Anatomy of heart

ANATOMY OF HEART

Q. 1

Which structure does NOT lie in the coronary sulcus?

 A

Circumflex artery

 B

Coronary sinus

 C

Right coronary artery

 D

Right marginal artery

Q. 1

Which structure does NOT lie in the coronary sulcus?

 A

Circumflex artery

 B

Coronary sinus

 C

Right coronary artery

 D

Right marginal artery

Ans. D

Explanation:

The coronary sulcus is the groove which separates the atria from the ventricles. The right and left coronary arteries, circumflex artery, and coronary sinus all lie in this groove. The right marginal artery is a branch of the right coronary artery which lies on the right ventricle and supplies that chamber of the heart.


Q. 2

Right border of the heart in CXR is formed by

 A

Pulmonary artery

 B

Superior vena cava

 C

Rt atrium

 D

b and c

Q. 2

Right border of the heart in CXR is formed by

 A

Pulmonary artery

 B

Superior vena cava

 C

Rt atrium

 D

b and c

Ans. D

Explanation:

B i.e., Superior vena cava; C i.e. Right atrium


Q. 3

Normal heart axis is:

 A

-90 to + 90°

 B

-90 to + 180°

 C

-30 to +90°

 D

-90 to 180°

Q. 3

Normal heart axis is:

 A

-90 to + 90°

 B

-90 to + 180°

 C

-30 to +90°

 D

-90 to 180°

Ans. C

Explanation:

Answer is C (-30 to +90°)


Q. 4

In the adult heart, floor of fossa ovalis represents:

 A

Septum intermedium

 B

Septum primum

 C

Septum spurium

 D

Septum secundum

Q. 4

In the adult heart, floor of fossa ovalis represents:

 A

Septum intermedium

 B

Septum primum

 C

Septum spurium

 D

Septum secundum

Ans. B

Explanation:

Ans. B: Septum primum

Fossa ovalis and anulus ovalis lie on the atrial septum, which separates the right atrium from the left atrium.

The fossa ovalis is a shallow depression, which is the site of the foramen ovale in the fetus.

The anulus ovalis forms the upper margin of the fossa.

The floor of the fossa represents the persistent septum primum of the heart of the embryo, and the anulus is formed from the lower edge of the septum secundum


Q. 5

NOT a content of middle mediastinum:

 A

Ascending aorta

 B

Oesophagus

 C

Pulmonary trunk

 D

Phrenic nerve

Q. 5

NOT a content of middle mediastinum:

 A

Ascending aorta

 B

Oesophagus

 C

Pulmonary trunk

 D

Phrenic nerve

Ans. B

Explanation:

The esophagus is considered to be located in the superior and posterior mediastinum.


Q. 6

Base of the heart is formed mainly by:

 A

Right atrium

 B

Left atrium

 C

Right ventricle

 D

Left ventricle

Q. 6

Base of the heart is formed mainly by:

 A

Right atrium

 B

Left atrium

 C

Right ventricle

 D

Left ventricle

Ans. B

Explanation:

The heart has three surfaces: sternocostal (anterior), diaphragmatic (inferior), and a base (posterior).

It also has an apex, which is directed downward, forward, and to the left.

The sternocostal surface is formed mainly by the right atrium and the right ventricle.

The right border is formed by the right atrium; the left border, by the left ventricle and part of the left auricle.

The diaphragmatic surface of the heart is formed mainly by the right and left ventricles. The inferior surface of the right atrium, into which the inferior vena cava opens, also forms part of this surface.

The base of the heart, or the posterior surface, is formed mainly by the left atrium, into which open the four pulmonary veins.


Q. 7

Which of these does not form the right border of the heart on X-ray:       

 A

Right atrium

 B

Arch of aorta

 C

Superior vena cava

 D

Inferior vena cava

Q. 7

Which of these does not form the right border of the heart on X-ray:       

 A

Right atrium

 B

Arch of aorta

 C

Superior vena cava

 D

Inferior vena cava

Ans. B

Explanation:

 Right border of the mediastinal shadow (chiefly produced due to the heart and the vessels entering and leaving it) is formed from above downwards by the right brachiocephalic vein, superior vena cava, right atrium and the inferior vena cava

The Base of the Heart

  • The base is located posteriorly and is formed mainly by the left atrium.
  • It lies opposite T5 to TS (supine position) and T6 to T9 vertebrae (erect position) and faces superiorly, posteriorly and towards the right shoulder.
  • The base or posterior aspect of the heart is quadrilateral in shape and it is from its most superior part from which the ascending aorta and pulmonary trunk emerge, and into which the superior vena cava enters.
  • The base is separated from the diaphragmatic surface of the heart by the posterior part of the coronary groove (L. sulcus).

The Apex of the Heart

  • This blunt apex is formed from by the left ventricle, which points inferolaterally.
  • The apex is located posterior to the left 5th intercostal space in adults, 7 to 9 cm from the median plane, and just left of the midclavicular line.
  • The apex beat is an impulse imparted by the hear; it is its point of maximal pulsation or the lowest, most lateral point at which pulsation can be felt.

The Sternocostal (Anterior) Surface of the Heart

  • This surface of the heart is mainly formed by the right ventricle and is visible in PA radiographs of the thorax.

The Diaphragmatic (Inferior) Surface of the Heart

  • The surface of the heart is usually horizontal or slightly concave.
  • It is formed by both ventricles, mainly the left one.
  • The posterior interventricular sulcus divides this surface into a right 1/3 and a left 2/3.

The Pulmonary (Left) Surface of the Heart

  • This surface of the heart is mainly formed by the left ventricle and occupies the cardiac notch of the left lung.

Radiological Anatomy of the Heart

  • In PA radiographs of the thorax, the right border of the cardiovascular silhouette is formed by (superior to inferior): (1) the superior vena cava; (2) the right atrium; (3) the inferior vena cava.
  • The left border of the cardiovascular silhouette is formed by: (1) the arch of the aorta, which produces a characteristic aortic knob; (2) the pulmonary trunk; (3) the left auricle; (4) the left ventricle.

Q. 8

Right side of mediastinal shadow is NOT formed by:

September 2012

 A

Superior vena cava

 B

Right innominate

 C

Right atrium

 D

Right ventricle

Q. 8

Right side of mediastinal shadow is NOT formed by:

September 2012

 A

Superior vena cava

 B

Right innominate

 C

Right atrium

 D

Right ventricle

Ans. D

Explanation:

Ans. D i.e. Right ventricle

Radiology of heart

Right border of heart is formed by:

–  SVC/ Right brachiocephalic vessels,

– IVC and

– Right atrium

Left border of heart is formed by:

–  Left atrial appendage,

– Left ventricle,

– Aortic arch and

–  Pulmonary artery


Q. 9

In PA view of X-ray chest, right border of the heart is formed by all except:

 A

Superior venacava

 B

Inferior venacava

 C

Right atrium

 D

Left atrial appendage

Q. 9

In PA view of X-ray chest, right border of the heart is formed by all except:

 A

Superior venacava

 B

Inferior venacava

 C

Right atrium

 D

Left atrial appendage

Ans. D

Explanation:

Ans. Left atrial appendage


Q. 10

Right border of the heart in a chest X-ray is not formed by:

 A

WC

 B

SVC

 C

Right atrium

 D

Aorta

Q. 10

Right border of the heart in a chest X-ray is not formed by:

 A

WC

 B

SVC

 C

Right atrium

 D

Aorta

Ans. D

Explanation:

Ans. Aorta


Q. 11

Prominent left border of heart is formed by all the following except:

 A

Azygous vein

 B

Pericardial cyst

 C

Coronary artery aneurysm

 D

Enlarged left auricular aneurysm

Q. 11

Prominent left border of heart is formed by all the following except:

 A

Azygous vein

 B

Pericardial cyst

 C

Coronary artery aneurysm

 D

Enlarged left auricular aneurysm

Ans. A

Explanation:

Ans. Azygous vein


Q. 12

The right side of mediastinum shadow is not formed by:

 A

Superior vena cava

 B

Right innominate vein

 C

Right atrium

 D

Right ventricle

Q. 12

The right side of mediastinum shadow is not formed by:

 A

Superior vena cava

 B

Right innominate vein

 C

Right atrium

 D

Right ventricle

Ans. D

Explanation:

Ans. Right ventricle


Q. 13

The Diagram shows the venous draingae of Heart. Identify the Structure marked B in the Diagram ?

 A

Great Cardiac Vein

 B

Coronary Sinus

 C

Middle Cardiac Vein

 D

Anterior Cardiac Vein

Q. 13

The Diagram shows the venous draingae of Heart. Identify the Structure marked B in the Diagram ?

 A

Great Cardiac Vein

 B

Coronary Sinus

 C

Middle Cardiac Vein

 D

Anterior Cardiac Vein

Ans. B

Explanation:


Q. 14

Right border of heart is formed by ‑

 A

Right ventricle

 B

Right atrium

 C

SVC

 D

IVC

Q. 14

Right border of heart is formed by ‑

 A

Right ventricle

 B

Right atrium

 C

SVC

 D

IVC

Ans. B

Explanation:

External features of heart

The heart has following borders and surfaces :- 

A) Borders

i) Right border :- Formed by right atrium.

ii)  Left border (obtuse margin):- Formed mainly by left ventricle and partly by left auricle (in its upper most part).

iii) Inferior border (acute margin):- Formed mainly by right ventricle and partly by left ventricle near apex.

iv) Upper border :- Mainly by left atrium and partly by right atrium where SVC enters.

v) Apex :- Formed by left ventricle.

B) Surfaces

i) Anterior (sternocostal) surface :- Formed mostly by right ventricle (major) and right auricle and partly by left ventricle and left auricle.

ii) Inferior (diaphragmatic) surface :- It is formed by left ventricle (left 2/3) and right ventricle (right 1/3). It is traversed by posterior interventricular groove (PIV) containing PIV branch of RCA.


Q. 15

Not a middle mediastinal structure ‑

 A

Pulmonary trunk

 B

Phrenic nerve

 C

Thymus

 D

Heart

Q. 15

Not a middle mediastinal structure ‑

 A

Pulmonary trunk

 B

Phrenic nerve

 C

Thymus

 D

Heart

Ans. C

Explanation:

 Thymus


Q. 16

Posterior surface of heart is formed by –

 A

RA

 B

LA

 C

LV

 D

RV

Q. 16

Posterior surface of heart is formed by –

 A

RA

 B

LA

 C

LV

 D

RV

Ans. B

Explanation:

Ans. is ‘b>a’ i.e., LA>RA

Surfaces of the heart

  1. Anterior (sternocostal) surface :- Formed mostly by right ventricle (major) and right auricle and partly by left ventricle and left auricle.
  2. Inferior (diaphragmatic) surface :- It is formed by left ventricle (left 2/3) and right ventricle (right 1/3). It is traversed by posterior interventricular groove (PIV) containing PIV branch of RCA.
  3. Base (posterior surface) :- Formed mainly by left atrium and partly by right atrium. It is separated from T5 to T, vertebrae by pericardium, oblique pericardial sinus, esophagus and descending thoracic aorta.
  4. Right surface :- Mainly by right atrium.
  5. Left surface :- Mainly by left ventricle and partly by left auricle.

Q. 17

Base of heart is at the level of which vertebrae ‑

 A

C4 – C7

 B

C7 – T2

 C

T5 – T8

 D

T9 – T12

Q. 17

Base of heart is at the level of which vertebrae ‑

 A

C4 – C7

 B

C7 – T2

 C

T5 – T8

 D

T9 – T12

Ans. C

Explanation:

Ans. is’c’ i.e., T5 – T8


Q. 18

Base of the heart is formed by ‑

 A

Right atrium

 B

Right ventricle

 C

Left atrium

 D

Left ventricle

Q. 18

Base of the heart is formed by ‑

 A

Right atrium

 B

Right ventricle

 C

Left atrium

 D

Left ventricle

Ans. C

Explanation:

Ans. is `c > a’ i.e., Left atrium > Right atrium 


Q. 19

Heart is fully developed at which age of intrauterine life ‑

 A

3rd month

 B

4th month

 C

5″ month

 D

6″ month

Q. 19

Heart is fully developed at which age of intrauterine life ‑

 A

3rd month

 B

4th month

 C

5″ month

 D

6″ month

Ans. A

Explanation:

Ans. is ‘a’ i.e., 3rd month 



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