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364.Circulatory adaptation to the extrauterine, postnatal environment
includes which of the following pairs of changes?


a. The interventricular and interatrial foramen close
b. The septum primum closes against the septum secundum and the aorta under-
goes coarctation
c. The septum primum closes against the septum secundum and the ductus arte-
riosus closes
d. The foramen ovale closes and there is transposition of the great vessels
e. The interatrial foramen closes and the interventricular septum closes


365.A 48-year-old man is brought to the emergency room by ambulance
due to sudden shortness of breath and left-sided chest and back pain. ECG
and blood work suggest normal cardiac function and noevidence of a heart
attack. He has diminished lung sounds on the left side and extreme ten-
derness in the mid-back on the left side about 6 cm off the midline. History
reveals that he was kneed in the back during a game one week ago while
playing goalie. He is 5 ft 10 in. and 165 lb. His urine is normal in color,
smell, and volume. An AP chest film suggests fluid in the left pleural space
at the costophrenic recess. You order CTs of the thorax and abdomen to
look for which of the following?


a. Enlarged right ventricle consistent with pulmonary hypertension
b. A cracked rib
c. Cardiac tamponade
d. Appendicitis
e. Inflamed gallbladder


366.Coronary artery disease is a frequent cause of myocardial infarction
in the United States. If an echocardiogram suggests reduced posterior ven-
tricular wall movement, there will be reduced blood flow within which of
the following coronary arteries and veins?


a. Circumflex branch of the left artery; great cardiac vein
b. Anterior interventricular artery; great cardiac vein
c. Anterior interventricular artery; middle cardiac vein
d. Right marginal branch of the right artery; small cardiac vein
e. Posterior interventricular artery; middle cardiac vein


Thorax 475
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