Self-taught class 20. Anastomoses of the vessels of lower extremity

a) What are the normal internal features of the right atrium?

b) Describe the normal development of the interatrial septum and the basis for the defect.
The Heart

The _____________ pumps blood to the lungs.

The _____________ pumps blood to the body; it's the strongest chamber of the heart.

The middle layer, of heart muscle itself, is known as the _______________.

The _____________ takes in blood from the superior and inferior vena cavae.

The _____________ takes in blood from the 4 pulmonary veins.

The _____________________ is the body's largest artery.

The _________________ valve is between the left atrium and left ventricle.

The _________________ valve is between the left atrium and the left ventricle.

The ___________________ is between the right and left ventricles

A blockage of a coronary artery can lead to a ______________.
Blood Vessels

The ____________ carry blood away from the heart.

The ____________ are under high pressure.

Large, thick walled arteries, located near the heart, are called ______________.

The smallest type of artery, that connects with the capillaries, is called ______________.

The smallest type of blood vessel is the _____________.

Nutrients & wastes are exchanged at the ___________.

______________ carry blood to the heart

The ____________ have one-way valves.

__________ is the volume of blood flowing through an area in a certain amount of time.

__________ is the pressure exerted on the blood vessel by the blood

__________ pressure is when the heart contracts and BP is at its highest.

High blood pressure is known as ______________.

The ___________ artery drains the kidney.

1. 
   Anastomoses between the portal system and the vena caval system include:
   
   1. 
      Left gastric vein (portal) and azygos system (vena caval)
      
   2. 
      Inferior mesenteric vein (portal) and superior rectal vein (vena caval)
      
   3. 
      Veins of the descending and ascending colon (portal) and renal and lumbar veins (vena caval)
      
   4. 
      *a and c
      
   5. 
      a, b and c
      
2. 
   The aorta
   
   1. 
      becomes the descending aorta at TV4
      
   2. 
      enters the abdomen at TV 12
      
   3. 
      bifurcates into the common iliac arteries at LV4
      
   4. 
      b and c
      
   5. 
      *a, b and c
      
3. 
   The medial umbilical ligament represents:
   
   1. 
      *an obliterated umbilical artery
      
   2. 
      an obliterated umbilical vein
      
   3. 
      an obliterated urachus
      
   4. 
      an obliterated ductus venosus
      
   5. 
      none of the above
      
4. 
   Each of the following statements about the azygos system of veins is true EXCEPT:
   
   1. 
      it consists of veins on each side of the vertebral column
      
   2. 
      it drains the back and walls of the thorax and abdomen
      
   3. 
      *the right and left superior intercostal veins drain into the azygos system
      
   4. 
      the accessory hemiazygos vein joins the azygos vein
      
   5. 
      all of the above are true
      
5. 
   Tributaries of the coronary sinus include each of the following EXCEPT:
   
   1. 
      *anterior cardiac veins
      
   2. 
      oblique vein of the left atrium
      
   3. 
      small cardiac vein
      
   4. 
      great cardiac vein
      
   5. 
      middle cardiac vein
      
6. 
   The right coronary artery typically supplies the:
   
   1. 
      sino-atrial node
      
   2. 
      right ventricle
      
   3. 
      posterior interventricular septum
      
   4. 
      a and b
      
   5. 
      *a, b and c
      
7. 
   The film of a postero-anterior chest x-ray shows a well defined outline of the heart. Which of the following is a TRUE statement?
   
   1. 
      *the entire right border is right atrium.
      
   2. 
      the right border is both right atrium and ventricle.
      
   3. 
      the left border is entirely left atrium
      
   4. 
      the inferior border is entirely right ventricle.
      
   5. 
      the inferior border is 2/3 left ventricle and 1/3 right ventricle
      
8. 
   A radiograph of the deep and superficial palmar arches was taken after both were injected with contrast medium. When looking at the film, which arch is more distal in the hand?
   
   1. 
      *superficial palmar arch
      
   2. 
      deep palmar arch
      
   3. 
      they are both at the same level in the palm
      
   4. 
      cannot determine from data given
      
   5. 
      none of the above answers is correct
      
9. 
   Which artery lies on the anterior surface of the anterior scalene muscle?
   
   1. 
      superior thyroid artery
      
   2. 
      *ascending cervical artery
      
   3. 
      vertebral. artery
      
   4. 
      costocervical trunk
      
   5. 
      subclavian A
      
10. 
    A rhabdomyosarcoma (malignant striated muscle tumor) involves the whole of the middle scalene muscle. What structures will be affected by the tumor?
    
    1. 
       dorsal scapular nerve
       
    2. 
       long thoracic nerve
       
    3. 
       subclavian artery, if tumor extends anteriorly
       
    4. 
       a and c
       
    5. 
       *a, b and c
       
11. 
    The subclavian artery passes
    
    1. 
       anterior to the phrenic nerve
       
    2. 
       anterior to the scalenus anterior muscle
       
    3. 
       posterior to the lower trunk of the brachial plexus
       
    4. 
       posterior to the scalenus medius muscle
       
    5. 
       *posterior to the vagus nerve
       
12. 
    The interosseous membrane between the tibia and fibula is pierced by the :
    
    1. 
       anterior tibial artery
       
    2. 
       deep peroneal nerve
       
    3. 
       peroneal artery
       
    4. 
       *a and c
       
    5. 
       a, b and c
       
13. 
    The pulsations of the posterior tibial artery are best felt:
    
    1. 
       behind the knee
       
    2. 
       *behind the medial malleolus
       
    3. 
       between the medial and lateral malleoli
       
    4. 
       behind the lateral malleolus
       
    5. 
       the posterior tibial artery can not be palpated
       
14. 
    All the following statements about the deep femoral artery are true EXCEPT:
    
    1. 
       the medial circumflex femoral artery runs in between the pectineus muscle and iliopsoas muscle.
       
    2. 
       the lateral circumflex femoral artery runs deep to the rectus femoris muscle.
       
    3. 
       the deep femoral artery runs in between the adductor longus and brevis muscles.
       
    4. 
       the perforating branches of the artery pass through the adductor magnus.
       
    5. 
       *the terminal branch of the artery passes through the adductor hiatus
       
15. 
    Just before birth, the largest branch of the internal iliac artery is the
    
    1. 
       inferior gluteal artery
       
    2. 
       internal pudendal artery
       
    3. 
       middle rectal artery
       
    4. 
       superior gluteal artery
       
    5. 
       *umbilical artery
       
16. 
    Passing between the lumbosacral trunk and Sl nerve is the
    
    1. 
       inferior gluteal artery
       
    2. 
       internal pudendal artery
       
    3. 
       obturator artery
       
    4. 
       *superior gluteal artery
       
    5. 
       none of the above
       
17. 
    Between which two muscles does the internal pudendal artery leave the pelvic cavity?
    
    1. 
       a. coccygeus and levator ani
       
    2. 
       b. *piriformis and coccygeus
       
    3. 
       c. piriformis and gluteus maximus
       
    4. 
       d. piriformis and obturator internus
       
    5. 
       none of the above
       
18. 
    Enlarged veins radiating from the umbilicus in the abdominal wall would most likely result from blockage of the
    
    1. 
       *portal vein proper
       
    2. 
       splenic vein
       
    3. 
       superior mesenteric vein
       
    4. 
       all the above
       
    5. 
       none of the above
       
19. 
    The great cardiac vein travels with
    
    1. 
       the posterior interventricular artery
       
    2. 
       the anterior interventricular artery
       
    3. 
       the circumflex artery
       
    4. 
       a and c
       
    5. 
       *e. b and c
       
20. 
    On an anterior-posterior X-ray of the chest, the right border of the heart shadow consists of the:
    
    1. 
       a. acute margin
       
    2. 
       b. left atrium only
       
    3. 
       c. obtuse margin
       
    4. 
       *right atrium only
       
    5. 
       right atrium and right ventricle
       
21. 
    In the cubital fossa, the brachial artery is:
    
    1. 
       lateral to the tendon of the biceps brachii muscle
       
    2. 
       *medial to the tendon of the biceps brachii muscle
       
    3. 
       medial to the median nerve
       
    4. 
       a and c
       
    5. 
       b and c
       
22. 
    The axillary artery:
    
    1. 
       begins at the lateral border of the first rib
       
    2. 
       lies anterior and inferior to the axillary vein
       
    3. 
       gives off the posterior humeral circumflex artery
       
    4. 
       *d. a and c
       
    5. 
       a, b, and c
       
23. 
    When inserting a cardiac catheter through the brachial vein, it would reach the medial end of the subclavian vein at the
    
    1. 
       beginning of the superior vena cava
       
    2. 
       behind the anterior scalene muscle
       
    3. 
       *behind the medial end of the clavicle
       
    4. 
       lateral margin of the anterior scalene muscle
       
    5. 
       lateral margin of the first rib
       
24. 
    Which of the following statements is TRUE?
    
    1. 
       the anterior tibial artery travels posterior to anterior above the interosseous membrane
       
    2. 
       the peroneal artery travels within the lateral compartment and supplies the muscles there-
       
    3. 
       the dorsalis pedis artery is a continuation of the anterior tibial artery and becomes the deep plantar artery
       
    4. 
       a and b
       
    5. 
       *a and c
       
25. 
    Muscles of the posterior compartment of the thigh receive their blood supply from:
    
    1. 
       popliteal artery
       
    2. 
       medial femoral circumflex artery
       
    3. 
       perforating branches of the deep femoral artery
       
    4. 
       a and c
       
    5. 
       *a, b, and c
       
26. 
    The medial circumflex femoral artery
    
    1. 
       is observed in the femoral triangle
       
    2. 
       passes between the iliopsoas and pectineus muscles
       
    3. 
       contributes a branch to the cruciate anastomosis
       
    4. 
       a and c
       
    5. 
       *a, b and c
       
27. 
    The superior gluteal artery typically exits the pelvis
    
    1. 
       above the lumbosacral trunk
       
    2. 
       *between the lumbosacral trunk and S 1 nerve
       
    3. 
       between the S1 and S2 nerves
       
    4. 
       between the S2 and S3 nerves
       
    5. 
       through the lesser sciatic foramen
       
28. 
    All of the following pass through the pelvic inlet EXCEPT the
    
    1. 
       abnormal obturator artery
       
    2. 
       *lateral sacral artery
       
    3. 
       median sacral artery
       
    4. 
       ovarian artery
       
    5. 
       round ligament of the uterus
       
29. 
    The division of the aorta with the fewest branches is normally the:
    
30. 
    *ascending aorta
    
    1. 
       aortic arch
       
    2. 
       descending thoracic aorta
       
    3. 
       abdominal aorta
       
    4. 
       same number of branches in all aortic divisions listed
       
31. 
    Matching Type
    

1. 
   left atrium
   
2. 
   left ventricle
   
3. 
   right atrium
   
4. 
   right ventricle
   
5. 
   right auricle
   

1. 
   a b c d e --opening of the coronary sinus
   
2. 
   a b c d e --opening of the right pulmonary veins
   
3. 
   a b c d e --sinus venarum
   
4. 
   a b c d e --conus arteriosus
   
5. 
   a b c d e --septal papillary muscl
   
1. 
   Matching Type
   

1. 
   branch of the axillary artery
   
2. 
   branch of the ulnar artery
   
3. 
   branch of the radial artery
   
4. 
   branch of the subclavian artery
   
5. 
   branch of the brachial artery
   

1. 
   a b c d e --superior ulnar collateral A
   
2. 
   a b c d e --crosses the floor of the anatomical snuffbox
   
3. 
   a b c d e --vertebral A
   
4. 
   a b c d e --anterior humeral circumflex A
   
5. 
   a b c d e --dorsal scapular
   
1. 
   The following statements about the superior vena cava are true, EXCEPT:
   
   1. 
      It begins at the level of the right first costal cartilage.
      
   2. 
      It receives the right and left brachiocephalic and the azygos veins.
      
   3. 
      It follows the right phrenic nerve.
      
   4. 
      *It follows the right vagus nerve.
      
   5. 
      It enters the right atrium.
      
2. 
   The pacemaker for the heart is ordinarily the:
   
   1. 
      *sinoatrial node
      
   2. 
      atrioventricular node
      
   3. 
      atrioventricular bundle (of His)
      
   4. 
      subendocardial plexus
      
   5. 
      membranous interventricular septum
      
3. 
   All of the following participate in the arterial anastomosis around the elbow joint EXCEPT:
   
   1. 
      superior ulnar collateral A
      
   2. 
      anterior descending branch of profunda brachii A
      
   3. 
      radial recurrent A
      
   4. 
      *anterior interosseous A
      
   5. 
      inferior ulnar collateral
      
4. 
   You are to perform a venipuncture of the median cubital vein. Which of the following structures is most suitably located to afford protection against your inadvertently entering the brachial artery rather than the veins?
   
   1. 
      the cord-like tendon of the biceps brachii M.
      
   2. 
      *the bicipital aponeurosis
      
   3. 
      the tendon of the brachialis .
      
   4. 
      the brachioradialis M.
      
   5. 
      the medial epicondyle of the humerus
      
5. 
   Pick the discordant pair:
   
   1. 
      radial N. profundus brachii A
      
   2. 
      axillary N. posterior humeral circumflex A
      
   3. 
      ulnar N superior ulnar collateral A
      
   4. 
      *median N. posterior interosseous A
      
   5. 
      anterior interosseous N.anterior interosseous A
      
6. 
   The correct arrangement of the following structures from superficial to deep is:
   

1. 
   palmar aponeurosis
   
2. 
   lumbricals
   
3. 
   superficial arterial arch
   
4. 
   metacarpal bones
   
5. 
   digital branches of the median nerve
   

1. 
   1-2-3-4-5
   
2. 
   *1-3-5-2-4
   
3. 
   1-3-2-5-4
   
4. 
   1-2-3-5-4
   
5. 
   1-5-3-2-4
   
1. 
   Which of the following arteries is not a branch of the axillary artery:
   
   1. 
      thoracoacromial
      
   2. 
      *profunda brachii
      
   3. 
      lateral thoracic
      
   4. 
      anterior humeral circumflex
      
   5. 
      subscapularis
      
2. 
   Obstruction of the portal vein may result in all of the following, EXCEPT:
   
   1. 
      dilation of veins around the umbilicus
      
   2. 
      *varicosities of the great saphenous V.
      
   3. 
      dilation of veins around the lower esophagus and, possibly,vomiting of blood
      
   4. 
      enlargement of veins along the large bowel
      
   5. 
      bleeding into the rectum or anal canal
      
3. 
   All the following are branches of the external carotid artery, EXCEPT:
   
   1. 
      ascending pharyngeal A.
      
   2. 
      superior thyroid A.
      
   3. 
      occipital A.
      
   4. 
      *vertebral A.
      
   5. 
      lingual A.
      
4. 
   All of the following are correctly matched with their arterial origin, EXCEPT:
   
   1. 
      anterior humeral circumflex A.third part of the axillary A.
      
   2. 
      *common interosseous A. radial A.
      
   3. 
      deep brachial A. : brachial A.
      
   4. 
      lateral thoracic A. : second part of the axillary A.
      
   5. 
      anterior ulnar recurrent A :ulnar A.
      
5. 
   Bone injuries around the knee are very common. Which structure lies closest to a fractured lower end of the femur?
   
   1. 
      popliteal vein
      
   2. 
      tibial nerve
      
   3. 
      *popliteal artery
      
   4. 
      common peroneal nerve
      
   5. 
      saphenous nerve