Germ Cells and Fertilization: Practice Question with answers

1. How does the oocyte assure that only one sperm cell enters it during fertilization?

A) An acrosomal reaction occurs

B) The corona radiata slows the progress of all but the strongest sperm cells
C) The zona pellucida becomes impenetrable (impermeable) after one sperm cell enters.
D) The position of the oocyte in the uterine tube restricts access for most sperm
Correct answer C

2. In which period of development as described by embryologists are most organ systems

highly susceptible to injury?

A) Germinal period
B) Embryonic period
C) Second trimester
D) Third trimester
E) Fetal period

Correct answer B

3. The male and female processes of meiosis are equal.

A) True
B) False; for males it results in four spermatids and females result in two ovum with two
polar bodies
C) False; for males it results in four spermatids and females results in one ovum with three
polar bodies
D) False, for males it results in one spermatid with three polar bodies and females result in
two ovum with two polar bodies

Correct answer C
4. The correct order for origin and migration of germ cells is:

A) Epiblast to hypoblast to gonadal region (genital ridge)

B) Epiblast to mesoderm to gonadal region (genital ridge)
C) Epiblast to yolk sac to gonadal region (genital ridge)
D) Epiblast to mesoderm to gonadal region (genital ridge)
E) Hypoblast to yolk sac to gonadal region (genital ridge)
F) Hypoblast to epiblast gonadal region (genital ridge)

Correct answer C

5. Where does the process of sperm capacitation take place?

A) Within the testes

B) Within the male urethra
C) Within the female genital tract
D) Within the ovum
E) Within the embryo

Correct answer C

6. In what phase do the oogonia become arrested until puberty?

A) Meiosis II metaphase
B) Meiosis II prophase
C) Meiosis I metaphase
D) Meiosis I prophase
E) G-phase

Correct answer D

7. The first meiotic division is completed just prior to ovulation, forming a secondary
oocyte. The second division begins immediately but does not finished unless:

A) hCG levels are high

B) Fertilization takes place
C) The epiblast is no longer present
D) The sperm are uncapacitated
E) A developmental anomaly is present

Correct answer B
8. What has to happen to the spermatazoa in order for it to be able to pass through the
layer indicated by arrow X in the image below?

A) It has lost its tail

B) Its mitochondria will have been depleted
C) It must have undergone capacitation
D) The acrosome reaction must have already taken place

Correct answer C
 Weeks 1 – 2 of Development
1. The amniotic cavity appears on the eighth day as a slit-like space between the trophoblast
and which of the following structures?
A) Extraembryonic mesoderm
B) Bilaminar germ disc
C) Exocoelomic membrane
D) Connecting stalk
E) Chorion
B) This is correct as the amniotic sac lies between the trophoblast and bilaminar germ disc

2. Which of the following occurs during the 1st and 2nd week of development?
A) The morula implants into the endometrium
B) The blastocyst is composed only of epiblast and syncytiotrophoblast
C) The syncytiotrophoblast degrades the endometrium of the uterus
D) The prechordal plate is only composed of epiblast cells
C) Correct answer- This structure breaks down the endometrial lining to enhance
incorporation of the blastocyst

3. Which of the following is a characteristic feature during the 2nd week of development?
A) The amniotic sac is situated below the hypoblast layer
B) The definitive yolk sac is formed by day 8
C) Lacunae spaces are found within the syncytiotrophoblast
D) Epiblast cells migrate into the primitive streak
C) Correct answer

4. The lining of the uterus in which the embryo implants itself is called the
A) Myometrium
B) Trophoblast
C) Endometrium
D) Yolk plug
E) Lanugo
C) Correct answer
5. Cleavage divisions result in more but smaller cells in the developing individual. One stage of
cleavage is the morula stage which is:
A) An embryo with 4 cells
B) An embryo with a darkly pigmented vegetal hemisphere
C) A collection of 16 cells resembling a raspberry
D) A hollow ball of cells enclosing a fluid filled space
C) Correct answer

6. The development of a zygote into increasingly smaller blastomeres is called _____.

A) Cleavage
B) Fertilization
C) Gastrulation
D) Implantation
E) Organogenesis
A) Correct answer

7. Pregnancy tests generally are based upon the detection in maternal urine of:
A) Estrogen
B) Progesterone
C) human Chorionic Somatommotropin
D) human Chorionic Gonadotrophin
E) human Chorionic Corticotropin

D) Correct answer

8. Which structure bounds the cells after fertilization as they compact to form the morula?

A) Zona pellucida
B) Corona radiata
C) Pronucleus
D) Inner cell mass
E) Outer cell mass

A) Correct answer
9. An ectopic pregnancy would occur if implantation occurred in all of the following places
EXCEPT:

A) Rectum
B) Bladder
C) Posterior superior wall of the uterus
D) Cervix
E) Right or left uterine (Fallopian) tube

C) Correct answer

10. The cells of the developing individual form the hypoblast and epiblast, which is collectively
known as the:

A) Morula
B) Blastocyst
C) Bilaminar germ layer
D) Trilaminar germ layer

C) Correct answer

11. On day nine, trophoblastic lacunae and maternal sinusoids begin to form around what cells:

A) Extraembryonic coelom
B) Extraembryonic splanchnopleuric
C) Exocoelomic
D) Syncytiotrophoblast

D) Correct answer
12. The images shown below of implantation are representative of which day post-fertilization?

A) Day 2
B) Day 4
C) Day 6
D) Day 10
E) Day 14

C) Correct answer

13. Structure 3 in the image below is known as the:

A) Amniotic cavity
B) Chorionic Cavity
C) Primary yolk sac
D) Secondary yolk sac
E) Exocoelemic cyst

A) Correct answer
 Week 3 – 4 of Development with answers

1. Which of the following is a characteristic feature for the 3rd and 4th week of development?
A) The embryonic disc is composed of two layers
B) The intermediate mesoderm will form the heart
C) The endodermal layer migrates into the primitive streak to form somites
D) The endodermal layer will form simple columnar cells that line the inside of the stomach
E) The cardiogenic area lies at the base of the primitive streak
D) This is correct -Endoderm lines the GI tract

2. Which structure is derived from neural crest cells?

A) Gonads
B) Oropharyngeal membrane
C) Cardiogenic area
D) Somites of the back
E) Medullary region of the adrenal (suprarenal) gland
E) Correct answer-Neural crest cells migrate into the center of the adrenal gland-thus
forming the medulla of the adrenal gland

3. What germ layer will form the epithelium of the small and large intestine which are
components of the gastrointestinal tract?
A) Endoderm
B) Mesoderm
C) Ectoderm
D) Neural crest
E) Hypoblast
A) Correct answer
4. Mesoderm is formed from which of the following?
A) Hypoblast cells
B) Extraembryonic ectoderm
C) Notochordal cells
D) Epiblast cells
E) Amnioblasts
D) Correct answer - Epiblast invaginates to form mesoderm

5. Which of the following structures in the image below is most intimately

associated with
the yolk sac?

A) Structure A
B) Structure B
C) Structure C
D) Structure D
E) Structure E

E) Correct answer as endoderm

6. During what stage of development do the three primary tissue layers

first appear?

A) Cleavage
B) Blastulation
C) Neurulation
D) Fertilization
E) Gastrulation

E) Correct answer
3. Which of the following is correct regarding the anatomy of the lungs?

A. The left lung has one oblique fissure and one transverse fissure

B. The right lung has a lingula

C. The right lung has an impression for the arch of the azygos vein

D. A left lung collapse would cause a mediastinal shift to the right

E. Most aspirated objects are lodged in the left main bronchus

The typical right lung has one oblique and one transverse fissure, while the typical left lung has only an
oblique fissure. The lingual is on the left lung. A left lung collapse would cause a mediastinal shift to the
affected side. Most aspirated objects are lodged in the right main bronchus because it has a steeper
angle of descent.

4. A weak, elderly patient has been lying in a hospital bed for weeks with pneumonia. He aspirates
(breathes in) some fluid into his lungs while swallowing. In which of the following bronchopulmonary
segments is the fluid most likely to end up?

A. Inferior segment of the lingula

B. Medial segment of the left inferior lobe

C. Medial segment of the right middle lobe

D. Anterior segment of the right superior lobe

E. Superior segment of the right inferior lobe

Inhaled material tends to go into the right bronchus because it is wider and more vertically orientated
than the left. The superior segment branches posteriorly off of the inferior lobe bronchus, so it is most
likely to receive foreign bodies that enter the right main bronchus if the patient is lying down because of
the effect of gravity. If the patient is standing up/sitting up, the aspirated matter will likely end up in one
of the basal segments via a tertiary bronchi from the rest of the inferior lobar bronchus.

5. A patient arrives to your office, his complaint is that he’s been having difficulty breathing. On
examination you observe no external trauma to the thoracic cavity and you order a chest x-ray. You
suspect that the patient has a tension pneumothorax. What would you expect to see?

A. Dark lung field on the affected lungs, mediastinal shift and trachea deviation towards unaffected
lung

B. Grey lung field on the affected lungs, mediastinal shift and trachea deviation towards unaffected lung

C. Dark lung field on the affected lungs, mediastinal shift and trachea deviation towards affected lung

D. Grey lung field on the affected lungs, mediastinal shift and trachea deviations towards affected lung
On x-ray, air appears black. So in a tension pneumothorax, air escapes from the alveoli and gets trapped
in the thoracic cavity hence the affected lung field would be dark. The trapped air in the affected lung
increases the intrathoracic pressure and pushes the mediastinum and trachea away from the affected
lung or towards the unaffected lung.

6. A 5 year old boy is brought in to the clinic by his mother who is severely concerned about her son's
cough. The parent reports that she witnessed the boy playing with some marbles and might have tried
to swallow one. If a marble is stuck in the boy's airway, where would it most likely be?

A. Left main bronchus

B. Right main bronchus

C. Terminal bronchiole of the right lung

D. Terminal bronchiole of the left lung

E. Left inferior bronchus

Right main bronchus. The right bronchus is shorter, wider, and more vertical than the left bronchus.
Inhaled objects will enter the right main bronchus. Terminal bronchioles are too small to hold small
objects such as marbles.

7. Which of the following structures would you NOT find at the hilum of the lung?

A. Pulmonary artery

B. Bronchus

C. Bronchiole

D. Pulmonary vein

You would also find Bronchial artery and nerve plexus and hilar lymph nodes (note these were not
covered in the lecture, but you will see them in the lab as black spots).

8. During your ER rotation, you observe a young man who has been stabbed in the back by one of his ex-
girlfriends. You quickly assess the situation. The knife seemed to have pierced the left lung midway to
the diaphragmatic surface. What is the most likely area of injury?

A. Hilum

B. Superior lobe

C. Lingula

D. Inferior lobe
 B) Day 20
C) Day 24
D) Day 28
E) Day 32

D) Correct answer

11. The limb bones forms from which of the following?

A) Paraxial mesoderm
B) Intermediate mesoderm
C) Lateral plate mesoderm
D) Surface ectoderm
E) Neural crest cells

C) Correct answer

12. Lateral folding and head and tail folding of the embryo leads to the formation
of the:

A) Oropharyngeal membrane
B) Cloacal membrane
C) Vitelline duct
D) Hepatic duct
E) Neuroectoderm

C) Correct answer

13. In the image below which of the arrowed regions is the most dorsal?
 A) Area A
B) Area B
C) Area C
D) Area D
E) Area E

E) Correct answer

14. A worried mother brings her

three-month old baby to the
pediatrician as she think she “looks
funny” Upon detailed
investigations it is discovered the
baby has an abnormal front bone.
This is most likely due to abnormal
development of which of the
following?

A) Neural crest cells

B) Lateral plate mesoderm
C) Paraxial Mesoderm
D) Intermediate Mesoderm
E) Endoderm

A) Correct answer
5) Which of the following cardiac abnormalities appears to be linked to an increased risk
of developing migraines?

A) Membranous ventricular septal defect

B) Sinus venosus defect
C) Probe patent foramen ovale
D) Muscular ventricular septal defect
E) Common atrium

6) How many shunts exist in the fetal cardiovascular system?

A) 0
B) 1
C) 2
D) 3
E) 4

7) Which region of the heart tube is continuous with the aortic arch arteries in the early
stages of heart/vascular development?

A) Bulbus cordis
B) Primitive atrium
C) Truncus arteriosus
D) Primitive ventricle
E) Sinus venosus
Development of Vasculature

8) Which of the following is NOT involved with the development of the venae cavae?

A) Right vitelline vein

B) Right common cardinal vein
C) Right subcardinal vein
D) Right posterior cardinal vein
E) Right anterior cardinal vein

9) At which of the following locations does fetal blood contain the highest level of
oxygen?

A) Left umbilical artery

B) Proximal region of descending aorta
C) Ductus venosus
D) Right atrium
E) Inferior vena cava

10) A 6-year-old boy is brought to the physician by his parents for a follow up
examination because of a heart murmur that has been present since birth. His only
symptom is fatigue. His pulse is 110/min, and blood pressure is 80/40 mm Hg.
Physical examination shows no cyanosis or clubbing of the fingers. Cardiac
examination shows a normal S1 and a split S2. A grade 3/6 pansystolic murmur is heard
maximally at the lower left to mid left sternal border. He undergoes cardiac
catheterization and is found to have a higher than expected oxygen level in the right
ventricle. Which of the following is the most likely cause of these findings?

A) Coarctation of the aorta

B) Tetralogy of Fallot
C) Pulmonary artery stenosis
D) Patent ductus arteriosus
E) Ventricular septal defect

11) Failure of the aorticopulmonary septum to undergo the 180-degree spiral will result
in which of the following?

A) Tetralogy of Fallot
B) Transposition of the great vessels
C) Persistent truncus arteriosus
D) An atrial-septal defect
E) Pulmonary stenosis
 4. The chorionic plate is derived from which of the following?

A) Lateral plate mesoderm

B) Paraxial mesoderm

C) Intermediate mesoderm

D) Extra-embryonic mesoderm

Correct answer D). A)-C) are forms of intraembryonic mesoderm and form the structure of the
embryo/fetus

5. The image below is representative of an embryo, supporting structures and part of the
female reproductive tract at the end of the eighth week of development. Which of the
arrowed letters is pointing to the decidua parietalis?

Correct answer I.
.
 Lung Questions With Answers

1. While taking the practical exam for first semester anatomy at Ross University, you get a question
about a specimen which appears to be a right lung. Which of the following unique characteristics would
be a good indicator to distinguish a right lung apart from a left?

A. Airway opening superior to the pulmonary artery

B. Airway opening inferior to the pulmonary artery

C. An impression made by the descending aorta on the mediastinal surface

D. The cardiac notch

E. Two lobes

The right lung has the “eparterial” superior lobar bronchus located at level to or superior to the
pulmonary artery opening in the hilum (as opposed to a subarterial one in the left).

2. What are the proper anatomical names for the 1) hilar lymph nodes and 2) carinal lymph nodes?

A. Bronchopulmonary, tracheobronchial

B. Pulmonary; supraclavicular

C. Sentinal, bronchopulmonary

D. Axillary, tracheobronchial

E. Pulmonary, tracheobronchial

Bronchopulmonary lymph nodes = hilar lymph nodes; tracheobronchial lymph nodes = carinal lymph
nodes
3. Which of the following is correct regarding the anatomy of the lungs?

A. The left lung has one oblique fissure and one transverse fissure

B. The right lung has a lingula

C. The right lung has an impression for the arch of the azygos vein

D. A left lung collapse would cause a mediastinal shift to the right

E. Most aspirated objects are lodged in the left main bronchus

The typical right lung has one oblique and one transverse fissure, while the typical left lung has only an
oblique fissure. The lingual is on the left lung. A left lung collapse would cause a mediastinal shift to the
affected side. Most aspirated objects are lodged in the right main bronchus because it has a steeper
angle of descent.

4. A weak, elderly patient has been lying in a hospital bed for weeks with pneumonia. He aspirates
(breathes in) some fluid into his lungs while swallowing. In which of the following bronchopulmonary
segments is the fluid most likely to end up?

A. Inferior segment of the lingula

B. Medial segment of the left inferior lobe

C. Medial segment of the right middle lobe

D. Anterior segment of the right superior lobe

E. Superior segment of the right inferior lobe

Inhaled material tends to go into the right bronchus because it is wider and more vertically orientated
than the left. The superior segment branches posteriorly off of the inferior lobe bronchus, so it is most
likely to receive foreign bodies that enter the right main bronchus if the patient is lying down because of
the effect of gravity. If the patient is standing up/sitting up, the aspirated matter will likely end up in one
of the basal segments via a tertiary bronchi from the rest of the inferior lobar bronchus.

5. A patient arrives to your office, his complaint is that he’s been having difficulty breathing. On
examination you observe no external trauma to the thoracic cavity and you order a chest x-ray. You
suspect that the patient has a tension pneumothorax. What would you expect to see?

A. Dark lung field on the affected lungs, mediastinal shift and trachea deviation towards unaffected
lung

B. Grey lung field on the affected lungs, mediastinal shift and trachea deviation towards unaffected lung

C. Dark lung field on the affected lungs, mediastinal shift and trachea deviation towards affected lung

D. Grey lung field on the affected lungs, mediastinal shift and trachea deviations towards affected lung
On x-ray, air appears black. So in a tension pneumothorax, air escapes from the alveoli and gets trapped
in the thoracic cavity hence the affected lung field would be dark. The trapped air in the affected lung
increases the intrathoracic pressure and pushes the mediastinum and trachea away from the affected
lung or towards the unaffected lung.

6. A 5 year old boy is brought in to the clinic by his mother who is severely concerned about her son's
cough. The parent reports that she witnessed the boy playing with some marbles and might have tried
to swallow one. If a marble is stuck in the boy's airway, where would it most likely be?

A. Left main bronchus

B. Right main bronchus

C. Terminal bronchiole of the right lung

D. Terminal bronchiole of the left lung

E. Left inferior bronchus

Right main bronchus. The right bronchus is shorter, wider, and more vertical than the left bronchus.
Inhaled objects will enter the right main bronchus. Terminal bronchioles are too small to hold small
objects such as marbles.

7. Which of the following structures would you NOT find at the hilum of the lung?

A. Pulmonary artery

B. Bronchus

C. Bronchiole

D. Pulmonary vein

You would also find Bronchial artery and nerve plexus and hilar lymph nodes (note these were not
covered in the lecture, but you will see them in the lab as black spots).

8. During your ER rotation, you observe a young man who has been stabbed in the back by one of his ex-
girlfriends. You quickly assess the situation. The knife seemed to have pierced the left lung midway to
the diaphragmatic surface. What is the most likely area of injury?

A. Hilum

B. Superior lobe

C. Lingula

D. Inferior lobe
The injury most likely occurs to the Inferior lobe. This is aided by the fact that the superior lobe occupies
a small space in the posterior left lung.

9. Cardiothoracic surgeons must be familiar with bronchopulmonary segments since individual segments
of the lung can be removed while leaving the rest of the lung intact and functional. Which of the
following is a correct characterization of bronchopulmonary segments?

A. They are arranged with their bases directed toward the hilum of the lung

B. They are separated by parietal pleura

C. The arterial supply is located in the periphery of each segment

D. Each segment is supplied by a secondary or lobar bronchus

E. Veins may be used to localize the planes between segments

Answer: E ("M&D", pp 125-130) Veins may be used to localize the planes between segments. Although
the segmental bronchus and artery tend to be centrally located (answer C), the veins do not accompany
the arteries, but tend to be located subpleurally and between bronchopulmonary segments. Indeed, in
surgery the intersegmental veins are useful in defining intersegmental planes. Bronchopulmonary
segments, the anatomic and functional units of the lung, are roughly pyramidal in shape, each with its
apex directed toward the hilum of the lung (answer a), and are separated from each other by connective
tissue septa. Each bronchopulmonary segment is supplied by one tertiary or segmental bronchus
(answer D), along with a branch of the pulmonary artery. The parietal pleura (answer B) only covers the
superficial ends of the bronchopulmonary segments.

10. A 14 year-old female patient came to your office with fever, rhinitis and productive coughs with
frothy, pink-tinged sputum. Upon chest X-ray, the following image was presented to you by a radiology
technician. You suspect that the patient is suffering from viral pneumonia. Which of the following lobes
is the most likely location of consolidation?

A. Right Superior lobe

B. Right Middle lobe

C. Right Inferior lobe

D. Left Superior lobe

E. Lingular

F. Left Inferior lobe

Answer B. Above radiological image shows consolidation in the lower part of the right lung as it appears
as lighter shade of grey. (Eliminate A, D, E, F) Since the borders of the oblique fissure is not visible, the
inferior lobe is not infected. (Eliminate C) If the inferior lobe is infected, the area above oblique fissure
would show dark (air). Therefore the infected lobe is the right middle lobe. The middle lobe of the right
lung covers the anterior surface of the lung, thus any congestion/consolidation in the middle lobe will
obscure the radiological findings in the inferior lobe, which is located posterior to it.

11. A man was shot in his chest and rushed to the ER. He was bleeding profusely and had difficulty
breathing. A chest x-ray was performed and there was a mediastinal and tracheal shift to the left side.
Which side of the chest was he most likely shot in?

A. Left side

B. Right side

The gunshot wound caused an open pneumothorax leading to the lung collapse (atelectasis). In an open
pneumothorax, the mediastinum and tracheal shift occurs to the affected side.

12. A patient came into the Emergency room due a stab wound to his back. The attending physician
suspected the knife nicked the right lung. If the wound was half way between the Apex and the
Diaphragm, would structure would most likely be damaged?

A. Superior lobe

B. Middle lobe

C. Inferior lobe

D. Lingula

E. Hilum

F. Esophagus

The Inferior lobe of both lungs make up most of the Posterior surface of both lungs, so a stab to the
halfway point would likely damage the Inferior lobe.
13. The horizontal fissure of the right lung divides the middle lobe from the __________

You should have included the terms: 'Superior', 'lobe'

14. During a lung transplant, the surgeon thought he made a mistake. He was holding what he believed
was the right lung when his patient needed a new left lung. How did the surgeon know that he was
holding the right lung and not the left lung?

A. 2 lobes

B. Pulmonary artery superior to the bronchus

C. Bronchus is posterior to pulmonary artery

D. Has a lingula

E. Has a cardiac notch

The Pulmonary Artery on the right lung is anterior to the bronchus. Another way to say this, is the
bronchus is posterior to the pulmonary artery. The other 4 descriptions are characterizing the left lung.

15. A 60 year old male walks into your clinic complaining of fever, coughing, and trouble breathing. You
suspect him to have pneumonia so you order a chest x-ray. The radiology department delivers the x-ray
but forgets to include the report. You notice that the right, inferior border of the heart is hard to
visualize because of consolidation. Which lobe of the lung is most likely to have the pneumonia?

A. RIght upper lobe

B. Left inferior lobe

C. Left lingula

D. Right middle lobe

E. Right lower lobe

The right middle lobe sits on the right, inferior border of the heart so consolidation of this lobe will most
like block the border of the heart. The right upper lobe does contact the right border of the heart, but
only the most superior aspect. If the left border of the heart was hard to visualize then the lingula would
be the most likely lobe affected.
16. You see a patient in your clinic for a complaint of right sided chest pain. He is 25 years old, has
smoked for 8 years, and is also having trouble breathing. All of these symptoms occurred suddenly while
he was resting. He has no history of previous lung disease. He is normotensive. On auscultation you hear
diminished breath sounds on the right and on percussion the right side is hyper resonant. There is no
deviation of the trachea evident. You order a chest x-ray. What is your preliminary diagnosis?

A. Tension pneumothorax

B. Primary spontaneous pneumothorax

C. Open pneumothorax

D. Secondary spontaneous pneumothorax

E. Pulmonary embolism

F. Myocardial infarction

This is a classic presentation for primary spontaneous pneumothorax. The sudden onset and young age
are key points. There is no evidence of trauma to the chest wall so open pneumothoax should not be
considered. The lack of a history of lung disease rules out secondary spontaneous pneumothorax. This
could progress to a tension pneumothorax but it is lacking the mediastinal shift and hypotension that
would be associated with that. PE and MI don't fit the scenario.
Development of the Heart

1) Within hours of birth, an otherwise healthy newborn baby develops clinical cyanosis.
Which of the following congenital heart defects could be responsible for this condition?

A) Patent ductus arteriosus

B) Transposition of the great vessels
C) Tetralogy of Fallot
D) A and B
E) B and C

2) Which of the following heart defects is most likely to be associated with a failure of
neural crest cell migration?

A) Probe patent foramen ovale

B) Muscular ventricular septal defect
C) Ostium secundum atrial septal defect
D) Persistent truncus arteriosus
E) Dextrocardia

3) Which region of the embryonic heart tube gives rise to the sinus venarum?

A) Bulbus cordis
B) Right horn of the sinus venosus
C) Primitive atrium
D) Primitive ventricle
E) Truncus arteriosus

4) The image below depicts the primitive heart tube inflow and outflow tracts before
looping. Which part of the adult heart, or inflow or outflow tracts, is derived from the
region indicated by the yellow arrow?

A) Aorta & pulmonary trunk

B) Trabeculated (rough area) of an atrium
C) Sinus venarum
D) Right vitelline vein
E) Trabeculated (rough area) of a ventricle
5) Which of the following cardiac abnormalities appears to be linked to an increased risk
of developing migraines?

A) Membranous ventricular septal defect

B) Sinus venosus defect
C) Probe patent foramen ovale
D) Muscular ventricular septal defect
E) Common atrium

6) How many shunts exist in the fetal cardiovascular system?

A) 0
B) 1
C) 2
D) 3
E) 4

7) Which region of the heart tube is continuous with the aortic arch arteries in the early
stages of heart/vascular development?

A) Bulbus cordis
B) Primitive atrium
C) Truncus arteriosus
D) Primitive ventricle
E) Sinus venosus
Development of Vasculature

8) Which of the following is NOT involved with the development of the venae cavae?

A) Right vitelline vein

B) Right common cardinal vein
C) Right subcardinal vein
D) Right posterior cardinal vein
E) Right anterior cardinal vein

9) At which of the following locations does fetal blood contain the highest level of
oxygen?

A) Left umbilical artery

B) Proximal region of descending aorta
C) Ductus venosus
D) Right atrium
E) Inferior vena cava

10) A 6-year-old boy is brought to the physician by his parents for a follow up
examination because of a heart murmur that has been present since birth. His only
symptom is fatigue. His pulse is 110/min, and blood pressure is 80/40 mm Hg.
Physical examination shows no cyanosis or clubbing of the fingers. Cardiac
examination shows a normal S1 and a split S2. A grade 3/6 pansystolic murmur is heard
maximally at the lower left to mid left sternal border. He undergoes cardiac
catheterization and is found to have a higher than expected oxygen level in the right
ventricle. Which of the following is the most likely cause of these findings?

A) Coarctation of the aorta

B) Tetralogy of Fallot
C) Pulmonary artery stenosis
D) Patent ductus arteriosus
E) Ventricular septal defect

11) Failure of the aorticopulmonary septum to undergo the 180-degree spiral will result
in which of the following?

A) Tetralogy of Fallot
B) Transposition of the great vessels
C) Persistent truncus arteriosus
D) An atrial-septal defect
E) Pulmonary stenosis
12) The course of the adult recurrent laryngeal nerves differs on the two sides because
of differences in the transformation of the sixth aortic arch arteries. Which of the
following results from the transformation?

A) Right recurrent laryngeal nerve hooks around the ligamentum arteriosum

B) Right recurrent laryngeal nerve hooks around the right subclavian artery
C) Right recurrent laryngeal nerve hooks around the brachiocephalic trunk (artery)
D) Left recurrent laryngeal nerve hooks around the pulmonary artery
E) Left recurrent laryngeal nerve hooks around the left common carotid artery

13) In the fetus, the vasculature undergoes extensive remodeling. Which of the
following vessel/s do/does not normally degenerate in its/their entirety during this event?

A) Left dorsal aorta

B) Right umbilical vein
C) Left umbilical vein
D) Fifth aortic arch arteries

14) The superior vena cava is a major vessel draining the head and neck. Which
embryological vessels give rise to this structure?

A) The left anterior cardinal vein with the right anterior cardinal vein
B) The left anterior cardinal vein and the left common cardinal vein
C) The right anterior cardinal vein and the right common cardinal vein
D) The left common cardinal vein and the right common cardinal vein
E) The right posterior cardinal vein and the right common cardinal vein

Answers:
1E, 2D, 3B, 4E, 5C, 6D, 7C, 8D, 9C, 10E, 11B, 12B, 13C, 14C