1. The developmental anomaly shown in this image would result in which one of the following syndromes/conditions? A.Horner’s syndrome B.Eisenmenger’s syndrome C.Pneumothorax D.Thoracic outlet syndrome What vascular sign is used to detect this anomaly?

2. The developmental anomaly shown in this image would result in which one of the following syndromes/conditions? A.Horner’s syndrome B.Eisenmenger’s syndrome C.Pneumothorax D.Thoracic outlet syndrome*** What vascular sign is used to detect this anomaly? Addison’s sign – loss of radial pulse upon abduction of arm above horizontal.

3. The skeletal anomaly shown in this image is: A.Pectus excavatum B.Supernumerary 1 st rib C.Pectus carinatum D.Supernumerary 12 th rib Note: “Pectus carinatum” is misspelled in the clinical supplement. There is no condition called pectus ca v inatum. Carina means “keeled” or “ridged”.

4. The skeletal anomaly shown in this image is: A.Pectus excavatum B.Supernumerary 1 st rib C.Pectus carinatum*** D.Supernumerary 12 th rib Note: “Pectus carinatum” is spelled incorrectly in the clinical supplement. There is no condition called pectus ca v inatum. Carina means “keeled” or “ridged”.

5. The term “Widow-maker” refers to which one of the following branches of the coronary arteries? A.Nodal branch B.Atrioventricular branch C.Marginal branch of right coronary artery D.Proximal portion of left anterior descending artery E.Distal portion of left anterior descending artery

6. The term “Widow-maker” refers to which one of the following branches of the coronary arteries? A.Nodal branch B.Atrioventricular branch C.Marginal branch of right coronary artery D.Proximal portion of left anterior descending artery*** E.Distal portion of left anterior descending artery It is because the LAD supplies most of the left ventricle whose contraction is essential for systemic circulation.

7. Lung Sounds

8. Pneumo, Hydro, & Hemo (Thorax)

9. Tension Pneumothorax

10. Throacocentesis

11. The Heart

12. Auscultation of the Heart

13. Cardiac Temponade Pericardiocentesis Insertion of needle into pericardial cavity to draw off blood or pericardial fluid The patient undergoing pericardiocentesis is positioned supine with the head elevated 30 to 60 degrees. This places the heart in proximity to the chest wall for easier insertion of the needle into the pericardial sac. Anatomically, the procedure is carried under the xiphisternum up and to the left Can also position needle through the 5th or 6th intercostal space at the left sternal border at the cardiac notch of the left lung. Or through the infrasternal angle

14. Cardiac Radiology

15. Heart Dominance 80 % population Right Dominance 10% Left dominance 10% Co-dominance Coronary vaculatiure highly variable

16. Coronary Vasculature (R. Dom)

17. Coronary Vasculature (L. Dom)

18. Coronary Angiography http://askdrwiki.com/mediawiki/index.php?title=Coronary_Angiography #LEFT_CORONARY_ARTERY LAO – Left Anterior Oblique view RAO – Right Anterior Oblique view Contraindications: Coagulopathy, Decompensated congestive heart failure, Uncontrolled Hypertension, Refractory Arrythmia, GI Haemorrhage Pregnancy, Inability for patient cooperation, Active infection, Renal Failure Contrast medium allergy

19. Coarctation of the Aorta

20. Aortic Dissection