thoracic duct Right common carotid artery left subclavian vein

19. Regarding the thoracic duct (a) It is a largest lymphatic channel in the body (b) It begins in the abdomen at the cisterna chily (c) Travel lymph of whole body from below the diaphragm & left side of the upper half of head & neck (d) In posterior mediastinum it placed in between aorta & azygos vein (e) In the superior mediastinum it comes to the right of the oesophogus toward the apex of the right triangle of the neck 20. (a) (b) (c) (d) (e) 21. (a) (b) (c) (d) (e) 22. (a) (b) (c) (d) (e) SVC could be damaged by a stab wound deep to 1st intercostal space 4th intercostal space Right sternoclavicular joint Left 1st costal cartilage Left sternoclavicular joint T/F Coronary arteries are anatomical end arteries SA node is usually supplied by the left coronary artery Anterior cardiac vein drains in to the left artrium Lymph drainage of the upper 1/3 of the oesophogus is to deep cervical lymph nodes Thymus is supplied by inferior thyroid artery T/F regarding intercostals nerves Immerge from the intervertibral foramen above the corresponding vertibra Enter the intercostal space between parietal pleura and posterior intercostals membrane There is no anterior cutaneous branch to the second intercostals The 2nd intercostal nerves are not enter the anterior abdominal wall The 2nd intercostal nerve supplies the skin over the armpit

23. T/F (a) The right phrenic nerve runs on the right bracheocephaic artery (b) The posterior cusp of the mitral valve intervenes between the inflow and outflow of the blood to the left ventrical (c) The moderator band passes from the septum to the left ventricle 24. (a) (b) (c) (d) (e) T/F Ostium secondum defeat is usually associated with ventricular septal defeat In the left ventrical superior papillary muscle springs from the antero-costal wall The mitral valve posses a small anterior and a large posterior cusp Right ventrical is circular in cross section The pericardium has lymphatic drainage in to the trachea-broncheal lymph nodes

25. (a) (b) (c) (d) (e) 26. (a) (b) (c) (d) (e) 27. (a) (b) (c) (d) (e) 28. (a) (b) (c) (d) (e) 29. (a) (b) (c) (d) (e) 30. (a) (b) (c) (d) (e) 31. (a) (b) (c) (d) (e) 32. (a) (b) (c) (d) (e)

T/F Sternal angle lies at the lower border of the 4th thoracic vertibra Apex of the heart is medial to the midaxillary line Right coronary artery supplies the posterior 1/3 of the inter ventricular septum The arch of aorta extends upwards as far as the jugular notch Fossa ovalis can be seen below the opening of the coronary sinus T/F AV node is situated at the upper part of the crista terminal is Segmental bronchus can be removed surgically Patent ductus arteriosus result by connection between left pulmonary vein and descending aorta Greater splanchnic nerve contains T5 to T9 12th rib has no angle T/F Deep cardiac plexus lies inferior to the bifurcation of the trachea In the posterior mediastinum oesophogus lies posterior to the right atrium Eosophogeal opening of the diaphragm lies in front of the T12 vertibra 1st intercostal nerve has no anterior cutaneous branch Lower border of the lung crosses the T12 rib at the mid axillary line T/F Neck of the rib is the weakest point Each intercostals space has 2 intercostal arteries Internal intercostal muscle starts from sternum and runs backward to the angle of the rib Suprapleural membrane attach to the 7th cervical vertebral body Internal artery supplies from clavical to umbilicus W.O.F are T/F regarding thoracic cavity Nipple of the male lies over 5th intercostal space Superior border of scapula is opposite to the spine of the 3rd thoracic vertebrae Thoracic curvature is a primary curve 3rd costosternal joint is a synovial joint 11th rib is a floating rib which doesnt articulate with transverse processes of vertebrae About intercostal spaces External oblique muscle is limited to chondral area All anterior intercostals veins drain in to internal thoracic vein First seven intercostal nerves supply only to their I.C.S Intercostal nerves supply to rectus abdominis Internal intercostal muscles are involve on expiration Regarding respiration Paradoxical respiration can be produced by loss of tone of intercostal muscles Expiration is not affected by flail chest Serratus posterior superior is an expiratory muscle In inspiration bifurcation of trachea descent by two vertibra Internal intercostal is an inspiratory muscle W.O.F are T/F The level of diaphragm is higher in recumbent than in upright position Oesophogus & left recurrent laryngeal nerve are posterior relation to the trachea The base of the heart is formed by the left ventricle The coronary sinus is the continuation to the great cardiac vein AV bundle consist of modified nerve & cardiac muscle fibers

33. (a) (b) (c) (d) (e) 34. (a) (b) (c) (d) (e) 35. (a) (b) (c) (d) (e) 36. (a) (b) (c) (d) (e) 37. (a) (b) (c) (d) (e) 38. (a) (b) (c) (d) (e) 39. (a) (b) (c) (d) (e) 40. (a) (b) (c) (d) (e)

T/F regarding mediastinum Extend posteriorly up to C4 vertebra Widening of angle between bronchi indicate enlargement of tracheobroncheal nodes Collection of pus in the retropharyngeal space can spread down to the posterior mediastinum Enragement of mediastinal lymph nodes result in horsness of voice A tumor in the posterior mediastinum can compress the aorta W.O.F are T/F regarding the lungs Visceral pleura extend in to the interlober fissure Pumonary lightment gives free expansion to the pulmonary vein Cervicle pleura directly contacts with subclavius muscle During respiration lung route is fixed Broncho-pulmonary segment segmentaly supply to the branchiopulmonary artery W.O.F are T/F regarding heart Pericardium is attached to the sternum by ligaments Oblique sinus is formed by inferior vena cava and four pulmonary veins Auricular appendage are derived from sinus venosum Sympathetic supply from the cardiac plexus is cardiac inhibitory S.A node is located in the upper part of the crista terminalis Regarding the oesophogus It is 5 inches long In the neck it is in the midline white it entering the thoracic inlet it slightly deviate to the left side Oesophogus crosses the diaphragm at T10 level It is separated from the left atrium by the fibrous pericardium Lymph drainage is to internal ileac nodes Which of the following are T/F regarding the nerves of the thorax Sympathetic chain is the most laterally placed structure in the posterior mediastinum Splanchnic nerve pierce the crus of the diaphragm before entering into the renal and celiac ganglin Stelate ganglion is formed by the 1st cervical ganglia Vagus nerve lies lateral to hemi azygus vein Thymus is not related to phrenic nerves T/F regarding diaphragm Entire motor supply from the phrenic nerve Left crus surround the oesophogus Paralyze of the right phrenic nerve show radio graphical elevation of that side Medial arcuate ligament is thickening of psoas fascia Aorta is at the level of the T12 The 1st rib Has the scaleni tubercle on its media border Has the sympathetic trunk crossing its media end in front of the superior intercostals artery Is crossed superiorly by the branch of the first thoracic nerve passing between subclavian artery & vein Has a costal cartilage which forms a part of the sternoclavicular joint Has one primary center of ossification Regarding surface anatomy of the thorax Trachea ends at supersternal notch Apex beat is normally felt in the left third intercostal space Cervical pleura does not extend above the level of the clavicle Aortic arch lies behind the manubrium sterni Intercostal vessels are just below the corresponding ribs

42. (a) (b) (c) (d) (e) 43. (a) (b) (c) (d) (e) 44. (a) (b) (c) (d) (e) 45. (a) (b) (c) (d) (e) 46. (a) (b) (c) (d) (e) 47. (a) (b) (c) (d) (e)

The right phrenic nerve Is posterior to the thoracic duct Is posterior to the vagus as it crosses the arch of the aorta Has no branches in the throrax than those supplying the diaphragm Does not give any branches to the right crus of the diaphragm Is posterior to the left brachiocephalic vein T/F Pulmonary ligarment allows to move pulmonary vessels in respiration Visceral pleura is insensitive to pain & touch The supraplueral membrane is a thickening of the endothoracic fascia Pluera is supplied by the phrenic nerve Bronchopulmonary segments is separate respiratory unit Regarding the heart Right ventrice forms right border of the heart Sternocostal surface mainly formed by two ventricles The cornory sinus opens into the right atrium The AV bundle descends behind the septal cusp of the mitral valve Cardiac pain is felt in the heart W.O.F T/F Mucus membrane of trachea is supplied by superior laryngeal nerve Carina can be seen in bronchoscopy Thymus is situated in the posterior mediastinum Foreign bodies enter the left bronchus rather than the right bronchus Upper lobe of the lung can be easily examined in the back of the chest wall True/False regarding thorax Suprasternal notch lies in the intervertibral disc level between the 1st and 2nd thoracic vertebrae Cardiac plexus of nerves is at the level of the sternal angle Apex of the breathing lung extends up to the level of the body of the 7th cervical vertebrae In quiet breathing lungs extend in to the costomediastinal recess During expiration pulmonary ligament helps in increasing venous dead space True/False Diaphragm contracts in forced expiration Visceral layer of pleura can be peeled easily from the lung surface Bronchopulmonary segments are the anatomical, surgical and functional units of the lung Visceral pleura is sensitive to pain Female is mainly dependent on thoracic type of respiration

48. (a) (b) (c) (d) (e)

True/False regarding heart Aortic opening is separated from atrioventricular foramen by anterior cusp of mitral valve Venae cordis minimae (small veins) open in to all chambers of the heart Intertribal septum directs anterior & to the left Left atrium forms the base Auricle of the left atrium is smooth