Gray's anatomy review: thorax Exam Questions With Correct Answers.
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Gray\'s Anatomy
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Gray\'s Anatomy
Gray's anatomy review: thorax Exam
Questions With Correct Answers.
1 A 2-day-old newborn is diagnosed with transposition of the great arteries. Which structure is
responsible for the division of the truncus arteriosus into the great arteries?
A. Septum secundum
B. Septum primum
C. Bulbar sept...
Gray's anatomy review: thorax Exam
Questions With Correct Answers.
1 A 2-day-old newborn is diagnosed with transposition of the great arteries. Which structure is
responsible for the division of the truncus arteriosus into the great arteries?
A. Septum secundum
B. Septum primum
C. Bulbar septum
D. Aorticopulmonary septum
E. Endocardial cushions - answer✔1 D. The aorticopulmonary septum functions to divide the
truncus arteriosus and bulbus cordis into the aorta and
pulmonary trunk. The septum secundum forms an
incomplete separation between the two atria. The septum
primum divides the atrium into right and left halves. The
bulbar septum is derived from the bulbus cordis and will
give rise to the interventricular septum inferior to the
aorticopulmonary septum, eventually fusing with it. The
endocardial cushions play a role in the division of the AV
canal into right and left halves, by causing the AV cushions
to approach each other.
2 A 32-year-old woman in her third trimester of pregnancy is undergoing a routine ultrasound
examination. The examination of the fetus reveals enlarged and echogenic lungs, inverted
diaphragm, and fetal ascites. Which condition is best characterized by these signs?
A. Laryngeal atresia
B. Tracheal atresia
C. Polyhydramnios
E. Oligohydramnios - answer✔2 A. Laryngeal atresia (congenital high airway obstruction
syndrome) is a rare obstruction of the upper fetal airway.
Distal to the site of the atresia, the airways dilate, lungs
enlarge and become echogenic, the diaphragm flattens or
inverts, and fetal ascites and/or hydrops develop. Tracheal
atresia is a rare obstruction of the trachea, commonly found
with a tracheoesophageal fistula, probably resulting from
the unequal division of foregut into esophagus and trachea.
Polyhydramnios is an excess of amniotic fluid, often
associated with esophageal atresia or tracheoesophageal
fistula. Lung hypoplasia is reduced lung volume, often seen
in infants with a congenital diaphragmatic hernia.
Oligohydramnios, or a decrease in amniotic fluid, is
associated with stunted lung development and pulmonary
hypoplasia.
3 A 2-year-old child is seen in the pediatric cardiology unit for a congenital heart condition.
Which of the following conditions occurs most often?
A. Membranous ventricular septal defect
B. Tetralogy of Fallot
C. Muscular ventricular septal defect
D. Ostium secundum defect
E. Ostium primum defect - answer✔3 A. Ventricular septal defects account for 25% of
congenital heart defects. The most common of these are
defects in the membranous portion of the interventricular
septum (membranous ventricular septal defects).
4 A 2-day-old is diagnosed with transposition of the great arteries. If this condition were to be
left untreated for more than 4 months, it would be fatal. Which of the following structures must
remain patent so that the infant can survive until surgical correction of the malformation?
E. Pulmonary stenosis - answer✔4 A. In a case of transposition of the great arteries,
oxygenated blood travels from the left ventricle into the
pulmonary trunk, where it will eventually reach the lungs. In
contrast, the aorta would be carrying deoxygenated blood
into the systemic circulation. A patent ductus arteriosus
acts as a shunt between the aorta and pulmonary trunk,
allowing oxygenated and deoxygenated blood to mix and
therefore allowing some oxygenated blood to reach the
tissues. None of the other answer choices would correct
this problem; with these structures remaining patent, the
body would still not receive sufficient oxygenated blood for
survival to be possible.
5 A 2-day-old newborn female is diagnosed with pulmonary stenosis, overriding of the aorta,
ventricular septal defect, and hypertrophy of the right ventricle. Which condition is best
characterized by these signs?
A. Tetralogy of Fallot
B. Atrial septal defect
C. Transposition of the great vessels
D. Pulmonary atresia
E. Ventricular septal defect - answer✔5 A. Tetralogy of Fallot is always characterized by four
cardiac defects: pulmonary stenosis, ventricular septal
defect (VSD), overriding aorta, and these in turn lead to
right ventricular hypertrophy. An atrial septal defect (ASD)
is characterized by the communication between the two
E. Atrioventricular canal malformation - answer✔6 A. Superior malalignment of the
subpulmonary
infundibulum causes stenosis of the pulmonary trunk. This
leads to the four symptoms mentioned and is known as
tetralogy of Fallot. A defect in formation of the
aorticopulmonary septum is characteristic of transposition
of the great arteries. An endocardial cushion defect is
associated with membranous ventricular septal defects.
7 A 5-year-old boy is admitted to the hospital with severe dyspnea. During physical examination
a loud systolic murmur and a wide, fixed, split S2 sound is noted. What is the most likely
diagnosis?
A. Ventricular septal defect
B. Atrial septal defect
C. Tetralogy of Fallot
D. Transposition of the great arteries
E. Aortic stenosis - answer✔7 B. The murmur at S2 localizes the defect at an atrioventricular
valve. An atrial septal defect causes a
diastolic murmur in the tricuspid valve, whereas a ventricular septal defect would cause a
pansystolic murmur. Transposition of the great arteries and aortic stenosis will cause a murmur
at S1, and tetralogy of Fallot does not cause a murmur at S1 or S2
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