Practice Quiz - Heart

    Below are written questions from previous quizzes and exams. Click here for the new format Practical Quiz. Click here for the old format Practical Quiz.

  1. Blockage of which of the following arteries would lead to ischemia of the apex of the heart?
    Anterior interventricular (descending)
    Left circumflex
    Posterior interventricular (descending)
    Right marginal
    Right coronary
  2. If the ductus arteriosus does not spontaneously close off soon after birth (to become the ligamentum arteriosum), it may have to be surgically ligated. When clamping or ligating it, what important structure immediately behind it must be identified and saved?
    arch of the azygos vein
    internal thoracic artery
    left phrenic nerve
    left recurrent laryngeal nerve
    left superior intercostal vein
  3. A hand slipped behind the heart at its apex can be extended upwards until stopped by a line of pericardial reflection that forms the:
    Cardiac notch
    Costomediastinal recess
    Hilar reflection
    Oblique pericardial sinus
    Transverse pericardial sinus
  4. A stethoscope placed over the left second intercostal space just lateral to the sternum would be best positioned to detect sounds associated with which heart valve?
  5. Which valves would be open during ventricular systole?
    Aortic and pulmonary
    Aortic and tricuspid
    Mitral and aortic
    Tricuspid and mitral
    Tricuspid and pulmonary
  6. Which chamber's anterior wall forms most of the sternocostal surface of the heart?
    Left atrium
    Left ventricle
    Right atrium
    Right ventricle
  7. A 3rd-year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers?
  8. A patient involved in an automobile accident presents with a sharp object puncture of the middle of the sternum at about the level of the 4th or 5th costal cartilage. If the object also penetrated pericardium and heart wall, which heart chamber would most likely be damaged?
    Left atrium
    Left ventricle
    Right atrium
    Right ventricle
  9. Which statement is true of the right atrioventricular valve?
    it is also called the mitral valve
    it is open during ventricular diastole
    it transmits oxygenated blood
    it is opened by the pull of chordae tendineae
    it consists of 2 leaflets
  10. A 23-year-old male injured in an industrial explosion was found to have multiple small metal fragments in his thoracic cavity. Since the pericardium was torn inferiorly, the surgeon began to explore for fragments in the pericardial sac. Slipping her hand under the heart apex, she slid her fingers upward and to the right within the sac until they were stopped by the cul-de-sac formed by the pericardial reflection near the base of the heart. Her fingertips were then in the:
    Coronary sinus
    Coronary sulcus
    Costomediastinal recess
    Oblique sinus
    Transverse sinus
  11. An elderly lady suffers a coronary occlusion and subsequently it is noted that there is a complete heart block (that is, the right and left bundles of the conduction system have been damaged). The artery most likely involved is the:
    acute marginal branch
    circumflex branch
    anterior interventricular (Left anterior descending)
    obtuse marginal
    posterior interventricular (posterior descending)
  12. During fetal life and sometimes persisting into the adult there is an opening between the right and left atria; this opening is called the:
    atrioventricular canal
    coronary sinus
    foramen ovale
    sinus venosus
    truncus arteriosis
  13. The heart sound associated with the mitral valve is best heard:
    In the jugular notch
    In the second left intercostal space
    In the second right intercostal space
    In the fifth left intercostal space
    To the right of the xiphoid process
  14. Which heart valve has leaflets described as "anterior, left and right"?
    Left atrioventricular
    Right atrioventricular
  15. In preparation for thoracic surgery, a median sternal splitting procedure was carried out. But an improper depth setting on the saw blade resulted in a slight nick on the underlying sternocostal surface of the heart. Which heart chamber would most likely have been opened had the blade completely penetrated this wall?
    Left atrium
    Left ventricle
    Right atrium
    Right ventricle
  16. The sound associated with tricuspid stenosis (narrowing) in a 40-year-old male would be best heard at which location on the anterior chest wall?
    Below the left nipple
    In the right 2nd intercostal space near the sternum
    Over the apex of the heart
    Over the sternal angle
    Xiphoid area, just off the sternum
  17. Blockage of blood flow in the proximal part of the anterior interventricular artery could deprive a large area of heart tissue of blood supply, unless a substantial retrograde flow into this artery develops via an important anastomosis with which other artery?
    Left marginal
    Posterior interventricular
    Right coronary
    Right marginal
  18. Traumatic, acceleration/deceleration injuries to the aorta usually occur where its mobile and fixed portions meet. This would be at the:
    at the ligamentum arteriosum
    junction of aortic arch with the descending portion
    junction of the ascending aorta with the heart
    origin of the brachiocephalic artery on the arch
    point where the descending aorta passes through the diaphragm
  19. Which structure does NOT lie in the coronary sulcus?
    circumflex artery
    coronary sinus
    right coronary artery
    right marginal artery
    left coronary artery
  20. Which structure contains postganglionic sympathetic fibers?
    greater thoracic splanchnic nerve
    recurrent laryngeal nerve
    sympathetic trunk
    ulnar nerve
    vagus nerve
  21. Which posterior mediastinal structure is most closely applied to the posterior surface of the pericardial sac?
    Azygos vein
    Thoracic duct
  22. In obstruction of the superior or inferior vena cava, venous blood is returned to the heart by an alternate route via the azygos vein, which becomes dilated in the process. Which of the following structures might it compress as a result?
    root of the left lung
    phrenic nerve
    thoracic duct
    descending aorta
  23. Elevated systolic blood pressure in the right ventricle suggests stenosis of which valve?
  24. During examination of a 62-year-old man, the senior resident tells you to put your stethoscope on the left 5th intercostal space, slightly below the nipple, and listen for a clearly audible murmur. You hear it distinctly and know it must be associated with severe stenosis of which heart valve?
  25. A 26-year-old male is brought into the emergency room after having been kicked in the chest by a horse. After examination, it is concluded that the most likely immediate danger is cardiac tamponade (bleeding into the pericardial sac). You prepare to draw off some of the blood from the sac to relieve the pressure on the heart. The safest site at which to insert the needle of the syringe in order to miss the pleura would be:
    Just below the nipple on the left
    Just to the left of the xiphisternal junction
    Near the sternal angle
    Through the jugular notch
    4th left intercostal space in the midaxillary line
  26. A 22-year-old male involved in an automobile accident presents with symptoms suggestive of myocardial contusion due to blunt trauma, specifically compression of the sternocostal surface of the heart by the sternum when his chest hit the steering wheel. Which heart chamber was most likely damaged?
    Left atrium
    Left ventricle
    Right atrium
    Right ventricle
  27. While attempting to suture the distal end of a coronary bypass onto the anterior interventricular artery, the surgeon accidentally passed the needle through the adjacent vein. Which vein was damaged?
    Anterior cardiac vein
    Coronary sinus
    Great cardiac vein
    Middle cardiac vein
    Small cardiac vein
  28. While listening to a patient's heart sounds with a stethoscope, you identify a high-pitched sound in the second right intercostal space, just lateral to the edge of the sternum. Your correct conclusion is that you have detected stenosis of which heart valve?