2mod 3 Test V 2019.ru - en

Translated from Russian to English - www.onlinedoctranslator.
com
Federal State Budgetary Educational Institution

higher education
"Russian National Research Medical University
named after N.I. Pirogov"
Ministry of Health of the Russian Federation Department of
Topographic Anatomy and Operative Surgery
Faculty of Pediatrics
Vishchipanov A.S., Solovieva N.N.,
under the editorship of Professor Andreitsev A.N.
Electronic version of the teaching aid

for students of medical and pediatric
faculties
Topographic anatomy and operative surgery of the head, neck,

chest wall and chest cavity
Test tasks for the colloquium
Moscow 2019
Chapter: Colloquium on topographic anatomy and operative surgery of the head, neck,
Module: TOPOGRAPHIC ANATOMY AND OPERATIONAL SURGERY
Topic: Colloquium on topographic anatomy and operative surgery of the head, neck,
one. The presence of the border zone of the brain and facial parts of the head - the base of the skull - explains such
formidable intracranial complications and their symptoms as:
one) meningitis and brain abscess with purulent inflammation of the middle ear, paranasal sinuses, orbit
2) damage to the wall of the brachiocephalic trunk and common carotid artery
3) germination of a malignant tumor of the cells of the ethmoid labyrinth on the dura mater
4) outflow of cerebrospinal fluid from the nose and nasopharynx with a fracture of the base of the skull in the anterior
cranial fossa and pneumocephalus
5) dysfunction of the cranial nerves with corresponding neurological symptoms in the area
faces
2. The basis for combining the frontal, parietal and occipital regions into one region is:
one) form the arch of the brain, characterized by a spherical surface
2) have the same layer structure
3) inflammatory processes and extracranial hematomas are localized only in the subcutaneous tissue
4) neurovascular bundles are directed from the lower border (periphery) of the region to the center (parietal
hillock)
5) the same types of localization, clinical picture, complications of pathological processes and
surgical techniques
3. The skin of the frontal-parietal-occipital region is characterized by the fact that it:
one) covered with hair (except for the frontal area)
2) contains sweat and a large number of sebaceous glands
one Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

3) thick
4) innervated by branches of cranial nerve VII
5) inactive due to strong fusion with the tendon helmet
4. Anatomical prerequisites for traumatic scalped wounds of the fronto-parieto-occipital region:
one) the skin is firmly connected to the tendon helmet by connective tissue bridges
2) the tendon helmet is separated from the periosteum by the subaponeurotic space
3) the periosteum is firmly connected to the bones in the seams
4) the subcutaneous base has a pronounced cellular structure
5) between the bone and the periosteum is the subperiosteal space
5. Diffuse purulent processes and hematomas of the fronto-parieto-occipital region are localized in:
one) subperiosteal space (within the boundaries of the bone)
2) subcutaneous basis
3) in the thickness of the periosteum
4) subaponeurotic space
5) deep in the skin
6. Significant bleeding in soft tissue injuries of the fronto-parieto-occipital region
are explained:
one) arteries of the region - branches of the external carotid, form an anastomotic network with the arteries of the other
half
2) branches of the external carotid artery anastomose widely with the arteries of the carotid and
vertebrobasilar basins
2 Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

3) the blood vessels of the area gape (do not collapse); woven into their outer shell
connective tissue bridges running from the skin to the tendon helmet
4) arteries and veins occupy a superficial position
5) veins of the region anastomose with the pterygoid and pharyngeal plexuses
7. Anatomical relationships of a.meningea media with the cerebral surface of the squamous part
temporal bone determine the difficulties of hemostasis:
one) in 2/3 of observations, the arterial trunk is located in the bone canal
2) on the surface of the dura mater branches of the artery (frontal, parietal) with the usual
hemostatic forceps cannot be captured, since they lie in its thickness closer to
surface plate
3) the proximal end of the artery contracts into the spinous foramen
4) branches a.meningea media widely anastomose with other meningeal branches
5) anatomical relationships of a.meningea media with lamina interna are of no practical importance
for hemostasis
eight. With carbuncle of the occipital region, septic thrombophlebitis can spread along
mastoid emissary vein into the sinuses of the dura mater of the brain:
one) sinus drain
2) straight
3) transverse
4) superior sagittal
5) sigmoid
9. The layers that make up the bone of the cranial vault and their characteristics:
one) spongy substance contains red bone marrow and diploic veins

2) endosteum - dura mater, loosely connected to the bones of the arch
3) outer plate - thick, durable, with a large radius of curvature
4) inner (glass) plate - thin, fragile, with a smaller radius of curvature
5) periosteum loosely connected to outer lamina
10. Features of the squamous part of the temporal bone:
one) the periosteum is firmly fused with the squamous part
2) although it consists of three layers, it is thinned (1-3 mm)
3) spongy substance is weakly expressed
4) the bone is translucent and has low strength
5) a.temporalis superficialis adjoins the cerebral surface of the squamous part
11. Sinus of the dura mater - an organ that provides optimal intracerebral
(intracranial) pressure (N.N. Burdenko), has differences from the peripheral vein:
one) when damaged, gapes, does not subside
2) sinus of the dura mater does not differ from v.femoralis
3) cerebrospinal fluid is filtered into the sinus (upper sagittal)
4) no valves
5) no middle shell
12. Injuries of the cerebral part of the head are accompanied by the formation of intracranial hematomas:
one) epidural
2) subdural

3) subperiosteal
4) subarachnoid hemorrhage
5) intracerebral
13. The most formidable syndrome of intracranial acute volumetric process are displacements
various parts of the brain (dislocation syndrome):
one) under the falciform process
2) into the foramen of the cerebellum
3) into the occipital-cervical dural funnel (in the foramen magnum)
4) herniation of the brain is accompanied by severe functional disorders
respiratory and cardiovascular systems
5) in the complex treatment of dislocation syndrome, external and internal decompression is used
brain
14. During lumbar puncture, the following signs indicate subarachnoid hemorrhage:
one) Beer needle does not expel cerebrospinal fluid
2) opalescent cerebrospinal fluid enters
3) cerebrospinal fluid leaks out
4) in the cerebrospinal fluid admixture of pus
5) cerebrospinal fluid color "cranberry juice"
15. CSF outflow pathways, the blockade of which can be the cause of occlusive hydrocephalus:
one) interventricular holes (Monroe) - communicate the lateral ventricles with III
2) aqueduct of the midbrain (sylvian aqueduct) - connects the III with the IV ventricle

3) arachnoid granulations
4) median aperture of the IV ventricle (foramen of Magendie) - communicates the IV ventricle with the subarachnoid
space
5) lateral apertures of the IV ventricle (foramina Luschka) - connect the IV ventricle with the subarachnoid
space
16. Clinical and morphological manifestations of cerebrovascular disorders are explained
blood supply to the brain from various developmental basins:
one) arterial (willisian) circle of the brain
2) small (pulmonary) circulation
3) carotid pool
4) large (bodily) circle of blood circulation
5) vertebrobasilar basin
17. In case of epidural hematoma, trefination holes are placed in accordance with the scheme
Cronlein at the intersection points:
one) the front vertical with the lower horizontal, i.e. in the middle of the upper edge of the zygomatic arch
2) along the bisector of the angle between the projection of the central sulcus and the upper horizontal
3) front vertical with upper horizontal
4) rear vertical with upper horizontal
5) points of intersection of the anterior vertical with the upper horizontal with the point of intersection of the sagittal
back vertical lines
18. Occlusive hydrocephalus with impaired outflow of cerebrospinal fluid from the ventricles of the brain into
subarachnoid space is a consequence of:
one) hypersecretion of cerebrospinal fluid

2) adhesive process in the cerebrospinal fluid
3) brain tumors
4) CSF resorption disorders
5) brain cysts of various origins
19. The facial section of the head consists of the areas:
one) lateral with its deep section
2) parotid chewing
3) eye sockets
4) nose with paranasal sinuses
5) mouth
20. The fascial capsule of the parotid gland has "weak" points:
one) at the site of exit from the gland of the superficial temporal artery
2) between the medial pterygoid muscle and the styloid process with the muscles of the "anatomical
bouquet "(pharyngeal process of the gland)
3) at the point of attachment of fascia parotideomasseterica to the angle of the lower jaw
4) clippings of the cartilage of the external auditory canal that allow lymphatic vessels to pass through
5) at the exit point of the ductus parotideus
21. Anatomical relationships of the parotid-masticatory fascia with the parotid gland in purulent
parotitis is determined by:
one) uneven and non-simultaneous damage to the gland by a purulent process
2) the occurrence of shooting pains, aggravated by increased swelling and chewing

3) may have difficulty swallowing and breathing
4) dry mouth due to a sharp decrease in salivation
5) three pain points are determined: at the tragus of the auricle, at the top of the processus mastoideus, downward from
zygomatic arch
22. In the thickness of the parotid gland, respectively, fossa retromandibularis are located:
one) trunk of the facial nerve and branches of the 2nd order of its parotid plexus
2) pterygoid plexus
3) external carotid artery with maxillary and superficial temporal arteries branching off from it
4) deep parotid lymph nodes
5) n.mandibularis
6) v. retromandibularis
23. Purulent streaks with phlegmon of the buccal region spread to neighboring areas along the processes
cheek fat pad:
one) temporal - into the temporal fossa under the zygomatic arch along the lateral wall of the orbit
2) from the pterygo-mandibular space along n. lingualis into the maxillary-lingual groove
3) orbital - into the infratemporal fossa to fissura orbitalis inferior
4) from the interpterygoid space to the temporal pterygoid space along the deep temporal
(anterior and posterior) neurovascular bundles
5) pterygopalatine, which through the lower medial part of the superior orbital fissure can reach
cavernous sinus of the dura mater
24. The deep area of the face is represented by the contents of the pits:
one) canine
eight Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

2) infratemporal
3) mandibular
4) temporal
5) pterygopalatine
25. The pterygo-mandibular space communicates with:
one) interpterygoid space
2) retrobulbar space of the orbit
3) temporal-pterygoid interval
4) cheek fat pad
5) lateral space of the floor of the mouth (maxillary-lingual groove)
26. Features of the blood supply and the position of the neurovascular bundles, which determine the difficulties
hemostasis in facial injuries:
one) arteries and veins go from bottom to top, from the lateral side to the medial
2) part of the blood vessels is located in deep and hard-to-reach parts of the face (pterygopalatine
fossa, mandibular canal, retrobulbar space of the orbit, etc.)
3) a large number of intra- and intersystem anastomoses
4) veins of the facial region are extracranial tributaries v. jugularis interna
5) blood vessels have a close relationship with facial muscles
27. The upper wall of the orbit forms:
one) inferior wall of the anterior cranial fossa
2) superior wall of the pterygopalatine fossa

3) lateral wall of the infratemporal fossa
4) superior wall of the sinus frontalis
5) lateral wall of the temporal fossa
28. Medial wall of the orbit in the suture between the frontal bone and the orbital plate of the ethmoid bone
has openings for neurovascular bundles:
one) infraorbital
2) anterior trellis
3) deep temporal
4) greater palatine
5) rear lattice
29. Retrobulbar space (corpus adiposum orbitae) contains nerves:
one) visual, at the lateral semicircle of which the ganglion ciliare is located
2) ocular and infraorbital
3) oculomotor and block
4) diverting
5) ophthalmic (first branch of the trigeminal nerve)
30. A. centralalis retinae (from the ophthalmic artery) supplies blood to:
one) lacrimal gland
2) optic nerve
3) conjunctiva

4) retina - the inner (sensitive) membrane of the eyeball
5) choroid of the eyeball
31. The ophthalmic artery anastomoses with the branches of a.carotis externa:
one) occipital
2) facial
3) superficial temporal
4) back ear
5) maxillary
32. The maxillary sinus is involved in the inflammatory process when:
one) pulpitis
2) periapical dentoalveolar abscess of the second upper molar
3) phlegmon of the buccal region
4) canine fossa abscess
5) nasopharyngitis
33. The lymphoepithelial ring of the nasopharynx (Waldeyer-Pirogov) consists of the tonsils:
one) two palatine - in the tonsil fossa between the palatine arches; the largest sizes are in 8-13 years
2) two tubal - at the pharyngeal opening and the cartilaginous part of the auditory tube; greatest development
reach in 4-7 years
3) peripharyngeal and pharyngeal lymph nodes
4) pharyngeal (adenoid) tonsil - at the point of transition of the upper pharyngeal wall to the back; greatest
size is 8-20 years old
eleven Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

5) lingual tonsil - at the root of the tongue; reaches its maximum development during adolescence
34. Nasopharyngitis is complicated by the transition of infection to:
one) paranasal paranasal sinuses (in the first place, sinusitis-maxillitis or sinusitis develops)
2) auditory tube and tympanic cavity (inflammation of the middle ear)
3) conjunctiva
4) parotid gland
5) larynx, trachea, bronchi
35. The palatine tonsil has a close relationship with the arteries:
one) external carotid
2) facial
3) lingual
4) maxillary
5) internal carotid
36. A terrible complication of a symmetrical fracture of the lower jaw in the chin area is
mechanical asphyxia due to:
one) displacement of the middle fragment of the jaw posteriorly and downwards by the pull of the anterior muscles of the suprahyoid group
2) violations of the fixation of the lower jaw in the temporomandibular joint
3) traction of the temporal muscle, raising the lower jaw and pulling it slightly backwards
4) posterior displacement of the attachment site of the muscles that stretch the tongue anteriorly, followed by
retraction and pressure on the epiglottis
5) complete anatomical interruption n.alveolaris inferior

37. "Tunnel" - a pronounced pain syndrome with involvement in the inflammatory process of the alveolar
neurovascular bundles due to:
one) vertical position of the upper posterior alveolar bundles
2) inflexibility of the walls of the bone canals of the alveolar neurovascular bundles
3) anastomoses of the branches of the facial and trigeminal nerves
4) sharp compression of the components of the neurovascular bundle during the transition of the inflammatory process
(pulpitis) on the alveolar canal
5) outflow of blood into the pterygoid plexus
38. In cancer of the tongue, metastases are localized in the following lymph nodes:
one) submandibular
2) submental
3) buccal
4) pharyngeal (from the back third of the tongue)
5) jugular-scapular-hyoid node
39. Cellular space of the floor of the mouth communicates with:
one) submandibular space
2) anterior peripharyngeal space
3) cheek fat pad
4) pterygomandibular space
5) parotid space
40. In relation to the bones of the cranial vault, the following methods of trepanation are distinguished:
thirteen Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

one) trefination - the formation of milling holes
2) resection - after removal of a part of the bone and performing an operative technique in the cranial cavity
bone defect remains open
3) osteoplastic - the periosteal-bone flap is completely or partially placed on the previous one
place, closing the defect
4) cranioplasty
5) decompression trepanation for a depressed fracture of the "celluloid bag" type
41. Osteoplastic trepanation of the skull according to Olivekron in the temporo-parietal region, except
skin-aponeurotic flap, form a flap consisting of:
one) bones
2) periosteum
3) dura mater
4) aponeurotic helmet
5) temporalis muscle
42. Stages of osteoplastic craniotomy:
one) formation of temporary skin-aponeurotic and periosteal-bone flaps
2) dissection of the dura mater and performing an operative reception
3) hermetic closure of the dura mater
4) returning the flaps to their original place and fixing them
5) performing cranioplasty
43. Choice of incision of the dura mater (horseshoe, linear, cruciform)
osteoplastic trepanation of the skull is determined by:

one) position of the patient on the operating table
2) purpose of the operation
3) direction of the arteries and veins of the dura mater
4) type of surgery
5) the position of the sinuses
44. Types of liquor-draining surgeries for hydrocephalus:
one) puncture of the anterior horn of the lateral ventricle
2) ventriculopuncture (according to A.A. Arendt) - under strictly aseptic conditions, dosed abduction
cerebrospinal fluid from the lateral ventricle into a sealed vessel
3) ventriculocisternostomy (according to Torkildsen, Rostotskaya, Shamova) - diversion of cerebrospinal fluid from the posterior
horns of the lateral ventricle into the cerebellar cistern with extra- or intracranial
by holding a rubber or PVC tube
4) lumbar puncture
5) ventriculoauricolostomy (according to Holger and Pudenz) - diversion of cerebrospinal fluid from the lower
horns of the lateral ventricle into the right ear with a catheter with a shunt valve through the external jugular vein
45. Trepanation of the mastoid process is performed in order to:
one) restoration of the function of the organ of hearing and balance
2) removal of pus and granulations from the air cells and mastoid cave
3) creating a bone cavity without overhanging edges
4) drainage of a purulent cavity (a strip of glove rubber)
5) exclusion of ear deformity
46. Possible serious complications of trepanation of the mastoid process in case of deviation from the projection

Shipo triangle:
one) damage to the cartilage and bone parts of meatus acusticus externus
2) injury to the trunk of the facial nerve due to the expansion of the bone wound from top to bottom and anteriorly
3) penetration into the middle cranial fossa through the tegmental wall of the tympanic cavity with
displacement of the trepanation zone upward
4) damage to the sigmoid or transverse sinuses with the expansion of the trepanation zone in the posterior
direction
5) inflammation of the ceruminous (sulfur) glands
47. The choice of the direction of incisions in the parotid-masticatory region is associated with:
one) the direction of the branches of the facial nerve
2) processes of the fatty body of the cheek
3) position of the parotid duct
4) direction of the facial artery and vein
5) position n.mandibularis
48. Rules for the surgical treatment of facial wounds:
one) the best time for surgery is 24 hours from the moment of injury
2) tissue excision should be very economical, dissection - with careful hemostasis (Mukhin)
3) ligation of the external carotid artery in the carotid triangle is required
4) it is necessary to strive for cosmetic requirements: use primary bone grafting,
cosmetic sutures
5) for the prevention of suppuration in the wound, cicatricial deformities and contractures, it is advisable to "sheath
wounds”, i.e. suture of the skin and mucous membrane
sixteen Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

49. The neck area is considered as a "dangerous" area, because in it:
one) organs that perform a conductive function are located: larynx, trachea, pharynx, esophagus,
main blood vessels of the carotid and vertebrobasilar basins, cranial and
spinal nerves and lymphatic ducts
2) injury to the arteries of the neck threatens with jet bleeding, veins - air embolism
3) dislocation in the acromioclavicular joint is complicated by impaired respiratory function
4) acute edema, trauma, foreign body of the larynx are the cause of mechanical asphyxia
5) traumatic injury to the walls of the trachea and esophagus are complicated by phlegmon of the neck with
spread of pus into the mediastinum
50. The anatomical basis for dividing the neck into anterior and posterior sections by a plane drawn through
transverse processes of the cervical vertebrae, is:
one) the departments are separated from each other by attaching the plates of the fascia to the transverse processes of the cervical
vertebrae
2) in the anterior section are the organs of the neck cavity with neurovascular bundles, in the posterior - muscles
3) in the anterior section, five fascia and cellular spaces of the neck are concentrically located, in
back - two fascia
4) as a rule, pathological processes are localized in the anterior part of the neck
5) the presence of a large subclavian fossa
51. The anterior part of the neck consists of:
one) anterior neck region
2) sternocleidomastoid region
3) lateral region of the neck
4) armpit
5) infraspinatus

52. The posterior part of the neck is represented by the posterior or nuchal region of the neck, limited by:
one) top notch line - top
2) a line between the acromions passing through the spinous process of the VII cervical vertebra - from below
3) III cervical vertebra - from above
4) posterior edges of the sternocleidomastoid muscles - from the lateral sides
5) lateral edges of the trapezius muscles - from the side
53. Anterior region of the neck; synonym - the anterior triangle of the neck consists of triangles:
one) submandibular
2) sleepy
3) scapular-tracheal
4) submental
5) triangle N.I. Pirogov
54. The sternocleidomastoid region is limited:
one) edges of the sternocleidomastoid muscle (anterior, posterior)
2) mastoid process of the temporal bone and the lateral part of the superior nuchal line
3) spina scapulae
4) the upper edge of the sternum and the sternal end of the clavicle
5) mandibular angle
55. Right small supraclavicular fossa in the composition of the sternocleidomastoid region, having
value in determining the phrenicus symptom is limited:
eighteen Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

one) scapular-hyoid muscle - from above
2) lateral edge of the medial part of the sternocleidomastoid muscle
3) medial edge of the lateral part of the sternocleidomastoid muscle
4) clavicle - below
5) dome of the pleura
56. The lateral region of the neck, synonymous with the posterior triangle of the neck, includes:
one) scapular-clavicular triangle
2) jugular fossa
3) clavicular-thoracic triangle
4) large supraclavicular fossa
5) scapular-trapezoid triangle
57. External landmarks along the anterior median line of the neck include:
one) mental protrusion of the mandible and body of the hyoid bone
2) the angle formed by the plates of the thyroid cartilage and the arch of the cricoid cartilage
3) collarbone
4) jugular notch of sternum and jugular fossa
5) cartilages of the trachea with isthmus of the thyroid gland
58. Internal landmarks indicate the middle of the incision of the layers of the neck by anterior access:
one) tooth II cervical vertebra
2) tendon suture mm. mylohyoidei
nineteen Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

3) anterior (carotid) tubercle of the transverse process of the VI cervical vertebra
4) sternoclavicular joint
5) "White" line of the neck - fusion of II and III fasciae of the neck (according to V.N. Shevkunenko) along the midline
59. Lateral to the midline of the neck are the following external landmarks:
one) lower edge and angle of the mandible
2) sternocleidomastoid and trapezius muscles
3) collarbone
4) greater and lesser supraclavicular fossa
5) cricoid cartilage of the larynx
60. In the large supraclavicular fossa, you can feel:
one) external jugular vein
2) plexus brachialis in the form of a dense cord
3) inferior belly of the scapular-hyoid muscle
4) sternoclavicular joint
5) subclavian artery, which is pressed against the 1st rib
61. Between the sternocleidomastoid muscle and the eminence formed by the organs of the neck along
midline, there is a recess corresponding to the carotid triangle, limited:
one) greater horn of the hyoid bone
2) superior belly of the scapular-hyoid muscle
3) hind belly m. digastricus
twenty Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

4) trachea
5) front edge m. sternocleidomastoideus
62. The right and left common carotid arteries are projected along lines with dots:
one) upper - the middle of the distance between the angle of the lower jaw and the mastoid process
2) upper - the middle of the gap between the angle of the lower jaw and the front edge m.
sternocleidomastoideus
3) lower - 1 cm laterally from the sternoclavicular joint - right common carotid artery
4) lower - sternoclavicular joint - a.carotis communis sinistra
5) lower - sternoclavicular joint - right and left common carotid arteries
63. According to N.I. Pirogov bifurcation of the common carotid artery corresponds to the level:
one) mandibular angle
2) upper border of the thyroid cartilage
3) VII cervical vertebra
4) jugular notch of sternum
5) hyoid bone
64. Erb's point - a reference point for the exit of the cutaneous branches of the cervical plexus when turning the head in
the opposite side is at the intersection:
one) mandibular angle
2) v. jugularis externa
3) anterior border of the sternocleidomastoid muscle
4) hyoid bone

5) posterior border of the sternocleidomastoid muscle
65. Venous angle N.I. Pirogov is projected between:
one) the anterior edge of the medial part of m.sternocleidomastoideus
2) I edge
3) the posterior edge of the lateral part of m.sternocleidomastoideus
4) lower belly of the scapular-hyoid muscle
5) clavicle
66. The purpose of the cervical vagosympathetic blockade according to A.V. Vishnevsky - prevention or relief
developing pleuropulmonary shock, shock in severe thoracoabdominal injuries
by interrupting pathological impulses to the brainstem by:
one) upper spine of the neck loop
2) phrenic nerve
3) sinus branch of the IX nerve
4) vagus (X) nerve
5) sympathetic trunk
67. Neck vagosympathetic blockade provides the following effects:
one) eliminates pain syndrome
2) relieves cough reflexes
3) tones the cardiovascular system
4) stimulates hemostasis
5) raises blood pressure

68. The following symptoms will indicate the achievement of the effect of cervical vagosympathetic blockade:
one) hyperemia of the face on the side of the blockade
2) hyperemia of the sclera (white membrane of the eye)
3) Bernard-Horner's "eye triad" (retraction of the eyeball, narrowing of the palpebral fissure, narrowing
pupil)
4) respiratory failure due to retraction of the root of the tongue
5) tachycardia (fast heart rate)
69. Operations in the neck area are performed by the following accesses:
one) longitudinal
2) projection
3) combined or patchwork
4) endosurgical
5) transverse
70. Indication for one of the responsible emergency operations, accompanied by high mortality
or severe cerebral complications - ligation of the common carotid artery:
one) wounds (gunshot, cut) of the artery trunk and its branches if recovery is impossible
cerebral circulation
2) fracture of the transverse process of the sixth cervical vertebra
3) arrosive bleeding with phlegmon of the neck or a decaying malignant tumor with
involvement of the artery wall
4) parenchymal bleeding during subtotal subfascial resection of the thyroid
glands
5) temporary ligation of the artery with a wide ribbon (a strip of glove rubber) with "bloody"
operations on the brain and facial sections of the head and pharynx

71. Operative access to the common carotid artery with a 6-8 cm incision is performed, focusing on:
one) posterior belly of digastric muscle
2) upper edge of the thyroid cartilage
3) posterior edge of sternocleidomastoid muscle
4) anterior margin of m.sternocleidomastoideus
5) edge of the trapezius muscle
72. Indications for ligation of the external carotid artery in the carotid triangle:
one) osteosynthesis for bilateral fracture of the body of the lower jaw
2) injuries to the trunk and branches of the artery (impossibility or inefficiency of hemostasis in the wound)
3) arrosive bleeding in malignant tumors, phlegmon, and angiomas of the face
4) nosebleeds in hypertensive crisis
5) exsanguination of the operation area during "bloody" operations: resection of the upper and lower jaws,
parotidectomy, etc.
73. Stages of ligation of the external carotid artery in the standard position of the patient: on the back, under
a roller is placed on the shoulder blades, the head is thrown back and turned in the opposite direction from the operation site:
one) incision (6-8 cm) along the anterior edge of m.sternocleidomastoideus with a middle corresponding to the upper
edge of the thyroid cartilage
2) approach the artery through the posterior wall of the fascial sheath of the sternocleidomastoid
muscles
3) m.sternocleidomastoideus is separated along the fibers
4) through a grooved probe, the sheath of the neurovascular bundle is opened
5) shift the cervical loop to the medial side, identify and bandage a. carotis externa

74. Identification of the external carotid artery (not to ligate a. carotis interna!)
the following signs:
one) internal carotid artery supplies blood to the brain
2) a sign of "anatomical paradox" - a discrepancy between the name and position of the branches of the common carotid
arteries:outdoor - situatedinside (medially) and anteriorly,inside - outside (lateral)
and backwards
3) a sign of branches - in the carotid triangle, the following depart from the external carotid artery: ascending pharyngeal,
superior thyroid, lingual, facial arteries; internal - does not give branches
4) the external carotid artery is crossed by the XII cranial nerve and the facial (common facial) vein
5) clinical reception: with digital compression of the external carotid artery, the pulse in the temporal
area on a. temporalis superficialis
75. Terrible complications are possible when ligating the external carotid artery:
one) accidental ligation of the internal carotid artery (instead of the external) is accompanied by acute
circulatory disorders in the carotid pool with the possibility of death or deep
disability!
2) thrombosis (thrombembolism of the internal carotid artery)
3) trauma of the reflexogenic sinocarotid zone with dysfunction of the cardiovascular system
4) damage to the upper root of the cervical loop with the development of dysphagia
5) bleeding from a wound in the sternocleidomastoid muscle
76. Lymphosorption - surgical intervention, which consists in extracorporeal sorption
detoxification of the body consists of the following steps:
one) external drainage of the thoracic duct
2) stimulation of lymph production and lymph outflow in order to obtain central lymph
3) lymphosorption: selection of a sorbent for perfusion, preparation of a sorbent for cleansing the lymph from toxic
products;

4) extracorporeal sorption of lymph
5) reinfusion of purified lymph into the venous bed with correction of missing substances
77. For external drainage of the thoracic duct, its cervical part is exposed:
one) in the right carotid triangle after displacement of the cervical loop
2) in the left prescalene intermuscular space, focusing on the venous angle N.I. Pirogov
3) access by V.N. Shevkunenko - a transverse incision 1 cm above the collarbone with its continuation along
the posterior edge of this muscle along the lower third
4) access by D.A. Zhdanov - a longitudinal incision along the lower third of the posterior margin
sternocleidomastoid muscle
5) in the right scalene-vertebral triangle
78. Identification of the thoracic duct is carried out as follows:
one) after the selection of the section of the duct for catheterization, all actions are temporarily stopped in order to
duct expanded and filled with lymph
2) the thoracic duct swells and moves away from the dome of the pleura
3) anatomical tweezers gently pinch the duct; its leading part increases in diameter
due to wall expansion
4) a vessel similar to a duct is taken on a holder and punctured, flow rate and appearance
contents will point to the thoracic duct
5) duct has valves
79. The essence of subtotal resection of the thyroid gland according to O.V. Nikolaev is that:
one) the remaining part of the posterolateral surface at the lower pole of each lobe of the gland (3-6 gr)
compensates for hormonal function against the background of drug treatment; danger decreases
development of hypothyroidism (myxedema)

2) easier to ensure reliable hemostasis
3) parathyroid glands are preserved, more often located at the site of penetration into the parenchyma
glands of the inferior thyroid arteries
4) the risk of damage to the recurrent laryngeal nerve, which has various
relationship with the inferior thyroid artery
5) drainage of the wound with a "U"-shaped drainage ensures the outflow of discharge in the early
postoperative period
80. Subfascial resection of the thyroid gland - resection between the clamps "mosquito", without going beyond
limits of the fascial capsule, with local detoxification of the wound, aimed at prevention
postoperative thyrotoxicosis:
one) during the operation, the lobules, follicles, interfollicular islets are crushed with the release
contents into the wound
2) from the wound, toxic products partially enter the body through the lymphatic vessels and veins,
creating a risk of postoperative thyrotoxicosis
3) fascial capsule prevents the entry of a large amount of toxic products into the body
4) stump of the lobe of the gland, covered with a fascial capsule with the parathyroid glands and n. laryngeus
reccurens remain fixed to the trachea
5) the risk of injury to the components of the neurovascular bundle of the anterior triangle of the neck is reduced
81. Triangle N.I. Pirogov - a landmark for exposure and ligation of the lingual artery - is limited:
one) marginal branch of the lower jaw of the facial (VII) nerve
2) hypoglossal (XII) nerve
3) digastric tendon
4) free edge of the maxillohyoid muscle
5) hyoid-lingual muscle

82. The neurovascular bundle of the anterior triangle of the neck consists of:
one) internal jugular vein with accompanying lateral deep cervical (jugular)
lymph nodes
2) recurrent laryngeal nerve
3) common carotid artery, along the anterior wall of which the cervical loop is located
4) nervus vagus
5) sympathetic trunk
83. The fascial sheath of the neurovascular bundle of the anterior triangle of the neck has the following
structure:
one) formed by the parietal plate of the intracervical fascia (IV according to V.N. Shevkunenko)
2) the second fascia of the neck is involved in the formation of the fascial sheath of the bundle (according to V.N. Shevkunenko)
3) inside the bundle sheath there are partitions that form cases separately for the internal
jugular vein, common carotid artery and vagus nerve
4) between the case of each organ of the bundle and the common vagina is spatium caroticum, s.spatium
vasenervorum
5) in front of the sheath of the bundle adjoins the fascial case m. sternocleidomastoideus
84. Spatium caroticum connects cellular spaces:
one) cheek fat pad
2) anterior peripharyngeal
3) parotid
4) upper mediastinum
5) posterior peripharyngeal

85. Reflexogenic carotid sinus zone in the area of bifurcation of the common carotid artery is formed by:
one) n. hypoglossus (XII) nerve
2) sinus branch (Hering's nerve) of the IX nerve
3) carotid sinus - expansion of the common carotid artery at the beginning of its branching into the internal and external
carotid arteries with weak development of the media and thickening of the outer shell
4) neck loop
5) carotid glomus - paraganglion of the common carotid artery (the size of a grain of rice), adjacent to
posterior wall of the carotid sinus and containing chemoreceptors
6) accessory nerve
86. "Virchow" metastasis of gastric cancer by the lymphogenous route to the medial lymph node along the course
transverse artery of the neck (Troisier's node) palpation determine:
one) From the left side
2) in the small supraclavicular fossa
3) in the angle between the sternocleidomastoid muscle and the clavicle
4) at the confluence of the thoracic duct into the venous node
5) in the greater supraclavicular fossa
87. Large veins are located in the prescalene intermuscular space:
one) brachiocephalic
2) internal jugular
3) external jugular
4) upper hollow
5) subclavian

88. Interscalene intermuscular space is limited by:
one) collarbone
2) scalene anterior
3) scapular-hyoid muscle (lower abdomen)
4) I rib
5) scalenus mediaus
89. Interscalene intermuscular space contains:
one) phrenic nerve
2) trunks of the brachial plexus
3) thoracic duct
4) second subclavian artery
5) cervicothoracic ganglion of the sympathetic trunk
90. With osteochondrosis of the cervical spine, circulatory disorders occur in
vertebrobasilar basin of the brain due to:
one) compression or displacement of the vertebral artery by osteophytes
2) involvement of the vertebral neurovascular bundle in the inflammatory process in spondylitis
3) subclavian steal syndrome
4) irritation of the vertebral plexus with the development of angiodystonic conditions
5) with prolonged exposure to the vascular wall, these factors can cause the formation
atherosclerotic plaques
91. Frenicus symptom is determined by:
thirty Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

one) on the right side
2) in the greater subclavian fossa
3) between parts of the sternocleidomastoid muscle above the clavicle
4) in the scapular-trapezoid triangle
5) in the small supraclavicular fossa
92. Anatomical and physiological features of v. subclavia dextra, explaining the possibility of its puncture and
catheterization:
one) available for puncture
2) the vein does not collapse even in conditions of a hypovolemic state; its walls are fixed to the fascia
subclavian muscle and I rib
3) has a large diameter and volumetric blood flow rate, which prevents thrombosis
4) rapid access of drugs to the superior vena cava and the “right” heart
5) merges with the left subclavian vein, forms v.cava superior
93. Groups of cellular spaces are distinguished in the neck area, explaining clinical and morphological
manifestations of phlegmon:
one) communicating - with the spread of the purulent process to neighboring areas
2) bone-fibrous bed of the long muscles of the head and neck
3) closed (relatively) with predominant localization of the purulent focus in a certain
space
4) fascial sheath of the neurovascular bundle of the anterior triangle of the neck
5) fascial sheath of the sternocleidomastoid muscle
94. Communicating cellular spaces of the neck include:

one) spatium caroticum
2) spatium interaponeuroticum suprasternale
3) spatium previscerale and its part spatium pretracheale
4) spatium retroviscerale
5) spatium retro-et parapharyngeale
95. The group of closed cellular spaces of the neck consists of:
one) suprasternal interfascial
2) blind behind sternocleidomastoid sac
3) spatium prevertebrale
4) submandibular space
5) deep cellular space of the posterior triangle of the neck, accompanying the subclavian
vessels and brachial plexus
96. The pharyngeal cellular space containing the pharyngeal lymph nodes is limited:
one) vertebral bodies to the level of the IV cervical vertebra, where it continues into the spatium retroviscerale
2) fascia of the posterior pharyngeal wall
3) styloid process and muscles of the "anatomical bouquet"
4) prevertebral fascia with long muscles of the head and neck
5) pharyngovertebral fascia
97. Inflammation of the pharyngeal lymph nodes is a consequence of inflammation:
one) trachea (tracheitis)

2) auditory tube (eustachitis)
3) parotid gland (mumps)
4) palatine tonsil (tonsillitis)
5) nasal cavity and nasopharynx (nasopharyngitis)
98. The anterior part of the peripharyngeal space on the lateral side is limited:
one) branch of the lower jaw
2) pharyngeal process of the parotid gland
3) styloid process of the temporal bone with muscles of the "anatomical bouquet"
4) medial pterygoid muscle
5) hind belly m.digastricus
99. Injuries of the trachea are dangerous for the development of complications:
one) dysphagia
2) asphyxia
3) subcutaneous emphysema
4) emphysema of the upper mediastinum
5) phlegmon of the pretracheal space
100. In loose fibrous connective tissue between the fibrous and fascial capsules of the thyroid
glands are located:
one) hypoglossal nerve
2) parathyroid glands

3) recurrent laryngeal nerve
4) arteries and veins of the thyroid gland
5) jugular venous arch
101. A terrible complication of neck vein injury is air embolism due to:
one) formation of the venous angle N.I. Pirogov
2) gaping veins - the walls of the veins are fixed by the fascia of the neck
3) lymphatic ducts open into neck veins
4) suction action of the chest wall
5) proximity of the neck veins to the right atrium
102. Main indications for tracheostomy:
one) obstruction of the larynx and upper trachea as a result of obstruction by a foreign body,
tumor, swelling of the vocal folds of infectious, allergic etiology
2) primary central respiratory disorders in trauma or brain diseases
3) ineffectiveness of conservative measures in violation of the biomechanics of respiration in patients with
chest trauma, severe polytrauma and in the postoperative period
4) hemorrhagic shock
5) the need for prolonged artificial respiration by insufflation
103. Tracheostomy allows to provide:
one) free breathing with mechanical obturation at the level of the larynx and above it
2) restoration of peristalsis of the esophagus
3) by 2/3 to reduce the "dead" space and 50% - breathing resistance, which contributes to

elimination of "functional" respiratory failure
4) long-term artificial ventilation of the lungs using automatic devices
5) stimulation of cerebral circulation in the vertebrobasilar basin
104. During operations in the neck area, a roller is placed under the shoulder blades of the patient in order to:
one) increasing the gap between the lower jaw and the jugular notch of the sternum
2) more superficial position of the larynx and trachea due to increased cervical lordosis
3) displacement of the neurovascular bundle of the anterior triangle posteriorly and medially
4) increase in the length of the cervical part of the trachea (the trachea is "pulled out" from the superior mediastinum)
5) performing infiltration anesthesia
105. When performing emergency operations in the neck (cricothyroidotomy, tracheostomy), it is necessary
fix the head in the standard position, because:
one) larynx and trachea are characterized by active and passive displacement
2) in the elderly and senile age, the fibrocartilaginous base of the larynx and trachea is dense, fragile
3) dissection of the wall of these organs with an arcuate surface may be accompanied by slipping
scalpel to the side
4) there is a risk of injury to the common carotid artery and internal jugular vein
5) fixation of the head during operations in the neck area is not of fundamental importance
106. Tracheostomy is performed in the following position of the patient:
one) horizontal - on the back; in an extremely serious condition, the operation is performed in a sitting position
sick
2) under the shoulder blades put a roller 12-15 cm high

3) head thrown back and fixed by an assistant
4) the outer median landmarks of the head and neck should be on the same line
5) left leg bent at the knee
107. The advantages of prompt access to the organs of the neck through the "white line" are:
one) access is less traumatic
2) provides a wide approach to the larynx and trachea
3) performed away from the neurovascular bundle of the anterior triangle of the neck
4) minor blood loss
5) there is no danger of injury to the pyramidal lobe and isthmus of the thyroid gland
108. In the process of operative access to the trachea during lower tracheostomy, the following, except
subcutaneous tissue, cellular spaces:
one) parapharyngeal
2) behind the organ
3) suprasternal interfascial
4) sleepy
5) pretracheal
109. Lower tracheostomy is indicated for children due to:
one) high position (above the III cervical vertebra) of the larynx, cervical part of the trachea and hyoid bone
2) wide, short, thick, inactive tongue
3) high position of the isthmus of the thyroid gland

4) "tenderness" of the structure of the fibrocartilaginous base of the larynx and trachea
5) the longitudinal axis of the larynx is tilted back and forms an obtuse angle with the trachea
110. Before dissecting the tracheal wall, it is necessary to ensure:
one) careful hemostasis to exclude the development of aspiration pneumonia due to blood flow
into the trachea
2) displacement with blunt hooks to the lateral side of the common carotid artery and internal jugular vein
3) ligate the left recurrent laryngeal nerve
4) securely fix the larynx and trachea
5) introduction into the trachea by puncture method 0.3-0.5 ml of 1% solution of dicaine to relieve cough
reflex
111. The depth of puncture of a pointed scalpel during tracheostomy is regulated by the following methods:
one) the scalpel is wrapped with adhesive tape or a napkin, leaving 1 cm of the blade
2) the depth of the injection is determined visually, empirically
3) the index finger is placed on the side surface of the scalpel, stepping back from the end of the blade 1 cm
4) the depth of the scalpel does not matter
5) the scalpel is fixed between the thumb and the rest of the fingers in a perpendicular position,
the little finger is 1 cm from the end of the blade
112. When dissecting the wall of the trachea with a scalpel, the following can be damaged:
one) membranous (posterior) wall of the trachea; complication - phlegmon of the neck
2) plexus brachialis trunks
3) anterior wall of the esophagus with the formation of an esophageal-tracheal fistula or suppuration in the spatium
retroviscerale

4) isthmus (or lobe) of the thyroid gland
5) main blood vessels of the neck: common carotid artery, internal jugular vein
113. The following instruments are used to expand the wound of the trachea during tracheostomy:
one) single prong sharp hook
2) Farabef hook
3) laborda dilator
4) trousseau dilator
5) three prong blunt hook
114. Stages of introducing a tracheostomy cannula into the trachea (the edges of the wound of the trachea are separated
Trousseau tracheo dilator):
one) the order of insertion of the cannula into the trachea is of no practical importance
2) shield (flange) of the cannula corresponds to the axis of the trachea; the end of the cannula is inserted into the trachea
3) after the cannula enters the trachea, its shield is transferred to the transverse direction
4) the cannula is advanced into the trachea while the trachea dilator is removed
5) breath recovery control - a thin silk thread is brought to the outer opening of the cannula
ligature, the vibrations of which will indicate inhalation and exhalation
115. Complications of tracheostomy: subcutaneous emphysema and emphysema of the upper mediastinum develop when:
one) damage to the dome of the pleura
2) tracheal wound significantly larger than the diameter of the cannula
3) with a tightly sutured skin wound, the exhaled air between the cannula and the wall of the trachea enters
subcutaneous and pretracheal tissue

4) air travels through the pretracheal space into the superior mediastinum
5) emphysema of the upper mediastinum is accompanied by cardiovascular insufficiency due to
compression of large veins of this part of the mediastinum
116. How do you make sure that breathing is restored naturally during decannulation (removal of
tracheostomy cannula)?
one) decannulation is a simple technique - removing the cannula from the trachea
2) after prolonged use of the cannula, psychological preparation is necessary
3) the patient is asked to close the outer opening of the cannula with a finger and make several respiratory
movements
4) the wound is epithelialized after removal of the cannula
5) removal of the cannula from the trachea is difficult due to scarring
117. In the process of exposing the cervical part of the esophagus, the organ is identified by its features:
one) located between the trachea (in front) and the spine (back)
2) longitudinal direction of the muscle fibers
3) brownish-red color of the wall
4) common carotid artery pulsates
5) palpation is determined by the probe inserted before surgery into the esophagus
118. During esophagotomy, the wall of the esophagus is dissected as follows:
one) in the longitudinal direction
2) simultaneously all the membranes of the esophagus
3) in the unaltered pathological process (“healthy”) part of the wall

4) first cut the muscle membrane to the mucous membrane
5) the mucous membrane is dissected with scissors after the formation of a fold using anatomical
tweezers
119. The wound of the esophagus is sutured in the following order:
one) the mucous membrane with the submucosa is sutured in the transverse direction
2) 1st row of suture: both shells are captured in a continuous catgut suture
3) 2nd row of suture: the muscular membrane is sutured in the longitudinal direction with interrupted sutures
non-absorbable material (lavsan)
4) sutured separately for each shell
5) in the seam capture the entire thickness of the wall
120. Purpose of puncture and catheterization of the subclavian vein:
one) long-term intensive intravenous therapy
2) phlebography
3) sounding of the superior vena cava, right atrium and ventricle
4) performing endovascular (transvenous) operations (for example, embolization of an open
ductus arteriosus)
5) stenting of the left internal carotid artery
121. The subclavian vein is punctured by supraclavicular access at the Ioffe point, located several
above the angle between:
one) jugular notch of the sternum
2) clavicular part of the sternocleidomastoid muscle
3) external jugular vein

4) upper edge of the clavicle
5) lower belly of the scapular-hyoid muscle
122. Subclavian access puncture v. subclavia dextra is carried out from points:
one) obaniaka
2) Erba
3) Wilson
4) Gillis
5) Kera
123. Possible severe complications during puncture of the subclavian vein:
one) pneumothorax
2) air embolism
3) damage to the esophagus with the addition of a suppurative process
4) subclavian artery puncture
5) brachiocephalic injury
124. Phlegmon of the peripharyngeal space is opened with a cut, focusing on:
one) posterior edge of mandibular ramus
2) lower edge of the zygomatic arch
3) mandibular angle
4) styloid process of the temporal bone with the muscles of the "anatomical bouquet" starting from it
5) lateral wall of the pharynx

125. Opening of the pharyngeal abscess is carried out by incisions:
one) intraoral laterally from the pterygo-mandibular fold of the oral mucosa
2) external (extraoral) along the posterior edge of the sternocleidomastoid muscle from the level of the angle
mandible
3) parallel to the lower edge of the lower jaw, stepping back 2 cm
4) intraoral in the zone of greatest fluctuation of the posterior pharyngeal wall (in young children)
5) along the upper edge of the zygomatic arch
126. The discrepancy between the upper border of the chest wall and the chest cavity is that:
one) the liver, stomach, spleen, kidneys are projected onto the chest wall
2) part of the chest cavity is located in the neck
3) the superior thoracic inlet is the upper border of the chest wall, and the dome of the pleura and the apex
lung 2-3 cm above the clavicle
4) behind the pleura and the apex of the lung correspond to the level of the spinous process of the VII cervical-I thoracic
vertebra
5) subclavian artery and vein adjacent to the dome of the pleura
127. The difference between the lower border of the chest cavity and the chest wall is that:
one) the lower border of the chest cavity is displaced upward due to the high standing of the diaphragm
2) the right dome of the diaphragm corresponds to the IV rib along the midclavicular line
3) some organs of the upper abdominal cavity (liver,
stomach, spleen, kidneys)
4) the left dome of the diaphragm is at the level of the fifth rib along the midclavicular line
5) the lower borders of the chest wall and chest cavity correspond to apertura thoracis superior

128. Along linea axillaris anterior intercostal fissure (intercostal canal), with located intercostal
vascular-nerve bundle, limited:
one) rib groove (top)
2) musculus serratus anterior (front)
3) external intercostal muscle (front)
4) internal intercostal muscle (behind)
5) musculus latissimus dorsi (back)
129. In case of fractures of the lower ribs, parenchymal organs of the abdominal cavity can be damaged:
one) liver (right)
2) duodenum
3) spleen (left)
4) kidney and adrenal
5) ureter
130. The mammary gland is characterized by close relationships with the superficial fascia of the breast:
one) superficial fascia, splitting into two plates, forms a capsule of the organ
2) separate fibrous bundles starting from the clavicle and thoracic fascia and woven into the thickness
adipose and connective tissue along the posterior surface of the gland make up ligg. suspensoria mammaria
3) spurs of the superficial fascia divide the organ into lobes
4) between the superficial and proper fascia of the breast is the retromammary space
5) connective tissue partitions are directed from the anterior surface of the gland to the skin
131. The mammary gland has the following general structure plan:

one) gland body; it is formed by 15-20 radially arranged lobes surrounded by adipose tissue
2) the mammary gland is separated from the own fascia of the breast by the retromammary space
3) lobe consists of lobules that open into the lactiferous duct
4) the lactiferous duct forms the lactiferous sinus before entering the nipple
5) the terminal narrowed part of the lactiferous duct opens at the top of the nipple with the lactiferous opening
(some ducts merge, the number of lactiferous openings is from 8 to 15)
132. Changes in the shape and size of the breast of a woman are determined by:
one) age
2) functional state of the organ (pregnancy, feeding)
3) the volume of layers of adipose tissue penetrated by bundles of fibrous connective tissue
(interstitium)
4) localization of pathological processes: mastitis, fibrocystic mastopathy, benign
or malignant tumor
5) enlargement of the lymph nodes in the armpit
133. Lymph outflow from the mammary gland is provided by lymphatic networks:
one) superficial, formed by the lymphatic vessels of the skin
2) axillary lymph nodes
3) deep lateral cervical lymph nodes
4) deep network represented by the lymphatic vessels of the body (parenchyma) of the gland
5) parasternal lymph nodes and nodes of the anterior mediastinum
134. When breast cancer metastasizes, a “skin track” appears early due to the fact that:

one) deep lymphatic vessels anastomose widely with superficial
2) in the presence of a tumor node, atypical lymph outflow tracts develop
3) infiltration by malignant cells of the lymphatic vessels of the skin - “skin path”
metastasis indicates the prevalence of the malignant process
4) breast cancer does not metastasize lymphogenously
5) malignant cells are transported by the hematogenous route (through the veins)
135. Lymph node of Zorgius (or several nodes from the medial group) is located at
intersection:
one) clavicle
2) mid clavicular line
3) lower edge of the pectoralis major muscle
4) pectoralis minor muscle
5) III ribs
136. Possible localizations of metastases of breast cancer in the lymphogenous way:
one) axillary (all five groups. Apical lymph nodes were called subclavian by BNA)
2) deep elbow lymph nodes
3) deep lateral cervical lymph nodes (according to BNA - supraclavicular)
4) peristernal and mediastinal nodes
5) axillary lymph nodes on the opposite side (contralateral metastasis)
137. If there is a tumor node in the mammary gland and complaints of pain in the cervical and upper thoracic
parts of the spinal column, metastases in the spine that have spread through the veins should be suspected:

one) 3rd-7th superior posterior intercostal veins connect with anterior intercostal veins
2) with the development of a malignant tumor, atypical ways of outflow of blood from the mammary gland take place
3) partially outflow of blood from the mammary gland occurs in the posterior intercostal veins
4) an intervertebral vein empties into each of the posterior intercostal veins
5) the intervertebral vein is formed from the veins of the external and internal vertebral plexuses
138. Arteries of the chest wall involved in collateral circulation in case of occlusion of the abdominal
parts of the aorta are:
one) lateral thoracic
2) bronchial branches of the thoracic aorta
3) internal thoracic
4) superior epigastric
5) intercostal
139. To the "weak" areas of the diaphragm of a triangular shape, where the thoracic-abdominal barrier is formed
connection intrathoracic and intra-abdominal fascia, include:
one) esophageal opening
2) right sternocostal triangle (Morgagni's fissure)
3) right lumbocostal triangle (right fissure of Bochdalek)
4) left lumbocostal triangle (left fissure of Bochdalek)
5) left sternocostal triangle (Larrey's fissure)
140. The following pathological processes can take place in the “weak” parts of the diaphragm:
one) abdominal aortic aneurysm

2) breakthrough of a retroperitoneal abscess into the subpleural space of the chest cavity
3) diaphragmatic hernia
4) spread of an abscess from the subpleural space to the retroperitoneum
5) pleural empyema
141. The passage of the inferior vena cava in the opening of the diaphragm explains the following vascular phenomena:
one) contraction of the diaphragm contributes to the outflow of blood from the subdiaphragmatic region v. cava inferior to
right atrium ("pulsation" of the vein)
2) changes in pressure in the thoracic and abdominal cavities
3) when inhaling at the level of the diaphragm, compression and bending of the inferior vena cava occurs (external
"valve")
4) diaphragmatic hernia formation
5) in chronic nonspecific lung disease due to a significant increase
sagittal and transversal dimensions of the chest, there is a flattening of the diaphragm, with
gross hemodynamic disorders of blood flow in v. cava inferior
142. Anatomical and functional differences of the pleura are as follows:
one) a pleural cavity is formed between the sheets of the pleura, in the recesses of which accumulates
pathological fluid
2) the visceral pleura is firmly connected to the lung parenchyma, the parietal pleura is loosely (through
subserous base)
3) visceral pleura produces serous fluid, parietal - resorbs
4) pleural sheets have plasticity - the property to form adhesions
5) the parietal pleura receives a rich sensory innervation, the visceral pleura is innervated
lung nerves

143. When mobilizing the apex of the lung, large blood vessels can be damaged:
one) brachiocephalic trunk
2) subclavian vein
3) left brachiocephalic vein
4) subclavian artery
5) superior vena cava
144. The pleural cavity has the following recesses or sinuses:
one) dome of the pleura
2) costal-diaphragmatic (along linea axillaris media with a depth of 6-8 cm)
3) costal-mediastinal
4) oblique sinus of the pericardium
5) diaphragmatic-mediastinal
145. The main localization of abscesses of the mammary gland:
one) in the subcutaneous tissue - pre- or antemammary abscess
2) phlegmon of superficial subpectoral space
3) in the parenchyma of the gland - interstitial and parenchymal mastitis
4) phlegmon of deep subpectoral space
5) in the retromammary space (retromammary abscess)
146. Incisions are used to open purulent mastitis and retromammary abscess:
one) linear radial - from halos to the periphery, according to Angerer

2) semicircular - along the skin fold of the base of the mammary gland, according to Bardengeyer
3) along the lower edge of the pectoralis major muscle
4) semicircular at the border of the areola
5) horizontal at the level of the third rib
147. Linear radial incisions in purulent mastitis have disadvantages:
one) do not meet cosmetic requirements
2) provoke scar deformity of the organ
3) characterized by significant blood loss
4) the need for a compression bandage with an elevated position of the organ
5) with acute purulent infiltration of the gland, 3-4 linear incisions are used
148. Indications for sectoral resection of the mammary gland:
one) benign tumor
2) fibrocystic mastopathy
3) retention cyst
4) acute purulent mastitis
5) retromammary phlegmon
149. Stages of sectoral resection of the mammary gland:
one) skin incision bordering the node, followed by separation of the skin and subcutaneous tissue
2) within healthy tissues in the form of a wedge, one or more lobules are excised along the interlobar
partitions

3) provide thorough hemostasis; cavity walls are connected with catgut sutures
4) the wound is drained with a strip of glove rubber for 1-2 days and skin sutures are applied
5) the wound is sutured tightly
150. Puncture of the pleural cavity in case of hydrothorax is performed in the following position of the patient:
one) sitting on the dressing table
2) body leans forward
3) the arm on the side of the puncture is raised
4) upper body leans back
5) the patient is in a horizontal position
151. In order to remove the pathological fluid, the puncture of the pleural cavity is carried out,
focusing on:
one) X-XII rib
2) upper edge of the rib
3) VII-VIII rib
4) between midaxillary and scapular lines
5) along the midclavicular line
152. External landmarks for puncture of the pleural cavity in pneumothorax are:
one) I rib
2) midaxillary line
3) II-III rib

4) mid clavicular line
5) V rib
153. Possible complications of puncture of the pleural cavity include:
one) pneumothorax
2) lung injury
3) shear injury of the intercostal nerve
4) puncture of the transverse colon
5) injury to the liver (right), spleen (left)
154. Indications for rib resection:
one) fractura ribs
2) osteomyelitis
3) rib tuberculosis
4) excision of healthy ribs to expand operational access to the chest cavity
5) correction of chest deformities or use of a free bone grafting rib
155. Stages of subperiosteal resection of the rib in thoracotomy:
one) soft tissues are dissected along the rib, the periosteum along the middle of the rib, and at the ends of the incision -
across
2) the periosteum is separated from the rib with preservation of the intercostal neurovascular bundle
3) the rib along the edges of the separated periosteum is cut with wire cutters (in children - with scissors)
4) layer-by-layer dissect the remaining layers of the intercostal space

5) resection of the rib together with the periosteum
156. Penetrating wounds of the chest wall are complicated by:
one) adhesive process in the pleural cavity
2) development of pleuropulmonary shock
3) pneumothorax and its consequence - lung atelectasis
4) hemothorax - bleeding into the pleural cavity
5) pleural cavity infection
157. Types of pneumothorax:
one) open - communication of the pleural cavity with atmospheric air through a defect in the chest wall
2) lung atelectasis
3) closed - a consequence of a closed lung injury with the integrity of the chest wall or the absence
the gaping of her wound
4) adhesions at the base of the lung
5) valvular - with wounds of the chest wall and closed injuries of the lung, when damaged
tissues, like a valve, allow air to pass only into the pleural cavity; grows with every breath
compression of the lung
158. Surgery for open pneumothorax includes:
one) incision in the neck n. phrenicus on the side of surgery
2) excision of the edges of the wound within healthy areas
3) revision of the lung and pleural cavity with careful hemostasis
4) elimination of the gaping wound of the chest wall

5) drainage of the pleural cavity
159. Chest wall wound with open pneumothorax is sutured with sutures:
one) pleural
2) pleuromuscular
3) muscular-fascial
4) dermal (with subcutaneous base)
5) muscular
160. Drainage of the pleural cavity when suturing an open pneumothorax is dictated
necessity:
one) removal of air remaining in the pleural cavity to straighten the lung
2) early diagnosis of possible complications due to errors in the technique of wound closure
lung and chest wall (resolving the issue of rethoracotomy)
3) evacuation of pathological fluid (exudate) from the pleural cavity
4) stimulation of the formation of adhesions in the area of operation
5) administration of an antibiotic into the pleural cavity
161. The lung has the following surfaces:
one) Diaphragmatic
2) top
3) Costal
4) mediastinal
5) Vertebral part of the costal surface

162. The edges of the lung separate the surfaces of the organ:
one) Anterior - costal from mediastinal (medial)
2) Inferior - costal and mediastinal from diaphragmatic
3) The lower edge is the costal from the diaphragmatic
4) Anterior margin - costal from diaphragmatic
5) Inferior edge from the hilum of the lung
163. Oblique fissure of the lung from the level of the spinous process of the third thoracic vertebra is directed:
one) From top to bottom and anteriorly along the costal surface to the lower edge near its transition to the anterior edge
2) According to the border of the bone and cartilage parts of the VI rib
3) Up and back to the mediastinal surface and to the hilum of the lung
4) The oblique fissure divides the lung into two separate parts in front and behind, connecting in the area of the gate
- upper and lower lobes
5) Oblique fissure not expressed
164. The horizontal fissure of the right lung (the left one does not have it) is located as follows:
one) Starts on the costal surface
2) In the middle of the oblique fissure at the intersection with the middle axillary line
3) Almost horizontally directed anteriorly (at the level of the IV rib) to the anterior edge of the lung
4) The horizontal gap is expressed
5) Passes to the mediastinal surface and reaches the hilum of the lung, to the hilum of the lung
is directed at the level of the VI rib
165. The main components of the root of the right lung have the following syntopy:

one) Syntopy is defined by the abbreviation "BAV"
2) The main bronchus is superior and posterior
3) The pulmonary artery is posterior to the bronchus
4) Pulmonary artery - anterior and inferior to the bronchus
5) Pulmonary veins - anterior and inferior to the pulmonary artery
166. In the left lung, the main bronchus and pulmonary vessels are located under the abbreviation "ABV":
one) Pulmonary artery superior and anterior to the bronchus
2) Bronchus - down and behind the pulmonary artery
3) Bronchus behind and above the artery
4) Pulmonary veins inferior and anterior to the main bronchus
5) Pulmonary veins superior and posterior to the bronchus
167. Loose fibrous tissue accompanies the main bronchus, pulmonary artery and veins at the root of the lung.
connective tissue:
one) Prepleural tissue
2) The parabronchial space is Marshall's fasciocellular compartment containing
bronchial branches, lymphatic vessels, nodes, nerves of the lung
3) Paravasal space
4) Marshall's sheath is a pathway for the spread of air and infection in ruptures and fistulas
bronchi
5) Cicatricial changes in the paravasal space make it difficult to mobilize the pulmonary vessels at the root
lung
168. In relation to the pericardium, the pulmonary vessels (artery, superior and inferior veins) have sections:

one) Extrapericardial
2) Orifices of the pulmonary veins
3) intraligamentous
4) intrapericardial
5) Extraligamentous
169. Lung lobe is characterized by the following features:
one) Delimited from the other lobe by the interlobar groove
2) Ventilated by the lobar bronchus (II order)
3) Functional blood supply (pulmonary circulation) is provided by the lobar artery and
vein (II order)
4) The trophic blood supply to the bronchi occurs through the bronchial branches of the thoracic aorta.
5) The share has no external reference points
170. Signs that characterize the segment of the lung:
one) Part of the lobe delimited from other segments by connective tissue layers
2) The border of the segment corresponds to the "low-vascular" zone
3) It has the form of a pyramid, the base of which is directed to the surface of the pulmonary pleura, the top - to
gate lung
4) At the top of the segment is a "leg" - segmental bronchus and artery (II order)
5) The “leg” of the segment is directed towards the base of the lung
171. Techniques to determine the boundaries of the lung segment during surgery:
one) The boundaries of the segment do not matter in anatomical resections of the organ

2) Finger compression of the segmental bronchus in the hilum of the lung is accompanied by a collapse of the parenchyma
(atelectasis) in the bronchial ventilation zone
3) Catheterization of the segmental bronchus with subsequent increase in pressure - lung parenchyma
bloated
4) Introduction to the segmental artery of dyes (zone of discoloration of the lung parenchyma)
5) Determination of segment boundaries during anatomical resection provides the best functional
results in the postoperative period
172. Mobilization of the right main bronchus during pneumonectomy in conditions of adhesions can
be complicated by damage to the veins:
one) Jugular venous arch
2) unpaired
3) Top hollow
4) Right brachiocephalic
5) semi-unpaired
173. When isolating and processing the left main bronchus, there is a danger of injuring the arteries:
one) Pulmonary trunk
2) Shoulder head trunk
3) Aorta (ascending, arch, thoracic aorta)
4) Left subclavian
5) Left vertebral
174. Name the arteries that supply blood to the main bronchi and the source of their origin:
one) Branches of the pulmonary artery

2) Bronchial branches
4) Branches of the internal mammary artery
5) Thoracic aorta
175. Anatomical and functional features of the lungs, explaining the frequency of localization of tuberculosis in
upper sections and pneumonia - in the lower:
one) The upper sections have better ventilation conditions
2) The secret from the bronchioles and bronchi leaves on its own
3) In the lower parts of the lung, there is stagnation of secretion in the bronchioles and bronchi
4) Emptying components of the lower bronchial tree requires postural drainage
5) Features of the structure and function of bronchioles and bronchi do not matter in the development of pathological
lung conditions
176. Operations on the lungs are performed by:
one) Longitudinal median sternotomy
2) Bronchoscopy
3) Thoracoscopy
4) Transpleural thoracotomy
5) Extrapleural thoracotomy
177. Classical operative approaches for open operations on the lungs:
one) Anterolateral without dissection of the costal cartilages
2) Anterolateral with dissection of the IV-V costal cartilages, retreating 2-3 cm from the sternum (or with resection

one rib) along the IV intercostal space to linea axillaris posterior
3) Posterolateral along the paravertebral line from ThIV to the angle of the scapula, then along the VI intercostal
mid-axillary line
4) Lateral access ("standard" thoracotomy)
5) The choice of operative access is not determined by the type and localization of the pathological process
178. Anterolateral thoracotomy is used for operative admission to:
one) Upper lobe
2) Upper segment (CII)
3) Middle lobe (right)
4) Anterior basal segment (CVIII)
5) Medial segment (CV)
179. Posterolateral access is used for prompt reception on:
one) Middle lobe (right)
2) lower lobe
3) Posterior basal segment (CX)
4) Apical segment (CI)
5) Lateral segment (CIII)
180. The essence of surgical techniques "wedge-shaped" and "marginal" lung resection is:
one) Removal of a small area of the lung
2) Performing resection without taking into account the intraorgan distribution of bronchi and blood vessels

3) Application of sealing hemostatic sutures along the resection line
4) Elimination of the post-resection surface of the lung
5) Performing resection taking into account low-vascular zones of the lung
181. Stages of quality control of pneumothoraphy (lung suture):
one) The pleural cavity is filled with warm saline
2) Remove fluid from the pleural cavity by suction
3) The lung is immersed in liquid
4) The anesthetist raises the pressure in the airways
5) The criterion for the tightness of the suture of the lung is the absence of air bubbles and blood
182. Typical stages of pneumonectomy (after thoracotomy):
one) Mobilization of the lung (discharge of the lung from adhesions - pneumolysis)
2) Isolation of lung root components
3) Separate treatment of pulmonary arteries, veins and main bronchus
4) Lung removal
5) Drainage of the pleural cavity and suturing the wound of the chest wall
183. In case of pneumonectomy due to lung cancer, treatment of bronchopulmonary "triad" begins with
selection and dressing:
one) pulmonary artery
2) Inferior pulmonary vein
3) main bronchus

4) superior pulmonary vein
5) The purpose of processing the components of the bronchopulmonary "triad" is to prevent the release of cancer cells into the bloodstream.
cells
184. In the first hours of a child's life, the lungs change:
one) Position
2) Volume
3) form
4) No lung changes
5) Weight
185. Large blood vessels adjoin to the thoracic part of the trachea:
one) Aortic arch
4) Left brachiocephalic vein
5) The initial part of the left common carotid artery
186. Behind and from the sides to the thoracic part of the trachea adjoin:
one) Esophagus
2) thymus
3) Right phrenic nerve
4) Right mediastinal pleura

5) Left mediastinal pleura
187. The epithelial layer of the trachea contains:
one) ciliated epitheliocytes
2) Goblet cells that produce mucus
3) Basal (stem) cells
4) Accumulation of myeloid cells
5) Endocrine cells that secrete norepinephrine, serotonin, dopamine
188. The clinical significance of the anatomical relationship of the trachea with aneurysm of the aortic arch is that
what:
one) Syntopy of the trachea and large arteries of the thoracic cavity have no clinical significance
2) Aneurysm can sever the trachea and esophagus
3) Move the trachea to the right
4) Constant pressure and pulsation of the aneurysm may be accompanied by ulceration of the tracheal wall.
5) Aneurysm can rupture into the trachea with a fatal outcome
189. Due to different conditions of mechanical action, the cartilaginous skeleton of the bronchi has a different
structure outside and inside the lung:
one) Outside the lung, the bronchi are made up of cartilaginous semirings.
2) When approaching the hilum of the lung, cartilaginous connections appear between the cartilaginous semirings.
3) In the segmental bronchi, the semicircles break up into separate plates.
4) By decreasing the diameter of the bronchi, the size of the plates decreases
5) The bronchi and bronchioles have the same structure throughout

190. Narrowing of the lumen of the trachea up to its closure - the result of compression of the organ from the outside:
one) Enlarged tuberculous lymph nodes
2) Tumors of neighboring organs of the mediastinum
3) Mediastinal cysts
4) Postoperative scars of the chest wall
5) With congenital deformity of the chest wall
191. Caution during bronchoscopy (blockage of a single bronchus!) is dictated by the presence of options
bronchial discharge and malformations of the lungs:
one) The right upper lobe bronchus departs from the trachea 1.25 cm above the carina tracheae (keel)
2) Lung atelectasis
3) Lung agenesis
4) Bronchial atresia
5) Esophageal atresia
192. In small children, the main bronchi are characterized by the following features:
one) Relatively narrow
2) Cartilage is soft
3) Elastic fibers are poorly developed
4) The mucous membrane (like the trachea) is poor in secretory elements.
5) The bronchus does not differ in structure from the bronchi of an adult.
193. Up to 70% of foreign bodies are localized in the right main bronchus, because it has:

one) More vertical direction (is, as it were, a continuation of the trachea)
2) Three lobar bronchi
3) Shorter length (3cm)
4) The wall contains 6-8 cartilages
5) Wide (diameter 1.6cm)
194. The left main bronchus is characterized by:
one) At the root of the lung is located above and behind the pulmonary artery
2) Longer than right (4-5cm)
3) The wall contains 9-12 cartilages
4) Already right (diameter 1.3cm)
5) Divides into 2 lobar bronchi
195. In case of pneumonectomy, the following method of suturing the stump of the main bronchus is used:
one) Separate interrupted sutures are applied with an atraumatic needle with synthetic thread or
chrome catgut
2) They capture all the membranes of the bronchus so that the membranous wall is connected to the cartilaginous
3) If necessary, the bronchus stump is covered with flaps of the mediastinal pleura (pleurisy)
4) The main bronchus is ligated with a thick silk ligature.
5) A mechanical suture is used with a bronchus stump suture (for example, UKB-40)
196. For the prevention of broncho-pleural fistula, plastic cover of the stump can be used.
bronchus:
one) mediastinal pleura

2) Flap of the fibrous pericardium
3) Lobar or segmental bronchus is covered with adjacent lung parenchyma
4) Muscular flap of the diaphragm on the vascular "pedicle"
5) Marshall's fascio-cellular sheath
197. Requirements for pneumography:
one) Ensuring aerostasis, i.e. tightness
2) Achieve meticulous hemostasis
3) The wound is captured to the full depth; the remaining cavity may be the site of a lung abscess
4) Intraoperative quality control of the lung suture
5) If necessary, the tightness of the seam is provided by the second row - pleuro-pleural seam
198. Ways of drainage of lung abscesses:
one) Pneumotomy is performed in such a way as to exclude infection of the pleural cavity
2) Bronchoscopic catheterization of an abscess, provided that the abscess communicates with the bronchus
3) Simultaneous pneumotomy in the presence of adhesions of the parietal and pulmonary pleura in the abscess zone
4) Two-stage pneumotomy in the absence of adhesive process between the pleura
5) Severe intoxication of the body dictates the need for simultaneous pneumotomy, even with
absence of pleural adhesions
199. Research methods necessary to clarify the localization of lung abscess:
one) Abscess Puncture
2) Physical (percussion, auscultation)

3) X-ray
4) CT scan
5) Bronchography
200. Stages of simultaneous pneumotomy in lung abscess:
one) Layered incision of soft tissues (10-12 cm) along the rib in the projection of the abscess
2) Subperiosteal resection of 1-2 ribs (10-12 cm) and dissection of the inner periosteal plate above
abscess
3) With adhesions in a blunt way for 5-7 cm, the pleura is exfoliated from the intercostal muscles, in the middle
this place with a thick needle puncture the lung
4) Upon receipt of pus, the abscess is opened with an electric knife, the cavity is examined (with a finger wrapped
gauze swab) and drained with a thin catheter
5) In the postoperative period, daily administration of antibiotics into the abscess cavity
201. Drainage of the purulent cavity of the lung with a thin rubber tube provides:
one) Evacuation of purulent discharge
2) Introduction to the purulent cavity of antibiotics
3) Reliable hemostasis
4) Lung expansion
5) Sclerosis of the purulent cavity
202. Stages of two-stage pneumotomy in lung abscess:
one) Dissection of soft tissues along the rib and subperiosteal resection of 2 ribs above the abscess
2) Pressing into the pleural cavity of the periosteum, together with the parietal pleura, lubricated with iodine
tincture (provocation of adhesion formation)

3) Pressing the parietal pleura to the lung with a gauze swab inserted into the wound
4) After 8-10 days, the wound of the chest wall is opened, the tampon is removed; in the area of adhesions puncture and
needle open abscess
5) In the postoperative period, the acid-base state of the body is controlled
203. Entry into the lungs of oxygen-saturated air and its removal (gas exchange) is ensured by:
one) Active respiratory movements of the chest wall
2) Contraction and relaxation of the diaphragm
3) Contractility of the lung in combination with airway function
4) Collateral breathing (bypassing the bronchi and bronchioles)
5) Disorder of the function of the apparatus that provides breathing, accompanied by respiratory and
cardiovascular insufficiency
204. Collateral respiration in adults is carried out through peculiarly constructed acini:
one) Atypical complexes of alveoli and alveolar ducts are localized in the lower lobes of the lung, it is unclear
divided into lobules and acini
2) There are pores in the walls of the alveoli
3) Alveoli and alveolar ducts take on the appearance of trabecular cords
4) Alveolar cords create conditions for collateral breathing
5) The growth of connective tissue in the parenchyma of the lung causes the development of pulmonary hypertension
205. Secondary purulent pleurisy (90% of all purulent pleurisy or pleural empyema) occurs as
complication:
one) Inflammatory processes of the neck organs
2) Bronchopneumonia

3) Lymphadenitis of tracheal and bronchial nodes
4) Croupous inflammation of the lung
5) lung abscess
206. According to S.D. Ternovsky, "complaints of pain in the abdomen with purulent pleurisy in case of insufficient
careful examination may lead to misdiagnosis":
one) Acute appendicitis
2) helminthic obstruction
3) Acute cholecystitis
4) Ileocecal intussusception
5) Acute pancreatitis
207. In the treatment of purulent pleurisy, the following rules should be followed:
one) Complete removal of pus from the pleural cavity
2) Maintenance of negative intrapleural pressure
3) Exclusion of lung collapse
4) Introduction to the pleural cavity of antibiotics
5) Suction without letting air into the pleural cavity
208. Expand the concept of "interpleural space" and its clinical significance:
one) gap between the right and left mediastinal pleura, respectively, anterior and posterior
chest walls
2) the possibility of extrapleural access to the organs of the anterior and posterior mediastinum
3) when accessing the mediastinal organs through the interpleural space, pneumothorax is excluded

4) no infection of the pleural cavity
5) no need for drainage of the pleural cavity
209. Anterior interpleural space consists of fields:
one) right
2) top
3) left
4) lower
5) domes of the pleura
210. Anterior and posterior interpleural spaces are the spaces between:
one) pulmonary and parietal pleurae
2) right parietal pleura
3) left parietal pleura
4) sternum and pericardium
5) pericardium and esophagus
211. Operational access to mediastinal organs through interpleural spaces is called:
one) "standard" thoracotomy
2) extrapleural (without opening the pleural cavity)
3) longitudinal sternotomy
4) anterolateral thoracotomy
5) posterolateral thoracotomy

212. Fascia endothoracica lining the chest cavity has the following plates:
one) costal
2) diaphragmatic
3) clavicular-thoracic
4) own breast fascia
5) mediastinal
213. The retrosternal cellular space through which the branch of the sternotomy is passed is limited by:
one) anterior - posterior sternum
2) behind - retrosternal fascia, part of fascia endothoracica
3) from the sides - by fascial septa of the retrosternal fascia to the edges of the sternum
4) from above - by fixing the retrosternal fascia to the jugular notch of the sternum (separates the retrosternal
space from neck spaces); below - attached to the diaphragm
5) laterally from these partitions, the intrathoracic fascia forms a vagina for the internal chest
vessels
214. Tela subserosa between fascia endothoracica and pleura is unevenly developed:
one) within the dome of the pleura and upper ribs is expressed, which ensures free exfoliation of the pleura
2) laterally from the spine to a width of 5-6 cm, a significant layer of the subserous base creates
possibility of extrapleural access to the posterior mediastinum
3) downward from the IV rib, this layer extends to the diaphragm
4) in the anterior direction - reaches the border of the transition of the rib to the costal cartilages
5) the subserous base in all parts of the chest cavity is poorly developed

215. Mediastinum limited:
one) anterior - sternum and retrosternal fascia
2) behind - the thoracic spine and the necks of the ribs lined with the prevertebral fascia (part
intrathoracic fascia)
3) from the sides - the mediastinal pleura and adjacent mediastinal plates of the intrathoracic
fascia
4) from below - the upper fascia of the diaphragm
5) from the sides - mediastinal surfaces of the lungs
216. At the level of the upper thoracic inlet, the mediastinal tissue is separated from the fascial-cellular
spaces of the neck with fascial spurs located between the organs and associated with the fascia,
covering:
one) pectoralis major muscle
2) sternum
3) collarbone
4) anterior scalene muscle
5) thoracic vertebral bodies
217. Cellular spaces of mediastinum include:
one) peritracheal and periesophageal
2) retrosternal
3) periaortic
4) retropericardial
5) prevertebral

218. In accordance with the anatomical nomenclature in relation to the horizontal plane passing
through the border of the handle and body of the sternum (in front) and the bodies of ThIV-ThV (behind), the mediastinum consists of sections:
one) top
2) middle
3) lower
4) rear
5) front
219. From the standpoint of operational access to the organs, the mediastinum is divided into departments:
one) upper
2) anterior
3) the average
4) rear
5) anterior interpleural field
220. Parts of the lower mediastinum:
one) upper
2) anterior
3) the average
4) rear
5) pericardial cavity
221. The superior mediastinum is limited from above and below:

one) Apertura thoracis superior (organs of the neck continue into the organs of the mediastinum)
2) a horizontal plane passing along the upper edge of the roots of the lungs
3) dome of the pleura
4) aortic arch
5) anterior-inferior sinus of the pericardium
222. The anterior part of the lower mediastinum, between the body of the sternum and the anterior wall of the pericardium, contains:
one) a. et v. thoracicae internae
3) retrosternal lymph nodes
4) anterior mediastinal lymph nodes
5) inferior vena cava
223. In the middle mediastinum are located:
one) pericardium with the heart enclosed in it and intrapericardial departments of large blood vessels
vessels
2) bifurcation of the trachea with the main bronchi
3) pulmonary arteries and veins
5) phrenic nerves with their accompanying phrenic-pericardial veins, as well as
lymph nodes
224. In the posterior mediastinum, between the bifurcation of the trachea, the posterior wall of the pericardium and the spine,
contains:

one) part of the thoracic aorta and thoracic duct
2) esophagus and accompanying vagus nerves with esophageal plexus
3) unpaired and semi-azygous vein and lymph nodes
4) sympathetic trunks with their nodes, large and small thoracic splanchnic nerves
225. In the structure of the pericardium, as a fibrous-serous sac, there are layers:
one) retrosternal fascia
2) fibrous (external), which passes to the walls of the extrapericardial sections of the circulatory
vessels, forming vascular sheaths for them
3) submucosa of the esophagus
4) serous (internal), parietal plate, which lines the fibrous pericardium from the inside, and
visceral plate - outer layer of the heart - epicardium
5) prevertebral fascia
226. The following departments are distinguished in the pericardium:
one) fibrous pericardium
2) sternocostal (anterior) - between the right and left mediastinal pleura, connected to
sterno-pericardial ligaments
3) diaphragmatic (lower), fused with the tendon center of the diaphragm
4) mediastinal (right and left), in front and lateral sides fused with the mediastinal pleura
5) serous pericardium
227. Posteriorly, the mediastinal pericardium is adjacent to:

one) superior vena cava
2) esophagus
3) thoracic aorta
4) unpaired and semi-unpaired veins
228. In the pericardial cavity between the pericardium, the surface of the heart and large vessels are formed
sinuses:
one) transverse
2) oblique
3) costal-mediastinal
4) diaphragmatic-mediastinal
5) anterior-inferior (distinguished by clinicians)
229. When the sternocostal pericardium passes into the diaphragmatic pericardium, anterior-inferior sinus is formed, where
may accumulate:
one) blood (hemopericardium)
2) tracedat (hydropericardium)
3) exudate
4) air
5) lymph
230. The walls of the transverse sinus located at the base of the heart are formed by:
one) front and top - pulmonary trunk

2) behind - anterior surface of the right atrium
3) behind - v. cava superior
4) in front and above - the initial section of the ascending aorta
5) you can enter the transverse sinus on the left - from the side of truncus pulmonalis, on the right - from the side
ascending aorta
231. The oblique sinus of the pericardium, located on the diaphragmatic surface of the heart, is limited by:
one) mouth sections of the left pulmonary veins - on the left
2) inferior vena cava - right
3) left atrium - anterior
4) pericardium - behind
5) with purulent pericarditis in the oblique sinus, abscesses may be localized
232. To examine the oblique sinus, the heart should be displaced:
one) anteriorly
2) to the left
3) up
4) posteriorly
5) right
233. Pericardiotomy by extrapleural access can be performed within the chest area,
respectively:
one) attachment of the sternocostal part of the pericardium to the chest wall
2) V-VII left costal cartilages

3) sternum
5) at the level of VI-VII intercostal spaces and linea axillaris media
234. The transverse sinus of the pericardium is used for:
one) operations on a "dry" heart (when a heart-lung machine is connected)
2) heart transplant
3) treatment of pulmonary arteries and veins during pneumonectomy for lung cancer with root metastases
body
4) pericardial puncture
5) pericardiotomy to drain the pericardial cavity
235. The pericardium of a newborn child is characterized by:
one) spherical (rounded) shape, fits snugly to the heart
2) its upper border is located high - along the line connecting the sternoclavicular joints,
lower - corresponds to the lower border of the heart
3) mobile due to underdevelopment of the sterno-pericardial ligaments
4) small cavity volume
5) by the age of 14, the boundaries of the pericardium and its relationship with the organs of the mediastinum are the same as in
adults
236. The shape of the heart is not constant, it depends on:
one) changes in chest pressure
2) age

3) pathological conditions of the organ
4) constitution
5) pathological conditions of the abdominal organs
237. The heart has surfaces:
one) apex cordis
2) sternocostal, or anterior, facing the sternum and costal cartilages
3) lower, or diaphragmatic, which in the clinic is called the back
4) pulmonary, or lateral surfaces, which are visible when the lungs are displaced from the heart
5) basis cordis
238. Anterior surface of the heart is formed by:
one) anterior wall of the right ventricle
2) only along the left edge - the left ventricle
3) anterior wall of the right atrium and the right ear - from above and to the right
4) the tip of the left ear covering the truncus pulmonalis
5) left atrium
239. Large blood vessels, the initial sections of which belong to the anterior surface of the heart:
one) superior vena cava - on the right and somewhat posteriorly
2) ascending aorta - between v. cava inferior et truncus pulmonalis
3) pulmonary trunk, which occupies a left-sided position
4) coronary sinus of the heart

240. There are grooves on the anterior surface of the heart:
one) coronary - the border of the atria and ventricles
2) in this groove in the subepicardial tissue is the right coronary artery
3) anterior interventricular sulcus corresponds to the interventricular septum
4) in this groove passes the anterior interventricular branch of the left coronary artery
5) in the same groove lies a large vein of the heart
241. Diaphragmatic (posterior) surface of the heart is limited:
one) pulmonary trunk
2) left atrium
3) right atrium
4) part of the (small) left ventricle
5) attached to the organs of the posterior mediastinum
242. In the coronal groove of the posterior surface of the heart are:
one) right coronary artery
2) circumflex branch of left coronary artery
3) coronary sinus
4) small vein of the heart
5) pulmonary trunk

243. Along the posterior interventricular sulcus, corresponding to the posterior edge of the interventricular
partitions are located:
one) posterior interventricular branch of the right coronary artery
2) middle vein of the heart
3) coronary sinus
4) small vein of the heart
244. Shells of the heart:
one) fibrous pericardium
2) epicardium - outer shell - visceral sheet of the serous pericardium
3) myocardium - up to 7/10 of the wall thickness of the heart - cardiac striated muscle tissue,
made up of cardiomyocytes
4) endocardium - one layer of endotheliocytes on the basement membrane; on the border with the myocardium there is a thin
layer of loose fibrous connective tissue
5) parietal layer of the serous pericardium
245. The cavity of the heart consists of chambers:
one) left, or arterial heart; right or venous heart
2) left atrium
3) left ventricle
4) right atrium
5) right ventricle

246. In the right atrium there are:
one) orifice of inferior vena cava
2) venous sinus
3) own right atrium
4) right ear of the heart
5) orifice of the superior vena cava
247. Interatrial septum from the side of atrium dextrum has:
one) oval fossa covered with a thin membrane
2) the fossa is the remnant of an overgrown oval foramen, which communicated the right and left in the fetus
atrium
3) non-closure of the fossa ovale, especially in combination with other defects (mitral valve stenosis),
leads to severe circulatory disorders
4) primary atrial septal defects are characterized by a slit-valve structure,
passing blood from right to left
5) atrial septal defect has no clinical significance
248. Interventricular septum has parts:
one) middle
2) muscular - anterior-lower (large)
3) membranous - superior-posterior (closer to the atria)
4) top
5) lower

249. In the upper part of the right ventricle has openings:
2) right atrioventricular
3) opening of the coronary sinus
4) conus arteriosus with supraventricular crest
5) opening of the pulmonary trunk
250. The right atrioventricular orifice is closed by the right atrioventricular
(tricuspid) valve:
one) on the front surface - front sash
2) on the posterior lateral - the posterior leaflet
3) when the ventricles contract, the free edges of the valves close
4) on the medial semicircle - septal leaflet
5) the valves in the atrium do not turn out, because they are held from the side of the ventricle
tendon chords
251. The right atrium has openings:
3) along the bottom edge of the hole v. cava inferior valve of the inferior vena cava is located
4) in the embryo (and fetus) valve v. cava inferior directs blood from the right atrium to the left through
oval hole
5) between the holes of the hollow veins is an intervenous tubercle - the remainder of the valve that guides
the embryo has blood from v. cava superior into the right atrioventricular orifice

252. In addition to the openings of the vena cava in the right atrium there are:
one) right atrioventricular orifice
2) opening of the coronary sinus (between the opening of the inferior vena cava and the atrioventricular
hole)
3) at the mouth of the coronary sinus - a thin crescent-shaped fold - the valve of the coronary sinus
4) next to the opening of the coronary sinus - the opening of the smallest veins
5) opening of the pulmonary trunk
253. At the beginning of the pulmonary trunk there is a valve with semilunar valves:
one) anterior
2) left
3) right
4) alveole (sinus) of semilunar valve
5) when pressure drops in the right ventricle, the edges of the valves close due to the return current
blood filling the holes (sinuses)
254. The left atrium contains openings:
one) two - right pulmonary veins
2) two - left pulmonary veins
3) pulmonary veins do not have valves
4) left atrioventricular
5) coronary sinus
255. The left atrioventricular (mitral) valve consists of triangular cusps:

one) anterior, starting on the medial semicircle of the opening (near the interventricular
partitions)
2) posterior, starting from the posterolateral semicircle
3) left
4) right
5) semilunar
256. Aortic opening of the left ventricle (located to the right of the atrioventricular opening)
covered with a valve of semilunar flaps:
one) rear
2) right
3) left
4) between each valve and the wall of the aorta there is a hole (sinus) of the semilunar valve
5) in the middle of the free edges of the valve have nodules larger than those of truncus pulmonalis
257. Arteries of the heart are predisposed to atherosclerotic lesions due to:
one) depart at a right or approaching angle (right coronary - 63.4%, left - 42%)
2) with age, the sheath of the coronary arteries, formed by the subepicardial base, becomes sclerosed and
fuses with their walls
3) coronary arteries have a "diving" course (15.2 - 90%: alternation of subepicardial and
intramyocardial position)
4) most of the blood enters the arteries during diastole
5) arteries and veins of the heart form the third - the coronary circulation
258. The main components that make up the conducting system of the heart:

one) sinoatrial node (Keys-Fleck node in the wall of the right atrium between the right ear and
superior vena cava)
2) atrioventricular node (Ashoff-Tavar node in the right fibrous triangle below
attachment of the septal leaflet of the tricuspid valve)
3) atrioventricular bundle (His bundle, connecting the atrial myocardium with the myocardium
ventricles)
4) right and left legs of the atrioventricular bundle
5) the terminal branches of the fibers of the conducting system (Purkinje fibers) end at
ventricular cardiomyocytes
259. Thrombi can form in the heart ears as additional blood reservoirs due to:
one) slowing blood flow in violation of cardiac activity
2) far advanced stenosis of the atrioventricular orifices
3) ciliated artery
4) post-infarction aneurysm of the left ventricle
5) atherosclerosis of the aortic arch
260. The essence of the stages of surgery in Lutembaher's syndrome (combination of secondary defect
interventricular septum with mitral valve stenosis):
one) dissect the wall of the right atrium along the line connecting the mouths of the superior and inferior vena cava
2) in 70-85% of cases, the edges of the defect are sutured with a twist suture
3) for extensive defects, a pericardial or Teflon patch is used (in adults)
4) simultaneously perform mitral commissurotomy
5) the operation is performed on a "dry" heart under the cover of AIK

261. Congenital ventricular septal defect (Roger's disease) is characterized by:
one) in 85-90% of cases, this is an anterior subcretal defect in the membranous part of the interventricular
partitions
2) in close proximity to the atrioventricular bundle
3) defect of the muscular part of the septum can be multiple, such as "Swiss cheese"
4) closure of the defect with a Teflon patch on a “dry” heart is possible from the right atrium through
tricuspid opening, as well as from the left ventricle
5) the greatest danger of the operation is damage to the bundle of His or its legs
262. Pericardial puncture is indicated for:
one) pneumothorax
2) hydropericardium
3) hemothorax
4) hemopericardium
5) chylothorax
263. External reference points for pericardial puncture according to Larrey are:
one) tip of the xiphoid process
3) left edge of the xiphoid process
4) site of attachment of the cartilage of the VII left rib
5) point Oboniaka
264. The Voynich-Syanozhentsky safety triangle is bounded by:

one) on the right - a fold of the right mediastinal pleura
2) from above - jugular notch of the sternum
3) on the left - a fold of the left mediastinal pleura
4) below - costophrenic sinus
5) bottom - aperture
265. During puncture of the pericardium and pericardiotomy through the safety triangle, such
complications like:
one) hemopericardium
2) pneumothorax
3) hydropericardium
4) pleural cavity infection
5) liver damage
266. For intracardiac administration of medicinal substances, reference points are used:
one) IV intercostal space
2) linea medioclavicularis
3) tip of the xiphoid process
4) the angle formed by the left edge of the xiphoid process and the cartilage of the VII left rib
5) linea parasternalis
267. Stages of suturing the wound of the heart after pericardiotomy:
one) the wound is closed with the index finger of the left hand

2) the edges of the wound are reduced by "P" - shaped handles
3) the wound is sutured with interrupted or "P" - shaped sutures with a synthetic thread in an atraumatic needle with
capturing all the membranes of the heart, stepping back from the edge of 6-8 mm
4) in case of cardiac arrest, sutures are applied in the intervals between direct massage of this organ
5) fibrillation is removed by a defibrillator discharge with a voltage of 2-3 kV
268. In chronic ischemic heart disease, the following operations are performed:
one) coronary artery stenting
2) imposition of mammarocoronary anastomosis (use a. thoracica interna)
3) coronary artery bypass grafting using an autovein or artery (tributaries v. saphena magna, a.
radialis)
4) bandage a. thoracica interna
5) transmyocardial laser myocardial revascularization (TMLRM)
270. Types of operations for coarctation of the aorta - congenital narrowing of the aortic segment distal to the mouth a.
subclavia sinistra:
one) resection of coarctation with subsequent connection of the ends of the aorta
2) isthmoplasty - sewing a patch into the narrowing of the aorta
3) resection of coarctation with aortic plastic surgery
4) thoracic aortic endarterectomy
5) ligation of the thoracic aorta
271. Separation of small (pulmonary) and large (bodily) circles of blood circulation with open
arterial (Botallian) duct is carried out by:
one) endovascular embolization (transarterial or transvenous access)

2) duct clipping by thoracoscopic method
3) suture of the duct with a vasoconstrictor
4) dissection of the duct between the clamps, followed by application to the aortic and pulmonary ends
entwined vascular suture (according to A.N. Bakulev) in an open way (historical interest)
5) duct stenting
272. Resection of the thoracic esophagus in cancer is performed from the following approaches:
one) right-sided thoracotomy in the VI intercostal space
2) left-sided thoracotomy in the VII intercostal space with tumor localization in the lower third
thoracic esophagus
3) thoracoabdominal access
4) "standard" thoracotomy
273. In the process of mobilization of the thoracic part of the esophagus, the following complications are possible:
one) right-sided chylothorax with injury to the thoracic duct
2) bleeding due to damage to the azygous vein
3) infection of the pleural cavity and posterior mediastinum with microflora of the esophagus
4) injury v. cava inferior
5) thoracic aortic injury
274. The following types of operations are used for cancer of the thoracic esophagus:
one) esophagostomy
2) resection of the esophagus with the formation of external fistulas of the esophagus and stomach (operation
Dobromyslov-Torek)

3) esophagotomy
4) resection of the esophagus with restoration of the digestive tube through the esophagogastric
or esophago-intestinal anastomoses
5) gastrointestinal anastomosis
275. Stages of the Dobromyslov-Torek operation in the localization of cancer in the middle third of the esophagus:
one) right-sided transpleural thoracotomy along the VI-VIII intercostal space
2) mobilization of the esophagus and its transection above and below the tumor (in accordance with the principle
ablasticity)
3) suturing of the stump of the esophagus with immersion of the lower one into the stomach and removal of the upper one from the chest
cavities in the neck
4) the formation of an esophagostomy (esophageal fistula) in the neck and gastrostomy (one of
accepted methods)
5) creation of esophago-esophagoanastomosis
276. Resection of the esophagus in cancer of the lower third by left-sided thoracoabdominal access can be
completed in the following ways:
one) creation of esophago-esophagoanastomosis
2) plastic surgery of the esophagus with a tube from the greater curvature of the stomach
3) formation of an external fistula of the esophagus
4) replacement of the resected part of the esophagus with the stomach raised into the chest cavity
5) imposition of esophagojejunostomy
277. For esophagoplasty, the following organs of the peritoneal cavity are used:
one) large intestine (right and left halves)

2) greater curvature of the stomach
3) small intestine
4) ileocecal angle
5) a longitudinal tube formed from the skin of the chest wall by wrapping it inward with the epidermis
(historical interest)
278. The main ways of conducting a section of the intestine on the "leg" in esophagoplasty:
one) presternal (antethoracic)
2) retrosternal (retrosternal, through the anterior mediastinum)
3) through the posterior mediastinum
4) transpleural
5) bougienage of the esophagus

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Federal State Budgetary Educational Institution

Vishchipanov A.S., Solovieva N.N.,

under the editorship of Professor Andreitsev A.N.

Electronic version of the teaching aid

Topographic anatomy and operative surgery of the head, neck,

Test tasks for the colloquium

cranial fossa and pneumocephalus

one) form the arch of the brain, characterized by a spherical surface

2) have the same layer structure

one) covered with hair (except for the frontal area)

2) contains sweat and a large number of sebaceous glands

one Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

4) innervated by branches of cranial nerve VII

5) inactive due to strong fusion with the tendon helmet

4. Anatomical prerequisites for traumatic scalped wounds of the fronto-parieto-occipital region:

3) the periosteum is firmly connected to the bones in the seams

4) the subcutaneous base has a pronounced cellular structure

5) between the bone and the periosteum is the subperiosteal space

one) subperiosteal space (within the boundaries of the bone)

3) in the thickness of the periosteum

5) deep in the skin

6. Significant bleeding in soft tissue injuries of the fronto-parieto-occipital region

2 Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

4) arteries and veins occupy a superficial position

temporal bone determine the difficulties of hemostasis:

4) branches a.meningea media widely anastomose with other meningeal branches

one) sinus drain

3 Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

3) outer plate - thick, durable, with a large radius of curvature

4) inner (glass) plate - thin, fragile, with a smaller radius of curvature

5) periosteum loosely connected to outer lamina

10. Features of the squamous part of the temporal bone:

one) the periosteum is firmly fused with the squamous part

2) although it consists of three layers, it is thinned (1-3 mm)

3) spongy substance is weakly expressed

4) the bone is translucent and has low strength

5) a.temporalis superficialis adjoins the cerebral surface of the squamous part

one) when damaged, gapes, does not subside

2) sinus of the dura mater does not differ from v.femoralis

3) cerebrospinal fluid is filtered into the sinus (upper sagittal)

4 Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

various parts of the brain (dislocation syndrome):

one) under the falciform process

2) into the foramen of the cerebellum

3) into the occipital-cervical dural funnel (in the foramen magnum)

4) herniation of the brain is accompanied by severe functional disorders

respiratory and cardiovascular systems

one) Beer needle does not expel cerebrospinal fluid

2) opalescent cerebrospinal fluid enters

3) cerebrospinal fluid leaks out

4) in the cerebrospinal fluid admixture of pus

5) cerebrospinal fluid color "cranberry juice"

5 Andreitsev A.N., Vishchipanov A.S., Solovieva N.N.

16. Clinical and morphological manifestations of cerebrovascular disorders are explained

blood supply to the brain from various developmental basins:

one) arterial (willisian) circle of the brain

2) small (pulmonary) circulation

4) large (bodily) circle of blood circulation

Cronlein at the intersection points:

3) front vertical with upper horizontal

4) rear vertical with upper horizontal

back vertical lines